Term
|
Definition
| usually unilatera, diminished visual acuity due to anatomical or sensory deoiviration, not a pathology |
|
|
Term
| other than not seeing well, why is amblyopia a concern |
|
Definition
| lack of neurosensory stimulation due to conflicting or blurred immages |
|
|
Term
| what is the general cause of amblyopia? what are three specific causes? |
|
Definition
any interruption in visual development (birth to 6-8 yo)
strabismus
refractive errors
occlusion |
|
|
Term
| what is the most common cause of amblyopia? define it |
|
Definition
strabismus
eye is structurally abnormal causing misalignment
visual axis is not at the same fixation point |
|
|
Term
| what is the pathogenesis of strabismus |
|
Definition
| loss in bioncular vision because the deviated eye's image is supressed by the brain which interrupts normal development of higher vision centers in the brain (not corelated with degree of deviation) |
|
|
Term
|
Definition
| difference in refractive error between the eyes |
|
|
Term
| what is the pathogenesis of refractive amblyopia |
|
Definition
eye with the lesser refractive error provides a more clear image
so the image from the eye with more error is supressed |
|
|
Term
| how can you detect refractive amblyopia |
|
Definition
no ovbious physical signs
visual acuity testing |
|
|
Term
| what are some examples of causes of occlusion amblyopia (4) |
|
Definition
| cataract, corneal scaring, ptosis, tumor |
|
|
Term
| what is the pathogenesis of occlusion amblyopia |
|
Definition
| obstruction blocks stimuli from coming into the eye |
|
|
Term
| what are the three keys to testing for ambyopia |
|
Definition
early detection
family history
eye exam |
|
|
Term
| what is done on a newborn eye exam to test for amblyopia (3) |
|
Definition
corneal light reflex
red reflex
fundus exam |
|
|
Term
| what is done on a infant to 2yo eye exam to test for amblyopia (3) |
|
Definition
assess visual function (not accuity)
determine central eye fixation location
assess eye motility |
|
|
Term
| what is done on a 2-5yo eye exam to test for amblyopia (1), how can you tell if the test is normal |
|
Definition
picture card or tumbling E visual acuity test
(accuity 3yp = 20/30) |
|
|
Term
| what is done on a 5yo+ eye exam to test for amblyopia (1) |
|
Definition
|
|
Term
| how is amblyopia treated? (2) |
|
Definition
treat the underlying cause (strabismus, anisometropia, cataract, ptosis, etc)
occlude the bettwe seeing eye, titrating the time to the amblopia depth and age of child |
|
|
Term
| what is the problem with eye patching as a treatment |
|
Definition
| can cause amblyopia in the good eye if patched too long (reverse amblyopia) |
|
|
Term
| what are the four ways to categorise strabismus, in one or two words describe each |
|
Definition
concomitant- non paralytic
non comitant- paralytic
phoria- latent deviation
tropia- manifest deviation |
|
|
Term
| define concomitant tropia |
|
Definition
| angle of misalignment is EQUAL in all directions of gaze |
|
|
Term
| who gets concomitant tropia (2) |
|
Definition
adults who lost an eye
children with abnormal anatomy |
|
|
Term
| define non-comitant tropia / imcomitant tropia |
|
Definition
| angle of misalignment VARIES with direction of gaze |
|
|
Term
| what causes incomitant tropia (2) |
|
Definition
| muscle of nerve dysfunction or mechanical restriction |
|
|
Term
| give examples of three conditions that cause incomitant tropia |
|
Definition
CN palsy
orbital disease
orbital trauma: blow out fracture |
|
|
Term
|
Definition
| binocular vision of fusion interrupted, you can only see the problem whent the patient looks around, fowrard gaze is fine |
|
|
Term
|
Definition
| deviation present when both eyes are open, you can see the problem in forward gaze right away |
|
|
Term
| what are the types of tropia |
|
Definition
| consistant and intermittent |
|
|
Term
|
Definition
Esoteopia: light reflex is temporal, pupil is nasal
Exotropia: light reflex is nasal, pupil is temporal
Hypertrophia: light reflex is inferior, pupil is superior
Hypotrophia: light reflex is superior, pupil is inferior |
|
|
Term
| what are the three steps in testing for strabismus |
|
Definition
general inspection
corneal light reflex
cover test |
|
|
Term
| what are the 4 parts of the general inspection for strabismus, what are their relivence |
|
Definition
Epicanthus evalulation: prominent folds or wide nasal bridges can cause pseudostrabismus
Motility exam
Nystagmus exam: nystagmus means poor vision
Head tilt exam |
|
|
Term
| how is strabismus treated (4) |
|
Definition
rule out neurological causes
normalize vision: treat amblyopoia (patch)
equalize vision: treat refractive errors
surgery if these dont work and there is still a misalignment |
|
|
Term
| what are the two approaches to strabismus surgery, in general how are they done |
|
Definition
Weaken muscles: cut and attach muscle more anterior
Strengthen muscles: cut and attach muscles more posterior |
|
|
Term
| corneal light reflex testing: what does it test for, who do we do it on, how is it measured |
|
Definition
Assessment of ocular alignment
Helpful in newborns and young kids
1 mm of deviation of the light = 7 deg deviation = 14 prism diopters of deviation |
|
|
Term
| cover test: what does it detect, who do we do it on |
|
Definition
detects tropias
adults and kids |
|
|
Term
| cover test: how is it done, what should you see |
|
Definition
Cover strabismus eye and uncover and the straight eye will always stay fixated on the object
When the straight eye is uncovered the strabismus eye will not be fixed, but when you cover the straight eye it will fix on the object |
|
|
Term
| alternate cover test: how is it done, what does it detect |
|
Definition
detects phorias
cover is moved back and forth |
|
|
Term
| alternate cover test: how is it done, what should you see |
|
Definition
When the straight eye is uncovered it will not move
When the strabismus eye is uncovered it will deviate to one side |
|
|
Term
| red reflex test: tip for bettwe results |
|
Definition
| dilate pupils if needed for better view |
|
|
Term
| what does it mean if leukocoria is found on red reflex test (4) |
|
Definition
white pupil
retinal detachment, cataract, retinoblastoma |
|
|
Term
| 9 diseases of the external ear |
|
Definition
skin cancer
external otitis -swimmers ear
osteomycosis
cerumen impaction
eczema
TMJ capsulitis
auricular hematoma
necrotizing milignant external otitis
osteomas of the extranal canal |
|
|
Term
| basal cell carcinoma: disease process, how to recognise (2) |
|
Definition
o Not malignant, local invasion
o Cell circumscribed margins
o Raised margins with depressed center |
|
|
Term
| squamous cell carcinoma: disease process, metastazise patterns, how to diagnose, how to get |
|
Definition
o Malignant – if they metastasize they go to the neck
o Ulcerated with everted edges
o Excessive sun exposure leads to solar keratoses |
|
|
Term
| external otitis: definition, common cause |
|
Definition
• Inflammation of the external ear canal
• Commonly due to infection with pseudomonas aeruginosa |
|
|
Term
|
Definition
o Auricular tenderness
o Swollen canal
o Pain |
|
|
Term
| external otitis: 5 treatments |
|
Definition
o Oral antibiotics if severe - ciprodex
o Acid drops – pseudomonas needs a basic pH to live
o Steroids
o Old time cure
o Otowic – allows drops to get into length of canal |
|
|
Term
|
Definition
Push back until you see top and put drops in it and it will expand
if you cant see the eardrum the drops cannot penetrate |
|
|
Term
| what is the old time cure for external otitis, what percautions, why does it work |
|
Definition
Vinegar – to lower pG
Alcohol – to dry the ear out
Ok as long as there isn’t a hole or tube in the drum |
|
|
Term
| cpirodex issue, alternative |
|
Definition
| many insurance dosent cover it so use cipro HC for external otitis |
|
|
Term
| otomycosis: definition, cause, sign |
|
Definition
• Fungal infection of the external ear
Prolonged treatment with antibiotic drops
Painful, can erode through the drum and cause holes in tympanic membrane |
|
|
Term
|
Definition
o Frequent cleaning
o Difficult
o Antifungal drops, ointment works better |
|
|
Term
| who normally gets cerumen impaction |
|
Definition
| elderly, common for everyone though |
|
|
Term
| cerumen impaction causes and signs |
|
Definition
o Cotton swabs pushing wax back
o Conductive hearing loss
o Complete meatus obstruction |
|
|
Term
| what is the weak part of the ear drum |
|
Definition
|
|
Term
| cerumen imaction treatment |
|
Definition
| o Irrigation – remove wax first so you know if there is a hole you cannot see |
|
|
Term
| eczema of the external canal signs 4 |
|
Definition
o Dry external canal
o Very little cerumen
o Extremely itchy
o Infections due to digging at ears – usually pseuxomonas |
|
|
Term
| eczema of the external canal treatment |
|
Definition
| o Steroid creams or drops |
|
|
Term
| TMJ capsulitis: definition, 4 signs |
|
Definition
inflammation of TMJ
o Ear pain (otalgia)
o Flat or broken teeth due to clenching or grinding
o Unilateral pain with palpation
o Clicks |
|
|
Term
| treatment TMJ capsulitis 5 |
|
Definition
o NSAIDS, steroids
o Low mechanical diet, bite guards
o Dental exam |
|
|
Term
| auticular hematoma causes and process and signs |
|
Definition
o Trauma
o Cartilage gets blood from perichondrium and it separates the perichondrium from the cartilage
