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what part of the ear controls balance
inner
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what directs sound waves into the ear
auricle
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what is the resonator for the sound we hear
external auditory canal
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what vibrates as sound waves hit it
tympanic membrane
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what are the 3 ossicles of the middle ear
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where are the vestibular system and cochlea located
inner ear
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how does brain interpret sound
thru vibrations of cranial nerve 8
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auditory dx test
evaluates and dx conductive sensoreneural hearing loss
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auditory evoked response (AER)
identifies electrical activity of the auditory nerve
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auditory brainstem response (ABR)
- measures electrical activity from inner ear to the brain
- if pt had stroke or acoustic neuroma we would use this to see whats going on w brainstem
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caloric test
- uses hot and cold water
- affects vestibular system
- dx nystagmus
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deafness can be associated with
- congenital (fam history)
- thyroid goiter
- tumors of auditory nerve
- neurofibromytosis
- (acoustic neuroma benign tumor)
- malignant tumor of CNS
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tympanometry does what
- looks for middle ear disorders
- creates variation of air pressure into middle ear and measures bone conduction and mobility of the ear drum
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test acuity with
voice test and tuning fork
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to dx conductive hearing use what
weber tuning fork over midline of the head
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rinne tuning fork
place behind ear to test bone conduction vs ear conduction
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age related inner ear changes
- loss of hair cells, decreased blood supply, less flexible basilar membrane, degeneration of spiral ganglion cells and decreased production of endolymph
- loss of high frequency sounds
- loss of middle to low frequency sounds
- (talking loud to elderly doesn't always work)
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age related middle ear changes
- stiff and weak muscles and ligaments
- decrease in the acoustic reflexes
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external ear age related changes
increase in cerumen so keratin content will be increased which causes difficulty hearing
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otitis externa (and treatment)
- swimmers ear
- inflammation of outer ear and ear canal r/t impaired skin integrity and bacterial invasion
- from using objects to clean ear, swimming in contaminated water, eczema and atopic dermatitis
- causes painful edema in canal, pruritis
- treat with antibiotic, steroids analgesics and sometimes heat
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impacted cerumen
- should be treated as foreign body
- can obstruct hearing
- fxs are
- cleaning
- lubrication
- protection
- antibacterial/antifungal
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excess cerumen can cause
- decreased hearing
- otalgia (ear pain)
- dizziness
- ringing in the ear
- fullness in ear
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how to remove ear wax
- syringing
- docusate
- olive oil
- baby oil
- glycerol
- debrox
- (if it hardens pt can sometimes experience conductive hearing loss)
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otis media
- ear infection
- inflammation, air or fluid in the space between the tympanic membrane and the inner ear
- skick child
- painful grasping at ear
- decreased hearing
-
how to treat otis media
antibiotics
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aerous Otis media causes
- eustachian tube is obstructed for long period of time
- upper resp infection (lots of them)
- allergies
- hay fever
- decreased hearing
- snapping or popping of the ear
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acute Otis media causes and factors
- follows an upper resp infection
- edema of Eustachian tubes
- persistent conductive hearing loss
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chronic Otis Media
- permanent perforation of the tympanic membrane
- result of recurrent acute OM and eustachian tube dysfunction and trauma or other disease
- antibiotics will usually restore sound conduction
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acute mastoiditis
- infection of mastoid bone
- leading cause of deafness in children
- treat with oral, IM and IV antibiotics
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symptoms of acute mastoiditis
- drainage from ear
- ear pain
- fever
- headache
- hearing loss
- redness of the ear or behind the ear
- swelling behind the ear, may cause ear to stick out
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Otosclerosis
- common cause of conductive hearing loss
- abnormal bone formation that causes footplate or stapes to become thick so it won't move around like its supposed to
- hereditary
- most common in Caucasians and females
- treat surgically
- can have metallic prothesis
- stapedectomy (small prosthesis inserted)
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vertigo (inner ear disorder)
- feeling of motion when stationary
- sensation of movement when there is none
- disorder of equilibrium
- sensation of whirling, rotation or movement
- disabling
- falls or injury
- N/V, sweating, hypotension, and salavation
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labyrinthitis (inner ear disorder)
- inflammation of the inner ear
- wertigo
- sensorineural hearing deficit
- nystagmus (rapid involuntary eye movement)
- N/V
- falls
- bacterial
- viral (sudden onset)
- temp to perm hearing loss
-
meniers disease with endolymphatic hydrops
- excess of endolymph
- part of endolymphatic sac becomes swollen
- no known cause
- will have vertigo
- gradual loss of hearing
- tinnitus
- feeling of fullness
- roaring or ringing sensation
- can last minutes to hours
- DX with caloric test
- rinne and webber tuning
- xrays and CT scan
- glycerol test
- tx
- IV valium
- meclizine helps with whirling sensation and nausea
- diruretics
- bed rest
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acoustic neuroma
- non cancerous tumor in internal meatus
- sypmtoms are
- unilateral hearing loss
- tinnitus
- vertigo
- nystagmus
- dizziness
- treatment is surgery
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what could tonsilitis patients have
post op ear pair...doesnt mean they have an ear infection, no citrus things...soft foods, jello, apple sauce etc bedrest is not necessary but no vigorous exercise
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sensorineural hearing loss
- inner ear auditory nerve or auditory pathways
- can be caused by rubella, viral infections and meningitis
-
presbycusis is
- hair loss of cochlea degenrate
- gradual hearing loss with age
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