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61 Cards in this Set
- Front
- Back
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Only 2 tissues not containing lymph vessels
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Placenta
Brain |
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The 2 "bad" lymph nodes
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Infra and supraclavicular
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Lateral 1/3 of ear canal contains
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Hair, cerumen, sebaceous gland
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Medial 2/3 of EAC contains
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No hair, no structures
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Nerve that causes coughing if it's stimulated in the ear
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Nerve of Arnold
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Cerumen keeps canal at a ____ pH
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Low
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Reasons for removing cerumen (HOT VA)
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Hearing loss (conductive)
Otalgia Tinnitus Vertigo Otalgia Aural fullness |
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3 ways to remove cerumen
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Ceruminolytics
Irrigation Curette |
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Irrigation with
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Warm water, vinegar, rubbing alcohol
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Ceruminolytics
-Natural -Prescription --Numbing |
-Sweet oil, mineral oil
-Steroid ear drops, cerumenix, colace --Auralgan |
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Pain with chewing causes
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Cerumen impaction
Otitis externa |
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Conductive hearing loss causes (External Ear)
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Cerumen
Otitis externa Foreign body |
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Conductive hearing loss causes (Middle Ear)
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AOM
Acute/Chronic SOM Suppurative OM TM perforation Cholesteatoma Otosclerosis Barotrauma Glomus jugulare |
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Types of otitis media
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Acute
Acute serous Chronic serous Suppurative |
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Sensorineural hear loss causes
1. Congenital 2. Acquired |
2. Presbycusis
Meniere's Ototoxic drugs Laburinthitis Acoustic neruoma |
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Those more likely to get cerumen impaction
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-People who make "taffy" cerumen
-Common: use of q tips/ear plugs |
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-Otitis externa
--Uncommon in: -Symptoms |
-Inflammation of the skin & soft tissue of the EAC
--Children under 2 |
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Diseases causing otorrhea
(which have foul smell?) [EFMC] |
-Otitis externa
-Foreign body (foul smell) -Mastoiditis -Cholestatoma (foul smell) |
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Disease causing chronic otorrhea
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Chronic suppurative otitis media
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Otalgia, otorrhea, burning, itching, conductive hearing loss, pain with auricle movement, edema of pinna/helix, erythema/edema of EAC, otorrhea, mobile TM
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Otitis externa
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-Weber lateralizes to ____ ear with conduction loss
-Sensorineural |
-Bad
-Good |
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Rinne
-Conductive hearing loss -Sensorineural |
-Bone conduction better than air
-AC>BC but not 2:1 |
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Cause of OE
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Excessive moisture
Trauma Too little/too much cerumen |
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Etiology of OE
-Bacterial --#1 --2 --3, 4, 5 |
--Pseudomonas
--Staphylococcus aureus --Proteus, kebsiella, E.coli - |
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-Fungal etiology of OE
--1 --2 -Cause |
--Aspergillus
--Candida albicans -Too much moisture, excess topical otic abx |
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Treatment of OE
(4) [IASA] |
-Remove ear canal debris (irrigation)
-Analgesics (NSAIDS, narcotic) - +/-Steroids -Abx --Main treatment |
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OE Abx treatment
-Length -Not recommended -Recommended/used |
-3 days beyond cessation of symptoms (7-10d)
-Aminoglycosides (ototoxic) -Quinolones (floxin, ciprodex) |
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OE Antifungals
-E.g. -May exacerbate: ____ by ____ |
-Vol-Sol, Lotrimin
- fungal growth by destroying normal bacterial flora |
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Preventative measures for Swimmer's Ear
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1/2 vinegar, 1/2 alcohol drops after swimming/shower
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-Worsening ear pain out of line with findings
-Granulation tissue -Bone exposure in canal, mastoiditis -Parotitis, facial paralysis -Lymphadenopathy -Destruction of CN 7, 9, 11, 12 -Potentially fatal |
Malignant OE (Progressive Necrotizing OE)
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Malignant OE definition
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Infection that invades the bone and causes osteomyelitis of the temporal of mastoid bone
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Malignant OE likely to occur in what type of patient
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Elderly, diabetics, immunocompromised
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Bacterial cause of OE
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P aeruginosa
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Diagnosis of Progressive Necrotizing OE
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-CT, MRI
-Send to ENT! |
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Treatment of Malignant OE
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Hospitalization
IV abx Surgical debridement |
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Sever otalgia preceding a rash
Painful, burning blisters Vertigo Tinnitus SHL N/V Dysgeusia (alteration in taste) Associated eye symptoms |
Herpes zoster oticus
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-Herpes zoster oticus definition
-Progression of blisters |
-Infection of external, middle, or inner ear by herpes zoster virus
-Vesicules --> pustules --> crust |
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Herpes resides in ____
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nerves
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Bony protuberance in EAC, found incidentally
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Exostoses
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-Cause of exostoses
-Complications (2) -Treatment |
-Possibly associated with years of swimming in cold water
-Recurrent cerumen impactions and OE -Not treatment unless causes serious chronic problems |
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Unilateral:
-Otalgia -Otorrhea -CHL -Foul smell --Weber: bad hear --Rinne: BC>AC |
Foreign body
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Treatment for foreign body
-Best -Insects killed with |
-Irrigation
-Mineral oil |
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-Aurical pain
-Erythema, warmth of pinna -Purulent exudate on pinna -Lymphadeopathy -Fever -Malaise |
Auricular perichondritis
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-Auricular perichondritis definition
--Complication |
-Infection/inflammation of cartilage of pinna
--Cauliflower ear |
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-Cause of auricular perichondritis
-Etiology (#1, 2&3) -Treatment |
-Trauma
-Pseudomonas aeruginos (aslo staph/strep) -ENT referral |
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-Firm, ecchymotic, swollen area of helix
-Aural pain/fullness |
Auricular Hematoma
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-Auricular Hematoma definition
-Cause -Complication |
-Collection of blood of helix of the ear
-Trauma -necrosis a& fibrous scaring (cauliflower ear) |
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Treatment of auricular hematoma (AIC)
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Aspiration
Incise and drain Compressive dressing |
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Painfule nodule on the helix that grows rapidly, well demarcated with rolled edge, central ulcer
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Chondrodermatitis nodularis helicis
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Cause of Chondrodermatitis nodularis helicis
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Mostly unknown
Maybe repeated pressure, trauma, cold temps |
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Treatment of Chondrodermatitis nodularis helicis (CCRASPS)
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Cryotherapy
Collagen injectionsRemove offending agent Topical abx if 2nd infection Topical/intralesional steroid Prosthesis Surgery |
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Portion of ear where most problems occur
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Middle ear
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3 layers of TM
1. (outermost) |
1. Migratory epithelium
2. Fibrous 3. Mucosal |
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Hallmark for health of TM
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Mobility
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Fluid in middle ear
Loss of bony landmark Distorted light, conical shape Loss of mobility |
Bulging TM
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Negative pressure in middle ear
Concave shape Accentuated bony landmark |
Retracted TM
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Deposition of hyaline material within the layers of the tympanic membrane
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Tympanosclerosis
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Tympanosclerosis:
-Signs on TM -usually follows: -Affect on hearing -Treatment |
-Chalky white patch, irregular borders
-Severe OM -usually no impairment -Not clinically signigicant |
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Ossicles transmit sound from _____ to ______
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TM to oval window
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_____ drains the middle ear fluid into the nasopharynx
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Eustachian tube
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-Angle of ET in kids
-Adults |
10 degrees
45 degrees |