o If it occurs on both sides and the cartilage gets no blood at all this is a big problem
o Can cause necrosis of the cartilage and ear deformity (cauliflower ear) |
|
|
Term
| what is the most common presentation of TMJ capsulitis, what do you then ask |
|
Definition
present with ear pain
does it hurt when you chew? |
|
|
Term
| auricular hematoma treatment |
|
Definition
| early incision or drainage |
|
|
Term
| necrotizing milignant external otitis causes 4 |
|
Definition
o Diabetes
o Immunosupression
o Stubborn otitis external causes osteomyelitis of the skull bone
o Usually pseudomonas aeruginosa and aerobes |
|
|
Term
| necrotizing external otitis signs 2 |
|
Definition
o Painful
o Involvement of CN VII, IX-XII |
|
|
Term
| who usually gets necrotizing external otitis, what is the prognosis |
|
Definition
| • High risk of death, usually immune compromised |
|
|
Term
| osteoma of the external canal definition cause treatment |
|
Definition
• Benign bony overgrowth of the external canal
• Cause
o Frequent swimming in cold water
• Treatment
o None unless canal is occluded
clear cerumen impaction due to wax getting stuck beind
open canal with surgical incusion if needed, sometimes reoccurs though |
|
|
Term
| eustachian tube dysfunction definition |
|
Definition
| negative pressure in the middle ear, inability of the eustachian tube to ventilate the middle ear |
|
|
Term
| how is a eustachian tube dysfunction officially diagnosed |
|
Definition
| more negative than -150 is a type c tympanogram and diganosises eustachian tube dysfunction |
|
|
Term
| eustachian tube dysfunction causes 5 |
|
Definition
o Adenoid hypertrophy
o Inflammation
o Infection
o PND
o allergies |
|
|
Term
| signs of eustachian tube dysfunctions |
|
Definition
|
|
Term
| tympanosclerosis cause, presentation 3 |
|
Definition
• Hyaline degeneration followed by calcification
• Cause
o Repeated infections
o Ventilation tube insertion |
|
|
Term
|
Definition
o Chalk patches – don’t vibrate, bad transmission of sounds
o Ossicular fixation |
|
|
Term
| tympanic membrane perforation types |
|
Definition
o Marginal or central
o Wet or dry |
|
|
Term
| tympanic membrane perforation causes 4 |
|
Definition
o Trauma
o Infection
o Ventilation tubes
o Previous surgery |
|
|
Term
| tympanic membrane perforation indication for repair 3 |
|
Definition
o Restoring hearing
o Maintaining a dry ear
o Preventing cholestatoma |
|
|
Term
|
Definition
|
|
Term
| serous oritis media: causes, presentation 3 |
|
Definition
• Serous fluid in the middle ear space
• Cause
o Eustachian tube dysfunction
o Allergy |
|
|
Term
| describe the fluid in serous otitis media, how long is it present, how does it change over course of disease |
|
Definition
two components: serous, mucous
o Acute: Amber color seen in middle ear structures
o Chronic: clear serious fluid in middle ear structures
The longer it stays it gets a mucous look
o Fluid can stay 8-10 weeks |
|
|
Term
| serous otitis medial treatment 5 |
|
Definition
o Antibiotics – not always. Doesn’t change outcome
o Decongestants
o Antihistamines
o Steroids – if allergy is the cause
o Suspect nasopharyngeal tumor in unilateral otitis media in adult |
|
|
Term
| suppurlative otitis media: cause, presentation |
|
Definition
• Infected middle ear fluid
• Engorged vessels begin at the wall and dip into the umbo. The drum is pushing towards sometimes ruptures and relives pressure and pain |
|
|
Term
| what is the most common childhood infection |
|
Definition
|
|
Term
| suppurative otitis media signs 5 |
|
Definition
o Pain
o Fever
o Red bulging TM
o Hearing loss – due to fluid
o Purulent discharge if the TM ruptures |
|
|
Term
| where does nasopharyngeal tumor in adults usually hide, why is this an issue, what types of tumor can it be |
|
Definition
especially without hx of serous otitis
hides in rosenmueler’s fossa: mass compresses Eustachian tube orifice closed and it cannot function
primary lymphoma, squamous cells |
|
|
Term
| cholesteatoma: cause, signs 10 |
|
Definition
• Squamous epithelium trapped in the middle ear space and traps in retraction pockets and grows and localy destories
• CHRONIC DRAINING EAR, Slow expansion due to desquamation, Local destruction, If big enough: facial paralysis, vertigo, brain abscess
aural polyp - sign of draining
granulation tissue - proud flesh
inability to see drum somtimes
whitish lesion |
|
|
Term
| ossicular fixation: cause, 2 signs |
|
Definition
• Inability of ossicles to vibrate due to fixation to oval window or other ossicles
• Signs
o Conductive hearing loss
o Tympanosclerosis association |
|
|
Term
|
Definition
• Normal osteoclastic activity
• Abnormal osteoblastic activity causing spongy bone to be laid down around foot plate margins on stapedius
• Sporadic or inherited (autosomal dominant with incomplete penetrance) |
|
|
Term
|
Definition
o Bilateral conductive hearing loss
o More common in females around 20s or 30s
o Stapedial reflex absent
Protects inner ear on loud noise by contracting
o Van de Hoeve’s disease: otosclerosis and osteogenesis imperfect
Brittle bones and blue sclera
o Normal TM and tympanogram |
|
|
Term
|
Definition
o Nothing
o Hearing aid
o Stapedectomy or laser stapedotomy – never corrects it all the way |
|
|
Term
| how is otsclerosis officially diagnosed |
|
Definition
As tympanogram
A is normal
S is stiff |
|
|
Term
|
Definition
o Intermittent
o Vertigo, tinnitus, aural fullness, hearing loss
o Endolymphatic hydrops
o Initial low frequency hearing loss
o More women than men usually 30-35
o Usually unilateral |
|
|
Term
|
Definition
o Low sodium, diuretics
o Vestibular suppressants
o Allergy management – slows progression of hearing loss
o Surgery – endolymphatic sac decompression, labrynthectomy, vestibular nerve section |
|
|
Term
|
Definition
o Vertigo
o Temporary hearing loss, tunitus, aural fullness
o Sudden onset, duration minutes to hours, resolves in two weeks, self limiting
o Worsened by movement
o Association with upper respiratory infection |
|
|
Term
| vestibular neuronitis signs 7 |
|
Definition
o Sudden onset severe vertigo
o Initial episode is severe – hospitalization
o Acute attack lasts 2-5 days, dysequlibrium lasts several weeks, relapse 6 mo later
o No associated ear symptoms
o Previous URI 6-8 weeks prior |
|
|
Term
| vestibular neuronitis treatment |
|
Definition
|
|
Term
| benign paroxysmal positional vertigo cause |
|
Definition
| • Cupulolithiasis – free floating otlith in semicircular canal. One ear puts out more impulses and the world is perceived as spinninig |
|
|
Term
| benign paroxysmal positional vertigo signs 4 |
|
Definition
o Sudden onset with head movement or positional changes
o Short duration (less than 1 min)
o No other ear symptoms
o Positive dix-hallpike maneuver |
|
|
Term
| benign paroxysmal positional vertigo treatment |
|
Definition
| o Canalith reposition exercises (Epley maneuver) |
|
|
Term
| perilymphatic fistula signs 6 |
|
Definition
o Sudden onset vertigo
o Progressive sensorineural hearing loss
o Tinnitus
o Aural fullness
o Rupture of oval or round windows and perilymph leakage
o Sudden pressure changes associated with straining, sneezing, diving, blowing nose, flying, etc |
|
|
Term
| perilymphatic fistula treatment 3 |
|
Definition
o Surgery to patch any leaks
o Bed rest – avoid straining
o Probably over diagnosed |
|
|
Term
| vestibular insufficiency (VBI) cause, what exacerbates it |
|
Definition
• Inadequate supply through vertebral and basilar artery (PICA and AICA) to vestibular nuclei and surrounding structures
• Occurs with extension of neck or positional changes |
|
|
Term
| vestibular insufficiency (VBI) signs 6 |
|
Definition
o Vertigo
o Visual changes,
o Slurred speech
o Headaches
o Emesis
o Hemiparesis |
|
|
Term
| vestibular insufficiency (VBI) treatment and diagnosis |
|
Definition
o Seen on carotid Doppler
o asprin |
|
|
Term
| how is benign paroxysmal positional vertigo officially diagnosed |
|
Definition
| o Positive dix-hallpike maneuver – sit patient up and drop them back and turn head to the side. If they have nystagmus then it is positive. Try on both sides. diagnosis |
|
|
Term
| what is the eplay maneuver, why does it work, for what disease |
|
Definition
o Canalith reposition exercises (Epley maneuver) – trying to get otlith out of the semicircular canal into a position that dosent make you dizzy
benign paryxysmal positional vertigo |
|
|
Term
| atherosclerotic cardiovascular disease: cause 6 |
|
Definition
• athlerosclerosis of cerebral circulation causing narrow vessels
• decreased blood to labrynth
• increased in diabetes, hypertension, hyperlipidemia
• usually over 50 yo |
|
|
Term
|
Definition
• aminoglycosides
• diruetics
• salicylates
• chemotherapeutic agents |
|
|
Term
| multiple sclerosis: 9 signs |
|
Definition
o vertigo in 10% - 33%
o unsteadiness
o vertical nystagmus
o bilateral internuclear opthalmoplegia
o ataxic eye movements
o carcot triad (nystagmus, scanning speech, intention tremor)
o ENG can be normal with central or peripheral signs |
|
|
Term
| acustic neuroma: aka, signs 5 |
|
Definition
vestibular schwannoma
• Usually on superior division of the vestibular nerve
• Signs
o Unilateral symptoms
o Hearing loss, tinnitus, poor discrimination score
o May involve CN V or VII
o Cay cause brainstem compression |
|
|
Term
| central causes for ear issues |
|
Definition
MS
