Week 3 - Ear Flashcards
What are 8 causes of conductive hearing loss?
- ) Obstruction of ear canal
- ) Perforated tympanic membrane
- ) Dislocated ossicle
- ) Otitis media
- ) Otitis externa
- ) Otosclerosis
- ) Congential
- ) Cholesteatoma
What results from physical or mechanical problems that limit movement of the sound wave through the external and middle ear?
Conductive hearing loss
What is the result of damage to the hair cells or nerves that sense sound waves; a sensory problem in the inner ear?
Sensorineural hearing loss (SNHL)
What are 11 causes/associated conditions of SNHL?
- ) Acoustic trauma
- ) Barotrauma
- ) Head trauma
- ) Ototoxic drugs (Rx drugs and cocaine)
- ) Infection
- ) Aging
- ) Acoustic neuroma
- ) Sudden SNHL
- ) Meniere SNHL
- ) Vascular disease
- ) Multiple sclerosis
What would you call a combination of both conductive and sensorineural loss?
Mixed hearing loss
What is the perception of sound (e.g. buzzing, ringing, roaring, clicking) in absence of an acoustic stimulus. May be intermittent, continuous, pulsatile; either unilateral or bilateral.
Tinnitus
What are the 2 types of tinnitus?
- ) Subjective
2. ) Objective
Which type of tinnitus is audible only to patients, is high frequency, and is due to damage of fine hair cells?
Subjective tinnitus
What are 9 etiological conditions associated with subjective tinnitus?
- ) Acoustic trauma
- ) Barotrauma
- ) Eustacian tube dysfunction
- ) Meniere disease
- ) Drugs
- ) Presbycusis
- ) CNS tumor
- ) Infection (OM, labryinthitis, meningitis)
- ) Ear canal obstruction
What disease has hearing loss, vertigo, and tinnitus with gradual onset and often progresses to deafness and severe vertigo?
Meniere disese
What is unilateral hearing loss over 72hrs. and associated with microvascular event or head trauma?
Sudden SNHL (SSNHL)
Which type of tinnitus is rare and can be heard by the physician listening directly over the patient’s ear with their stethoscope?
Objective tinnitus
What do you call a tumor in the auditory nerve?
Acoustic neuroma
What are 4 etiological conditions associated with objective tinnitus?
- ) A-V malformations
- ) Turbulent flow in carotid A or jugular V
- ) Vascular middle ear tumor
- ) Monoclonus
What are 14 other types or causes for tinnitus?
- ) hyperlipidemia
- ) allergies
- ) diabetes
- ) hypertension
- ) hypotension
- ) syphilis
- ) cardiovascular dx
- ) endocrine dx
- ) metabolic dx
- ) TMJ disorders
- ) cervical injuries
- ) stress
- ) dietary problems
- ) intake of stimulants (nicotine, caffeine)
What is a non-specific term of describing a sensation of altered spatial orientation “illusory movement” most often cause by dysfunction of the vestibular, visual, or proprioceptive (posterior column) systems, or by diffuse impairment of blood flow to the brain?
Vertigo
What are the 2 CLASSIFICATIONS of vertigo?
- ) True vertigo
2. ) Non-vertigo
Which classification of vertigo is the sensation of movement and is caused by asymmetry in the vestibular system (CN8, inner ear, and cerebellum)?
True vertigo
Which classification of vertigo has syncope, fainting, or sensation of impending fainting?
Non-vertigo
What are the 2 FURTHER CLASSIFICATIONS of vertigo?
- ) Peripheral
2. ) Central
Which further classification of vertigo associated with nystagmus has unidirectional with fast component towards normal ear, with horizontal with rotation?
Peripheral vertigo
Which further classification of vertigo associated with nystagmus is any direction and sometimes changes direction?
Central vertigo
Which further classification of vertigo associated with other neuro signs is absent?
Peripheral vertigo
Which further classification of vertigo associated with other neuro signs is often present (ataxic gait, diplopia, slurred speech, numbness)?
Central vertigo
Which further classification of vertigo associated with postural instability has unidirectional instability and walking is preserved?
Peripheral vertigo
Which further classification of vertigo associated with postural instability has severe instability and patient can fall when walking?
Central vertigo
Which further classification of vertigo has a presence of hearing loss/tinnitus?
