Term
HOW DO WE HEAR?
Auricle/pinna collects ________.
Vibrations travel through ____ to _____.
TM is stimulated by ______.
Vibrations, in turn, pass though the ____ chain (____,_____,_____) to the oval window.
Movement of the stapes footplate create ____ wave in the _____. |
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Definition
HOW DO WE HEAR?
Auricle/pinna collects sound vibrations..
Vibrations travel through EAC to TM.
TM is stimulated by sound vibrations.
Vibrations, in turn, pass though the ossicular chain (malleus, incus, stapes) to the oval window.
Movement of the stapes footplate create pressure wave in the cochlea.
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Term
To conduct hearing:
How are vibrations picked up? |
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Definition
| by tiny endings called hair cells |
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Term
Hair cells stimulate _____ branch of cranial nerve _.
This nerve then carries the signal to the auditory center of the brain for interpretation. |
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Definition
Hair cells stimulate cochlear branch of cranial nerve VIII.
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Term
| What are three types of hearing loss? |
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Definition
Conductive Hearing Loss
Sensorineural hearing loss
Mixed hearing loss |
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Term
| What are three areas of the ear that can cause conductive hearing loss? |
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Definition
External auditory canal
tympanic membrane
middle ear (ossicles and air) |
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Term
| What two parts of the ear can cause sensorineural hearing loss? |
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Definition
cochlea
central auditory pathway |
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Term
What type of audiometry determines the type, degree, and configuration of hearing loss?
It assesses peripheral and central auditory systems. |
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Definition
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Term
| What type of audiometry assesses sensitivity when the signal is transmitted through the outer, middle and inner ear and then to the brain? |
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Definition
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Term
| What type of audiometry asses sensitivity when signal is transmitted through the bones of the skull to the cochlea and then to the brain? |
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Definition
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Term
Name the term:
impedence test to determine the status of TN and middle ear. |
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Definition
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Term
"Tymp types"
Type A: ______
Type As: ______
Type Ad: _______
Type B: ____
Type C: ______ |
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Definition
Type A: normal
Type As: shallow (stiff TM)
Type Ad: deep (hypermobile TM)
Type B: flat (effusion vs perforation)
Type C: negative pressure (TM retracted)
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Term
| What drugs can cause hearing loss/ototoxicity? |
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Definition
| aminoglycosides, chemo, furosemide |
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Term
During a Weber test, the ringing will lateralize toward ___ and AWAY from ___
Rinne: what is normal? |
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Definition
Weber: lateralizes towards conducting hearing loss, AWAY from sensorineural hearing loss
Rinne: normal (positive) AC>BC if BC>AC (negative)= CHL |
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Term
What are causes of CHL?
Canal (6)
TM (4)
Middle ear (7) |
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Definition
Canal: obstruction (ie. cerumen), FB, cysts, exostoses, canal cholesteotoma
TM: perforation, retraction, tympanosclerosis, tubes
Middle ear: effusion, ossicular chain disruption, otosclerosis, glomus tumor, cholesteatoma, midface deformity, prior ear surgery |
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Term
| What is the most common cause of pediatric CHL? |
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Definition
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Term
Chronic Otitis Media
What is the patho?
What can contribute to recurrent OME?(3) |
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Definition
Patho: inflammation in the middle ear with the buildup of fluid +/- infection
Cause: adenoid hypertrophy, URI, allergic rhinitis |
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Term
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Definition
ABx (staph, strep, h flu, m cat)
Decogestants/Antihistamines
Nasal steroid spray
Tubes>5-6 episodes per year or persistent effusion with HL, speech delay
Adenoidectomy |
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Term
| What are causes of sensorineural hearing loss? |
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Definition
Presbycusis: vascular "old age"
sudden hearing loss- viral, vascular, autoimmune, trauma
noise induced: sudden vs cumulative
tumor: acoustic neuroma (CN VIII)
Meniere's disease: episodic, quadrad of sx
congental- genetic, prenatal exposure (rubella, CMV, HSV, maternal DM, anoxia)
ototoxicity
Other: herpes, mumps, TB, syphillis |
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Term
Ototoxicity can affect ____ and/or _____.
