S7 L1 The Ear and Tuning Fork Tests Flashcards
Only 1 lecture this week!
(only 1 lecture this week)
Three sections of the ear
Symptoms and signs of ear disease…
- External, middle, inner ear
External, Middle, inner ear:
- Structures of each of these
- Lined with what?
- ‘Filled’ with what?
After answering the above questions, then label the diagram attached
Many Nerves Carry General Sensation from Ear - Implications for Referred Pain
- List 4 nerves that carry sensory information around the ear
- List 1 nerve that is for hearing and balance
Otalgia with a normal ear examination should lead you to suspect an alternative site of pathology:
- 2 types of pain?
- Examples of causes for this reffered pain?
- *The External Ear:**
- Anatomy of the external ear
- Name 3 abnormalities that could occur in the external ear
Pinna Haematoma:
- What is this?
- Cause of this?
- Treatment of it?
- What happens if it is left untreated?
External acoustic meatus:
- Lined with?
- Two areas…
- Shape?
- What does the outer_____ part contain? Barrier…
- Does the other part also have this?
- How does the self-cleaning function work?
2 Common conditions involving the External Acoustic Meatus
- Wax/Foreign bodies
- Ottis externa
Wax/Foreign bodies
Otitis externa:
- What is this?
- Symptoms?
- Treatment
- Rare, but life threatening complication of otitis externa
Tympanic Membrane
- List 2 common abnormalities
- Acute otitis media
- Otitis media with effusion
Tympanosclerosis:
- What is this? What has caused it? What does the tympanic membrane look like?
Acute otitis media:
- What is this?
- What does the tympanic membrane look like?
Otitis media with effusion:
- What is this?
- Another name?
- What happens?
- What does the tympanic membrane look like?
Cholesteatoma
- What is this?
- What does it look like?
- What happens?
- Cause
- Symptoms
- Complications
Cholesteatoma
- Recap of what happens…
- *Middle Ear**
- Describe the structure of the middle ear
- Role of this part of the ear and how does this part of the ear work?
- 2 muscles involved
Otosclerosis
- What is this?
- Causes
- What happens?
- Symptoms
Role of the Pharyngotympanic tube
- Role
- How does this whole process work (other structures involved)
(Middle ear)
Otitis media with effusion (“glue ear”)
- Cause?
- What happens?
- Treatment
(Middle ear)
Acute otitis media
- What is this?
- Signs and symptoms?
- Causes
- What does it look like?
Why are children more susceptinble to middle ear infections?
Complications of Acute Otitis Media
- 4… (plus more)
- Symptoms of one that causes ear to be pushed forward
Important Anatomical Relations of the Ear
- Thinking about where infections could potentially spread
- *Inner Ear**
- Anatomy (2 main)
- Filled with?
- Symptoms associated with inner ear?
- Go through the 2 main peices of anatomy: what are they filled up with? their role? how do they work to do their role? (nerve…)
Cochlea
- Role
- _____ filled?
- How does it work - i.e. action potential etc, to carry out its role…
label diagram attached
Left to right (top)
right to left (bottom)
Auricle
External auditory canal
Malleus
Incus
Ovale Window
Cochlea
Organ of Corti
Round window
Stapes
Tympanic membrane
Sound wave
How we hear?
- Full flow diagram about this
Vestibular apparatus
- Role
- Describe the structure of these?
- How does it perform it’s role (flow diagram of steps)
- Fluid that fills the ducts is called…
Presbycusis
- What is this
- Symptoms
Benign Paroxysmal Positional Vertigo
- What is this?
- Cause
- Symptoms
- How to diagnosis it
- How to treat it
Meniere’s Disease:
- Symptoms
- Cause
- Between episodes?
Acute Labrynthitis:
- Cause?
- Symptoms
Acute Vestibular Neuronitis:
- Cause?
- Symptoms
Patient Presents with Hearing Lost:
- What do you do?
- Two types of hearing loss
Weber’s test:
- What is this?
- How to do it?
- Results?
Weber’s test cont.:
- Patient with conductive hearing loss… explain what happens (result)?
- Patient with sensorineural hearing loss… explain what happens (result)?
Rinne’s test
- How to do it?
- Results mean…
Rinne’s test
- How to do it?
- Results mean…
- – Conductive vs sensorineural hearing loss…
Conductive hearing loss vs Sensorineural hearing loss
GW:
- What could predipose a child recurrent acute ear infections?
- Conductive hearing loss vs sensorineual hearing loss
- What is a vestibular schwannoma?
- Name conditions involving the structure or areas of the ear than can present with otalgia? (otological causes of otalgia)
- Name conditions not involving the structures of the ear that present with otalgia? (non-otological causes of otalgia)
- Which nerves are involved in innervating the structures of the ecternal and middle ear?
- What could predipose a child recurrent acute ear infections?
Adenoids - lymph tissue is enlarged, blocks the Eustachian tube, ear infection is predisposed to as can’t drain (fluid builds up - nice growth medium) - Vestibular schwannoma - Tumour that develops on the 8th cranial nerve (vestibulococchlear nerve), due to overproduction of Schwann cells) - Benign
- Otological causes: AVN, AL, Meneres disease
- Non-otological causes: TMJ arthritis, larynx, phraynz, dental issues
- Vagus, trigeminal, glossophrangeal, C2, C3
GW:
- With reference to the anatomy of the ear, how is the original infection able to spead learing to the mastoiditis?
- Name some locations where the infection could spread from the middle ear?
- Otoscope - how to use it?
- Webbers test
- Rinne’s test
Infection spreads from middle ear to mastoid antrum to air cells
Infections could spread to: meninges, petrous bone, sigmoid sinus (thombus)
Otoscope: Pull pinna of ear across and up (external auditory meatus) - as it is sigmoid shaped
Webber’s test - Bang the metal thing Put flat bit in midline of forehead Put finger over one ear, sound should become louder in this ear Then do it with the other ear
Rinne’s test - Bang the metal thing Put flat big bit on mastoid process (testing bone conduction), when stop feeling the vibration, move it to the front of external auditory meatus, listen for it (testing air conduction). Should hear it at a lower frequency than can feel it. Normal: air conduction between than bone conduction
Structure of the pinna of the ear
Ear:
- Where is the oval window?
- Where is the round window?
Label the tympanic membrane
