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ENT > 2.1: Ear Disease > Flashcards

2.1: Ear Disease Flashcards

1
Q

What frequency of tuning fork is used?

A

512 Hz

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2
Q

Describe how you carry out the Rinne test?

What is the function of this test?

A

Place the tuning fork on the mastoid process (conducting sound through bone) - ask patient when they can no longer hear it.
Move the tuning fork to outside the auditory canal and ask if they can hear it

Compares the perception of sound transmitted through air conduction to sound transmitted through bone conduction

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3
Q

Describe abnormal and normal results of the Rinne test?

A

Normal or positive Rinne test is when the sound heard outside the ear is heard after the patient can no longer hear the sound from the mastoid.

Abnormal or negative test is when they are unable to hear the tuning fork after the mastoid test.

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4
Q

Describe clinical significance of a positive and negative Rinne test result?

A 
Positive = Normal Hearing
Negative = Something is preventing sound waves getting to the middle ear and therefore this is CONDUCTIVE HEARING LOSS
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5
Q

Describe the Weber Test?

A

Tuning fork is placed on the patients forehead

They are asked which ear they can hear the sound better in

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6
Q

Describe the results of the Weber test? Significance?

A

Patient reports sound heard equally = Normal result, normal hearing
Patient reports sound louder in one ear –> Depends on which ear is effective.
Patient complains of right hearing loss and sound is louder in defective ear then they have CONDUCTIVE hearing loss. If sound is louder in normal ear then they have SENSORINEURAL hearing loss in the defective ear.

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7
Q

Weber Test:
Right ear is defective
Sound is heard better in left.. What type of hearing loss?
Sound is heard better in right.. What type of hearing loss?

A 
LEFT = SENSORINEURAL
RIGHT = CONDUCTIVE
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8
Q

Describe PTA?

  • Full Name
  • How is it carried out?
A

PTA = Pure Tone Audiometry
Patients wear headphones and have different frequency sounds played to them. The volume of the sound is increased until the patient is able to hear it and presses a button.
The volume at which the patient can first hear the sound is recorded

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9
Q

Describe PTA results?

A 
PTA results are recorded in a graph
Left ear = X 
Right ear = 0
The graph shows the volume at which patients can hear the sound
Shows hearing loss
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10
Q

Describe tympanography?

A

This looks at the ear drum and the middle ear

It looks at the response of the eardrum to changing pressures

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11
Q

Describe what a flat tympanograph most likely means?

A

Otitis Media

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12
Q

What are the three important tests?

A 
Tuning Fork (Weber and Rinne)
PTA (Pure Tone Audiometry)
Tympanography
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13
Q

Name 6 symptoms of ear disease?

A 
Dizziness
Discomfort
Deafness
Discharge
Din Din
Defective Moment of Face
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14
Q

What are the types of deafness?

A

Conductive
Sensorineural
Mixed
Central

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15
Q

Describe conductive deafness?

A

Conductive deafness is when sound waves are prevented from reaching the inner ear. This is caused by a problem in the pinna, ear canal, tympanic membrane or middle ear.

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16
Q

Describe Sensorineural deafness?

A

Sensorineural deafness is caused by either the cochlea (sensory) or the auditory nerve (neural)
This involves the inner ear

17
Q

Describe mixed deafness?

A

Caused by a mixture of conductive issues (outer and middle ear) and sensorineural issues (inner ear)

18
Q

Describe central deafness?

A

This is when there is no problem with the ear, sound is conducted normally to the brain however the patient cannot hear. Problem with the brain Eg: Stroke

19
Q

Describe anatomy and deafness?

A

Anatomy is important in determing cause
Outer ear, middle ear = Conductive
Inner Ear = Sensorineural

20
Q

Describe a common conductive and a common sensorineural problem?

A 
Conductive = Glue Ear, Otitis Media
Sensorineural = Cochlea problem in elderly
21
Q

What nerves cause discomfort?

A 
CN V - Trigeminal
CN VII - Facial
CN IX - Glossopharyngeal
CN X - Vagus
C2, C3 (spinal)
22
Q

What is the most common cause for earache?

A

Referred pain Eg: Toothache

23
Q

Describe discharge causes?

A

Caused by either:
Acute Otitis Media
Chronic Otitis Media
CSF leakage

24
Q

Describe acute otitis media?

A

Acute otitis media is common in children. An infection from the throat or sinuses travels up the eustachian tube and leads to a build up of infected pus. This causes pressure against the tympanic membrane and lots of pain. The pus bursts out through the tympanic membrane providing immediate relief to the child.

25
Q

Describe chronic otitis media?

A

In chronic otitis media, there is a hole in the eardrum that hasn’t healed. This leads to continued discharge of pus

26
Q

Describe CSF leakage?

A

This is often seen after trauma e.g.: Head injury, fracture etc. The roof of the middle ear lays just under the middle cranial fossa under a very thin covering. Some CSF fluid can leak out into the middle ear causing discharge.

27
Q

Describe dizziness?

A

There are two types of dizziness:
- Central (From the brain)
- Peripheral (From the ear)
WITH OR WITHOUT HEARING LOSS

28
Q

Describe Din Din?

A

Din Din = Tinnutitis
This is the hearing of sound that is not present externally and instead comes from within the body
Treatment involves sound therapy, behaviour therapy and hearing aids

29
Q

Describe defective facial movement?

A

This is a lower motor neurone facial palsy

Allows one side of the face to move while the other is unable to (Eg: Only one eye can be screwed up when asked)

30
Q

Describe Otitis Externa?

  • What
  • Who
  • Treatment
A

Otitis Externa is inflammation of the outer ear due to growth of fungus. Very itchy. Very common especially in swimmers.
Treatment is suction which provides immediate relief. Treatment twitch topical anti-fungal such as canesten.

31
Q

Describe acute otitis media?

  • What
  • Who
  • Treatment
  • Complications
A

This is inflammation of the middle ear. Very commonly seen in children. The ear drum becomes very red and distended as pressure builds up behind it. Pus may burst out if not caught in time.
Treatment is drainage of pus and antibiotics (Amoxicillin)
In rare cases, it can lead to a brain abscess if not caught.

32
Q

What is chronic otitis media?

  • What
  • Treatment
A

This is prolonged infection of the middle ear. Causes intermittent discharge.
Treatment is antibiotics to dry up infection plus surgery to close eardrum hole.

33
Q

Describe otitis media with effusion?

A

Also known as glue ear
Very common
This is the build up of fluid behind the ear drum in the absence of infection
The ear drum is intact

34
Q

If there is pus behind the eardrum due to infection this is..?
If there is long term pus behind the ear drum that leaks this is?
If there is fluid behind the eardrum and no infection this is..?

A

Otitis Media
Chronic Otitis Media
Otitis Media with effusion/glue ear

35
Q

What is a cholesteatoma?

Causes?

A

This is skin the wrong place - squamous epithelium from the outer ear in the middle ear (behind the ear drum)
The skin can get through due to a perforation in the ear drum

36
Q

Complications of cholesteatoma?
Can lead to?
Signs?

A

If not diagnosed and treated, it can grow causing damage to middle ear structures
Can lead to ear infection, hearing loss, facial palsy
Signs include smelly discharge and gradual hearing loss

37
Q

Treatment of cholesteatoma?

A

Surgical Removal

38
Q

Describe congenital cholesteatoma?

A

Very uncommon
Seen in some children
Cholesteatoma behind an intact ear drum

39
Q

Imaging used in ear disease?

A

CT

ENT (17 decks)

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