It often starts with what symptom? |
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Definition
can affect hearing and/or balance
Starts with tinnitus |
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Term
| What are medications that can cause ototoxicity? |
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Definition
gentamicin
streptomycin
Neomycin
polymixin B
Tobramycin
Erythromycin/azithromysin
Cisplatin
Furosemide
Bumetanide |
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Term
| What is the second most common cause of sensorineural hearing loss (after presbycusis)? |
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Definition
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Term
Common noises:
gunshot
jet takeoff
concert, chain saw
train, stero headphones
motorcycle, lawnmower
OSHA level
Conversation
Whisper |
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Definition
gunshot: 140 to 170 dB
jet takeoff: 140 dB
concert, chain saw: 110 to 120 dB
train, stero headphones: 110 to 120 dB
motorcycle, lawnmower: 90dB
OSHA level: 85 dB
Conversation: 60 dB
Whisper: 30 dB
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Term
What are the triad/quadrad of episodic attacks assoc with Meniere's disease?
What brings it on? |
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Definition
vertigo, SNHL, tinnitus, aural pressure
Brought on by increased fluid pressure in the inner ear, unilateral (10% can develop bilateral disease) |
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Term
| What is the treatment for Meniere's disease? |
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Definition
medical: diuretic to reduce fluid pressure
suppress the vestibular system with meclixine or valium or scopalamine
Intratympanic injections of Gentamicin- destroy vestibular function in affected ear
Surgery: less common
-Vestibular nerve section
-Labyrinthectomy |
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Term
What do you use for cerumen removal?
What two things do you NEVER do? |
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Definition
loops, curettes, lavage
never loop or curette blindly
never lavage an ear with known or suspected perforation or in apatient with hx of mastoidectomy, or extensive ear surgery
consider softeners first
lavage with warm water only |
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Term
| When someone has hearing loss, what do you use for amplification? |
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Definition
hearing aid
-digital
-programmable
-filters, directional microphones
-"open fit" style
-bone anchored (BAHA)
-Important to aid children early! |
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Term
What is used to stimulate the acoustic nerve directly, replacing function of lost hair cells?
What type of rehab is needed? |
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Definition
Cochlear implant
Rehab: aural and speech therapy
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Term
| What are obstacles (4) and benefits (4) of using amplification? |
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Definition
Obstacles: $$, pride, access, "buyer beware"
benefits: quality of life, education/learning, maintain independence, employment |
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Term
VERTIGO
sx of ___ movement
is only one type of dizziness
Important to differentiate from other forms such as ___ and ___
What are causes? |
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Definition
sx of illusory movement
is only one type of dizziness
Important to differentiate from other forms such as lightheadedness and dysequilibrium/unsteadiness
What are causes?
peripheral (ear) or central (brain)
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Term
| What are two parts of the vestibular system? |
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Definition
3 semicircular canals
2 otolith organs
separate system in each ear
stimulated by movement
info transmitted to brain stem
functions with input signal from eyes and spinal cord to maintain balance |
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Term
What are common causes of vertigo?
(8) |
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Definition
BPPV: typically brief (<1 min) episodes brought on by predictable head movement
Vestibular neuronitis- believed to be a viral or inflammatory disorder, often 1 to 2 weeks after URI, usually lasts 1 to 2 weeks, self limited
labyrinthitis- sudden onset, unilateral hearing loss, self limited, weeks
Acoustic neuroma
Meniere's disease
Labyrinthine concussion- post trauma, often BPPV after
Perilymphatic fistula- post trauma, barotrauma, sx provoked by pressure change or loud noise
Central: migraine, TIA, hemmorrhage, MS, tumor |
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Term
| What types of "things" can you do to evaluate pt with vertigo? |
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Definition
ear exam: r/o effusion, perforation
audiogram= r/o asymmetric SNHL (MRI with Gadolinium)
Cranial nerves, Romberg, Tandem gait, Dix-Hal-pike, nystagmus
Blood pressures: r/o orthostatic hypotension
ENG/VNG
Neuro referral |
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Term
| what is the treatment for vertigo? |
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Definition
often self-limited
Medications may be helpful- meclizine, diazepam
BPPV- vestibular rehab, Epley maneuver
Meniere's- diuretics, injections, surgery
Acoustic neuroma- surgery, gamma knife
Concussion/ototoxcitiy- vestibular rehab
Fistula- rest/surgery |
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Term
Sinusitis
What is acute vs chronic? (time frame) |
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Definition
acute- <4 weeks
chronic >4 weeks |
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Term
What is the cycle of chronic sinusitis? (4)
What is the tx? |
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Definition
inflammation, swelling, obstruction, infection
Tx: abx for 3-4 weeks
nasal steroid sprays for months
mucolytics
saline spray vs irrigation
Imaging (after tx)
non contrast CT =axial and coronal views
no plain films or MRI |
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Term
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Definition
indicated for positive CT scan with persisten sx despite approp tx
goal of surgery: maximize function
scar tissue from srugery can compromise mucus flow
septoplasty/turbinate reduction can improve airflow and drainage |
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Term
| What's treatment for allergic/non-allergic rhinitis? |
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Definition
primarily nasal sx
+/- facial pain
Tx: nasal steroid sprays, antihistamines
allergy testing
polyps1 |
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Term
Aging:
Process of growing old regardless of chronological age. Post-maturation starts after __ years
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Definition
| Process of growing old regardless of chronological age. Post-maturation starts after 30 years |
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Term
| Define senescence and senility. |
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Definition
Senescence: Combination of deleterious effects leading to deterioration of functioning & increased probability of death that occurs with advancing age
Senility: Physical & mental deterioration associated with aging
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Term
Define the following terms.
