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Head and Neck > Middle Ear > Flashcards

Middle Ear Flashcards

1
Q

what CN is for hearing and balance

A

vestibulocochlear nerve (8)

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2
Q

what 4 structures make up the external ear

A

auricle, external auditory meatus, auditory canal and tympanic membrane

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3
Q

what is inside the middle ear

A

the 3 ossicles, air, and is lined with mucosa

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4
Q

where is the middle ear located

A

within the petrous part of temporal bone

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5
Q

where is the internal ear located

A

small cavities within petrous part of temporal bone

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6
Q

what is contained in the internal ear

A

sensors of motion and balance

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7
Q

what is the function of the middle ear

A

mechanical conduction of sound to fluid-filled internal ear

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8
Q

what is located inside the mastoid part of the temporal bone

A

air cells

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9
Q

what is the region called deep to the tegman tympani

A

epitympanic recess

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10
Q

what is the region called that is deep to the epitympanic recess

A

tympanic cavity

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11
Q

what feature in the middle ear does the tympanic plexus rest on and mark the position of the cochlea

A

the promontory

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12
Q

what are the 3 bones in the osseus chain

A

malleus, incus, and stapes

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13
Q

what ossicle sits in the oval window

A

the stapes

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14
Q

which ossicle is joined to the tympanic membrane

A

malleus

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15
Q

how many synovial joints are between the ossicles

A

2

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16
Q

what is the joint called between the stapes and the incus

A

incudostapedial joint

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17
Q

what is the joint called between the incus and malleus

A

incudomalleolar joint

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18
Q

what are the 3 external facial muscles associated with the auricle

A

superior, anterior, and posterior auricular muscles

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19
Q

what is the pinna or auricle

A

the visible part of the external ear

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20
Q

what is the helix

A

the folded over outside edge of the ear

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21
Q

what is the antihelix

A

forms a “y” shape where the upper parts of the ear are (medial from the helix)

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22
Q

what is the tragus

A

small prominence, in front of the concha and projects backward over the EAM

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23
Q

what is the concha

A

the hollow next to the external auditory meatus

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24
Q

where is the antitragus

A

below the tragus

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25
Q

what glands are for ear wax and where are they located

A

cerumen glands - around the EAM

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26
Q

what types of tissue make up the EAM

A

half bone and half cartilage and skin

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27
Q

what is the umbo

A

the most depressed part of the tympanic membrane

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28
Q

what is the tympanic membrane

A

“eardrum” a thin cone-shaped membrane that separates the external and middle ear

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29
Q

what is the function of the tympanic membrane

A

to transmit sound from the air to the ossicles

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30
Q

what covers the tympanic membrane laterally and medially

A

laterally- connective tissue/skin of auditory canal and medially- mucosa of middle ear

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31
Q

what does a normal tympanic membrane look like

A

gray, translucent, may have vascular streaks

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32
Q

how can an otoscope look inside the canal that is curved

A

you pull the auricle superiorly, posteriorly and slightly lateral to straighten out

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33
Q

what is microtia

A

congenital absence or deformity of auricle, absence of auditory canal and fusion of the ossicles

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34
Q

who usually gets microtia

A

females, unilateral

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35
Q

what is the cause of microtia

A

in utero ischemia of area of development, chromosomal aberrations, Treacher-Collins or Goldenhar syndromes, thalidomide, Accutane

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36
Q

what are the symptoms of microtia

A

small, malformed or absent ear, conductive hearing loss on affected side by 40-60%

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37
Q

what are the treatments for microtia

A

reconstruction (begin in summer before 1st grade) using rib cartilage for auricle

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38
Q

what is a complication of microtia

A

unpleasant cosmetic result

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39
Q

what is exostosis

A

benign bony growths of auditory canal related to cold water exposure

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40
Q

what is a symptom of exostosis

A

conductive hearing loss

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41
Q

what are treatments for exostosis

A

exostectomy (canalplasty) - postauricular approach allows complete removal of exostoses and has less risk to CN 7, the TMJ or tympanic membrane

