PBL 2 Flashcards
what additional symptoms can hearing loss cause?
balance issues
headache
tinnitus
what additional symptoms can hearing loss cause?
balance issues
headache
tinnitus
how can we diagnose causes of hearing loss?
otoscopy whisper test finger rub test weber test rinne test audiogram
what is a normal rinne test result?
air conduction > bone conduction
what does it mean if a person has hearing loss but the rinne test seems normal?
that the hearing loss is sensorineural
what does it mean in the conductive hearing loss if bone conduction is > air conduction?
conductive hearing loss
whats a normal weber test result?
hearing the same sound in both ears
what does it mean if a person hears the tuning fork loudest in the diseased ear during the weber test?
there is conductive hearing loss
what does it mean if a person hears the tuning fork loudest in he normal ear during the weber test?
sensorineural hearing loss
what is conductive hearing loss
when sound cannot get through the outer and middle ear so we get a decreased perception of sound, particularly low frequency
what are the main causes of conductive hearing loss?
boyn outgrowths cerumen impaction congenital causes eustachian tube dysfunction otitis externa otitis media osteosclerosis trauma tumours of the middle ear tympanic membrane perforation
what are the 2 types of bony outgrowths in the ear that can cause conductive hearing loss?
exostoses and osteomas
what is an exostosis?
a benign outgrowth of cartilagenous tissue on the bone, associated with repeated cold water exposure
what are osteomas?
neoplasms of the temporal bone
who is cerumen impaction most likely in?
elderly
what is microtia?
malformation or absence of the auricle
what is external auditory canal atresia?
absence of the external auditory meatus
what can cause eustachian tube dysfunction?
colds, flus, sinus infections, allergies
what are some problems with eustachian tube dysfunction?
difficulty equalizing pressure
chemical and bacteria can get into the middle ear
cilia in the tube are unable to clear out middle ear cerumen - stagmant secretions can get infected leading to secondary problems
what is otitis external?
inflammation of the external ear canal, usually caused by swimming
whats the bacteria that most commonly causes otitis external?
pseudomonas aeruginosa
what is otitis media?
infection of the middle ear which leads to effusion which causes poor transmittance of sound waves
whos most likely to get otitis media?
6-18 month olds as risk factors are daycare and bottle feeding
what are some bacteria that commonly cause otitis media?
staphylococcas pneumonia
haemophilus influenza
moraxella catarrhalis
what is osteosclerosis in the ear?
abnormal bone growth in the ear, commonly a bony outgrowth of the stapes to the oval window so we get decreased vibration and conduction of sound waves
what is the cholesteatoma?
a sac of fluid, air or skin cells that form behind the ear drum
what is glomus tympanicum paraganglioma?
a common tumour of the middle ear that affects the tympanic nerve
how do we treat cerumen impaction?
cerumenolytics or irrigation or manual removal
how do we treat otitis external?
topical acidifying agent, glucocorticoids
how do we treat eustachian tube dysfunction?
surgery e.g. tympanostomy tube
how do we treat otitis media?
pain control
how do we treat osteosclerosis?
hearing aids
surgery e.g. stapedectomy
what are some causes of sensorineural hearing loss?
acoustic neuroma meningitis meningioma acoustic nerve neuritis congenital causes drug induced - ototoxic drugs labrynthitis menieres disease noise induced presbycusis trauma
what is acoustic neuroma?
a benign tumour developing in the vestibulocochlear nerve
how can meningitis cause sensorineural hearing loss?
by causing cochleitis
what is acoustic nerve neuritis?
inflammation of vestibulocochlear nerve often caused by MS or suphilis
what are some ototoxic drugs?
aminoglycoside antibiotics
cisplatin and carboplatin
temporary:
high dose aspirin
quinidine
loop diuretics
what is menieres disease?
a rare chronic inner ear disorder that causes problems with balance and hearing - causes episodic loss of hearing in 1 ear with tinnitus and vertigo
how loud does a sound have to be to cause noise induced sensorineural hearing loss?
