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Block 2 > The Ear > Flashcards

The Ear Flashcards

1
Q

What are the roles of the ear?

A

Hearing

Balance

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2
Q

What are the 3 main divisions of the ear?

A

External

Middle

Inner

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3
Q

Where can referred pain to the ear be from? What nerves are responsible?

A

Mandible and mandibular teeth (Vc)

Temporomandibular joint (Vc)

Laryngopharynx (X)

Larynx (X)

Cardiac (X)

Pharynx (IX)

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4
Q

What is the purpose of the auricle and pinna?

A

Capture sound waves and direct them into the ear

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5
Q

What is the sensory innervation of the external acoustic meatus?

A

CNVc and X

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6
Q

How should an examination of the ear be performed in an adult?

How is the external acoustic meatus directed in an adult?

A

Pull pinna posterior and superior to straighten out and examine.

The EAM in an adult is S shaped and directed antero-inferiorly.

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7
Q

How should examination of the ear be performed in a child?

How is the external acoustic meatus directed in a child?

A

Pull ear posterior and inferiorly to straighten out and examine.

EAM in a child is almost horizontal

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8
Q

How should the tympanic membrane appear on examination?

A

Concave

Cone of light pointing anterior and inferior

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9
Q

How can pathology change the appearance of the tympanic membrane?

A

Can cause convexity or increased concavity.

Green suppuration

Visible redness from inflammation

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10
Q

Describe the 3 layers of the tympanic membrane What is the sensory innervation of each layer?

A

Outer skin: CN Vc and X

Mesoderm

Inner respiratory mucosa: CN IX

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11
Q

Where can pain refer from/to the tympanic membrane? What is the innervation?

A

Outer skin layer (Vc and X):

  • Mandible/mandibular teeth
  • Temporomandibular joint
  • Laryngopharynx
  • Larynx
  • Cardiac

Inner layer (CNIX):

  • Pharynx
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12
Q

What is the sensory innervation to the middle ear and auditory tube?

A

CNIX

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13
Q

Where does CNIX supply sensory innervation to?

A

Middle ear and auditory tube

Inner layer of tympanic membrane

All portions of the pharynx

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14
Q

Where does the nasopharynx receive sensory innervation from?

A

CNVb

CNIX

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15
Q

Where does the laryngopharynx receive sensory innervation from?

A

CNIX and X

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16
Q

Where does the oropharynx receive sensory innervation from?

A

CNIX

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17
Q

What does damage to the ossicles of the middle ear cause?

A

Conductive hearing loss

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18
Q

What is the role of the ossicles of the middle ear?

A

Link tympanic membrane to the oval window

Amplify signal from tympanic membrane

19
Q

What type of joint is between the ossicles of the middle ear?

What prevents dislocation?

A

Mobile synovial joints

Ligaments prevent dislocation

20
Q

What are the bones of the middle ear?

A

From tympanic membrane to oval window:

  • Malleus
  • Incus
  • Stapes
21
Q

What are the muscles of the middle ear and their roles?

A

Control oscillatory ranges of the ossicles.

Tensor tympani:

  • Originates from bony canal above pharyngotympanic tube and inserts into neck of malleus
  • Pulls tympanic membrane taut (medially) to reduce force of vibrations

Stapedius:

  • Passes from pyramidal eminence to stapes
  • Pulls stapes, limiting its range of movement in response to large vibrations.
22
Q

What is the innervation of the middle ear muscles?

A

Stapedius: CNVII

Tensor tympani: CNVc

23
Q

What are the walls of the middle ear?

A

Lateral wall: Tympanic membrane

Inferior wall: Jugular wall (separates from jugular vein)

Roof: Petrous part of temporal bone (separates middle ear from middle cranial fossa)

Medial wall: Formed by lateral wall of inner ear

Posterior wall: Mastoid wall (partition between middle ear and mastoid air cells)

  • Contains hole called aditus to mastoid antrum

Anterior wall: bony plate with 2 openings:

  • Auditory tube
  • Tensor tympani muscle
  • Separates middle ear from internal carotid artery
24
Q

How can a middle ear infection cause mastoiditis?

A

Spread through the posterior wall of the middle ear into mastoid air cells through the aditus to the mastoid antrum

25
Q

Where is the auditory (pharyngotympanic/eustachian) tube located? Is it normally closed or open?

A

Runs from anterior wall of middle ear to nasopharynx Normally in closed position

26
Q

Which muscles open the auditory tube during swallowing?

A

Levator veli palatini

Tensor veli palatini

Salpingopharyngeus

27
Q

How can upper respiratory tract infections spread to the middle ear?

A

Via the auditory tube

28
Q

What is the auditory tube composed of?

A

1/3 bone

2/3 cartilage

29
Q

What type of mucosa lines the auditory tube?

A

Respiratory: Pseudo-stratified ciliated columnar epithelium

30
Q

What is glue ear? What can it cause?

A

Chronic secretory otitis media

  • Persistent build up of mucoid fluid due to blockage of auditory tube.

Causes conductive hearing loss

Can cause speech and language developmental problems in young children

31
Q

What is the tympanic membrane formed from embryologically?

A

Ecto and endoderm of the first pouch and cleft

32
Q

What does the first pharyngeal arch develop into embryologically?

A

CNV

Tensor tympani

Tensor veli palatini

Malleus and Incus

33
Q

What does the 2nd pharyngeal arch develop into?

A

Stapes

CNVII

34
Q

Which nerve can inner ear infections affect? What can this cause?

A

CNVII

Ipsilateral facial palsy

35
Q

What does the first pharyngeal cleft develop into?

A

External acoustic meatus

Part of auditory tube

36
Q

What does the first pharyngeal pouch develop into?

A

Forms part of the auditory tube, mastoid antrum and tympanic cavity

37
Q

What conditions can be caused by defects in the first pharyngeal arch?

A

Facial deformities

Hearing problems

38
Q

Which direction should the cone of light be pointing in the tympanic membranes?

A

Anterior and Inferior

39
Q

Which nerve travels through the middle ear? How does it get there

A

Chorda tympani

40
Q

What does the chorda tympani supply? What might disturb this nerve?

A

Taste to the anterior 2/3 of tongue

Can be disrupted by middle ear infections

41
Q

In what direction should the handle of malleus point?

A

Posterior and inferior

42
Q

How would you perform a Rinne’s Test? What does it test for? What is a normal and abnormal result?

A

Tests for sensorineural and conductive deafness

  • Place vibrating 512Hz tuning fork on the patient’s mastoid process
  • When the patient can no longer hear the sound, move tuning fork in front of EAM to test air conduction.
    • Normal= Air conduction is louder than bone conduction
    • Sensorineural deafness= Air conduction louder than bone conduction but both reduced from normal.
    • Conductive deafness= Bone conduction louder than air conduction
43
Q

How do you perform Weber’s test? What does it test? What does a normal and abnormal result look like?

A

Tests for conductive and sensorineural deafness:

  • Tap 512Hz tuning fork on your hand
  • Place in the middle of a patient’s forehead
    • Normal= sound equal in both ears
    • Sensorineural deafness= sound is louder on side of intact ear
    • Conductive deafness= sound is louder on the side of the affected ear

Block 2 (46 decks)

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