Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology and Special Senses > The External Ear > Flashcards

The External Ear Flashcards

1
Q

What is ear trauma commonly related to?

A

Sports injuries

Violence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How severe is ear trauma normally?

A

Normally uncomplicated and treatable under local anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why is the sensory supply to the pinna important?

A

Allow you to perform regional nerve blocks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are most lacerations of the external ear managed?

A

Clean wound

Simple primary closure of skin with suture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How should a laceration with exposed cartilage be managed?

A

Cover any exposed cartilage with skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What may be done if there is skin loss or a skin laceration can’t be closed by primary closure?

A

Plastic reconstructive surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the main risks with bites to the ear?

A

Infection from skin commensal or oral commensal of offending creature/person

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How would you manage a patient with an ear bite?

A

Take a good history - work out likely organism

Leave wound open

Irrigate wound thoroughly

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are pinna haematoma’s dangerous?

A

Disrupt blood supply to cartilage as it normally obtains nutrients via diffusion from vessels in the perichondrium.

Can lead to avascular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is cauliflower ear?

A

Cartilage undergoes avascular necrosis which stimulates the formation of new cartilage but it grows asymmetrically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What can cause a tympanic membrane perforation?

A

Blunt force - trauma to side of head
Penetrating trauma - e.g. cotton bud
Otitis media
Barotrauma - explosion/scuba diving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does a tympanic membrane perforation present?

A

Pain
Conductive hearing loss (possibly)

Can get tinnitus and serosanguineous discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can tympanic membrane perforation be managed?

A

Most heal within 8 weeks- monitoring
Antibiotics if contamination
Keep clean and cry

Not healing after 6 months or hearing loss/recurrent infection - myringoplasty

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is haemotympanum?

A

Blood in the middle ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can cause haemotympanum?

A

Basal skull fracture - most common
Nasal packing
Bleeding disorders/anticoagulants
Recurrent ear infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How does haemotympanum present?

A

Seen through tympanic membrane

Associated with conductive hearing loss

Sense of fullness in ear

Pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is haemotympanum managed?

A

Treat conservatively but follow up to ensure no residual hearing loss

However commonly associated with other issues - head trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is swimmer’s ear?

A

Otitis Externa - inflammation of the external ear canal lining

19
Q

What can cause Otitis Externa?

A

Bacteria - pseudomonas aeruginosa, staph aureus
Fungi - aspergillus and candida
Furuncle - deep folliculitis
Allergic

20
Q

How does otitis externa present?

A 
Painful discharge from ear
History of itchy ear
?History of swimming on holiday
Muffled hearing side of discharge
Fever
Peri-auricular lymphadenopathy
21
Q

Who commonly gets Malignant Otitis Externa?

A

Elderly, Diabetics or Immunocompromised

22
Q

How can Otitis Externa spread?

A

Through into bone causing several complications

23
Q

What are the possible complications of Otitis externa?

A 
Perforated Tympanic Membrane
Abscess
Sepsis
Become Chronic
Cellulitis
Malignant otitis externa - high mortality rate (10%) even with aggressive management
24
Q

How does malignant otitis externa present?

A

Chronic ear discharge despite topical treatment
Deep seated ear pain - out of proportion pain
Oedema
Exudate
Cranial Nerve palsies - usually CNVII

25
Q

How is otitis externa managed?

A

Topical drops for at least a week

  • Mild - acetic acid
  • Everything else - neomycin

Oral fluclox if systemically unwell/lymphadenopathy
Insert ear wick coated in steroid/antibiotics
Ear health advice - keep dry, dont use cotton buds, olive oil to stop wax build up

26
Q

How is malignant otitis externa treated?

A

Urgent ENT referral

Aggressive IV antibioic therapy alongside topical treatment - gentamicin

27
Q

What advice is given for swimming and flying for patients with otitis externa?

A

Ear plugs for swimming
Avoid getting water/shampoo in ears
Don’t fly with ear infections ideally - increase pain, risk of perforation and time to settle

28
Q

How can discharge be indicative of aetiology of otitis externa?

A

White-yellow - bacterial
Thick, grey with visible spores - fungal
Clear grey - likely otitis media

29
Q

What risk factors predispose otitis externa?

A 
Humid environment
Swim
Old age
Immunocompromised
Presence of foreign bodies or polyps
Eczema
Psoriasis
Seborrheic Dermatitis
30
Q

How long is the external auditory meatus and how is it made up?

A

2.5cm

Outer 2/3 - cartilaginous + hairs
Inner 1/3 - petrous part of temporal bone

31
Q

What are the key parts of the tympanic membrane that can be seen?

A 
Pars flaccida (top)
Pars Tensa (vibrates)
Cone of light
32
Q

How does a pinna haematoma occur?

A

Shearing forces separate the perichondrium from the tightly adhered cartilage

Perichondrial blood vessels tear leading to haematoma formation

33
Q

What are the complications associated with pinna haematoma?

A

Superimposed infection

Cauliflower ear

34
Q

How is a pinna haematoma managed?

A

Drainage within 24 hours of injury

Tight head bandage

35
Q

What problems may be associated with tympanic membrane perforation?

A

Basal skull fracture
Facial nerve palsy
Temporal bone fracture

36
Q

How does otitis external appear on examination?

A

Ear canal with erythema, oedema and exudate

37
Q

What happens in furuncle otitis external?

A

Small localised infection causing lots of pain and swelling

If lesion burst, there is a sudden relief of pain

38
Q

What happens in allergic otitis external?

A

Contact dermatitis

Fast onset with itching as main symptom

39
Q

How is otitis external investigated?

A

Only need to swab of MC&S if treatment failure or atypical

40
Q

What is malignant (necrotising) otitis externa?

A

Life threatening spread of otitis external into the mastoid or temporal bone

41
Q

When is otitis external classified as chronic?

A

> 3 Months

42
Q

What must you consider with patients that have chronic otitis externa?

A

Poor compliance
Abx drop can lead to fungal infection
Contact sensitivity to Abx drop

43
Q

How is chronic otitis external investigated and managed?

A

Swab

7 days acetic acid + corticosteroid drop

Neurology and Special Senses (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions