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Neurology
FA complete review Part 3.5 Otology
| Question | Answer |
|---|---|
| What are the main division of the ear? | Outer ear, Middle ear, and Inner ear |
| What accounts for the Outer ear? | Visible portion of ear (pinna), includes auditory canal and tympanic membrane. |
| How does the Outer ear transmit sound? | Via vibration of tympanic membrane |
| What is the "pinna"? | Visible portion of ear |
| What is included, besides the pinna, in the Outer ear? | Auditory canal and tympanic membrane |
| What is the Middle ear? | Air-filled space with three bones called the ossicles |
| What is the name given to group of three bones found in the Middle ear? | Ossicles |
| In which division of ear are the "ossicles" located? | Middle ear |
| The auditory canal is in the ______________ ear. | Outer ear |
| Which division or part of the ear has the tympanic membrane? | Outer ear |
| What are the names of the 3 ossicles? | Malleus, incus, and Stapes |
| What is the Malleus? | One of three ossicles (bones) in the middle ear. |
| The Malleus, ______________ and ______________, are the ossicles. | Incus and Stapes |
| What is the role or function of the ossicles? | Conduct and amplify sound from tympanic membrane to inner ear |
| What ear structure(s) is responsible to conduct and amplify sound from the tympanic membrane to the inner ear? | Ossicles |
| Snail-shaped, fluid-filled cochlea. | Inner ear |
| What part of the ear contains the basilar membrane? | Inner ear |
| Vibrates secondary to sound waves | Basilar membrane |
| How is vibration transduced in the inner ear? | Via specialized hair cells --> auditory nerve signaling --> brain stem. |
| Where in the inner ear does low frequency sounds are heard? | Apex near helicotrema |
| What type of frequency is perceived at the cochlea? | High frequency |
| Sound heard best at base of cochlea. | High frequency |
| What are the two types of hearing loss (diagnostically)? | 1. Conductive hearing loss 2. Sensorineural hearing loss |
| What are the two common tests performed to diagnose hearing loss? | Weber test and Rinne test |
| What type of hearing loss produces an abnormal Rinne test? | Conductive hearing loss |
| Which hearing test when performed it test the localization of sound? | Weber test |
| Which type of hearing loss is seen with Weber test that localized sound to affected ear? | Conductive hearing los |
| Sensorineural hearing loss Weber test: | Localizes to affected ear |
| A Weber test in the Conductive hearing loss: | Localizes to affected ear |
| Weber test n Sensorineural hearing loss: | Localizes to affected ear |
| Which auditory test is directed to indicate the localization of sound? | Weber test |
| Which auditory test is intended to indicate bone and air conductivity? | Rinne test |
| A person with Conductive hearing loss will have _______________ Rinne test. | Abnormal |
| What indicates a Normal Rinne test? | Air conductive > Bone conductivity |
| If the sound/vibratory conductivity of bone is larger, then Rinne test is _____________________. | Abnormal |
| Which type of hearing loss experiences a normal Rinne test? | Sensorineural hearing loss |
| Which type of hearing loss experiences an abnormal Rinne test? | Conductive hearing loss |
| Weber test -> Localized to affected ear Rinne test --> Abnormal What is the hearing loss type? | Conductive hearing loss |
| Weber test --> Localizes to unaffected ear Rinne test --> Normal What is the hearing loss type? | Sensorineural hearing loss |
| Which type of hearing loss has the sound localized to the "good" ear in a Weber test? | Sensorineural hearing loss |
| Which type of hearing loss will have the sound/vibration to localized at the "bad" or affected ear? | Conductive hearing loss |
| Bone > air | Abnormal Rinne test seen in Conductive hearing loss |
| What are the two most common types of hearing loss? | 1. Noise-induced hearing loss 2. Presbycusis |
| What is "Noise-induced hearing loss"? | Damage to stereociliated cell in organ of Corti |
| In Noise-induced hearing loss, which hearing frequency is lost first? | High-frequency hearing |
