Lecture 2 Bates ch 7 Ear and Sinus

Question 1

Nasal discharge

Answer 1

Rhinorrhea

Question 2

Sense of stuffiness or obstruction int he nose

Answer 2

Nasal Congestions

Question 3

Nose Bleed

Answer 3

Epistaxis

Question 4

Vomiting blood

Answer 4

Hematemesis

Question 5

Coughin up blood

Answer 5

Hemoptysis

Question 6

3 bones of the middle ear

Answer 6

Malleus, Incus, Stapes

Question 7

Cochlear nerve is innervated by

Answer 7

CN VIII

Question 8

Fluid in the ear cancals

Answer 8

Endolymph

Question 9

Phase that sound travels through to the TM

Answer 9

Conductive Phase

Question 10

Hearing loss from nerve or cochlea

Answer 10

sinoneural hearing loss

Question 11

ID structures top to bottom

Answer 11

Helix

Antihelix

Entrance to ear canal

Tragus

Lobus

Question 12

ID top to bottom left to right

Answer 12

Pars Flaccida

Incus

Pars Tensa

Short Process of Malleus

Handle of Malleus

Umbo

Cone of Light

Question 13

What innervates the inner ears cochlea and semicircular canals?

Answer 13

CN 8 (auditory nerve)

Question 14

The weber test is used for both conduct and sensoneural hearing loss.

If lateralization occurs to the good ear, the patient has what type of hearing loss?

Answer 14

Sensorineural loss

Because the inner ear or cochlear nerve damage of bad ear prevents vibration transmission

Question 15

In the weber test, if lateralization occurs to the impaired ear (room noise not well heard, but vibration improves) what types of hearin gloss is this is what type of hearing loss?

Answer 15

Conductive Hearing Loss

(Pt. says I hear it better in my bad ear, thats funny. You say, that neural transmission is fine, and vibration sensing acutally improves in conductively (inner/middle ear) impaired ears!)

Question 16

In the Rinne test (mastoid and air test)

What is the abnormal finding that suggests conductive hearing loss?

Answer 16

BC > AC

Bone conduction is greater than air conduction

Question 17

What structure gives us our sense of balance?

Answer 17

Semicircular canals

Question 18

what two maneuvers can ellicit pain in otitis media?

Answer 18

Pulling up on the pinna, and pushing on the tragus

Question 19

What test can confirm your suspicion for effusion?

Answer 19

Pneumatic Otoscopy

Question 20

What are the steps for testing auditory acuity?

Answer 20

1. Ask pt. to cover other ear
2. stand 2 feet behind patient.
3. whisper 3 sweet nothings into their ear
4. Ask pt. to repeat the words back

Question 21

What are the two sinus that we palpate for pain/tenderness?

Answer 21

Frontal Sinus

Maxillary Sinus

Question 22

What do you have your patient do each time before inspecting a nostril?

Answer 22

Have patient cover opposite nostril and blow to ensure patency

Question 23

If there is pain on sinus palpation, what is the next test to perform?

Answer 23

Sinus Transillumination

Question 24

What are the 5 types of dizziness? (dizziness is too nonspecific)

Answer 24

Vertigo

Presyncope

Disequilibrium

Psychiatric

Multifactorial or Unknown

Question 25

What is the difference between peripheral and central veritgo

Answer 25

The root cause: Central vertigo is usually comes from brainstem deficits - dysarthria, ataxia, and crossed motor/sensory deficits Peripheral: Isn't central

Question 26

This kind of peripheral vertigo can cause N/V/Nystagus and occurs suddeny when rolling affected side of the head, and last between seconds and a minute

Answer 26

BPPV

Question 27

This kind of peripheral vertigo could last upto 2 weeks, and can cause N/V/Nystagmus

Answer 27

Vestibular Neuronitis (Labyrinthitis)

Question 28

This type of peripheral vertigo can last from several hours to more than a day, presenting with sensorineural hearing loss, with fluctuating Tinnitus (also N/V/Nystagmus)

Answer 28

Meniere's Disease

Question 29

This type of peripheral vertigo is linked to exogenous substances, where vertigo may/may not be reversible, and hearing loss and tinnitus may be present (includes N/V)

Answer 29

Drug Toxicity

Question 30

This type of peripheral vertigo is insidious from CN VIII compression (vestibular branch), with hearing impaired to one side, with Tinnitus, and may invole CN V and VII?

Answer 30

Acoustic Neuroma

Question 31

What type of nystagmus suggests central vertigo?

Answer 31

Up - Down nystagmus

Question 32

Answer 32

Keloid

Question 33

An accumulation of uric acid in what condition?

Answer 33

A Tophi from GOUT

Question 34

Answer 34

Cutaneous Cyst AKA sebaceous cyst no biggie unless inflamed/infected

Question 35

Answer 35

Basal cell carcinoma

Question 36

Answer 36

TM Perforation heals on its own

Question 37

Answer 37

Tympanosclerosis (can be old, from scarring of surgery or previous infections)

Question 38

Answer 38

TM Effusion open eustachian and let it drain!

Question 39

Answer 39

Otitis Media

Question 40

Answer 40

Bullous Merengitis tiny little bubbles on top of the TM