Phys Dx Exam Iii

Front 1

Two types of hearing loss

Back 1

Conductive and Sensorineural

Front 2

Pathologics for Conductive HL

Back 2

External and Middle Ear

Front 3

Pathologics for Sensorineural HL

Back 3

Cochlea/Cochlea N. and Brain Stem

Front 4

(HL) Loudness of Speech
Conductive vs. Sensorineural

Back 4

Conductive = Softer
Sensorineural = Louder

Front 5

(HL) Impaired
Conductive vs. Sensorineural

Back 5

C = Air conduction
S = Air and Bone conduction

Front 6

(HL) Rinne
Conductive vs. Sensorineural

Back 6

C = Negative
S = Positive

Front 7

(HL) Weber
Conductive vs. Sensorineural

Back 7

C = Heard on "deaf side"
S = Heard on better side

Front 8

Congenital deafness accounts for ____ of all deafness in ______.

Back 8

50%
Children

Front 9

Formation of new bone in the labyrinth, and causes fixation of stapes to ______ window.
Also found in what type of HL?

Back 9

Otosclerosis
Oval
Conductive

Front 10

With the exception of _______, conductive HL alters appearance of ______?

Back 10

Otosclerosis
Tympanic Membrane

Front 11

Causes of Vertigo and frequently assoc w/ ?

Back 11

Assoc with a loss of vestibular fxn (unsteady gate)
Results from: (IMNOP)
Iatrogenic
Menier's ds: causes severe paroxysmal vertigo from labyrinthine lesions
Neurologic
Otologic
Psychological

Front 12

Clinical triad for Meniere's Syndrome

Back 12

Vertigo w/ vomiting
Tinnitus
HL

Front 13

What is Otalgia?
What are the Localized causes?

Back 13

Ear Pain
Otitis Externa (Swimmers ear)
Otitis Media

Front 14

What is Otalgia?
What are the Referred causes?

Back 14

Ear Pain
Teeth, TMJ, cervicals (C2-3), pharynx (mucosal swelling)
Inflammation, trauma, or neoplasm anywhere along C.N. V, VII, IX, X
-Present in ipsilateral ear and is referred

Front 15

What is tinnitus and what might cause it?

Back 15

The sensation of hearing sound, such as buzzing or ringing, in the absence of environmental input.
It is assoc w/ a conductive or sensorineural hearing loss

Front 16

What are causes for nodules in and around the ear?

Back 16

Tophi (from gout) on helix or antihelix
Carcinoma & hematomas
Scar tissue from trauma (piercing)

Front 17

Differences between examining the inner ear of a child vs. an adult

Back 17

Access the external auditory canal, tympanic membrane, malleus
Adults = pull Posterior and Superior
Child = pull Posterior and Inferior

Front 18

Features of the normal tympanic membrane

Back 18

Intact, ovoid, semitransparent, pearly gray membrane
-Ds will be yellow or red
"Light reflex" should be AnterioInferior of pars tensa
Long process of the incus is usually posterior to the malleus

Front 19

How is patency of the Eustachian tube determined?

Back 19

Obstructed eustacian tube moves inward = Retract
Fluid in the middle ear will have decreased or absence of movt = Bulging

Front 20

S/S for Acute Otitis Externa

Back 20

-Swimmers ear
-Painful when pulling on tragus and auricle
-Inflammation of external canal but NORMAL tympanic membrane
-Yellowish-green discharge

Front 21

S/S for Acute Otitis Media (aka Baterial)

Back 21

-Primary in children
-No pain when pulling on auricle and tragus
-Tympanic membrane is fiery red and BULGING outward

Front 22

S/S for Secretory Otitis Media

Back 22

-Primary in ADULTS
-Air becomes trapped w/in middle ear (air bubble); tympanic membrane will RETRACT
-Amber color

Front 23

Weber Test

Back 23

Compares BONE conduction in BOTH ears
(512 MHz)

Front 24

Rinne Test

Back 24

Compares AIR and BONE conduction separately
(512 MHz)

Front 25

Rinne Positive test

Back 25

AC > BC (Normal or Sensorineural los)

Front 26

Rinne Negative test

Back 26

BC > AC (Conduction HL)

Front 27

What is a false negative Rinne test?

Back 27

Total deafness
Pt. will hear fork on mastoid of deaf ear b/c it transmits vibrations across the skull to the healthy ear

Front 28

How would a perforation look with an otoscopic exam?

Back 28

Perforations may be central or marginal. Present as a hole and name described where the perforation is. A central does not involve the margin of the tympanic membrane.
Marginal is more severe.

Front 29

Nasal conditions usually occur ______?

Back 29

Middle meatus

Front 30

Nasal:
Thin watery discharge

Back 30

Viral or Allergic rxn

Front 31

Nasal:
Thick purulent

Back 31

Bacterial infection

Front 32

Nasal:
Bloody

Back 32

Neoplasm, trauma, fungal infxn

Front 33

Nasal:
Foul Smelling

Back 33

Foreign object, chronic sinusitis, malignant ds

Front 34

Nasal:
Clear watery discharge increases w/ coughing or bending head forward

Back 34

CSF

Front 35

What is the difference between the Nasal and Sinus Exam?

Back 35

Nasal:
Inspection, Palpation, Olfactory, Internal Exam

Sinus: Inspection, Palpation, Percussion, Transillumination

Front 36

How are turbinates clinically different from a polyp?

Back 36

Polyp:
-Most common cause of anosmia
-Pale, Translucent, and moveable
-Round, Darker pink, Smooth, and on the Medial Meatus

Turbinate:
-Round, light pink, and ridged

Front 37

Difference between acute rhinitis and allergic rhinitis

Back 37

Acute Rhinitis is non-seasonal and due to stress, nasal spray abuse, prego, hypothyroidism

Allergic Rhinitis is seasonal and non-seasonal congestion due to allergens
Seasonal:
Spring = weeds, pollen, trees
Fall = weeds and pollen
Summer = grass

Non-seasonal:
-Animal dander
-Dust
-Mold

Front 38

How are the Ethmoid and Sphenoid sinuses evaluated?

Back 38

XRAY

Front 39

What do you palpate and percuss, and transillumination of maxillary is lateral to nose below medial aspec of eye

Back 39

Frontal and Maxillary sinuses

Front 40

What meatus do the sinuses drain into?
Nasal lacrimal duct
Anterior ethmoid
Posterior ethmoid

Back 40

-Nasal lacrimal duct drains into the inferior meatus
-Anterior ethmoid drains into the middle meatus
-Posterior ethmoid drains into the superior meatus