acustic neuroma / vestibular schwannoma
cerebrovascular accidents (stroke)
intracranula malignancies |
|
|
Term
| what is a bad sign in the eye, why |
|
Definition
| vertical nystagmus, it is a central sign |
|
|
Term
| what are the common causes of acute mastoiditis 3 |
|
Definition
| • Commonly S. pneumonia, S. pyogenes, S. aureus |
|
|
Term
| acute mastoiditis signs 10 |
|
Definition
o Post auricular pain, edema, erythema, tenderness
o Pinna pushed forward
o Edematous ear canal
o May be unable to see TM
o Febrile, possibly toxic
o Past history or otorrhea |
|
|
Term
| treatment for acute matoiditis 2 |
|
Definition
o Antibiotics have decreased frequency
o Surgical intervention probably needed |
|
|
Term
| chronic mastoiditis signs 5 |
|
Definition
o May not have mastoid or ear pain
o Opacification of air cells
o Sclerotic mastoid
o Poor pneumatization of air cells
o Persistent draining ear |
|
|
Term
| subperiosteal abscess: location, signs 6 |
|
Definition
o Post auricular pain, swelling, erythema
o Displacement of auricle
o Ferbile
o Elevated WBC |
|
|
Term
| bezolids abscess: cause, 4 signs |
|
Definition
• Mastoid abscess erodes through tip of mastoid into soft tissues of the neck (SCM)
• Signs
o Pain
o Fluctuant mass in upper neck with other signs of mastoiditis
o Elevated WBC
o febrile |
|
|
Term
| what is the first rule of mastoiditis |
|
Definition
| dont believe the CAT scan report. ossificied mastoid is immediate diagnosis and it dosent mean if they have mastoiditis |
|
|
Term
| what areh the 4 mastoid diseases |
|
Definition
acute mastoiditis
chronic mastoiditis
bezold's abscess
subperiosteal abscess |
|
|
Term
| what does poorly pneumonitized mastoid mean |
|
Definition
|
|
Term
| why is there fluid in the ear if there is fluid in the mastoid |
|
Definition
| fluid in the ear means fluid in the mastoid because it is an air reserve for the middle ear |
|
|
Term
| how can you tell the difference between subperiosteal abscess and mastoiditis |
|
Definition
CAT scan shows clear mastoid, puss pocket is outside
slice into subperiosteal and you get puss and directly beneath is bone |
|
|
Term
| what are the 4 reasons to do an audiology evaluation |
|
Definition
determine degree and configuration of hearling loss
determined site of lesion
determine need for nonsurfical intervention (hearing aid, lip reading, sign language)
determine need for futher testing |
|
|
Term
| what are the three areas of audiology testing |
|
Definition
pure tone auditometry
speech audiometry
immittance/impedence measures |
|
|
Term
| what are the two pure tone auditometry tests |
|
Definition
air conduction
bone conduction |
|
|
Term
| speech audiomatey two tests |
|
Definition
speech reception thresholds
speech discrimination thresholds |
|
|
Term
| immittance/impedence measures two |
|
Definition
| tympanomatry and acustic reflexes |
|
|
Term
| what is a speech reception threshold test |
|
Definition
| lowest dB pt can repeat spondiaic (spondless) words at 50% |
|
|
Term
|
Definition
| two syllable word with equal ephsis on both syllables |
|
|
Term
| what is the specificity of the speech reception test |
|
Definition
| can confirm tone thresholds within 10dB of PTA at the average air conduction of 500, 100, and 200 Hz |
|
|
Term
|
Definition
|
|
Term
| what is the difference between Hz and dB |
|
Definition
dB is the volume
Hz is high or low pitch |
|
|
Term
| what is a speech detection threshold |
|
Definition
| lowest dB level in the patient responds to speech |
|
|
Term
| who gets a speech detection threshold |
|
Definition
| kids, mentally retarded, language barriers, when speech repetition cannot be done |
|
|
Term
| what does a speech discrimination score determine |
|
Definition
| how clear a pt can hear speech |
|
|
Term
| how is speech discrimination score done |
|
Definition
| patient repeats a list of 50 phonetically balanced words, tessl about th einner ear, nerve, and brain |
|
|
Term
| what is the scoriing for speech discrimination testing |
|
Definition
90-100% correct is normal
76-88% correct is slight difficulty
60-74% correct is moderate difficulty
40-58% correct is poor
<40% correct is very poor |
|
|
Term
| what does an A tympanogram mean |
|
Definition
| normal: pressure on both sides of TM are equal, middle ear and ossicles are functing normally |
|
|
Term
| what does an Ad tympanogram mean |
|
Definition
| increased: TM is floppy due to atrophy or disarticulation of the ossicles |
|
|
Term
| what does an As tympanogram mean |
|
Definition
| stiff Tm from osicular fixation or diffuse tympanosclerosis |
|
|
Term
| what does an C tympanogram mean |
|
Definition
| decreased: pressure in the middle ear is negative related to external. most commonly caused by eustachian tube dysfunction but could be from otitis media |
|
|
Term
| what does a B tympanogram mean |
|
Definition
| immobility of the TM, middle ear is incompressable due to hole in TM or fluid filled middle ear |
|
|
Term
| webber test: how is it done, what do the results mean |
|
Definition
place fork in midlike and the tone should be heard in both ears equally
in conductive loss it is louder in the bad ear
in sensorineural loss it is louder in the good ear |
|
|
Term
| rinne test: how is it done, what do the results mean |
|
Definition
compares air and bone conduction. alternate position between pinna and mastoid
tone should be louder in air.
in conductive loss tone is louder at the mastoid
in sensorineural loss the tone is louder at the ear |
|
|
Term
| what is the main goal in infant screening |
|
Definition
| screen them before they leave the hospital (or by 3 mo) |
|
|
Term
| what what age in infant screening do we begin rehabilitation or correction, basically when can we confirm hearing problem |
|
Definition
|
|
Term
| what tests do a newborn get |
|
Definition
ABR: auditory brainstem response: response to sound recorded via brain waves
OAE: otoacustic emissions |
|
|
Term
| at birth how should a baby respond to noise |
|
Definition
eyes wide
blinking
stirring or arousal
startle |
|
|
Term
| what 6 mo how should a babay respond to noise |
|
Definition
|
|
Term
| at 13 mo how should a baby respond to noise |
|
Definition
| direct or localize sound from any direction |
|
|
Term
| what are the denoted symbols in pure tone audiometry |
|
Definition
left ear : right ear
X: good air conduction :O
square: masked air conduction :triangle
>: good bone conduction :<
]: masked bone conduction :[
right arrow: no response :left arrow |
|
|
Term
| what is the scale of dB for hearing impairment |
|
Definition
-10 - 20 normal
21-40 mild loss
41055 moderate loss
56-70 mod to severe loss
71-90 severe loss
>90 profound loss |
|
|
Term
| what is conductive hearing loss |
|
Definition
problem with the hardware, more outer ear
ossicles, ET, drum, mastoid, pinna |
|
|
Term
| what is sensorineural hearing loss |
|
Definition
problems with the wiring, more inner ear
semicircular canals, facial nerve, cochlea, auditory nerve, vestibular nerve, brain |
|
|
Term
| what are some examples of conductive hearing loss |
|
Definition
cerumen impaction
foreign body
atresia of ET or auricle
ossicular fixation
otosclerosis
tumor
tympanosclerosis
TM perforation |
|
|
Term
| what are some examples of sensorineural hearing loss |
|
Definition
| ototoxicity, neurologiclal disorders, hematological disorders, infection, bone disease, autoimmune, prebyscus, endocrine, metabolic, hededitary, |
|
|
Term
| what is mixed hearing loss |
|
Definition
|
|
Term
|
Definition
| inflammation of the middle ear |
|
|
Term
| define middle ear effusion |
|
Definition
| liquid resulting from otitis media |
|
|
Term
|
Definition
| discharge through the perforated tympanic membrane |
|
|
Term
| what are the 5 types of effusion describe them |
|
Definition
serous: thin, watery (transudate)
mucoud: thick, viscous, mucous like
purulent: puss like
blood
CSF |
|
|
Term
| where is otitis media with effusion in rank with childhood diseases |
|
Definition
|
|
Term
| what are some factors that statistically increase chances of otitis media with effusion |
|
Definition
under 3 yo
male>female
cleft palate |
|
|
Term
|
Definition
| collapse (passive) or retraction (active pulling inward) of TM |
|
|
Term
|
Definition
| localized area of aelectasis of TM |
|
|
Term
| what is the most important factor to pathogenesis of the middle ear |
|
Definition
| abnormal function of the eustachian tube |
|
|
Term
| what are 5 underlying causes of eustachian tube dysfunction |
|
Definition
immaturity of the tube
immaturity of the muscles of the soft palate
submucosal clefts / cleft palate
adenoid hypertrophy
retrograde migration of bacteria |
|
|
Term
| what are the three functions of the eustachian tube |
|
Definition
| ventelation, protection, drainage |
|
|
Term
| pathogenesis of acute otitis media |
|
Definition
congestion of respiratory and ET mucosa cause obstruction
secretions in middle ear accumulate and allow for pathogens to proliferate |
|
|
Term
| how do microbes get into the middle ear |
|
Definition
| infection is secondary to aspiration, insufflation, or reflux of nasopharyngeal bacteria up the tube and into the middle ear |
|
|
Term
| what are 5 pathologies of the eustachian tube |
|
Definition
functional obstruction: floppy tube, poor tensor veli palatini function
mechanical obstruction: intrinsic (inflammation), extrinsic (adenoids or tumor)
abnormal patency: patulous ET |
