Otorrhea and Otalgia Flashcards
2 main sources of ear discharge and pain
External auditory canal and middle ear/mastoid area
T/F: Cerumen production happens in the cartilaginous outer part of the EAC
T
How do you straighten the EAC for examination?
Pull the pinna outward, backward, and upward
3 Ossicles comprising the inner ear
Malleus, incus, stapes
This part of the middle ear allows ventilation of the tympanic cavity
Eustachian tube
T/F: The EAC is the common reason for acute and chronic otitis media
F
Middle ear
Otitis externa is usually caused by what pathogen/s?
Staphylococcus aureus and Pseudomonas
T/F: Otitis externa aka Swimmer’s ear is due to the removed lipid layer covering the skin of EAC
T
This pathogen commonly produces localized/circumscribed otitis externa
Staphylococcus aureus
T/F: Pseudomonas causes diffuse otitis media
F: it causes diffuse otitis EXTERNA, where there is circumferential swelling and narrowing
Management of External ear infections:
Aural Toilette, otic drops (ear wick)
How does otitis media develop?
Usually due to impaired middle ear ventilation brought by eustachian tube dysfunction and mucosal inflammation
Ciliary dysfunction and other causes may lead to eustachian tube function, which impairs ventilation, leading to negative pressure in the middle ear that would further increase mucosal edema and inflammation, that would further damage the eustachain tube
T/F: URTI causes acute otitis media
T
S. pneumoniae, H. influenzae, M. catarrhalis, and respiratory viruses ascend and reach the eustachian tube to enter the middle ear
What are the stages of acute otitis media?
Hyperemic > exudative > suppurative > complication/resolution
Hallmark of chronic otitis media
Non-healing perforation
What is cholesteatoma?
result of perforation of the tympanic membrane, where the epithelium seeps from the external to the middle ear, thus disrupting the normal drainage of the middle ear
TX: Myringoplasty or tympanoplasty
T/F: Nasal endoscopy is performed if otitis Media with effusion is bilateral or unclear cause
F
unilateral
T/F: Intracranial complications are more urgent than extracranial complications
T
Tx of intracranial complications are prioritized over the treatment of ear infection itself
Bezold abscess is a complication due to the inferior direction of the spread of ear infection to the SCM
T
Thrombophlebitis is a complication due to the lateral direction of the spread of ear infection to the venous sinuses
F - MEDIAL direction
Ear infections affecting the parotid gland and subperiosteal spreads in what direction and produce what complications?
- Lateral Direction
-Complications: Parotid Abscess, Subperiosteal Abscess
T/F: Cholesteatoma develops from a developing epithelial pocket
F
Cholesteatoma develops from an ATROPHIC epithelial pocket
T/F: Ear infection and inflammation arise when there are factors that interfere with normal defenses
T
T/F: Antibiotics can easily permeate the EAC
F: they have poor penetration through the external ear
Antibiotics that can be used to manage external ear infection
Polymyxin, Neomycin, Gentamicin, Gramicidin
Antifungals that can be used to manage external ear infection
Clotrimazole, Nystatin
What are 2 functional disturbances leading to otitis media?
Has 2 functional disturbances:
○ Impaired middle ear ventilation
○ Mucosal inflammation
T/F: Chronic otitis media can be diagnosed in the presence of a chronic tympanic membrane perforation
T . it can be wet or dry
T/F: Surgery is recommended among children if ear infection is more than 3 months persistence
F: it’s in adults
