EENT Flashcards Preview

GW Clinical Medicine I > EENT > Flashcards

Flashcards in EENT Deck (73)
Loading flashcards...
1

oscillopsia

visual distortion

2

air conduction

gain from tympanum to oval window about 18 fold

3

bone conduction

temporal bone conduction has 60-dB loss

4

hair cells in ear

tonotopically organized on cochlear basilar membrane detect vib on membrane

5

Tympanosclerosis

calcification or scaring of TM and middle ear from inflammation

6

myringosclerosis

calcification of TM from OME and AOM, rarely hearing loss unless "porcelain eardrum"

7

myringosclerosis vs middle ear mass

pneumatic otoscopy shows diff as plaque moves with TM during insufflation

8

retraction pocket

invagination of pars tensa or pars flaccida from chronic inflamm and neg prssure in middle ear (atrophy, atelectaisis of TM)

9

adhesive otitis

continued inflammation between retracted TM and ossicles creating cholestetoma or fixation and erosion of ossicles

10

cholestetoma

pearly white mass seen in retraction pocket/ perforation... purulent drainage or granulation tissue/ polyps... SMELLS bad! keratinizing squamous epithelium in the middle ear and/or mastoid process

11

perforation from AOM: time frame, drug, limitations of patients behavior

heals within 2 wks, ototopical antibiotics for 10-14days referred to an otolarygologist 2-3 wks after rupture for hearing eval limit water activities/ use ear mold

12

tympanoplasty

repar eardrum after 7 when Eustachian tube reaches adult orientation

13

facial nerve

encased in temporal bone to stylomastoid foramen through middle ear

14

facial nerve paralysis...

not idiopathic Bell palsy until everything else excluded.

15

myringotomy

perforate TM to release fluid in middle ear with facial nerve paralysis, place tube

16

if cholesteatoma or mastoiditis is suspected

CT is indicated.

17

OME vs AOM

OM w/ effusion: fluid in the middle ear without inflammation, before/after an infection (few days - many weeks/ mths after AOM) common in young children.

18

tool to clear cerumen

ear curette or irrigation for hard/ flaky can add cerumen softener (H2O2)

19

tympanometry

measures TM compliance and volume of ear canal, displays as a graph, shows if perforated or intact TM

20

226 Hz tympanometry for kids older than 6 mths

1000hz for younger

21

chronic supperative OM (CSOM)

ongoing purulent ear drainage, TM perforation or tympanostomy tube ...can be assoc. with cholesteatoma, chronic mucosal edema, ulceration, granulation tissue, polyp formation

22

risk factors for CSOM

history of OM, crowded living, day care, lg fam, P.aeruginosa, S. aureus, Proteus sp. Klebsiela penuoniae, diptheroids

23

key to Mgmt

determine cause, cleaning drainage, topical antimicrobial

24

possible causes of CSOM

foreign body, neoplasm, landerhans cell histiocytosis, TB, granulomatosis, fungal infection, petrositis (bone probs)

25

immediate referral to an otolaryngologist

facial palsy, vertigo, CNS signs

26

supperative OM

labrynthitis can be sequelae bony obliteration of inner ear, including cochlea--> hearing loss

27

mastoiditis

AOM present, postauricular pain and erythema (later ear protrusion) infection spreads from middle ear space to mastoid part of temporal bone--> abcess possible 60% >2yrs old

28

symptoms / signs of mastoiditis

mastoid red/indurated, swollen and fluctuant, pinna pushed forward from postauricular swelling, narrowed ear canal. except in younger pts swelling is superior, an pushes ear down vs out

29

incidence of mastoiditis in patients on antibiotics

2/100,000 person years U.S. vs. 4.2 in Netherlands where only 31% get antibiotics

30

diff diagnosis for mastitis

lymphadentitis, parotitis, trauma, tumor, histiocytosis, OE, furncle