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57 Cards in this Set
- Front
- Back
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What is otitis externa?
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inflammation or infection of the epithelium of the auricle and ear canal.
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How do you administer ear drops?
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don't touch the ear, put patient in position that they can run down the ear canal and maintain the position for 2 minutes after administration
make sure the drops are room temperature sometimes an ear wick is used |
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What are the manifestations of cerumen impaction?
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hearing loss
otalgia (ear pain) tinnitus vertigo cough cardiac depression (vagal stimulation) |
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Where is the infection in acute otitis media?
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middle ear
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What is mastoiditis?
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it is when you get an ear infection and because the muous membrane is continuous, both the middle ear and the air cells of the mastoid bone can be involved
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What is otosclerosis?
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autosomal dominant disease
fixation of the footplate of the stapes in the oval window |
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What type of hearing loss is found in otosclerosis?
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conductive
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Is otosclerosis unilaterl or bilateral?
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bilateral
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What type of testing can you do for hearing loss in otosclerosis?
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Rinne and Weber test
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What is a normal Rinne test result?
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air conduction lasts longer than bone conduction. air conduction should be twice as long....so in Rinne, you put it on the mastoid bone and then up to the ear
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What is a normal Weber test?
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the sound is heard longer in the air than on the bone. so normal weber is you put tuning fork on head and then hold to ear....air is twice as long
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What is the deal with the Weber and Rinne test in regard to otosclerosis?
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because the bones of the ear are fixed, the conduction is not happening very well. So the patient will not hear the air twice as long as they should. they have a longer "conduction" on the bone than in the air, because the ear bones can't vibrate
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What are the three types of treatment for otosclerosis?
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hearing aid
surgery drug therapy |
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What types of drugs are used to treat otosclerosis?
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sodium fluoride
vitamin D calcium carbonate |
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What are the surgeries that are an option for otosclerosis?
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stapedectomy (partial removal of stapes) or fenestration (complete removal of stapes with implantation of an implant)
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Otosclerosis is considered the most common __________ ________ _______.
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conductive hearing loss
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When is the onset of otosclerosis?
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20 to 30 years old
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What CN is the hearing nerve?
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8
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If something is wrong with CN 8, what type of hearing loss is it?
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sensorineural
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What is Meniere's disease?
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overproduction or decreased reabsorption of endolymphatic fluid in the membraneous labryinth of the inner ear
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Meniere's disease affects both _________ and _________ function.
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vestibular and auditory
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What are the manifestations of meniere's disease?
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tinnitus
vertigo unilateral hearing loss |
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What is the difference between dizziness and vertigo?
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dizziness - no spinning
vertigo - room spinning |
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Describe the hearing loss in meniere's disease.
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Can be reversable, but eventually it wil cause permanent damage b/c of scar tissue
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What are some non pharmacological treatments for tinnitus?
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white noise
distraction relaxation |
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What is a non pharmacological treatment for vertigo?
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quiet dark room, decrease stimuli (get all your stuff done in there and get out of their room....)
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How do you diagnose meniere's disease?
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Caloric test
Rinne and Weber Glycerol test CT |
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What is the glycerol test?
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oral glycerol given and hearing is tested over 3 hours...hearing will improve if they have meniere's disease.
Positive glycerol=meniere's |
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What is the Caloric test?
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dx of meniere's disease
-putting cold or warm water in the ear and watching for nystagmus in the eyes. indicative of vestibular balance function |
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What are the diet and lifestyle changes to control meniere's disease?
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limit sodium/limit fluid
stop smoking bed rest and dark room/white noise |
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What are the medications used to treat Meniere's disease?
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sedatives (Valium)
anticholinergics (atropine) Vasodilators antihistamines (Bendaryl) |
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What are additional drugs other than valium, atropine and benadryl that the instructor mentions on her slide that can treat meniere's disease?
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Scopolamine patch (put behind ear)
diazapam or lorazepam (benzos, just like valium) |
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What are your interventions for post op ear surgery?
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HOB elevated, lay on unaffected side
assess for bleeding, drainage prevent n/v (administer antiemetics) no cough, sneeze, lifting greater than 5 lbs assess for vertigo (give patch) |
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Why would vertigo be a condition to assess for post any ear surgery?
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surgery will cause pressure on CN 8
This is because the CN 8 is both vestibular and auditory in function. If you put pressure on the nerve, it will cause vertigo. |
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What is an acoustic neuroma?
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benign tumor involving CN8
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With an acoustic neuroma, the _________ and ________ branches are affected.
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vestibular and cochlear
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What is the result of affecting the vestibular branch?
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loss of balance
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What is very important for an acoustic neuroma?
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early diagnosis to avoid compression of the facial nerves and arteries within the auditory canal (which would require more complicated surgery and increased risk of hearing loss and facial nerve function loss)
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Is the hearing loss with an acoustic neuroma unilateral or bilateral?
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Unilateral
(although it doesn't make any sense since the tumor is in a location prior to the nerve splitting to each ear..hmmmm) |
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What type of unilateral hearing loss is found with a acoustic neuroma?
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sensorineural (IT IS A NERVE!!!!)
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What is the progression of an acoustic neuroma?
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slowly progressive
patient may not even notice their own hearing loss...usually it is a spouse |
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Other than hearing loss, what are the early manifestations of an acoustic neuroma?
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unilateral tinnitus, nystagmus and smild intermittent vertigo
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What are the manifestations of a late stage acoustic neuroma?
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cranial nerves 5 and 7 become involved
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What is cranial nerve 7? How do you test for it?
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facial nerve (puff cheeks, smile, wrinkle forhead)
**can be affected in late stage acoustic neuroma |
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What is cranial nerve 5?
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trigeminal nerve - mastication
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Interesting to note that with conductive hearing loss, there is a _________ loss of hearing at _______ sound frequencies.
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EQUAL loss of hearing at ALL sound frequencies
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Loud noises do what type of hearing loss?
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sensorineural
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Sensorineural hearing loss is either from
a) or b) |
damaged inner ear
or nerve 8 damage |
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When someone has sensorineural hearing loss, it is most often ___lateral.
_______ frequency is lost, along with soft, discriminating consonants like ___, ___, and ___. |
Bilateral
loss of HIGH frequency soft discriminating consonants like s, f, ch |
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Other manifestations that might happen with sensorineural hearing loss include...
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tinnitus, vertigo and difficulty hearing in a loud room
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What type of hearing loss do "hearing aids" help?
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conductive
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What type of hearing loss do cochlear implants help?
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sensorineural
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Which clinical manifestations are indicative of otitis media?
a. pain on movement of tragus b. vertigo c. dry, flaky cerumen d. decreased hearing |
vertigo and decreased hearing
pain can be a problem too (wax doesn't play a role) |
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Remember that tinnitus can be an early sign of....
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ototoxicity
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When an ototoxic drug damages the hair cells in an ear, what type of hearing loss is this? Name some of the drugs that are known for ototoxicity.
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sensorineural
ASA Lasix aminoglycosides streptomycin vancomycin antimalarial drugs chemotherapy |
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Other than loud noises and drugs, what are some other causes of sensorineural hearing loss?
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rubella
viral infections meningitis trauma Meniere's disease aging |
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What does tympanometry test?
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the compliance and impedance of the middle ear to sound transmission
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