> 85dB
whats the pathology of noise induced sensorineural hearing loss?
overtsimulatuon of hair cells in the organ of corti causes nitric oxide and free radical release which damages the hair cells
what is presbycusis?
a gradual, symmetrical hearing loss in the elderly caused by the degeneration of hair cells at the base of the cochlea
how do we treat presbycusis?
hearing aids
how do we treat nosie induced hearing loss?
hearing aids
how do we treat menieres disease?
diretary change - less sugars, salts to prevent water retention
antiemetics
vestibular supressants
diuretics
how do we treat acoustic neuroma?
surgical resection or radiotherapy
what are cerumenolytics?
ear wax softerning agents
what are tympanostomy tubes?`
they create a direct opening between the middle and outer ear, allowing pressue to equibrilate more easily
whats an easy way to remember the order of cranial nerves?
Oh Oh Oh To Touch And Feel A Girls Vagina, Ah Heaven
what is cranial nerve 1?
olfactory
what is CN2?
optic
what is CN3?
occulomotor
what is CN4?
trochlear
what is CN 5?
trigeminal
what is CN6?
abducens
what is CN7?
facial
what is CN8?
vestibulocochlear
what is CN9?
glossopharyngeal
what is CN10?
vagus
what is CN11?
spinal accessory
what is Cn12?
hypoglossal
whats the function of Cn1?
senses smell and detects more advances aspects of taste
whats the function of CN2?
transmitting information for vision in the form of electrical impulses from the eye to the brain
whats the function of Cn3?
innervates superior rectus, inferior rectus, medial rectus, levator palpabrae superioris, inferior oblique, sphincter pupillae and ciliary muscles
whats the function of the trochlear nerve?
innervates superior oblique muscle
whats the function of abducens nerve?
innervates lateral rectus muscle
what are the branches of the trigeminal nerve?
opthalmic branch
maxillary branch
mandibular branch
whats the function of the opthalmic nerve?
innervates skin and mucous memvrane of forehead, scalp, frontal and ethmoidal sinus, upepr eyelid, conjucntiva, cornea, dorsum of nose
whats the function of the maxillary nerve?
innervates skin and mucous membranes of lower eyelid and conjunctiva, cheeks, macillary sinus, nasal cavity, lateral nose, upper lip, upper molar incisor, canine teeth and associated ginigva, superior palate
whats the function of the mandibular nerve?
mucous membranes and floor of oral cavity, external ear, lower lip, chin, anterior 2/3rds of tongue, lower teeth and associated gingiva, muscles of mastication, anterior belly of digastric muscle, mylohyloid muscle, tensor veli palatini, tensor tymapni
what are thw branches of the facial nerve?
frontal, zygomatic, buccal, marginal mandibular, and cervical.
whats the function of CN8?
hearing and balance
whats the function of CN9?
sensory innervation to middle ear, internal surface of tympanic membrane, Eustachian tube, carotid sinus and body, oropharynx, posteior 1/3rd of tongue palatine tonsils and stylopharyngeus muscle
whats the function of the vagus nerve?
sensory - innervates laryngopharynx and superior aspect of larynx, heart, GI tract to splenic fixture
motor - muscles of pharynx, cricothyroid, there-arytenoid, circa-arytenois, arytenoids, palatoglossus of tongue, muscles of soft palate
whats the function of the spinal accessory nerve?
sternocleidomastoid and trapezius motor innervation
whats the function of the Cn12?
motor innervation to extrnsic and intrinsic musces of the tongue other than the palatoglossus muscles (pharyngeal branch of vagus nerve)
what are the main branches of the glossopharyngeal nerve?
f tympanic, tonsillar, stylopharyngeal, carotid sinus nerve
what ar tha branches of the vagus nerve?
pharyngeal branches, superior laryngeal nerves, recurrent laryngeal nerves, and superior cardiac nerves.