module 8 ear

Question 1

external ear anatomy

Answer 1

external auditory meatus 
inertragic notch
tragus
antihelix
antitragus
helix
lobule 
triangular fossa

Question 2

Middle ear anatomy

Answer 2

eardrum 
lateral malleolar ligament
upper malleolar ligament
incudal ligament
malleus
incus
middle ear
stapedius muscle
stapes
stapes footplate and oval window
eustachian tube

Question 3

inner ear anatomy

Answer 3

anterior semicircular canal 
lateral semicircular canal 
posterior semicircular canal 
ampulla
oval window
vestibule
vestibular nerves
cochlear nerve 
cochlea

Question 4

weber test

Answer 4

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

Question 5

Rinne test

Answer 5

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.

Question 6

external nose anatomy

Answer 6

bridge
ala nasi: crease around nostril
nasal septum
tip (apex)
anterior naris (nostril)

Question 7

mouth and throat anatomy

Answer 7

teeth
soft palate
tonsil
tongue
lips
gums
hard palate
uvula

Question 8

CN I

Answer 8

olfactory

Question 9

testing nerves IX and X

Answer 9

gag reflex
palatal lift: say ahh
swallow

Question 10

nerves VII and XII

Answer 10

voice quality

articulation

Question 11

nerves VII and IX

Answer 11

taste

Question 12

cholesteatoma patho

Answer 12

abnml squamous epithelial tissue behind the tympanic membrane
- can perforate the tympanic membrane, erode the ossicles and temporal bone, invade inner ear structures

Question 13

cholesteatoma subjective

Answer 13

hx of recurrent acute otitis media 
unilateral hearing loss
ear fullness or pain 
tinnitus, mild vertigo
discharge from ear canal

Question 14

cholesteatoma objective

Answer 14

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

Question 15

conductive hearing loss patho

Answer 15

reduced transmission of sound to the middle ear

- auditory canal, tympanic membrane, middle ear

Question 16

conductive hearing loss subjective

Answer 16

turns sound controls up
hears better in noisy environment
asks to have info repeated
speaks softly (hears own voice by bone conduction)

Question 17

conductive hearing loss objective

Answer 17

bone conduction > air conduction
lateralization to affected ear
loss of low frequency sounds

Question 18

sensorineural hearing loss patho

Answer 18

reduced transmission of sound in the inner ear

- cochlea, associated structures, or CN VIII

Question 19

sensorineural hearing loss subjective

Answer 19

complains that people mumble
has difficulty understanding speech
speaks more loudly
unable to hear in a crowd

Question 20

sensorineural hearing loss objective

Answer 20

air conduction > bone conduction
lateralized to unaffected ear
loss of high-frequency sounds

Question 21

meniere disease patho

Answer 21

inner ear disorder characterized by episodes of hearing loss, vertigo, tinnitus, and ear fullness.

Question 22

meniere disease subjective

Answer 22

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

Question 23

meniere disease objective

Answer 23

hearing loss to low tones initially with fluctuating progression to profound sensorineural hearing loss

• imbalance
• nystagmus

Question 24

vertigo patho

Answer 24

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