|
|
Term
| what are 7 ddx to otitis media |
|
Definition
allergies
craniofacial abnormalities
oxidative and hydrolytic enzymes
cilliary dyskinesia
drugs: NSAIDS, steroids |
|
|
Term
| what are the systemic symptoms of otitis media (5) |
|
Definition
| fever, irritability, anorexia, vomiting, diarrhea |
|
|
Term
| what are the local symptoms of otitis media (6) |
|
Definition
otalgia: pain
otorrhea
tinnitus
vertigo
facial paralysis
swelling behind the ear |
|
|
Term
| what is seen when someone has otitis media on an otoscope exam |
|
Definition
| TM is full, bulging, opaque, limited or no mobility |
|
|
Term
| what statistically increases incidence of otitis media |
|
Definition
6-13 mo
males>females
day care, big family
winter
bottle feeding
american, canadian, and escimo indians |
|
|
Term
| what are the common bacterial causes of otitis media |
|
Definition
S. pneumoniae, H. influenza
mycoplasm pneumonia, anaerobic bacteria, chalmydia trachomatous, diptheria, TB |
|
|
Term
| what are the common viral causes of otitis media |
|
Definition
| RSV, influenza, coxsackie, adenovirus, parainfluenza |
|
|
Term
| what is the most common causes of otitis media |
|
Definition
| nothing! nothing shows on smear at all |
|
|
Term
| what are the initial treatments for otitis media |
|
Definition
| amoxicillin, TMP/SMX, amoxicillini/clauvonic acid, cefprozil, cefuroxime, omnicef |
|
|
Term
| what are the adjunctive therapies for otitis media |
|
Definition
| anaglesics, antipuretics, local heat, decongestants, antihistmaines, topical steroid nasal sprays |
|
|
Term
| what do you do if someone has a chronic otitis media |
|
Definition
|
|
Term
| when do you give otitis media treatment as a topical (drop) |
|
Definition
| TM perforation and discharge present |
|
|
Term
| what is the prophylaxis for otitis media |
|
Definition
| no longer used, not benificial |
|
|
Term
| what is a myringotamty, when do you do it |
|
Definition
hole in the TM
acute mastoiditis, labyrinthitis, facial paralysis, severe otalgia, intracranial suppurative complications |
|
|
Term
| when do you do tympanostomy tubes |
|
Definition
regulate middle ear pressure
drain secretions down ET
protect from nasopharyngeal secretions
prevent complications
restore hearing |
|
|
Term
| what is the most common complication of otitis media |
|
Definition
|
|
Term
| what are the intracranial complications of otitis media |
|
Definition
| meningitis, extradural abscess, subdural empyema, focal otitis encephalitis, brain abscess, lateral sinus thrombosis, otitic hydrocephalus |
|
|
Term
| how do you identify there is an intracranial complication of otitis media |
|
Definition
| stiff neck, focal seizures, ataxia, blurred vision, papilledema, diplopia, hemiplegia, aphasia |
|
|
Term
| what are the intratemporal complications of otitis media |
|
Definition
hearing loss, perforation of TM, chronic suppurative otitis media, retraction pocket, cholesteatoma, adhesive otitis media, tympanosclerosis, ossicular discontuniuty
ossicular fixation, mastoiditis, petrositis, labrynthitis, facial paralysis, cholesterol granuloma |
|
|
Term
| what are the 8 parts of the external eye |
|
Definition
upper lid
sclera
lower lid
pupil
iris
lacrimal papilla
plica semilunaris |
|
|
Term
| what are the 9 parts of the anterior eye |
|
Definition
ora serrata
ciliary body
posterior chamber
anterior chamber
cornea
pupil
iris
zonules
sclera |
|
|
Term
| what is the middle part of the eye called |
|
Definition
|
|
Term
| what are the 6 parts of the back of the eye |
|
Definition
retina
foeva centralis
centra retinal artery
optic nerve
central retinal vein
optic disc |
|
|
Term
| what are the 6 extraocular muscles and their innervation |
|
Definition
CN III: superior, inferior, and medial rectus, inferior bolique
CN IV (trochlear): superior oblique
CN VI (abducens): lateral rectus |
|
|
Term
| what should be done at a newborn to 3 mo old eye check (2) |
|
Definition
| red reflex, ocular alignment |
|
|
Term
| what should be done at a 6mo - 1yo eye exam |
|
Definition
|
|
Term
| what should be done at a 3 yo eye exam |
|
Definition
| snellen, allen picture, HOTV, or lea symbol chart |
|
|
Term
| explain the progression of vision over the ages |
|
Definition
3yo 20/50
4yo 20/40
5yo 20/30
6yo 20/20 |
|
|
Term
| what are the changes to the eye in pregnacy (3) |
|
Definition
| shape, refractive error changes, increased chance of diabetic retinopathy |
|
|
Term
| what 3 eye problems are normal with age |
|
Definition
prebyopia: need for reading glasses
pearl: starts around 40. loss of accomodation, need bifocals
cataracts 50-55 yo |
|
|
Term
| what are the two important history questions about a vision problem |
|
Definition
| important to ilicit timing ot onset and if it is associated with pain |
|
|
Term
| what are the first 3 rules of eye examination |
|
Definition
systematic:
vision first
with corrective lenses on
one eye at a time then both |
|
|
Term
| how is visual acuity tested |
|
Definition
| snellen chart for distance and rosenbaum or jager chart for near |
|
|
Term
| how do you test visual acuity without a chart |
|
Definition
| fingers held up at different distances |
|
|
Term
| what is the ultimate vital sign for the eye |
|
Definition
|
|
Term
| what are the three vital signs of the eye |
|
Definition
| visual acuity, pupils, pressure |
|
|
Term
| what do you do in the external eye exam |
|
Definition
examine head, face, eyelids, assymetry, ptosis, swelling or nodules
examine for bell's palsy (asymmetry in CV VII) |
|
|
Term
| how do you check the pupils |
|
Definition
dim roomwith penlight or transilluminator
assess for assymetry or anisocoria, swinging flash light test, consensual responses |
|
|
Term
|
Definition
| check pupils in light and dark to see which pupil is involved |
|
|
Term
| what do you do if someone dont has their glasses and you need to test their vision |
|
Definition
| put a hold in a piece of paper and have them look through and you can see if the vision problem is refractive or not |
|
|
Term
| how do you detect marcus gunn pupil, what is the real name for this, how can you tell |
|
Definition
afferent pupillary defect
swinging flash light test: one pupil dilates relative to the other |
|
|
Term
| what are the limbs of the pupillary reflex arch |
|
Definition
afferent CN II (optic nerve)
efferent CN III (oculomotor nerve) |
|
|
Term
| what are the two ways to test eye motility |
|
Definition
|
|
Term
|
Definition
| testing movement of each eye seperate |
|
|
Term
| what is versions, what information does this give us |
|
Definition
testing the eyes together
ilicits conjugate vs disconjugate gaze |
|
|
Term
| which muscle moves the eye laterally what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye medially, what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye superior lateral, what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye superior medial, what CN is it |
|
Definition
|
|
Term
| what muscle moves the eye inferior lateral, what CN is it |
|
Definition
|
|
Term
| what muscle moves, the eye inferior medial, what CN is it |
|
Definition
|
|
Term
| what is consenusal reflex of the pupil |
|
Definition
| shine light on right eye and left constricts slighly too, this is normal |
|
|
Term
| how do you test conforntational fields |
|
Definition
| cover one eye on you and the patient, flash fingers in four fields |
|
|
Term
| what are the degrees of visual fields in 4 directions |
|
Definition
50 deg superior
60 deg nasally
70 deg inferior
90 deg temporal |
|
|
Term
| what can you use to test intraocular pressure (5) |
|
Definition
schiotz tonometer, tonopen, perkins tonometer, goldmann applanation
last resort: use tactile sensation |
|
|
Term
| who should for sure get the ocular pressure tested (2) |
|
Definition
mentally or physically handicapped
young kids |
|
|
Term
| how can you palpate the eye pressure |
|
Definition
| with index finger genetly palpate the globe over the superior upper lip and compare the eyes |
|
|
Term
| what are the parts of the anterior segment exam (10) |
|
Definition
eyelids, cornea, conjunctiva, anterior chamber, iris, lens using a slit lamp or penlight
evert lid if foreign body
look for opacity, discoloration, nodules |
|
|
Term
| how can you check for a foreign body |
|
Definition
| evert the eye lid: have patient look down pull down and out the upper lid by grasping lashes. use cotton tip applicator to push down on the upper tarsus everting the lid |
|
|
Term
| how do you use the opthalamoscope (4) |
|
Definition
examing their eye with your same eye
start dial on zero
keeo your other eye open so you can guide yourself to the eye
adust the dial for a clear view |
|
|
Term
| what do you look for in the opthalamascope exam (4) |
|
Definition
| nerve, vessels, peripherial retina, macula |
|
|
Term
| how should the optic nerve look |
|
Definition
|
|
Term
| how should the retina look |
|
Definition
| orange hue, depends on race |
|
|
Term
| what is a normal optic cup to disc ratio |
|
Definition
|
|
Term
| what is the normal size of the optic nerve |
|
Definition
|
|
Term
| what do you look for in the optic disc examination |
|
Definition
| sharp border. blurred means edema |
|
|
Term
| what are the parts of the anterior segment exam (10) |
|
Definition
eyelids, cornea, conjunctiva, anterior chamber, iris, lens using a slit lamp or penlight
evert lid if foreign body
