module 8 ear Flashcards
external ear anatomy
external auditory meatus inertragic notch tragus antihelix antitragus helix lobule triangular fossa
Middle ear anatomy
eardrum lateral malleolar ligament upper malleolar ligament incudal ligament malleus incus middle ear stapedius muscle stapes stapes footplate and oval window eustachian tube
inner ear anatomy
anterior semicircular canal lateral semicircular canal posterior semicircular canal ampulla oval window vestibule vestibular nerves cochlear nerve cochlea
weber test
bone conduction
tuning fork placed along midline of skull
normal: sound heard equally in both ears (or louder in covered ear)
determines if hearing loss is present, does not determine if loss is conductive or sensorineural
Rinne test
Bone and Air conduction
toning fork placed on mastoid process, then near ear
Normal: air conduction heard twice as long as bone.
Determines the cause of the loss: conductive or sensorineural.
external nose anatomy
bridge ala nasi: crease around nostril nasal septum tip (apex) anterior naris (nostril)
mouth and throat anatomy
teeth soft palate tonsil tongue lips gums hard palate uvula
CN I
olfactory
testing nerves IX and X
gag reflex
palatal lift: say ahh
swallow
nerves VII and XII
voice quality
articulation
nerves VII and IX
taste
cholesteatoma patho
abnml squamous epithelial tissue behind the tympanic membrane
- can perforate the tympanic membrane, erode the ossicles and temporal bone, invade inner ear structures
cholesteatoma subjective
hx of recurrent acute otitis media unilateral hearing loss ear fullness or pain tinnitus, mild vertigo discharge from ear canal
cholesteatoma objective
spherical white cyst or pouch behind intact tympanic membrane
- membrane may bulge
foul-smelling discharge if membrane is perforated
conductive hearing loss
facial nerve paralysis rare
conductive hearing loss patho
reduced transmission of sound to the middle ear
- auditory canal, tympanic membrane, middle ear
conductive hearing loss subjective
turns sound controls up
hears better in noisy environment
asks to have info repeated
speaks softly (hears own voice by bone conduction)
conductive hearing loss objective
bone conduction > air conduction
lateralization to affected ear
loss of low frequency sounds
sensorineural hearing loss patho
reduced transmission of sound in the inner ear
- cochlea, associated structures, or CN VIII
sensorineural hearing loss subjective
complains that people mumble
has difficulty understanding speech
speaks more loudly
unable to hear in a crowd
sensorineural hearing loss objective
air conduction > bone conduction
lateralized to unaffected ear
loss of high-frequency sounds
meniere disease patho
inner ear disorder characterized by episodes of hearing loss, vertigo, tinnitus, and ear fullness.
meniere disease subjective
sudden onset of severe vertigo lasting 20 min to hours
hearing loss
tinnitus, continuous or intermittent
sensitivity to sound
ear fullness or pressure
episodes in clusters with periods or remission
meniere disease objective
hearing loss to low tones initially with fluctuating progression to profound sensorineural hearing loss
- imbalance
- nystagmus
vertigo patho
illusion of rotational movement by a patient, most often due to a disorder of the inner ear
- acute vestibular neuronitis: inflammation of the vestibular nerve after an acute viral upper respiratory infection
- Benign paroxysmal positional vertigo: otolith fragments gravitate into the semicircular canal, vertigo with head movements