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42
Q

what are complications of exostosis

A

water may become trapped between bony growths and tympanic membrane, causes ear infections

43
Q

what 4 sensory nerves innervate the external ear

A

lesser occipital nerve (C2), great auricular nerve (C2, C3), auriculotemporal V3, auricular branch of CN 10

44
Q

what nerve is the bulk of sensation for the auditory canal

A

auriculotemporal nerve of V3

45
Q

what is the vasculature to the external ear

A

posterior auricular from ECA, anterior auricular branches from superficial temporal artery and a branch from the occipital artery

46
Q

what is the blood supply to the auditory canal and lateral surface of the tympanic membrane

A

the deep auricular artery- branch from the maxillary artery

47
Q

what are the paths for drainage for the external ear

A

posterior auricular vein + posterior division of retromandibular vein –> to the external jugular fain

Or the anterior auricular veins to the superior temporal veins

48
Q

what is the drainage path for the auditory canal

A

deep auricular vein to the pterygoid venous plexus

49
Q

what causes auricular hematoma

A

trauma to pinna (wrestling injury most common)- perichondrial vessels bleed and pool between perichondrium and cartilages

50
Q

what are 2 symptoms of auricular hematomas

A

fluctuant swelling and pain

51
Q

what is the treatment for an auricular hematoma

A

drainage

52
Q

what is a complication of auricular hematomas

A

severe fibrous reaction will occur if blood supply to cartilages of auricle is not reestablished- resulting in “cauliflower ear”

53
Q

what muscle is in the middle ear

A

tensor tympani

54
Q

what is the superior wall of the middle ear called and what structure is near there

A

tegman tympani- middle cranial fossa

55
Q

what is the lateral wall of the middle ear called and what structure is near there

A

membranous wall- auditory canal

56
Q

what is the inferior wall of the middle ear called and what structure is near there

A

jugular wall- internal jugular vein

57
Q

what is the medial wall of the middle ear called and what structure is near there

A

labyrinthine wall - internal auditory meatus

58
Q

what is the posterior wall of the middle ear called and what structure is near there

A

mastoid wall- mastoid air cells

59
Q

what is near the anterior wall of the middle ear

A

internal carotid artery, nasopharynx via pharyngotympanic tube

60
Q

which 2 walls of the middle ear are thin

A

superior and inferior

61
Q

what is the purpose of the mastoid air cells

A

reserve air supply or to lighten the mastoid

62
Q

what is the tube that connects the middle ear to the nasopharynx

A

pharyngotympanic tube

63
Q

what are 2 functions of the pharyngotympanic tube

A

equilibrate pressure in middle ear and to drain mucus from middle ear and mastoid cells

64
Q

what 3 structures are continuous that allow for mucus drainage

A

middle ear, pharyngotympanic tube and mastoid air cells

65
Q

what is acute otitis media

A

infection with inflammation and effusion- fluid builds up in middle ear and puts pressure on tympanic membrane

66
Q

who is most likely to get an acute otitis medai

A

children by age 3 and people with a PT tube that is narrower, shorter, and immune systems that are underdeveloped

67
Q

what causes an acute otitis media

A

viral infection, adenoids, PT tube dysfunction

68
Q

what are symptoms of an acute otitis media

A

pain, fever, headache, clear fluid drainage, dizziness, and temporary hearing loss

69
Q

what is the treatment for otitis media

A

most will clear up on own, antibiotics, and myringotomy tubes for recurrent infections

70
Q

what are complications of an acute otitis media

A

ear drum rupture, mastoiditis, permanent damage of tympanic membrane and hearing loss

71
Q

what is coalescent mastoiditis

A

acute, usually associated with acute otitis media, inflammation of mastoid air cells - infection that spreads beyond the mucus of middle ear