Peripheral vertigo
Which further classification of vertigo has a absence of hearing loss/tinnitus?
Central vertigo
What are the 3 types of non-vertigo?
- ) Lightheadedness
- ) Disequilibrium
- ) Miscellaneous
“Graying out” of vision, pallor, and a roaring sound in the ears, suggesting hypoperfusion of the brain (global hypoperfusion) is a result of which type of non-vertigo?
Lightheadedness
Which type of non-vertigo occurs only when standing or walking (gait impairing), unsteady without any dizziness, and patient indicates the “dizziness is in their feet, not in their head”?
Disequilibrium
What are 8 causes of lightheadedness of non-vertigo?
- ) hypotension
- ) shock
- ) drugs
- ) dehydration
- ) decreased cardiac output
- ) severe anemia
- ) hypoglycemia
- ) cardiac arrythmias
What are 6 problems that cause disequilibrium in non-vertigo?
- ) cerebellum issue
- ) frontal lobe tumor
- ) basal ganglia issue
- ) stroke
- ) cervical spondylosis
- ) motor neuron disease
What are 7 causes of miscellaneous non-vertigo?
- ) chronic hyperventilation syndrome
- ) frequent deep breaths while relaxed
- ) new eyewear with diplopia
- ) phobias
- ) agoraphobia
- ) acrophobia
- ) extra-ocular muscular palsy resulting in diplopia
What are 4 RED FLAG concomitants of vertigo?
- ) Head or neck pain
- ) Ataxia
- ) Loss of consciousness
- ) Focal neurological deficit
What are 8 causes of otalgia (earache/ear pain)?
- ) external ear (impacted cerumen, foreign body, local trauma, or OE)
- ) middle ear (eustacian tube obstruction, OM, and neoplasms)
- ) referred pain (TMJ or wisdom teeth)
- ) local infections (tonsillitis, enlarged adenoids, peritonsillar abscess, atlas/axis subluxation)
- ) tumor (in pharynx, tonsils, tongue, larynx)
- ) thyroiditis
- ) neuralgia (trigeminal, shenopalatine, glossopharyngeal, geniculate)
- ) colds (allergies or cold wind blowing in the ears)
What are 5 RED FLAG concomitants for otalgia (earache/ear pain)?
- ) diabetes
- ) immunocompromised
- ) redness/pain over mastoid
- ) severe swelling of canal meatus
- ) chronic pain with head/neck symptoms
What are 4 ACUTE causes of otorrhea (ear discharge)?
- ) Acute OM with TM perforation
- ) Post-tympanostomy tube
- ) CSF leak from head trauma
- ) OE (infection or allergy)
What are 5 CHRONIC causes of otorrhea (ear discharge)?
- ) Cancer of ear canal
- ) Cholesteatoma
- ) Chronic purulent OM
- ) Foreign body (usually kids)
- ) Mastoiditis
What are 6 RED FLAG concomitants of otorrhea (ear discharge)?
- ) head trauma
- ) cranial nerve dysfunction
- ) fever
- ) erythema of the ear
- ) diabetes
- ) immune compromised
What are 4 sources of etiology for acute otitis externa (AOE)?
- ) Infection (strep, staph, E. coli, pseudomonas, aspergillus)
- ) Swimmer’s ear
- ) Forceful cleaning of ears (use of Q-tips)
- ) Trauma
What are 4 signs and sxs of AOE?
- ) itching
- ) pain
- ) discharge
- ) loss of hearing (swollen canal or canal filled with purulent debris)
What are 2 sources of etiology for chronic otitis externa?
- ) follows psoriasis, seborrheic dermatitis, eczema
2. ) allergy or fungus
What are 4 signs and sxs of chronic otitis externa?
- ) pruritis
- ) redness
- ) discharge
- ) itchiness
Trauma, insect bites leading to decreased blood supply to ear cartilage causing avascular necrosis and deformity are characteristics of what condition?
Perichondritis
What are 4 concomitants of tumors of the ear?
- ) sebaceous cysts
- ) osteomas (bony growths that may occlude ear canal)
- ) gouty deposits (tophi on outer ear)
- ) BCC or SCC (hx of sun exposure on external ear)
What are 3 causes of acute otitis media (AOM)?
- ) organism
- ) anatomic position of Eustachian tube
- ) immunological factors