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53 Cards in this Set
- Front
- Back
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What are some things to look for when doing an ear exam?
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Ear drum (color, position, bulging, retraction, lesions), Middle ear, Cone of Light reflex (points toward the chin)
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What is contained in the middle ear?
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Tympanic membrane to the vestibular apparatus: Malleus (hammer), Incus (anvil), Stapes (stirup)
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What is contained in the inner ear?
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From the cocjlea to the vestibular apparatus
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What is the function of the ear?
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Hearing and Balance
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What is the function of the Stapedius muscle?
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it acts like a damper on the stapes to decrease steady nose (it doesn't work for sudden noise)
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What is cauliflower ear?
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A healed hematoma from trauma, seen in boxers and wrestlers
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What are some painful nodules of the ear?
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Trauma, hematoma, skin lesions that would hurt even if it were in a different spot, neoplasm
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What are some painless nodules of the ear?
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Gouty tophi, Rheumatoid nodules, Leprosy (acid-fast mycobacterium), Basal cell carcinoma (slow growing), squamous cell carcinoma (fast growing), TB
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What is cerumen?
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Ear wax, Increase = Conduction deafness, Tinnitus, Vertigo (dizziness), Accumulation can cause coughing in children
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What is exostosis of the ear?
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Bony nodules of the external ear, clinically insignificant unless blocking canal, common in surfers (cold water)
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What is chondroma of the ear?
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Cartilage nodules of the external ear
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What is otorrhea?
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Discharge of yellow, melting earwax, blood (trauma), pus (infection) or CSF (skull fracture)
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What are foreign bodies of the ear?
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Bugs, beans, BB's etc. anything that kids could possibly fit in the ear
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What are polyps?
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Foul, purulent, discharge (the ear stinks), there is fungus and mildew as well
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What can go wrong with the eustacian tube?
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clogging gives intermittent pain, ear feels full or "stopped up" and results in a hearing deficit, infected eustacian tube happens more often in children (immune system, layout, physicality) because the tube is oriented in a more horizontal (shorter and straigher) fashion than in adults (longer and at a 45 degree angle = long uphill climb for bact)
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What is the difference between acute otitis media, acute suppurative otitis media, and serous otitis media?
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Acute suppurative otitis media - throbbing, severe earache, fever, dec hearing due to pus, bulging eardrum (red and inflammed), mastoid pain (late stage), eardrum can burst to relieve pressure,
Serous otitis media - fever is minimal or non-existent, amber beer liike fluid is seen behind the TM, membrane may be normal or retracted, doesn't hurt as bad as suppurative |
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What are some tests you can perform to differentiate between otitis media and otitis externa?
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Otitis externa - pain when tug on pinna of the ear,
Otitis media - no pain when tug on pinna of the ear |
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What is acute otitis externa?
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Swimmers ear, fungus or bacterial growthh, pain is milder
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What is mastoiditis?
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Occurs when there is a spread from another area (ex middle ear infection), pain with thumb pressure on mastoid
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What effect does trauma have on hearing?
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decreased hearing and tinnitus in the ears, no vertigo from head traumas, concussion, load noises,
May be dizzy with physical trauma |
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What is Meniere's disease?
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Tinnitus, decreased hearing, and Vertigo, usually unilateral and self-limiting
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What is chronic otitis media?
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pain not as bad as otitis externa, perforated TM
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What is acute toxic labyrinthitis?
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inflammation of the labyrinth, usually viral, takes 6-8 weeks to run its course, can be very disabling, there is no hearing loss of tinnitus but there is a severe decrease in BALANCE
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What happens with a CN VIII lesion?
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Dizziness, Nystagmus, Decreased hearing
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How do you differentiate between neurologic and GI vomitting?
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Neurologic = Projectile, GI has associated history of a preceding period of nausea and non-projectile EMESIS
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Explain the Weber test
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Tuning fork on top of head, Normal is NEGATIVE and it is when the sound is heard equally in both ears, Conduction deafness is sound heard in bad ear (Postivie Weber test), this can be due to stiff ossibles, stiff eardrum, sclerotic ear, or an increase in wax
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Explain the Rinne test
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Tuning fork on Mastoid and then in front of the EAM, Normal is POSITIVE when air conduction lasts twice as long as bone conduction, Conduction deafness = can hear bone conduction but not air conduction 2x, Sensorineural deafness - can hear nothing, Partially deaf nerve = the normal ratio of 2:1 holds but there is a decrease in the total time in the bad ear (should be same amount for both ears)
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What are some functions of the nose?
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Warms and moistens air, helps with eating by letting one breathe while one chews,
In summary: smell, humidification, and it separates the mouth from the airway |
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What are some anatomical parts of the nose?
