Nura 201 - Ears / Hearing

Front 1

Presbycusis

Back 1

Bilateral sensorineural(root is in nerve, brain, or inner ear) hearing loss occuring over time.
Caused by destructive effects of environmental noise.

Front 2

Tinnitus

Back 2

Ringing in ears

Front 3

Meiniere's disease

Back 3

A disorder of the inner ear, effects hearing and balance. Characterized by episodes of vertigo, low-pitched tinnitus, and hearing loss.

Front 4

Audiometric Testing

Back 4

Screening tool, to determine type and degree of hearing loss. Patient signals when first sound is heard.
Variations in pitch and volume.

Front 5

Caloric Test

Back 5

Cold or warm water is instilled into external ear canal – should cause nystagmus (uncontrollable eye movements). Absence indicates disease of labyrinth. Contraindicated in perforated tympaic membrane.

Front 6

Tympanocentesis

Back 6

Aspiration of middle ear fluid to determine cause of middle ear infection. Cannot move, may drain afterwards for 2-3 days.

Front 7

Whisper Test

Back 7

Softly whisper 1-2 syllable words approx 1-2 feet from pt ear. Should hear approx 50% of time.

Front 8

Watch Test

Back 8

Ticking watch 6 inches from pt ear, ask to notify when they hear ticking.

Front 9

Rinne Test

Back 9

Place vibrating tuning fork against mastoid bone. Count seconds until they no longer hear. Then move still vibrating fork to auditory canal and time until no longer hear. Air conducted sound should be heard 2x longer.

Front 10

Weber Test

Back 10

Place vibrating tuning fork in middle of forehead, should hear equally in both ears.

Front 11

Conductive Hearing Loss

Back 11

Transmission of sound to the inner ear is interrupted

Front 12

Causes of Conductive Hearing Loss

Back 12

Impacted Cerumen, Foreign Body, Infection
Trauma to external canal, Perforation of TM
Sclerosis of bones, Tumor, Fluid in middle ear

Front 13

Sensorineural Hearing Loss

Back 13

Defect is in cochlear or acoustic branch of the eighth cranial nerve

Front 14

Causes of Sensorineural Hearing Loss

Back 14

Complications from infection (measles, mumps, meningitis), Ototoxic drugs, Trauma, neuromas, noise, aging process.

Front 15

Mixed Hearing Loss

Back 15

Both conductive and sensorineural

Front 16

Hearing Aids

Back 16

Amplifies Sound
Doesn’t always restore hearing
Pick up environmental noises as well as speech

Front 17

Cochlear Implant

Back 17

Surgically implanted microphone, amplifier, battery, & receiver. Used for profound deafness.

Front 18

Communication Tips With Hearing Impaired

Back 18

Get attn by means other than sound, face so they can see lips, speak slowly, clearly, don’t shout.
Use diff. words if not understanding.
Don’t smile, chew gum or cover mouth while talking.
Use body language, write when necessary.

Front 19

Frequency

Back 19

Number of sound waves per second, pitch.
Human ear can perceive 20-20,000 Hz
Speech range is 500-2000 Hz.

Front 20

Loudness / Intensity

Back 20

Pressure exerted by sound. Measured in decibels.

Front 21

Loud Noise Hearing Loss

Back 21

Should not be exposed to > 90 dB for >8 hours/day
Sudden loud noises can perforate TM, fracture ossicles

Front 22

External Otitis (Swimmer’s Ear)

Back 22

Infection of ear canal, usu bacterial. Pain, fever, generally ill, edema, drainage, monitor mastoid process for tenderness.

Front 23

External Otitis Tx

Back 23

Abx ear drops with bacterial, systemic abx w/ extensive soft tissue or mastoid process involvement.
Steroids added to drops with excessive edema
PO antifungal if fungus. Antipyretics, analgesics.

Front 24

Otitis Media

Back 24

Infection of middle ear, assc. with allergic rhinitis.
More common in smaller children.
Erythema, purulent effusion, decreased movement of tympanic membrane, fever.

Front 25

Otitis Media Tx

Back 25

Antibiotic therapy (high dose amoxicillin) PO, Ear drops w/ tubes. Antipyretics, analgesics. Myringotomy tubes with repeated infections. Parents should not smoke.

Front 26

Myringotomy Tubes

Back 26

Outpatient surgery, used to drain fluid from middle ear to prevent otitis media.

Front 27

Care for Myringotomy Tubes

Back 27

Drink plenty of liquids, regular diet as tolerated.
Analgesics, ear drops as prescribed.
Quiet activities for several days, use ear plugs when in water. Fall out on own in about a year. Report purulent drainage.

Front 28

Motion Sickness

Back 28

Disturbance of equilibrium caused by constant motion that causes vestibular overstimulation.

Front 29

Motion Sickness S/S, Tx

Back 29

Sweating, pallor, N/V.
Antihistamines for vertigo (Dramamine)
Cholinergics (scopolamine patches)

Front 30

Meiner's Disease

Back 30

Episodic incapacitating vertigo, Tinnitus
Fluctuating sensorineural hearing loss.
Etiology unclear, more common in adults 20-50.

Front 31

Meiner's Disease Mgmt

Back 31

Low sodium diet, avoid caffeine and nicotine (vasoactive), avoid ETOH (can precipitate attack)
Antihistamines (Meclizine/Antivert) to suppress vestibular system.

Front 32

Labyrinthitis

Back 32

Infection of inner ear, bacterial or viral.
Incapaciting vertigo, N/V, tinnitis, decreased hearing aids.

Front 33

Presbycusis

Back 33

Progressive hearing loss associated with age
25% by age 65-74 years
50% by age 75+

Front 34

Presbycusis Diag / S/S

Back 34

First, rule out other causes
Symptoms include tinnitus, decreased ability to hear with background noise

Front 35

Prebycusis Risk Factors

Back 35

Cause unknown. Risk factors can include Exposure to loud noise, Meds (aminoglycosides, ASA), Psychogenic processes, Disease processes (diabetes).