Eent Exam 1

Front 1

Define glue ear.

Back 1

The end stage of the slow, continuous development of increased viscosity of ME effusion seen in chronic OME.

Front 2

Define otitis externa.

Back 2

"Swimmer's ear", an inflammation of the external auditory meatus (EAM) when caused by repetitive, prolonged exposure of the EAM to water leading to maceration and secondary infection.

Front 3

List extracranial complications of otitis media.

Back 3

Acute mastoiditis.
Facial palsy.
Labyrinthitis.

Front 4

Explain the process and symptoms of Acute Mastoiditis (a possible complication of otitis media).

Back 4

Bacteria spreads from the middle ear to mastoid air cells.
May be caused by a cholesteatoma.
Localized inflammation, severe pain of mastoid process.

Front 5

Define Facial Palsy (a possible complication of otitis media).

Back 5

Transient, peripheral CN VII paresis.

Front 6

List the symptoms associated with Labyrinthitis (a possible compllication of otitis media).

Back 6

Light-headedness, loss of balance, nausea/vomitting.
Conductive hearing loss.
Risk for permanent hearing loss.

Front 7

Besides otitis media, what are some other causes of a red (erythematous) tympanic membrane?

Back 7

Crying.
Removal of cerumen w/irritation of auditory canal.
Fever.

Front 8

Is the combination of fever, earache, crying, and irritability exclusively correlated with otitis media?

Back 8

NO, fever and ear pain are only present in 1/2 of cases.

Front 9

Of the three listed, which two features of the tympanic membrane do most strongly suggest otitis media: color, position, or mobility?

Back 9

Position - AOM=bulging, OM w/effusion=neutral or retracted
Mobility.

Front 10

Why is redness of the TM less reliable when diagnosing OM than position and mobility?

Back 10

Kids often cry during examinations leading to redness.

Front 11

What do the letters OME stand for?

Back 11

Otitis Media w/Effusion.

Front 12

What do the letters AOM stand for?

Back 12

Acute Otitis Media.

Front 13

What is another name for serous OM?

Back 13

OME.

Front 14

When is the eardrum retracted, in OME or AOM?

Back 14

OME.

Front 15

When is the eardrum bulging, in OME or AOM?

Back 15

AOM.

Front 16

What condition causes aural fullness, ear popping, and loss of hearing - OME or AOM?

Back 16

OME

Front 17

What condition causes intense earache, fever and screaming (children) - OME or AOM?

Back 17

AOM

Front 18

What is the medical name for earwax?

Back 18

Cerumen.

Front 19

List 2 causes of perforation of the eardrum.

Back 19

AOM (Purulent middle ear infection) - more common in children.
Traumatic perforation (central or marginal) - more common in adults.

Front 20

What are the indication criteria for insertion of ear tubes?

Back 20

Children w/chronic or recurrent OM.

Front 21

What are the major goals of insertion of ear tubes?

Back 21

Prevention of chronic conductive hearing loss.
Prevention of delayed language/cognitive development.
Prevention of dangerous complications such as cholesteatoma and chronic purulent OM.

Front 22

The hearing and vestibular organs are housed in what bone of the skull?

Back 22

Temporal.

Front 23

What bone of the skull contains the mastoid air cells?

Back 23

Temporal.

Front 24

List the structures, muscles, and nerves found in the middle ear.

Back 24

Ossicles (malleus, incus, stapes), stapedius and tensor tympani, chorda tympani nerve.

Front 25

Why can a middle ear lesion affect the facial nerve?

Back 25

The facial nerve runs very close to the middle ear through a bony canal.

Front 26

What role do the tensor tympani and stapedius muscles play?

Back 26

They dampen middle ear mechanics - (protective role, gain-control mechanism, reduce self-generated noise like chewing).

Front 27

Which structure provides aeration of the middle ear?

Back 27

Eustachian tube.

Front 28

The middle ear is continuous with the mastoid air cells and the nasopharynx through these 2 structures.

Back 28

The mastoid air cells via the antrum.
The nasopharynx via the eustachian tube.

Front 29

What are the 3 main indication criteria for insertion of tympanostomy tubes?

Back 29

1. Bilateral otitis media
2. Chronic otitis media (>3 months)
3. >30dB hearing loss
others: not responding to conservative treatment, learning disability, AOM w/barotrauma, craniofacial anomalies (e.g. cleft palate, Down's).

Front 30

What is the most common operation that children undergo?

Back 30

Bilateral myringotomy with insertion of tympanostomy tubes.

Front 31

What do the letters ETD stand for?

Back 31

Eustachian Tube Dysfunction.

Front 32

What causes most cases of ETD in children?

Back 32

Viral URTI.

Front 33

What is the most common complication of AOM?

Back 33

TM perforation
(chronic OME also common)

Front 34

What are the immediate consequences of ETD?

Back 34

Defective middle ear ventilation (absorption of middle ear air, retraction of the TM AND impaired or total cessation of TM mobility).
Defective middle-ear drainage (accumulation of clear, thin, and sterile effusion).

Front 35

What are the risks of prolonged effusion associated with ETD?

Back 35

Secondary bacterial infection (AOM).
"Glue ear" (late, chronic OME).

Front 36

Which structure of the inner ear (semicircular canals, cochlea, or the vestibule) is a sensorineural receptor organ, converting an acoustic waveform into a electrochemical stimulus that can be transmitted to the CNS?

Back 36

Cochlea.

Front 37

What is the most common cause of conductive hearing loss in children?

Back 37

OME.

Front 38

List the sensory nerve supply to the ear.

Back 38

Posterior roots of spinal nerves C2 and C3,
CN V, VII, IX, X

Front 39

What are the nerve supplies of the tensor tympani and stapedius?

Back 39

Tensor tympani - CN V
Stapedius - CN VII

Front 40

What is the medical term for middle ear inflammation, and what if it presents with a bulging tympanic membrane due to bacterial infection?

Back 40

Otitis media.
Acute otitis media.

Front 41

What is the most common pathogen involved in AOM?

Back 41

S. pneumoniae

Front 42

What type of tissue lines the surface of the external auditory meatus?

Back 42

Stratified squamous keratinized epithelium.

Front 43

Which does AOM typically present with - retracted ear drum, bilateral hearing loss, dysphagia, or otalgia?

Back 43

Otalgia.

Front 44

Which is associated with adult OME - viral URTI, tumor in nasopharynx, AOM, or sensorineural hearing loss?

Back 44

Tumor in nasopharynx.

Front 45

Does a patient with vertigo feel "dizzy", "unsteady", "light-headed", or like they're "moving"?

Back 45

Feel like they're "moving".

Front 46

What does a bilateral positive Rinne most likely indicate in asymptomatic adults?

Back 46

Bilateral normal hearing.

Front 47

True or False
OME is typically caused by S. pneumoniae.

Back 47

False
No infectious agent is directly responsible.
(AOM is caused by S. pneumoniae or other pathogens)

Front 48

What is the most common cause of referred otalgia in adults?

Back 48

DJD of the spine (C2 and C3 spinal nerves).

Front 49

What nerves are responsible for referred pain from the cervical spine to the ear?

Back 49

C2 and C3 spinal nerves.