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Bridge = part between the eyes, Ala Nasi = wings, Columnella = under, Naris = holes, Septum, Superior/middle/inferior conchae (turbinates) - superior not visible
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What is a cleft nose/palate/hare lip?
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genetic problem
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What are some INDICATIVE conditions of the nose?
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I = Infection = rhinitis (red mucosa with a thic discharge),
N = Neoplasm = polyp, D = Degenerative, I = Iatrogenic = surgery, drugs, C = Congenital = Cleft nose, A = Allergies = allergic rhinitis (pale mucosa with a watery discharge), T = Trauma == epistaxis, I = Intoxications = chlorine, V = Vascular = epistaxis E = Endocrine |
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What is a Saddle nose?
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A decreae in cartilage due to (congenital) syphilis or eaten out due to a hematoma
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What is a nasal septum abscess?
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can lead to brain abscess (via cavernous sinus)
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What is Coryza?
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Head cold, vs Allergy, Both: sneezing, tearing, clear rhinorrhea, but a cold has a fever and redder mucosa and an allergy has headache and paler mucosa
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What is acute rhinitis?
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fever, sneezing, malaise, if it reached the sinus one can have a mucopurulent pink exudate
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What is associated with allergic rhinitis?
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itching eyes
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What is vasomotor rhinitis?
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due to nervous innervation, which results in a chronic stuffy nose, can get stuffy during sex
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What explains a unilateral nasal discharge?
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not a cold or allergy, one side can be more free and open, can be position dependent, the top one is more open due to blood drainage with gravity
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What happens with the chronic use of nosedrops?
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rhinitis mendicamentosa, habit forming, nose becomes decreased in sensitivity with the increae in use, leads to more use of nosedrops, nasal spray can keep germs and colds around, increased use leads to tight plugging when withdrawal occurs
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What is CSF discharge from the nose?
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due to head trauma, tests positive for glucose
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What x-ray view should you take for sinus pain?
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Water's view, this will show any fluid that is in the sinus or demonstrate the presence of any tumors
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What is chronic sinusitis?
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when a nose is blown the discharge should be clear or white (normal), green or brown is abnormal
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What effect can antibiotics have on infections?
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they kill the bacteria located in the periphery of the sinus, the germs that are left living in the cavity will multiply, this can take place in otitis media in children, sinus infections, prostate infections, and in epididymal infections of the testes
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What are three intranasal masses?
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Cancer - destroys the mucosa making it look like hamburger,
Polyp - encapsulated and smooth, can be sessile or pedunculated, Mucoceal - squishy cyst within a capsule (aka Ranula) |
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What do you look for on inspection and palpation of the mouth?
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Teeth (number, shape, plaque),
Gums (retractions, pyorrhea, inflammation, bleeding), Breath (odor) Tongue (size, deviation, protrusion, coating, uvula, tumors), Tonsils (size, ulcers, abcess), Masses, Dysphagia (difficulty swallowing), Odynophagia (painful swallowing) |
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Who to refer to when teeth problems
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Orthodontist - crooked teeth,
Dentist - drills, fills, bridges, and crowns, Oral surgeon - surgery, implants, Periodontist - gums, Endodontist - root canals |
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Type of Bad breath
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Acetone = Ketone,
Ammonia = failing kidneys or liver, Fetor hepaticus = liver disease hepaticus mildew, Fetor oris/halitosis - bad breath from spoiled food |
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Abnormalities of Tongue
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Increased size - Down's, hypothyroidism, amyloidosis,
Deviation - toward the CN XII lesion, Restricted protrusion - frenulum, Whitish coating - candida albicans (diabetes mellitus), Abnormalities on the under surface - Leukoplakia (precancerous), Uvula - away from CN X lesion, Masses - cancers |
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Abnormalities of Tonsils
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Hyperplasia,
Ulcers - craters with pus (White pus = Staph albicans or candida, Yellow pus = Staph aureus), Abscess around the tonsil (pushes tonsil out) = peritonsillar abscess (aka Quinsy throat) |
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What are 6 conditions of the oral cavity?
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Labial deformity, Labial vesicles, Inflamed labial corners, Labial ulcers, Labial scarring/scaling, Labial pigmentation
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Labial deformities
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Cleft lip = incomplete fusion of the frontal nasal process with maxillary processed, accompanied by a cleft palata = midline opening in the hard palate due to failure of fusion of the maxillary processes
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Labial vessicles
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Herpes simplex = clear fluid surrounded by erythema, this is viral and the lesions are called "cold sores" or "fever blisters",
Carbuncle = painful localized swellings with erythema, these can drain into the cavernous sinus and thrombus |
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Inflammed labial corners
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Cheilosis = "active crows feet", "angular stomatitis", ulcerations at the corners of the mouth, crusting and fissuring, riboflavin deficiency or ill-fitting dentures are a cause
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