look for opacity, discoloration, nodules |
|
|
Term
| how can you check for a foreign body |
|
Definition
| evert the eye lid: have patient look down pull down and out the upper lid by grasping lashes. use cotton tip applicator to push down on the upper tarsus everting the lid |
|
|
Term
| how do you use the opthalamoscope (4) |
|
Definition
examing their eye with your same eye
start dial on zero
keeo your other eye open so you can guide yourself to the eye
adust the dial for a clear view |
|
|
Term
| what do you look for in the opthalamascope exam (4) |
|
Definition
| nerve, vessels, peripherial retina, macula |
|
|
Term
| how should the optic nerve look |
|
Definition
|
|
Term
| how should the retina look |
|
Definition
| orange hue, depends on race |
|
|
Term
| what is a normal optic cup to disc ratio |
|
Definition
|
|
Term
| what is the normal size of the optic nerve |
|
Definition
|
|
Term
| what do you look for in the optic disc examination |
|
Definition
| sharp border. blurred means edema |
|
|
Term
| why might someone have a white streak around their optic disc |
|
Definition
| in development the myelin sheath stops just short of the cribiform plate but sometimes it does. tis is benign and anatomical |
|
|
Term
| what does it mean if the the area around the disc looks like a donught |
|
Definition
|
|
Term
| what do yellow/white spots on the retina mean |
|
Definition
| cotton wool spots: retinal nerve fiber layer ischemia |
|
|
Term
| what does yellow exudate in the eye mean |
|
Definition
|
|
Term
| what does wispy vessels branching around the optic disc mean |
|
Definition
| neovasculization of the disc, diabetic retinopathy, formation of new flragile vessels |
|
|
Term
| what does it mean if the cup is bigger than the cup to disc ratio |
|
Definition
|
|
Term
| how do you check for occular alignment in a kid |
|
Definition
| hirschberg technique: red reflex equal in both eyes using penlight (can be a little nasal) |
|
|
Term
|
Definition
| light reflex is nasal to pupil |
|
|
Term
|
Definition
| light reflex is temporal to pupil |
|
|
Term
| what should be looked at in the eye exam of infants of any age |
|
Definition
distance between eyes and nose and laterally
palpebral fissures
lateral canthi should be equal or 1mm higher than medial |
|
|
Term
| what does it mean if the lateral canthus is slanted up |
|
Definition
| mongolian slant: down syndrome |
|
|
Term
| what does it mean if the lateral canthi is slanted down |
|
Definition
| anti-mongolian slant: treacher-collins syndrome |
|
|
Term
| what can prominent epicanthal folds give a false appearance of |
|
Definition
| estropia (pseudo strbismus. go back to the hirchbergs test to test alignment |
|
|
Term
| how can you a visual assessment of a infant or preverbal child before 6mo |
|
Definition
fix and follow should be present at 6mo
cover one eye at a time, if kid resists or gets aggitated it could be because of a visual acuity decrease |
|
|
Term
| what do you need to do before you call the opthalamologist (2) |
|
Definition
3 optic vital signs
good history |
|
|
Term
| proptosos: what is it, what is the cause |
|
Definition
| white bulging eyes, lid retraction, caused by graves disease |
|
|
Term
| dendritic lesion is caused by |
|
Definition
|
|
Term
| one pupil fixed and dilated is caused by |
|
Definition
| 3rd nerve palsy that is pupillary involving because it can be a sign of a posterior communicating artery injury |
|
|
Term
| what can cause ulceration of the lower eye lid |
|
Definition
|
|
Term
| pupil dilated, cloudy blue eye, pressure high. cause |
|
Definition
| angle closure glaucoma, emergeny |
|
|
Term
| what is the cause of a cherry red spot |
|
Definition
| chentral retinal artery occlusion, temporal arteritis |
|
|
Term
| temporal arteritis: who gets it, what lab values show it |
|
Definition
pt 60yo+
elevated sedimentation rate, CRP, platelets |
|
|
Term
| what are signs of temporal arteritis (6) |
|
Definition
| temporal headache, jae claudication, scalp tenderness, myalgia, arthralgias, low grade fever, weight loss |
|
|
Term
| what gives the official diagnosis of temporal arteritis |
|
Definition
|
|
Term
| temporal arteritis treatment |
|
Definition
| IV sterids - emergent can spread to other eye |
|
|
Term
| what causes blood and thunder, massive hemorrages in all 4 quadrants |
|
Definition
|
|
Term
| what is the ocular sign of horner syndrome (4) |
|
Definition
| mitosis, ahyidrosis, enophthalmosis, ptosis |
|
|
Term
| what does it mean if someones eye is swollen, fever, periorbital edema |
|
Definition
| canvernous sinus thrombosis |
|
|
Term
| what are the 6 bones of the orbit |
|
Definition
| frontal, ethmoid, lacrimal, maxullary, shpenoid, zygomatic |
|
|
Term
| what makes the roof of the orbit (2) |
|
Definition
| frontal bone and lesser wing of the sphenoid |
|
|
Term
| what is the hole in the top of the orbit, what does through it, where did it come from |
|
Definition
supraorbital notch
supratrochlear nerve, branch of the frontal nerve, which is a branch of the opthalmic nerve, which is a branch of trigeminal V1 |
|
|
Term
| what makes up the lateral wall of the orbit (2) |
|
Definition
| zygomatic bone, greater wing of sphenoid |
|
|
Term
| which area of the globe is susceptible to injury |
|
Definition
|
|
Term
| what makes up the medial wall of the orbit (4) |
|
Definition
| maxillary, ethmoid, lacrimal, sphenoid |
|
|
Term
| what is the thinnest bone of the orbit |
|
Definition
|
|
Term
| what does the lamina paprycea cover |
|
Definition
|
|
Term
| what is the most likley injured bone, what is it icalled |
|
Definition
blow out fracture
medial wall |
|
|
Term
| what is the bone most likley breached in ethmoid sinusitis, what does this cause |
|
Definition
lamina papyracea bone
causes orbital celluitis |
|
|
Term
| what makes up the orbital floor (3) |
|
Definition
| maxillary, zygomatic, palatine |
|
|
Term
| what is the hole in the bottom of the orbit, what runs through it, what is it a branch of |
|
Definition
infraorbital canal
infraorbital nerve
V2 |
|
|
Term
| what is the most common fracture of the orbit floor |
|
Definition
|
|
Term
| what happens when you get a blow out fracture of the orbit floor |
|
Definition
| hypoesthesia and numbness along distribution of V2 (maxillary division of trigeminal) |
|
|
Term
| what causes opening and closing of the eye lid |
|
Definition
CN III oculomotor superior division opens via levator
CN VII facial closes it via obicularis oculi |
|
|
Term
| what is the most concerning eyelid trauma, why |
|
Definition
| on the lid margin or canalicus because it may adversley affect form, function, and closure of the lid |
|
|
Term
| what do you need to make sure you check when someone has a eyelid laceration, why |
|
Definition
| if it is full or partial thickness, if you dont bring it together right it can cause chronic tearing |
|
|
Term
| where does tear drainage occur |
|
Definition
|
|
Term
|
Definition
| puncta: one on upper lid and one on lower (90%) |
|
|
Term
| explain the path through the lacrimal apparatus (3) |
|
Definition
| punctum, canaliculus, common caniculus, lacrimal sac, nasolacrimal duct, through valve of hasner, into the nose, down the nsaopharynx |
|
|
Term
| what happens if the lacrimal apparatus isnt repaired |
|
Definition
|
|
Term
| what is the most common injury to the eye |
|
Definition
|
|
Term
| why are corneal injuries so painful |
|
Definition
| there are many corneal nerves |
|
|
Term
| why dont we patch corneal injuries |
|
Definition
| because if it is a organic substance in the eye it increases the risk of fungal infection |
|
|
Term
| what type of corneal injury is the most scary, why |
|
Definition
| metal injury: occult ocular penetration and perforation |
|
|
Term
| what is in the anterior chamber |
|
Definition
|
|
Term
| where does a penetrating injury enter, how can you test for one, why are they a concern |
|
Definition
anterior chamber
seidel test
the penetrating wound can self heal |
|
|
Term
| how do you do the seidel test |
|
Definition
apply tetracaine to florescein strip
apply tetracaine to the eye
paint area affected at slit lamp with moist strip
observe any stream of orange to green turning aqueous
may need to apply gentile pressure |
|
|
Term
| how can you check for trauma to the iris or ciliary body (4) |
|
Definition
| see if pupil is round, hypohema, iritis, iris sphincter tears at the slit lamp |
|
|
Term
| what can a misshapen pupil indicate |
|
Definition
| iris prolapse due to ruptured globe or ocular contusion causing temporairly paralysis (self correcting) |
|
|
Term
| what is the most common cause of lens subluxation, why does it damage it |
|
Definition
| trauma that damages zonules |
|
|
Term
| what are 4 causes of lens subluxation |
|
Definition
| marfans syndrome, homocystinuria, weill marchesani |
|
|
Term
| what can trauma do to the vitreous humor |
|
Definition
| vitreous hemorrhage, posteror vitreous detachment |
|
|
Term
| what can blunt trauma do to the retina (3) |
|
Definition
| cause detachment, edema, commotio retinae (whitening) |
|
|
Term
| what do you do if you suspect a intraocular foreign body |
|
Definition
| get a X-ray or CT scan of orbits |
|
|
Term
| what is contraindicated in acute ocular trauma |
|
Definition
|
|
Term
| what needs to be included in a history for eye trauma |
|
Definition
who, what, where, when?
