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SUM '20 - Health Assessment > Week 1 ENT 1 of 4 > Flashcards

Week 1 ENT 1 of 4 Flashcards

1
Q

Using an otoscope to examine the adult ear, what do you do?

A

pull the auricle UP and BACK

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2
Q

Using an otoscope to examine an infant/child’s ear, what do you do?

A

pull the auricle DOWN and OUT

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3
Q

What is important to ensure regarding the otoscope when using?

A
  • brightly lit

- proper tip

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4
Q

This d/o occurs when there is an excessive amount of cerumen that occludes the external canal:

A

Impacted Cerumen

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5
Q

Subjective findings for impacted cerumen:

A
  • fullness of the canal
  • itching
  • pain
  • cough
  • vertigo
  • hearing loss
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6
Q

Objective findings of Impacted cerumen:

A

Hard/soft cerumen occluding external canal

-unable to visualize TM

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7
Q

Mgmt and Health Promotion for Impacted cerumen:

A

Mgmt:
- Removal of cerumen by warm water irrigation for symptomatic pts.
-Be mindful of foreign objects
HP:
- no using cotton swabs
-OTC products work well for cerumen removal

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8
Q

Inner Ear Disturbances include:

A
  • Labyrinthitis
  • Meniere’s Disease
  • Tinnitus
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9
Q

Inflammation of what CN can cause vertigo sensations?

A

CN 8 - Vestibulocochlear nerve

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10
Q

Subjective findings of inner ear disturbances:

A

severe vertigo
N/V
disequilibrium

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11
Q

Objective findings of inner ear disturbances:

A

there may be no objective findings

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12
Q

Mgmt of Labyrinthits:

A

prednisone tapered dose

Meclizine 25mg prn (for vertigo)

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13
Q

Mgmt of Meniere’s Dx:

A

otolaryngologist referral

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14
Q

Mgmt of Tinnitus:

A

otolaryngologist referral to R/O neuroma

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15
Q

Additional causes of tinnitus:

A
  • large/fast doses of IV Lasix
  • lidocaine toxicity (? 5mcg plasma concentration)
  • EPIDURAL turned venous
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16
Q

Explain how tinnitus can be associated with an epidural:

A

Epidural test dose is an epi and lidocaine mixture. when administered, if venous the pt will c/o of:

  • numbness
  • tingling
  • and/or TINNITUS
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17
Q

Functions of the Eustachian Tube:

A
  1. allows air into the middle ear
  2. Equalizes Pressure in the middle ear (d/t altitude)
  3. Drain normal secretions of the middle ear.
  4. Drains secretions into the nasopharynx
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18
Q

how do the eustachian tubes allow for middle ear secretions to drain?

A
  1. by a mucociliary transport system

2. repeated active tubal opening and closing

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19
Q

cellulitis of the external auditory canal that may extend to the auricle is:

A

otitis externa

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20
Q

Causes of Otitis externa:

A
  • excessive moisture

- any condition that compromises the integrity of the external ear

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21
Q

Subjective findings with otitis externa:

A
  • Pain and tenderness of external ear and/or canal

- itching

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22
Q

Objective findings with otitis externa:

A
  • redness and irritation of the canal
  • slough or exudate
  • edema of the canal
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23
Q

Mgmt and HP for otitis externa:

A

Mgmt:

  • topical abx (corisporine otic suspension)
  • pain control w/NSAIDS
  • Wick

HP - decrease moisture in canal

  • gentle use of blow dryer
  • 1:2 mix of vinegar/rubbing alcohol
24
Q

an inflammatory or infectious process that occurs in the middle ear from an accumulation of fluid is likely:

A

Otitis media

25
Q

Otitis media may result in what forms:

A
  • bacterial
  • fungal
  • viral
26
Q

Subjective findings for otitis media:

A

pain
hearing loss
stuffiness of ear
congestion

27
Q

Chronic congestion /chronic otitis media may potentially cause what in young children

A

speech delays

28
Q

Objective findings for otitis media:

A

-decreased /absent mobility of TM is Diagnostic
-erythema or bulging of the TM
(with obscure landmarks)

29
Q

-Mgmt and HP for otitis media:

A

Mgmt:

  • analgesics and auralgen (unless bacterial)
  • Amoxicillin if 1st line for bacterial

HP:
-assess each case carefully before RX meds/abx

30
Q

auralgen is

A

an ear gtt with:

  • benzocaine (pain)
  • Antipyrine (an anti-inflammatory)
  • glycerin (to soften ear wax; protect the ear)
31
Q

what % of otitis media cases are bacterial?

