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39 Cards in this Set
- Front
- Back
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what is the first sign of otitis externa
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itching
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how is external otitis dx
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otoscopic exam
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what is the treatment for otitis externa
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local topical or systemic antibiotic
may need “wick” lie 3-5 minutes to allow med to enter canal Figure 66-5, p. 1735 mild analgesic warm compresses/heat earplugs to keep moisture out or cotton with petroleum no swimming till healed then use earplugs |
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how is excess cerumen tx
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ear irrigation
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when is irrigation contraindicated for excess cerumen
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if u suspect perforation
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what is the tx for foreign object in ear
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irrigation but figure out what it is first, it might swell
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what is the most common bacterial infection in children
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otitis media
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what is the treatment for otitis media
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antibiotics
surgery myringotomy myringoplasty tympanoplasty [graft] mastoidectomy |
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tumor that grows as a result of otitis media
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cholesteoma
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name some otitis media complications
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mastoiditis
if chronic, otosclerosis, necrosis facial paralysis TM necrosis meningitis brain abscesses |
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otalgia
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earache
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Inflammatory process resulting in erythema, edema, exudate, heat, pain
primary referred TMJ teeth throat |
otalgia
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what are some common causes of otalgia
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Otitis externa e.g., swimmer’s ear
Otitis media Serous otitis media Mastoiditis Cholesteatoma External ear trauma Foreign bodies Eustachian tube disorders pharyngeal [including tonsils] or laryngeal tumors referred pain e.g., from TMJ |
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what are some manifestations of otalgia
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tinnitus, popping, fullness
tragal, auricular, canal, middle, inner ear pain ache, throbbing, intense TM bulging, retracted, perforated red, grey, white drainage/exudate vertigo |
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what are some inner ear disorders
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- sensorineural hearing loss
- acoustic neuroma - Mineares disease |
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what is the most common inner ear disorder
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acoustic neuroma
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what 4 systems maintain balance and quilibrium
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- vestibular
- visual - proprioceptive (nerves and muscles) - cerebellar (coordination) |
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what are some balance disorders
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- spinning
- vertigo - dizziness - syncope |
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perception you or your surroundings are moving
results from imbalance of neural signals from vestibular system in ears “constant motion in space” 2nd most common reported sx in U.S. chronic pain is 1st |
vertigo
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- light headedness
- disorientation in space |
dizziness
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Benign Paroxysmal Positional Vertigo [BPPV]
Labyrinthitis AKA vestibular neuronitis Ménière’s Disease Cholesteatoma |
peripheral vestibular disorders
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after head trauma or viral infections of inner ear
due to cupulolithiasis presence of calcium crystals in semicircular canals normally deposited on small hair-like structures in the ear [otoliths] otoliths slow responses to head motion when dislodged, head movements create hypersensitive response |
benign paroxysmal positional vertigo
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provoked when neck hyperextended to one side
rotational vertigo rapid head tilt to affected ear nystagmus self-limiting; spontaneously resolves |
benign paroxysmal positional vertigo
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infection or inflammation of cochlear or vestibular portion
preceded by URI sudden onset of vertigo peaks 24-48 hours subsides 1-2 weeks n/v NO hearing changes tx = supportive |
labyrinthitis
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excess endolymph in vestibular & semicircular canals
episodic; comes & goes over years |
minieres
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what are s/s of minieres
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paroxysmal vertigo
staying still decreases vertigo n/v fluctuating hearing loss tinnitus aural fullness |
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what is treatment for minieres
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low sodium diet, diuretics, balance exercises
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what are some central and systemic disorders
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- Temporary Ischemic Attack [TIA]
Physiologic vertigo Presbyastasis Orthostatic hypotension |
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temporary loss of blood flow to brain
s/sxs vary depending on involved area dizziness, numbness, tingling, weakness, speech changes, momentary LOC tx aggressive to prevent stroke |
TIA
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preceded full blown stroke
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TIA
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motion sickness
perspiration, n/v, increased salivation, yawning, malaise |
physiologic vertigo
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disequilibrium of aging
due to decreased vision, proprioception, labyrinth function difficulty with stability predisposes people to falls & trauma |
presbyastasis
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dizziness & sudden drop in blood pressure due to position change, i.e. from supine to upright
lightedness & faintness [syncope] NOT vertigo |
orthostatic hypotension
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what are some ways of managing balancing disorders
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Suppress the CNS and vestibular system
Promote vestibular rehabilitation Surgical management [<5%] Endolymphatic sac surgery Labyrinthectomy Vestibular nerve resection |
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via antivertigo agents to allow recovery
also, antibiotics, steroids, diuretics, tranquilizers, vitamins low salt diet, decreased caffeine no smoking, ETOH maintain sleep/rest engage in physical activity, but be safe e.g., driving, climbing no swimming reduce stress newer, air wave pulse transmissions for Ménière’s |
cns and vestibular system suppression
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usually guided by PT
consists of exercises to promote stability & vestibular adaptation, habituation, & ADLs results in vertigo tolerance Epley maneuvers to return dislodged otoliths to more normal position with labyrinth |
vestibular rehab
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decrease fluid pressure within labyrinth
via shunts to CNS or mastoid cavity needs refinement |
endolymphatic sac surgery
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destroys labyrinth & eliminates its abnormal input
sacrifices hearing nonsurgical labyrinthectomy via ototoxic drug injection to destroy vestibular hair cells in order to decrease abnormal signals series of injections concurrent cochlear toxicity |
labaryndectomy
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highly effective, usually with immediate relief
done around labyrinth to save hearing if through it, hearing sacrificed retrolabyrinthine approach is most common |
vestibular nerve resection
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