if chemical: name, type, acid or alkaline |
|
|
Term
| what do you do if someone has a metal on metal injury |
|
Definition
| refer for dilated fundus exam |
|
|
Term
| what do you do on the external exam for ocular trauma |
|
Definition
palpate superior and inferior orbital rims for step off
determine integrity of eyelids, look for lacerations |
|
|
Term
| what can step off of the orbital rim indicate |
|
Definition
| orbital roof or flood fracture |
|
|
Term
| what areas are we most concerned about for eyelid lacerations |
|
Definition
|
|
Term
| what should you never do if you suspect a ruptured globe |
|
Definition
|
|
Term
| for trauma: after physical exam what do you do |
|
Definition
visual acuity/double vision
pupil exam
ocular motility
slit lamp exam
radiological studies |
|
|
Term
| what does restriction in the up gaze indicate |
|
Definition
| orbital blow out fracture / floor fracture |
|
|
Term
| what do you assess on the slit lamp exam after trauma (8) |
|
Definition
integrity of cornea, iris, lens
hyphema
foreign body
abbrasions
penetration sites
fundus - direct opthalamascope |
|
|
Term
| what radiographs do you order for facial trauma or fracture |
|
Definition
| CT of face and orbits with axial and coronal views |
|
|
Term
| what radiographs do you order if you think there is intra-ocular foreign body |
|
Definition
| x-ray or CT on orbits within 1-2mm cut resolution |
|
|
Term
| what do you do if someone comes in with a chemical burn (2) |
|
Definition
determine if acid or alkali
irrigate with 1-2L saline until natural pH on litmus paper |
|
|
Term
| what kind of chemical burn is worse, why |
|
Definition
| alkaline: sponification of fat and quick absorption into the eye |
|
|
Term
| how can you quickly determine the severity of a chemical burn |
|
Definition
| red is good, white eye is bad |
|
|
Term
| what is the main concern with retrobulbar hematoma |
|
Definition
| control IOP. if there is elevated IOP and pupillary defect perform lateral canthotomy and cantholysis. repair a week later, |
|
|
Term
| what causes traumatic optic neuropathy (2) |
|
Definition
acceleration/deceleration injury
decrease vision with compression of the optic nerve |
|
|
Term
| how do you treat teaumatic optic neuropathy |
|
Definition
|
|
Term
| if you suspect a penetrating injury what test do you get |
|
Definition
|
|
Term
| if you suspect a foreign body in the eye what do you do |
|
Definition
| evert and inspect upper lid especially in vertiacal abrasion of cornea |
|
|
Term
| what must you see if it is involved in eyelid laceration (2) |
|
Definition
|
|
Term
| what do you stain with before you use a slit lamp to look for corneal abrasion |
|
Definition
|
|
Term
| what is a recourrant corneal erosion |
|
Definition
| linear abrasion heals but not tight enough so will open months or years later |
|
|
Term
| what happens to a foreign body in the cornea |
|
Definition
| begins to oxidate and form rust ring, may congeal into the cornea |
|
|
Term
| what is the most important things to think about during a hyphema |
|
Definition
| pressure and rebleed within first few days (put on bed rest) which can lead to traumatic cataract, traumatic glaucoma, or traumatic retinal detachment |
|
|
Term
| what is the cause of a traumatic iridodialysis |
|
Definition
| previous blunt injury that tore the iris root away |
|
|
Term
| why do you have to wait until to fix orbital floor blow out |
|
Definition
| wait until edema is resolved |
|
|
Term
| what is the cause of a peaked pupil, why |
|
Definition
| things go path of least resistance. Natural response to laceration in cornea is to plug the wound. Loss of pressure causes iris to plug the wound and keep the eye from loosing its contents |
|
|
Term
| how can a pointed pupil help you during exam |
|
Definition
| if the eye is too bloody or clouded it can point to area of concern |
|
|
Term
| what are the two weakest points of the eye |
|
Definition
| is lindus and posterior to the insertion of the extraocular muscles, this is usually where a globe will rupture |
|
|
Term
| why is cavernous sinus syndrome so scary |
|
Definition
| life and sight threatning emergency |
|
|
Term
| what causes cavernous sinus thrombosis (3) |
|
Definition
| sinusitis, facial infection, peridontal abscess |
|
|
Term
| what is the treatment for cavernous sinus thrombosis |
|
Definition
|
|
Term
| what travels through the cavernous sinus (6) |
|
Definition
| CN III, IV, V1, V2, IV, carotid bulb |
|
|
Term
| what are signs of shaken baby syndrome (2) |
|
Definition
| multilayered hemorrhages, white centered retinal hemorrhages |
|
|
Term
| what gives the best diagnostic impression |
|
Definition
|
|
Term
| what part of the exam confirms the diagnostic impression |
|
Definition
|
|
Term
| what is the most important part of the history, what needs to be added to it |
|
Definition
| CC, ask about other related illnesses |
|
|
Term
| what two parts of the history are updated each visit |
|
Definition
| medications and allergies |
|
|
Term
| what are the 4 important parts of the social history |
|
Definition
| tobacco, alcohol, occupation, ilicit drugs |
|
|
Term
| what is the main issue with tobacco |
|
Definition
| it is mutagenic, especially cigarettes |
|
|
Term
| where can tobacco cause cancer (9) |
|
Definition
| nasopharynx, oral cavity, oropharynx, hypopharynx, larynx, esophagus, lung, bladder, prostate cancer |
|
|
Term
| head and neck mucosal cancer can be _____ or _____ meaning it can occur in many sites |
|
Definition
| multicenteric or field cancerization |
|
|
Term
| how can you tell the risk of a smoker getting laryngeal SCC |
|
Definition
| liner relationship between number of cigarettes smoked |
|
|
Term
| what is the pack a year history |
|
Definition
| total years smoke x number of packs a day during that time |
|
|
Term
| what should be asked about alcohol in the social history (2), what assumption is made |
|
Definition
average number a drinks per day week or month
how many years drinking
patients underestimate their consumption |
|
|
Term
| heavy alcohol and tobacco consumption increases the risk of _______ in the ______ by _____ times |
|
Definition
cancer
upper artodigestive
15 times |
|
|
Term
| after the diagnosis and plan it is always importan to... |
|
Definition
| schedule a follow up visit |
|
|
Term
| what tools are needed for an EENT exam 7 |
|
Definition
otoscope
light source
nasal speculum
tongue blades
laryngeal mirrior
flexible fiberoptic nasolaryngeoscope
good hands |
|
|
Term
| what is the pack a year history when the risk of cancer or disease increases at an exponential rate |
|
Definition
| 20 pack a year history (a pack a day for 20 years) |
|
|
Term
| what is the most important tool in a physical exam |
|
Definition
|
|
Term
| what are the things nursing does in the physical exam, give a disease exampl they could find (5) |
|
Definition
blood pressure - hypertension
heart rate - bradycardia
RR - tachypena
weight - osa
temp - febrile illness |
|
|
Term
| 4 things to look for in the overall appearance of the face |
|
Definition
ill looking
deformities
changes in texture or color
swelling |
|
|
Term
| 8 things to look for in the overall appearance of the ears |
|
Definition
deformities
congenital abnormalities
position
symmetry
mastoid erythema
edema
tenderness
preauricular puts or apendages |
|
|
Term
| intranasal exam 7 things to look for |
|
Definition
discoloration of mucosa
turbinate hypertrophy
turbinate deformity
rhinorrhea
septal deviation
foreign bodies
nasal polyps
tumors |
|
|
Term
| oral mucosa: 4 things to look for |
|
Definition
| discolorations, ulcerations, masses, moisture or dryness |
|
|
Term
| oral cavity or oropharynx; 7 things to look at |
|
Definition
major and minor salivary glands
tonge
tonsils
palate
uvula
floor of mouth
dentition |
|
|
Term
|
Definition
| percuss over ethmoid, maxillary, and frontal sinuses |
|
|
Term
|
Definition
palpate 5 areas vierously and divide into triangles
estimate size and location |
|
|
Term
| what is the most common CC for thyroid issues |
|
Definition
|
|
Term
| what are the parts of the thyroid exam 7 parts |
|
Definition
palpation
location
biloped and isthmus
parathyroids
associated structures
symmetry
nodules |
|
|
Term
| how should the thyroid be palpated |
|
Definition
fron the front to the rear
ask to swallow
feel nodules run under fingers |
|
|
Term
| what is the percaution for the parathyroids, why |
|
Definition
always preserve in surfery
controls Ca metabolism |
|
|
Term
| if you find a neck nodule, when so you be concerned |
|
Definition
worry if solid and cold
less milignancy if hot and cystic |
|
|
Term
| what labs or tests are done on the thyroid, what conditiosn can they reveal 5 |
|
Definition
function studies - hyper, hypo, euthyroid
thyroid antibodies - autoimmune
ultrasound- sold or cystic masses
scan - hot or cold masses
fine needle aspiration and microscope exam or suspicious masses |
|
|
Term
| how should salivary glands be palpated |
|
Definition
| bimanual: one hand in mouth the other outside |
|
|
Term
| what are the major salivary glands |
|
Definition
| parotid, submandibular, submental |
|
|
Term