| What is a severe consequence of a sudden, extremely loud noise? | Hearing loss due to tympanic membrane rupture |
| The rupture of the tympanic membrane due to a sudden and extremely loud noise, is an example of which type of hearing loss? | Noise-induced hearing loss |
| What is Presbycusis? | Aging-related progressive bilateral/symmetrical sensorineural hearing loss du tot destruction of hari cell at the cochlear base. |
| Destruction of hair cell at the cochlear base, leads to what type of hearing loss? | Presbycusis |
| What population is most common to develop Presbycusis? | Elderly |
| Hearing loss associated with increasing age. | Presbycusis |
| What hearing is preserved in Presbycusis? | Low-frequency hearing at apex |
| What is destroyed in Presbycusis that leads to hearing loss? | Hair cells at the cochlear base |
| Overgrowth of desquamated keratin debris within the middle ear space. | Cholesteatoma |
| What is a Cholesteatoma? | Overgrowth of desquamated keratin debris within the middle ear space |
| Which part of the ear develops Cholesteatomas? | Middle ear |
| What type of hearing loss, conductive or sensorineural, is seen with Cholesteatoma? | Conductive hearing loss |
| What causes the conductive hearing loss in a Cholesteatoma? | The erosion ossicles, mastoid air cells |
| Painless otorrhea is a common symptom of _____________________. | Cholesteatoma |
| Middle ear mass + Painless otorrhea. Dx? | Cholesteatoma |
| Vertigo: | Sensation of spinning while actually stationary |
| What is a subtype of "dizziness," but distinct form "lightheadedness"? | Vertigo |
| What are the two types of vertigo? | - Central vertigo - Peripheral vertigo |
| What is more common , peripheral or central vertigo? | Peripheral vertigo |
| __________________ vertigo is an inner ear etiology. | Peripheral vertigo |
| What parto fo the ear etiology is peripheral vertigo considered? | Inner ear |
| What is the difference in etiology between Peripheral and Central vertigo? | Peripheral vertigo is an inner ear condition, while Central Vertigo is due to Brain stem or cerebellar lesion |
| What are common etiologies or condition that lead to development of Peripheral vertigo? | 1. Semicircular canal debris 2. Vericular nerve infection 3. Meniere disease 4. Benign Paroxysmal Positional Vertigo (BPPV) |
| What is the treatment for Peripheral vertigo? | Antihistamines, anticholinergics, antiemetics |
| Besides the general medications for Peripheral vertigo, what else is used to treat Peripheral vertigo caused by Meniere disease? | Low-salt diet + diuretics (if needed) |
| For which condition is the Epley maneuver performed? | Treatment of BPPV |
| BPPV causes _______________ vertigo. | Peripheral vertigo |
| What is the common triad associated with Meniere's disease? | 1. Sensorineural hearing loss 2. Vertigo 3. Tinnitus |
| A person with normal Rinne test, Weber test localized sound to non-affected ear, describes currently the room spinning around and a constant ring in the affected ear. Dx? | Meniere disease |
| What would be the Weber test for a Meniere's disease patient? | Localizes to unaffected ear |
| What does the Rinne test on a person with Meniere's disease demonstrate? | Normal; Air conduction is greater than bone conduction of sound and vibration. |
| What are two examples of etiologies that may cause brainstem or cerebellar lesions, leading to develop Central vertigo? | Stroke affecting vestibular nuclei or posterior fossa tumor |
| What ar the findings in Central vertigo? | - Directional or purely vertical nystagmus - Skew deviation - Diplopia - Dysmetria - Focal neurologic findings |
| Which type of vertigo is associated with vertical nystagmus and skew deviation? | Central vertigo |
| A ________________- fossa tumor may cause Central vertigo. | Posterior |
| What is Benign Paroxysmal Positional vertigo (BPPV)? | Sudden sensation that you're spinning or that the inside of your head is spinning |
| What is the Epley manuveur? | Type of exercise help that helps to treat the symptoms of benign paroxysmal positional vertigo (BPPV) |