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ears
ch 15
| Question | Answer |
|---|---|
| risk factors for hearing loss | environmental noise, ototoxic meds (antibiotics, aspirin; rare) , family history, age >50, autoimmune disorders, history of congenital hearing loss |
| theres a family history link with hearing loss and what disease | meniere's |
| hearing loss associated with age | presbycusis |
| hearing lost typically affected first | high freq |
| hearing loss can lead to what socially | reduced interpersonal communication, depression, exacerbation of coexisiting psychiatric conditions |
| vertigo | sensation of movt, usu whirllng or spinning |
| subjective vertigo | sensation that ones body is rotating in space |
| objective vertigo | sensation that objects are spinnng around the body |
| cardinal symptom of vestibular dysfunction | vertigo |
| ototoxic meds can cause | vertigo |
| common causes of vertigo | benign paroxysmal positional vertigo, meniere's disease, vestibular neuritits, labyrinthitis |
| cerumen impaction | excessive cerumen that occludes entire ear canal |
| feeling of cerumen impaction | ear feels full, decreases hearing |
| cerumen removal | fill with softening agent, block opening for 5-10 mins, irrigate with warm water or cerumen spoon can be used |
| test auditory function with | whisper test, finger rubbing test, webers test, rinne test, audiometry (tests CN VIII) |
| test vestibular function with | rombergs test (tests CN VIII) |
| abnormal finding of weber test | pt cant repeat at least 50 % of spoken words |
| simplest screening test to identify pt wiht hearing loss in office/clinic | whispered voice test |
| whispered voice test | stand 1-2 ft from pt, pt covers one ear, shield your mouth, whipser several 1-2 syllable words |
| problems with whisper test | variance in loudness of examiners |
| weber's test | activate tuning for by holding by base and striking forked section on hand, put base on midline of pt skull, sound transmitted along skull to inner ear |
| normal finding of webers test | should hear tone equally in both ears |
| abnormal finding of webers testq | lateralization of sound to one side |
| lateralization of sound to the deaf ear suggests | conductive hearing loss |
| lateralization of sound to the unaffected ear suggests | sensorineural hearing loss |
| rinne test | uses tuning for to compare air conduction to bone conduction. strike tuning fork, put on pt mastoid process, begin timing, have them tell u when they cant hear it, then put fork in front of ear, have pt tell u when they cant hear |
| normal result of rinne test | tone heard in front of ear should last twice as long as tone heard when fork was on mastoid process |
| problems with rinne test | force used to strike tuning fork can affect accuracy of results |
| clients with conductive hearing loss will have what result with rinne test | bone conduction longer than air conduction |
| result of rinne test for pt with sensorineural hearing loss | air conduction longer than bone conduction but less than 2:1 ratio |
| what does romberg's test test | ability of vestibular apparatus of inner ear to help maintain standing balance |
| romberg's test | have pt face you, have pt put feet together, arms at side, eyes closed, wait 20 sec and watch pt swaying and ability to maintain balance without stepping sideways |
| abnormal finding of romberg's test | pt is unable to maintain postion, steps sideways, widens base of support |
| positive finding of rombergs test suggests | inner ear or cerebellar problem |
| menieres disease effects | vestibular labyrinth |
| menieres | unknown etiology (autoimmune disorders may play role), typically in middle age, M & F equally affected |
| symptoms of menieres | fullness in ears, severe episodic vertigo (especially when upright but even lying down, lasts for weeks), tinnitus, fluctuating hearing loss; can lead to profound SNHL |
| indicators of hearing loss | pt asks u to repeat yourself, repaeatedly misunderstands questions, garbled speech sounds with word distortion, leans forward or tilts head, watches lips, speaks in loud monotone voice |
| conductive hearing loss | in middle or external ear, could be wax, perforation. in rinne test will have bone conduction longer than air conduction. in webers test will have lateralization to deaf ear |
| sensorineural hearing loss | inner ear or auditory N, 90% of heaing loss, from aging and ototoxicity. in rinne test air conduction is greater than bone but not 2:1 ratio. in weber test lateralization to unaffected ear. |
| benign paroxysmal postional vertigo | vertigo with rapid changes in head position that lasts for several seconds, usu along with nausea |
| cause of BPPV | presence of free floating debris in posterior semicircular canal associated with head trauma or prior viral inner ear infection |
Created by:
ashley0683
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