72
Q

what is the cause of coalescent mastoiditis

A

usually incomplete antibiotic treatment for acute otitis media

73
Q

what are 3 symptoms of coalescent mastoiditis

A

pain behind ear, protrusion of ear and fever

74
Q

what is the treatment for coalescent mastoiditis

A

mastoidectomy (surgical drainage)

75
Q

what are complications for coalescent mastoiditis

A

sigmoid sinus thrombosis, meningitis, abscesses, intratemporal involvement of CN 7 and/or labyrinth (causing sensineuronal hearing loss)

76
Q

what is the purpose of the tensor tympani and tendon of stapedius muscle

A

to keep ossicles from vibrating too violently

77
Q

which muscle dampens the vibrations of the tympanic membrane

A

tensor tympani muscle

78
Q

which muscle dampens ossciallations of stapes

A

stapedius muscle

79
Q

what innervates the tensor tympani

A

nerve to medial pterygoid from V3

80
Q

what innervates the stapedius muscle

A

nerve to stapedius from CN 7, branch in facial canal

81
Q

what are the 2 middle ear general efferents

A

nerve to stapedius (CN7) and nerve to medial pterygoid (V3)

82
Q

what are the general afferents and visceral efferents of the middle ear

A

tympanic plexus: tympanic nerve (CN 9 in jugular foramen) and caroticotympanic nerves (from sympathetic ICA plexus)

83
Q

what 2 nerves pass through the middle ear but do not innervate structures

A

lesser petrosal nerve (branches off tympanic plexus) and chorda tympani nerve (branch of CN7)

84
Q

what 2 structures does the facial canal run between

A

cochlea and semicicular canals of internal ear

85
Q

how many branches of CN7 that are given off in the facial canal are related to the ear

A

3 out of 4

86
Q

what is the venous drainage for the middle ear

A

pterygoid venous plexus

87
Q

what 3 structures are for balance

A

utricle, saccule, and semilunar circles

88
Q

what structure is for hearing

A

cochlear duct

89
Q

what 2 types of fluid are in the cochlear

A

perilymph and endolymph

90
Q

what is the blood supply to the internal ear

A

labyrinthine artery from anterior inferior cerebellar artery or basilar artery

91
Q

what is the venous drainage for the internal ear

A

labyrinthine veins to interior petrosal sinus or sigmoid sinus

92
Q

what happens to the sound waves after they go through the external ear and auditory canal

A

they vibrate the tympanic membrane- moves handle of malleus- moves head of malleus- moves incus- and pushes stapes into oval window

93
Q

what happens to the sound waves after they push the stapes into the oval window

A

cause waves in perilymph causing the round window to bulge laterally and trigger the cochlear receptors - CN 8 - brain

94
Q

what are the 2 components of mechanical conduction

A

air or bone conduction

95
Q

what are the steps for conduction

A

sound waves - external ear - ossicular chain - perilymph and cochlear duct

96
Q

what is the path for sensorineural

A

vibration of cochlear duct receptors - cochlear component of CN 8 - brain

97
Q

what happens if there is a deficit in air conduction

A

you will still have bone conduction and be able to hear some sound

98
Q

what is the weber’s test

A

to test for unilateral conductive or sensorineural hearing loss

99
Q

what is a normal result in a weber’s test

A

sound is heard loudest in center and equally in both ears, this can mean equal hearing loss on both sides

100
Q

what is an abnormal Weber’s test

A

sound is louder on one side

101
Q

what test is after the Weber’s test if there is an abnormal result

A

Rinne test- unilateral conductive hearing loss

102
Q

what is a normal result for a rinne test

A

sound is loudest when tuning fork is next to ear and is quieter when tuning fork is placed on mastoid process

103
Q

what is an abnormal result for a rinne test

A

sound is loudest when tuning fork is placed on mastoid process

Head and Neck (10 decks)

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