Longevity:
Mean Longevity:
Maximum Longevity:
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Definition
Longevity: Life span. Duration of life
Mean Longevity: Average longevity of a population. Life expectancy (U.S. CDC-79.9 2004: WHO- 77.5 2005, Male 75, Female 80)
Maximum Longevity: Age at death of the longest living member of a population. Approximately 120 years (122)
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Term
Define the following:
Gerontology:
Geriatrics:
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Definition
Gerontology: Scientific study of all aspects of aging (biological, medical, psychological, social, legal, anthropological etc.)
Geriatrics: Medical specialty concerned with the care of older adults. Usually a fellowship done after Internal Medicine or Family Practice residency
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Term
What age group is classified as:
Young-Old:
Mid-Old:
Old-Old:
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Definition
Young-Old: 65-74
Mid-Old: 75-84
Old-Old: 85 or >*
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Term
| What are 3 causes of increased life expectancy? |
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Definition
Medical advances
Public health advances
Lifestyle changes
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Term
| Name 7 cellular system changes that occur when aging. |
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Definition
Altered membrane transport (drugs, fluids, electrolytes)
DNA damage
Chromatin condensation
↓ RNA synthesis
Cytoplasmic lipofuscin
↓ number of mitochondria in post-mitotic cells
↓ efficiency of lysosomes
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Term
Name 3 System Changes:
Body Composition & Structure
Related to aging
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Definition
↓ lean body mass
↓ fat (altered pharmacokinetics)
↓ height
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Term
What are system changes when aging that affects integumentary system?
(7)
NORMAL! |
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Definition
↓ dermis collagen from UV damage
↓hypodermal fat
↓ sweat glands
↓ elasticity
↑capillary fragility
Gray hair & hair loss
Nails thicken
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Term
What are system changes when aging that affects integumentary system?
(7)
PATHOLOGIC |
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Definition
Xerosis
Pruritus
Senile purpura
Lentigo
Actinic keratosis
Seborrheic keratosis
Pressure ulcers
Cancer (basal & squamous cell) |
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Term
What are changing when aging related to:
System Changes: Special Senses
ALL NORMAL (7)
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Definition
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Arcus senilis
↑ intraocular pressure (IOP)
Presbyopia
↓ color vision
Presbycusis
↓ smell
↓ Taste
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Term
What are changing when aging related to:
System Changes: Special Senses
PATHOLOGIC (7) |
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Definition
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Pathologic:
Glaucoma, open-angle & acute angle-closure
Cataracts
Retinopathies (diabetic & hypertensive)
Macular degeneration
Hearing loss
Tinnitus
Vertigo
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Term
What are all normal parts of aging that affect the immune system?
(7) |
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Definition
↓ antibody secretion
↑autoantibodies
↑natural killer T cells
↓ helper T cell # & function
Binding of interleukin 2 with T cell
Involution of thymus
Blunted vaccination response
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Term
Aging: System Changes: Immune
PATHOLOGIC
Decreased surveillance & antagonistic effects with ↑susceptibility to: |
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Definition
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Decreased surveillance & antagonistic effects with ↑ susceptibility to:
Infection
Autoimmune disease
Malignancy
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Term
Aging:
What are normal changes that occur related to respiratory system? (10) |
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Definition
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Kyphosis
↓ rib cage mobility
↓ alveolar surface area & thickness
↓ FEV1
↓ FVC
↑residual capacity
↓ lung elasticity
↓ gas transfer
↓ PO2
↓ VO2MAX
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Term
What is the VO2 Max?
What is the equation? |
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Definition
VO2MAX = Maximum cardiac output
X Maximum (a-v) O2 difference
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Term
What is cardiac output?
equation... |
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Definition
Cardiac Output = stroke volume X heart rate
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