A

< 25%

32
Q

First line abx therapy for otitis media:

A

amoxicillin

33
Q

any tear in the integrity of the TM is known as:

A

TM rupture

34
Q

TM rupture can be caused by

A
  • Trauma
  • Infection
  • Neoplasm

“TIN for TiM”

35
Q

Subjective findings for TM rupture

A

pain

hearing loss

36
Q

objective findings for TM rupture

A

actual tear in the TM

37
Q

Mgmt and HP for TM rupture

A

Mgmt:

  • most heal spontaneously unless infx was the cause.
  • referral for surgical intervention

HP:

  • R/O cholesteatoma formation
  • monitor hearing function
38
Q

A cholesteatoma is an

A

abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it’s most commonly caused by repeated middle ear infections. A cholesteatoma often develops as a cyst, or sac, that sheds layers of old skin

39
Q

$$ Examples of Conductive Hearing Loss:

A 
Foreign body
Impacted cerumen
Infection
Cholesteatoma
Otitis media
Otosclerosis
Trauma
Tumor
40
Q

$$ examples of sensorineural Hearing loss:

A 
Acoustic tumor
Trauma
Congenital or hereditary 
Infection
Meniere’s 
Ototoxic medications
Neurological disorders
Presbycusis
41
Q

Otosclerosis

A

is the abnormal growth of bone of the MIDDLE ear.

This bone prevents structures within the ear from working properly and causes hearing loss. For some people with otosclerosis, the hearing loss may become severe.

42
Q

Presbycusis

A

is the most common type of Sensorineural Hearing Loss caused by the natural aging of the auditory system. It occurs gradually and initially affects the ability to hear higher pitched (higher frequency) sounds.

43
Q

For patients with PE tubes, ruptured TM or recent ear surgeries, what otic drops would be a better option for them?

A

Ciprodex

Otofloxin

44
Q

Pearls for ear examination:

A
  1. look carefully - repeatedly looking improves skills
  2. watch for foreign bodies (kids like ears)
  3. secure the head of kids during exam to reduce R/O trauma during exam
45
Q

Types of Ear Pain (broadly broken down)

A
  1. Primary - originating within ear STRUCTURES

2. Secondary - referred to the ear from OTHER REGIONS

46
Q

ear pain referred to the ear from another area is known as

A

secondary ear pain

47
Q

infections and inflammations of middle and external ear structures and mastoid tissues are considered what type of ear pain?

A

primary

48
Q

Examples of secondary ear pain

A
  • TMJ (dental and periodontal problems)
  • sinus/ nasopharyngeal infections
  • lesions of the tongue
  • cervical musculoskeletal problems
  • Neuralgias
49
Q

Name the components of physical ear exam:

A
  1. inspection - general appearance, external ear, inspection of ear w/an otoscope
  2. Palpation - each ear separately by pulling the pinna OUT and BACK, and either Up/Down.
    - apply pressure to the tragus
50
Q

functions of the ear include:

A
  1. interpreting and identifying sound
  2. detecting the direction of sound
  3. maintaining equilibrium
51
Q

Major parts of the ear include

A
  1. external ear (pinna or auricle & the ear canal
  2. middle ear (tympanic cavity)
  3. inner ear
52
Q

the hearing process begins here by collecting sound waves and channeling them through the ear canal

A

external ear

53
Q

This part of the ear contains the structures for balance and hearing through a series of connecting chambers and tubes

A

the inner ear

54
Q

functions as a conduit for hear and as a regulator of the ventilation pressure

A

the inner ear

55
Q

undiagnosed ear disorders may contribute to

A
  • poor language development
  • delayed learning
  • social isolation
  • hearing loss
  • risk for falls
  • missed dx of respiratory and oral infx’s

SUM '20 - Health Assessment (17 decks)

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