| minor slaivary glands: what disease are they associated with, why |
|
Definition
| more than 400 so more likley to cause dry mouth due to drugs or autoimmune diseases |
|
|
Term
| what does it mean if you have a cold cystic nodule |
|
Definition
| all cystic nodules are cold because it means that area is non functioning thyroid. cystic nodules are fine unless they cause compression |
|
|
Term
| what does it mean if you have a hot nodule |
|
Definition
| functional thyroid tissue can take control causing hyperthyroidism |
|
|
Term
| what are two conditions that cause hyperthyroidism |
|
Definition
|
|
Term
| what duct empties the parotid |
|
Definition
|
|
Term
| what duct empties the submandibular |
|
Definition
|
|
Term
| what are the 8 parts of the indirect exam |
|
Definition
naspharynx
hypopharynx
larynx, valleculae, epiglottis, arepeiglottic folds
atenyoids
anterior and posterior comissure
true and false vocal cords
post cricoid region
pyriform sinuses |
|
|
Term
| what is looked for in the nasopharynx exam 3 |
|
Definition
adenoids
eustachian tube
rosenmueller's fossae: behind eustachian orifiace. tumors like to hide here |
|
|
Term
| hypopharynx exam what is looked at |
|
Definition
base of tongue
pharyngeal wall
tonsils |
|
|
Term
| what is looked for on a mirrior or fibroptic scope exam 4 |
|
Definition
| larynx, valleculae, epiglottis, arepiglottic folds |
|
|
Term
| what are the parts of the neuro exam 4 |
|
Definition
extraocular muscle movement
pupillary reaction
CN
cerebellar exam |
|
|
Term
| how do you do an EENT exam on a baby |
|
Definition
| kid laying on lap with mom holding hands and elbows. use light on head. examine mouth last when they cry |
|
|
Term
| wat are the lateral, medial, lining, medial boundry of the auditory canal |
|
Definition
lateral: cardiladge, cerumen glands, hair follicles
medial, bone
lined: squamous epithelium
medial boundry: tympanic membrane |
|
|
Term
| what is the average lenth of the auditory canal |
|
Definition
|
|
Term
| what are the parts of the outer ear 8 |
|
Definition
triangular fossa
helical crus
tragus
helix
antihelix
scapha
anti tragus
lobule |
|
|
Term
| tympanic membrane: how is it divided, what are the names of the parts |
|
Definition
divided into quadrants
pars tensa, pars flaccida |
|
|
Term
| what are the three layers of the pars tensa, what is their significance in healing |
|
Definition
squamous
fibril - wont heal in perforation making healed area thin so it make be mistaken for still being perforated
mucosal |
|
|
Term
| what are the landmarks of the tympanic membrane 5 |
|
Definition
malleys
umbo
incudostapedial joint
chonda tympani
round window niche |
|
|
Term
| what seperates the neck and into what |
|
Definition
| sternocleidomastoid muscle into anterior and posterior triangle |
|
|
Term
| what are the five areas you need to look at in the neck, what is in them |
|
Definition
1. submadibular triangle
2. carotid triangle - jugular and gatric nodes
3. mid jugular nodes on omohyoid
4. lower jugular nodes at bottom on inferior carotid triangle
5. occipital triangle |
|
|
Term
| what are the 10 bones and cardiladges of the nose |
|
Definition
frontal bone
nasal bones
frontal process of the maxilla
septal cartiladge
lateral nasla cartiladge
lesser alar cardiladge
greater alar cartiladge
leteral crus
medial crus
anterior nasal spine |
|
|
Term
| whatare the 6 parts of the nasal septum |
|
Definition
| ethmoid, sphenoid bone, palatine bone, maxilla, cardiladge, vomer |
|
|
Term
| what are the common neck masses from age 0-15 in order of prevelence |
|
Definition
inflammatory
congenital
neoplasia: malignant > benign |
|
|
Term
| what are the common neck masses from age 16-40 in order of prevelence |
|
Definition
inflammatory
congenital
neoplasia: benign > malignant |
|
|
Term
| what40+ in order of prevelence |
|
Definition
neoplasia: malignant > benign (cancer until proven otherwise)
inflammatory
congenital |
|
|
Term
| what are the 7 common primary origins of neck masses in order of their prevelence |
|
Definition
tonsil 25%
base of tongue and nasopharynx 20%
hpoppharynx 15%
floor of mouth 10%
pharynx and thyroid 5% |
|
|
Term
| what parts are looked at on the physical exam for a neck mass(10) |
|
Definition
oral cavity, nasopharynx, hypopharynx, larynx, thyroid, salivary glands
skin of scalp, face, ears, neck |
|
|
Term
| what types of radiographic studies can be done for a neck mass (10) |
|
Definition
| chest x-ray, sinus x-ray, ultrasound, MTI, CT, mrA, arteriography, saliography, radionucleotid, endoscopy |
|
|
Term
| what is neck level 6, what is its significance |
|
Definition
paratracheal
dissected in thyroid ectomy for cancer |
|
|
Term
| what is level 2 of the neck |
|
Definition
|
|
Term
| what is level 3 of the neck |
|
Definition
|
|
Term
| what is level 4 of the neck |
|
Definition
|
|
Term
| what is level 5 of the neck |
|
Definition
|
|
Term
| what is level 1 of the neck |
|
Definition
|
|
Term
| why are the levels of the neck important for neck masses |
|
Definition
| they tell you where the primary is at |
|
|
Term
| what biopsies are done for neck masses |
|
Definition
| open or needle aspiration |
|
|
Term
| what areas drain into the posterior triangle |
|
Definition
| aurical and back, scalp, nasopharynx |
|
|
Term
| what areas drain into the submandibular triangle |
|
Definition
|
|
Term
| what areas drain into the preauricular triangle |
|
Definition
|
|
Term
| where are thyroid masses located in the neck, what can the mass be composed of, what should you do when you see one |
|
Definition
midline neck
can be benign, malignant, inflammatory, or infectious
always fine needle aspirate masses and send out specimine |
|
|
Term
| what are 5 studies that can be done on the thyroid, what is a percaution |
|
Definition
thyroid function studies
thyroid scan (99-Tc)
U/S
FNA
CT scan- do thyroid scan first, contrast will mess it up for 6 weeks |
|
|
Term
| what two types of neck masses can be due to carcinomas |
|
Definition
nasopharyngeal
paranasal and sinus |
|
|
Term
| what 4 neck masses are congenital |
|
Definition
branchial cleft cyst
thyroglossal duct cyst
laryngocele
lymphangomia |
|
|
Term
| what neck masses are adenoma / adentitis (6) |
|
Definition
warthin's tmor
pyelomorphic ademona of the salivary glands
Tb adentitis
cat scratch disease
actinomycosis
sialedentitis |
|
|
Term
| what areas metastazise into the upper jugular (1-3) |
|
Definition
| oral pharynx and oral cavity |
|
|
Term
| what areas metastasize into the lower jugular |
|
Definition
|
|
Term
| what areas metastasize into the submantibular triangle |
|
Definition
| oral cavity, nasal, sinus, facial |
|
|
Term
| what 5 neck masses are due to infection |
|
Definition
ludwigs angina
odontogenic abscess
submandibular abscess
midline neck abscess
adentitis |
|
|
Term
| what neck masses can be malignant 4 |
|
Definition
parotid
lymphoma
virchow;s node
glomus tumor |
|
|
Term
| what neck mass is autoimmune |
|
Definition
|
|
Term
| what neck mass is a benign tumor |
|
Definition
|
|
Term
| what neck mass is a sarcoma |
|
Definition
|
|
Term
| what neck mass is induced by trauma |
|
Definition
|
|
Term
| nasopharyngeal carcioma: CC, Dx, complications |
|
Definition
cc: i can't hear
dx: unilateral serious otitis media without history
complications: can invade skull base |
|
|
Term
| who commonly gets nasopharyngeal carcinoma (2), what causes it |
|
Definition
cantonese chinese between 44-55 yo
EBV associated |
|
|
Term
| what are the 3 types of nasopharyngeal carcinoma, which is the most common |
|
Definition
squamous cell
non-keratainizing
undifferentiated - most common |
|
|
Term
| who most commonly gets a paranasal or sinus carcinoma (4) |
|
Definition
males > females
50-79 yo
hardwood and niclel workers |
|
|
Term
| around when is a paranasal or sinus carcinoma diagnosed, why |
|
Definition
| 8 mo delay from symptoms becaise the symptoms are non-specific |
|
|
Term
| what types of carcinoma do hardwood workers get (3) |
|
Definition
| adenocarcinoma, squamous cell, anaplastic paranasal and sinuc carcinomas |
|
|
Term
| what types of carcinomas do nickel workers get (2) |
|
Definition
| squamous cell and anaplastic paranasal and sinus carcinoma |
|
|
Term
| when and how are paranasal and sinus carcinoma treated |
|
Definition
one sinus = send to surgery (espically if bony erosion)
especially if it is a bony erosion |
|
|
Term
| branchial cleft cyst: where is it located, when is it diagnosed |
|
Definition
anterior triangle
usually diagnosed as child or early adult |
|
|
Term
| describe the mass of a branchial cleft cyst (3) |
|
Definition
| non-tender, fluctuant, has abscess that is tender inflammed and painful |
|
|
Term
| what are 5 symptoms of branchial cleft cyst |
|
Definition
| mass, abscess, dysphagia, dyspenia, stridor |
|
|
Term
| first branchial cleft cyst: location |
|
Definition
| behind ear lobule, connects to external canal |
|
|
Term
| what do you do if a branchial cleft cyst develops an abscess |
|
Definition
|
|
Term
| second branchial cleft cyst: location |
|
Definition
| cyst in neck that connects to external canal, most common |
|
|
Term
| fourth branchial cleft cyst: location, sign |
|
Definition
