Week 6- ENT Flashcards
Ear development occurs at the same time as ___ development- malformation or dysfunction in one system should alert the healthcare provider to problems in the other.
Kidney
The external ear comprises:
Auricle and ear canal
In the air filled middle ear these structures transform sound vibrations into mechanical waves for the inner ear:
Ossicles- the malleus, the incus, and the stapes
The proximal end of ___ connects the middle ear to the nasopharynx.
The Eustachian tube
The inner ear includes:
The cochlea, the semicircular canals, and the distal end of the auditory nerve (vestibulocochlear nerve or CN VIII)
Movements of the ___ vibrate the perilymph in the labyrinth of the semicircular canals and the hair cells and endolymph in the ducts of the cochlea, producing electrical nerve impulses transmitted by the auditory nerve to the brain.
Stapes
The first part of the hearing pathway, from the external ear through the middle ear, is known as:
The conductive phase
The second part of the hearing pathway, involving the cochlea and the cochlear nerve is:
The sensorineural phase
____ describes the normal first phase in the head pathway.
Air conduction
A vibrating tubing fork, placed on the head, sets the bone of the skull into vibration and stimulates the cochlea directly.
Bone conduction
In normal hearing what is more sensitive: bone or air conduction?
AC is more sensitive than BC
AC > BC
Nontender modular swellings covered by normal skin deep in the ear canals that are non malignant overgrowths which may obscure the drum:
Exotosis
Movement of the auricle and tragus (tug test) is painful in:
Acute otitis externa
Tenderness behind the ear occurs in:
Otitis media
In an adult, to see the internal structures by straightening the ear canal:
Pull the auricle upward, backward, and slightly away from the head.
Cone of light in right ear:
At 5 o’clock
Cone of light in the left ear:
7 o’clock
Most specific and sensitive hearing test?
Whispered voice test - sensitivity 90-100% and specificity 70-87%. Defects significant hearing loss of greater than 30 decibels.
These tests may be done for patients failing the whispered voice test to help determine if hearing loss is conductive or sensorineural:
Weber and Rinne
Weber test is used for:
Unilateral hearing loss only
In unilateral conductive hearing loss sound is heard in what ear with the Weber test?
Impaired ear: explanations include otosclerosis, otitis media, perforation of the eardrum, and cerumen.
In unilateral sensorineural hearing loss with the Weber test, sound is heard in:
The good ear.
What tests compares air conduction and bone conduction?
Rinne
What is normal finding for the Rinne?
AC > BC
In conductive hearing loss with the Rinne test, sound is:
Heard through bone as long or longer than it is through air ( BC = AC or BC >AC)
In sensorineural hearing loss with the Rinne test, sound is heard:
Longer through air (AC > BC)
A pneumatic scope with peds patient allows puff of air to go into air canal and TM should flutter with air; if TM fails to move:
Likely middle ear effusion
Eustachian tube in peds is:
Shorter, wider, and more horizontal than an adults allowing for pathogens from the nasopharynx to migrate through to the middle ear.
This part of the ear transmits sound by vibrations of the TM causing the ossicles and oval window to set the inner ear fluids in motion:
Inner ear
Hair cells in the inner ear transmit impulses to what cranial nerve that then transmits to the brain:
CN VII
What part of the ear aids in balance?
Inner ear
Inflammation of the external auditory canal that may be infectious, allergic, or dermatological disease:
Otitis externa
Acute bacterial infection of the middle ear fluid:
Acute otitis media
These 3 components must be present to diagnose AOM:
Recent, abrupt onset of s/s
Middle ear effusion
Middle ear inflammation i.e. distinct erythema of the TM or distinct otalgia interfering with normal sleep/activity
Rhinorrhea occurs with:
Colds, allergies, sinus infection, or trauma
Unilateral congestion is indicative of:
Deviated septum, foreign body, or carcinoma
Epistaxis occurs with:
Trauma, vigorous nose blowing, foreign body
Involves inflammation and secondary infection of the paranasal sinuses and the adjacent nasal mucosa:
Rhinosinusitis ( sinus infections)
If clinical findings suggest rhinosinusitis radiographs are not needed; however is symptoms are of ___ radiographic imagind should be done.
Orbital, intracranial, or soft-tissue abscess
In viral exhibits the nasal mucosa is:
Reddened and swollen
In allergic rhinitis the nasal mucosa is:
Pale, bluish, or red
Pale, saclike growths of inflamed tissue that can obstruct the air passage or sinuses, seen in allergic rhinitis, aspirin sensitivity, asthma, chronic sinus infections, and CF.
Nasal polyps
Local tenderness, together with symptoms such as facial pain, pressure or fullness, purulent nasal discharge, nasal obstructions, and smell disorder, especially when present more than 7 days suggest:
Acute bacterial rhinosinusitis involving the frontal and maxillary sinuses
Men aged greater than 50 years, smokers, and heavy users of chewing tobacco and alcohol are at highest risk for:
Cancers of the tongue and oral cavity, usually squamous cell carcinomas on the side or base of the tongue
Any persistent nodule or ulcer, red or white (on the tongue) , is suspect, especially if indurated. These discolored lesions represent:
Erythroplakia and leukoplakia and should be biopsied
Infection of the upper airway relatively brief illness that fairs in severity from sub clinical to severe toxicity caused by group A beta-hemolytic strep.
Acute streptococcal pharyngitis
Acute streptococcal pharyngitis clinical manifestations:
Abrupt onset
Pharyngitis, HA, fever, abdominal pain
Tender anterior cervical lymphadenopathy
Tonsillitis and pharyngeal inflammation and exudate
Oral petechia may be due to:
Infection or decreased platelets, and trauma
A thickened white patch that may occur anywhere in the oral mucosa. This benign reactive process of the squamous epithelium may lead to cancer and should be violated. Another risk factor is HPV.
Leukoplakia
Acute inflammation and edema formation in the subglottic space.
Croup
Enlarged supraclavicular nodes is:
Always bad (cancer)
