otology Flashcards
what makes up the middle ear
TM to cochlea
what makes up inner ear
Includes auditory and Vestibular system. 8th cranial nerve. Cochlea (hearing) and Labrynth (balance).
what makes up outer ear
1/3 cartilage to 2/3 bone
wax produced in cartilaginous group
utricle and saccule deal with
linear movements
utricle-horizontal
saccule-sagittal
semicircular canals deal with
rotational movement
losing your pinna results in a decrease of
20 db
which bone touches the TM
malleus
which bone connects to the cochlea
stapes, hardening of stapes is otosclerosis
oval window
Thin connection between the middle and the inner ear.
Scala Vestibuli: Oval window connects to this fluid filled space (Perilymph).
promontary
Portion of the cochlea that extends into the middle ear and separates the oval from the round window
round window
Membrane at the basal end of the cochlea which connects the middle ear space
Scala Tympani: Round window connects to this fluid filled space (Perilymph).
Contains specialized hair cells bathed in endolymph fluid which detect sound and stimulate the acoustic nerve.
organs of corti
Sound is transmitted as air through the ear canal. Moves the ossicles which conduct sound to the oval window which moves perilymphatic fluid over the endolymphatic fluid containing the hair cells which stimulates the acoustic nerve. This transmits the sound to the auditory centers of the brain which process the sound.
hearing physio
Age and Noise exposure are the most common causes
sensorineural hearing loss
congenital hearing loss occurs ages
<70
Hearing loss involving the outer or the middle ear.
Causes: FB, wax, sclerosis, perf TM,
conductive hearing loss
sudden hearing loss,do this
get a hearing test, may need steroids
what is a tympanogram used for
Can help us tell if there is fluid or otosclerosis if you don’t see anything in the ear
special hearing test that can be used to track the nerve signals arising in the inner ear to the region of the brain responsible for hearing. This can tell us where along that path the hearing loss has occurred.
auditory brainstem response
special test of the balance mechanism of the inner ear. The test involves running a cool liquid and then a warm liquid through the ear canal
Electronystagmography (ENG)
Used for pts with vertigo, now with video
Helps determine if it is an inner ear issue and which ear
weber
sound lateralizes to impaired ear for conductive hearing loss and to good ear for sensinonerual
how does AOM present
Thick infected fluid,
- Ear pain**
- Hearing loss
- No drainage
how does serous OM present
Thin fluid, cold or URI
symptoms of chronic/serous otitis media
Hearing loss
No pain
No drainage
when to place tympanostomy tubes
Chronic Otitis Media for 3 months
Recurrent ear infections 3 per year for 3 years, 4 per year for 2 years, 5 in one year.
Speech delay
Cartilaginous portion of the ear canal is inflamed, red and draining.
otitis externa
Recurrent ear infections are usually from
eczema (dead skin cells + water = infection)
Give mometazone, don’t give PO anbx they won’t help
skin growth that occurs in the middle ear behind the eardrum. It is usually due to repeated infection, which causes an ingrowth of the skin of the eardrum
choleastoma, requires sx bc of pressure necrosis
Swelling and Redness behind the ear, ear may bulge forward, Patient must have fluid in the middle ear.
mastoiditis
may cause hearing loss or pulsating tinnitus.
characteristically affect hearing because they often are located within or adjacent to the temporal bone.
Glomus tumors
how to tx a perf TM
Observe for acute perforation.
Tympanoplasty for chronic perforation.
No anbx, avoid water in the ear
They should close on their own for acute perfs
central causes of vertigo
Tumors
Infarcts
Visual problems
inner ear problem that results in short lasting, but severe, room-spinning
BPPV
Turn head and you get dizzy, lasts seconds
Do vertigo exercises, if its not better in two weeks then MRI
inflammations of the inner ear or the nerves connecting the inner ear to the brain. The inflammation can be caused by either bacterial or mainly viral infections.
The symptoms will include dizziness and difficulty with vision and/or balance.
labrynthitis
Excessive fluid in the cochlea is known as cochlear hydrops. Excessive fluid in the semicircular canals results in dizziness and is known as vestibular hydrops. Almost all Meniere’s patients have both cochlear and vestibular hydrops
Meniere’s disease
Triad: Ear fullness, Hearing loss / ringing and Vertigo.
recurring problem, not usually seen on first visit
benign tumor (called a "schwannoma") arises from the myelin forming cells (Schwann cells") of the 8th cranial nerve at the point where the peripheral part of the nerve meets the brain. Presenting symptoms, tinnitus, asymmetric hearing loss and occasional vertigo.
acoustic neuroma
Inflammation of the cartilage of the ear.
tx w/steroids
Inflammation of the cartilage of the ear.
Cause: Ear trauma
MUST BE DRAINED AND BOLSTERED
auricular hematoma