open to skin
between internal and external carotid, over cn12, under aortic arch, up into piriform sinus |
|
|
Term
| what is the difference between a second and third branchial cleft cyst |
|
Definition
second goes over CN 9 and 12
third goes between CN 9 and 12
cant tell the difference until surgery |
|
|
Term
| what branchial cleft cyst is the most common |
|
Definition
|
|
Term
| what is the treatment of a branchial cleft cyst (2) |
|
Definition
surgical excision
use 18 gauge needle to get the thick green goo out |
|
|
Term
| thyroglossal duct cyst: location, complications (2) |
|
Definition
anterior midline neck
may become infected
may have more than one thyroid |
|
|
Term
| thyroglossal duct cyst: how to identify |
|
Definition
| moves with swallowing and potrusion of the tongue |
|
|
Term
| thyroglossal duct cyst: treatment (2) |
|
Definition
operation
thyroid scan before operation |
|
|
Term
| laryngocele: location, cause, who gets it (2) |
|
Definition
most common in 50-60s
more in males
midline neck
dilation of laryngeal ventricle and saccule |
|
|
Term
| laryngocele types and how to identify them |
|
Definition
internal: inside larynx, no neck mass, can cause airway stress
external; outside larynx, neck mass |
|
|
Term
|
Definition
aiways compormise (internal)
laterla neck mass (external)
increase in size with increased pressure
gurgling sensation |
|
|
Term
| lymphangomia: aka, location, cause |
|
Definition
cystic hygroma
posterior triangle
congenital malformation of the lymphatic system |
|
|
Term
| lymphangomia: where is it most commonly located, who is it seen in |
|
Definition
head and nack
usually found <2yo |
|
|
Term
| lymphangomia: symptoms(5) |
|
Definition
painless, soft, ill defined, doughy mass
dysphagia, paiin, stidor, dyspenia |
|
|
Term
|
Definition
| surgical excision (difficult due to finger like projections) |
|
|
Term
| what 4 things do you do when an inflammatory adenopathy is suspected |
|
Definition
observe, put on antibiotics for two weeks, repeat exam
if not better aspirate and send for tests |
|
|
Term
| warthin's tumor: aka, what is it, who gets it, where is it |
|
Definition
papillary cystadenoma lymphomatosum
benign cystic mass
more in men than women
usually in parotid, rarley bilateral |
|
|
Term
|
Definition
slow growing
non tendor
cystic |
|
|
Term
| warthin's tumor: treating |
|
Definition
| none, dont risk life to take it out |
|
|
Term
| pyelomorphic adenoma of the salivary glands: prognosis, treatment |
|
Definition
benign, high reoccurrance
operation: it can convert to cancer and damage to facial or marginal nerve |
|
|
Term
| what is the claim to fame of pyelomorphic adenoma of the alivary glands |
|
Definition
| most common benign salivary tumor |
|
|
Term
| who gets pyelomorphic adenoma of the salivary glands (2) |
|
Definition
|
|
Term
| where is pyelomorphic adenoma of the salivary glands usually |
|
Definition
|
|
Term
| tuberculosis adentitis: what disease category, what location, cause |
|
Definition
granulomatous adenopathy
posterior triangle
atypical mycobacterium (not usually TB)causes node to outgrow blood supply and abscess |
|
|
Term
| tuberculosis adentitis: who gets it (2) where is it located (2) |
|
Definition
| kids (more common) - anterior triangle adults - posterior triangle (may be TB) |
|
|
Term
| tuberculosis adentitis 4 signs |
|
Definition
progressive enlargement
fever, local pain, alaise |
|
|
Term
| cat scratch disease: disease family, location, cause |
|
Definition
granulomatous adenopathy
posterior triangle
regional lymphadentitis due to rochalimaea henselae infection from cat interaction 3 weeks prior |
|
|
Term
| cat scratch disease: who gets it and where |
|
Definition
| kids in periauricular and submandibular areas (posterior triangle says notes in other spot) |
|
|
Term
| cat scratch disease signs (6) |
|
Definition
lymphadenopathy
low grade fever
myalgia
malaise
headache
anorexia |
|
|
Term
| cat scratch disease pathology |
|
Definition
| multiple granulomas with micro abscesses |
|
|
Term
| cat scratch disease: treatment (4) |
|
Definition
resolves in 3 mo
analgesics
warm compress
antibiotics (erythromycin, clythromycin) |
|
|
Term
| actinomycosis: disease family, lcation (3), who gets it |
|
Definition
granulomatous adenopathy
seen in adults
in submandibular and upper jugular (other spot says posterior triangle) |
|
|
Term
| sialdentitis: what is it, what subtype is there |
|
Definition
infection of the slaivary glands
sialyosis: enlarged infected parotid |
|
|
Term
|
Definition
infection, dehydration, chemo, saliolithiasis,
saliosis: DM, alcoholic, vitamin deficiency, sjogerns |
|
|
Term
| sialdentitis treatment (3) |
|
Definition
| hydration, antibiotics, warm compress |
|
|
Term
|
Definition
| infection of the floor of the mouth usually due to dental procedure or treatment |
|
|
Term
| what are the signs of ludwigs angina (4) |
|
Definition
woody induration (not abscess)
submental and submandibular enlargement (fluid in all triangles)
high temperature
tongue displacement |
|
|
Term
| odontogenic abscess: cause, signs (2) |
|
Definition
infection due to dentition
painful swelling trismus
floow or mout elevated pushing tongue posterior |
|
|
Term
| odontogenic abscess treatment (2) |
|
Definition
|
|
Term
| what is the cause of a submandibular abscess, when and how is it treated |
|
Definition
impacted stone in submandibular duct
if swollen for >2 d then start antibiotics |
|
|
Term
| parotid malignancy: ddx, 3 signs, complications |
|
Definition
ddx: bells palsy
parotid mass, CN VII paralysis, pain in 5-7%
20% metastizises to lung and bone |
|
|
Term
| signs a neck mass is lymphoma (6) |
|
Definition
may or may not be symptomatic
soft, smooth, elastic, mobile node
slow growing |
|
|
Term
| how is a neck lymphoma diagnosed (2) |
|
Definition
|
|
Term
| how is a neck lymphoma treated |
|
Definition
| chemotherapy and or radiation |
|
|
Term
| what are the types of virchow;s nodes, where did they come from |
|
Definition
left supraclavicular: comes from anywhere in the body but the right chest
right supraclavicular: comes from the right chest
GI, GI, lung, pancreas |
|
|
Term
| glomus tumor: aka, prognosis, treatment |
|
Definition
chemdectoma
rarley malignant
surgical excision |
|
|
Term
|
Definition
firm round slow growing
on lateral neck |
|
|
Term
| glomus tumor diagnosis (4) |
|
Definition
| angiography, CT, mri, MRA |
|
|
Term
| sjogern's syndrome: aka, 3 signs |
|
Definition
dry eyes and mouth, arthritis
SICCA syndrom |
|
|
Term
| 4 ways to diagnose sjogern's syndrome |
|
Definition
sjogern;s antibody test
biopsy of lower lip
scarred down minor salivary glands
parotid enlargement |
|
|
Term
| hemangioma: location, when does it show up, when does it involution |
|
Definition
anterior triangle
usually evident by 6 mo
spontaneous involution by 7 mo |
|
|
Term
|
Definition
diffuse skin lesions
soft cystic masses |
|
|
Term
|
Definition
conservative therapy - dont operate early it will get smaller
surgery for cosmetic or functional impairment
steroids to slow or stop groath |
|
|
Term
| karposki's sarcoma: aka, who gets it, where is it |
|
Definition
diffuse adenopathy
seen in HIV positive
bilateral parotid masses |
|
|
Term
| acquired laryngocele : how does it happen give examples (4) |
|
Definition
prolonged increased intralaryngeal pressure
cough, straining, glass blowing, wind insturments |
|
|
Term
| What is he external ear derived from and when |
|
Definition
| Hillocks of his (mesoderm of 1st and 2nd arches) in the 6th week of gestation |
|
|
Term
| What comes from the first arch |
|
Definition
Hillock 1: targus
Hillock 2: helical crus
Hillock 3: helix |
|
|
Term
| What comes from the second arch |
|
Definition
Hillock 4: anti helix
Hillock 5: anti targus
Hillock 6: lobule and lower helix |
|
|
Term
| What comes from the 6th hillock |
|
Definition
|
|
Term
| What Do we need to know about the incostapedial joint |
|
Definition
| Likes to erode when there is negative pressure behind the tm |
|
|
Term
| What's In upper left internal auditory canal |
|
Definition
|
|
Term
| What's in lower left internal auditory canal |
|
Definition
|
|
Term
| What's in upper right internal auditory canal |
|
Definition
| Superior vestibular nerve |
|
|
Term
| What's in lower right internal auditory canal |
|
Definition
| Inferior vestibular nerve |
|
|
Term
| What divides upper and lower internal auditory canal |
|
Definition
|
|
Term
| Wha divides upper right and left internal auditory canal |
|
Definition
|
|
Term
| What is In the top of the internal auditory canal |
|
Definition
Superior scc
Horizontal scc
Utricle |
|
|
Term
| What is in the bottom of the internal auditory canal |
|
Definition
|
|
Term
| What is the most effective frequency why |
|
Definition
| 500-3000 Hz, range of human speech |
|
|
Term
| Explain impedance matching, how is it quantified |
|
Definition
Sound moves TM which moves ossicles as a level and gives stapedius a good push
This movement is transformed at a ratio of 22:1 which causes a 25dB increase |
|
|
Term
| What happens to hearing if. Something is wrong with ossicles |
|
Definition
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