OB/Peds
1412
Exam
2
-
Respiratory
function
of
eustachian
tubes
allows
drainage
from
middle
ear
to
pharynx
equalize
air
pressure
between
middle
ear
and
outside
environment
eustachian
tubes
close
to
stop
infection
from
traveling
up
from
nasopharynx
to
middle
ear
eustachian
tubes
are
closed
except
when
draining
fluid
yawning
swallowing
chewing
patho
of
otitis
media
obstruction
of
eustachian
tubes
⟶
doesn't
allow
drainage
⟶
infection
in
fluid
(AOM)/pressure
and
pain
from
fluid
(OME)
common
causes/risk
factors
for
otitis
media
A&P
of
infant
and
toddler
ears
⟶
shorter,
wider,
more
horizontal
viruses,
esp
URI
daycare
attendance/siblings
⟶
↑
exposure
to
viruses
adenoiditis
⟶
edema
⟶
obstruction
allergic
rhinitis
exposure
to
cigarette
smoke
bottle
propping
most
common
age
for
otitis
media
6-20mos AOM
(acute
otitis
media)
is
an
infection
of
rapid
onset
w/
fever
and
ear
pain
OME
(otitis
media
w/
effusion)
is
fluid
in
the
middle
ear
space
w/o
symptoms
of
acute
infection
blockage
may
be
extrinsic
intrinsic
extrinsic
blockage
sources
enlarged
adenoids
nasopharyngeal
tumors
intrinsic
blockage
sources
infection
allergies
URI
additional
r/f
for
OME
recent
AOM
s/s
of
AOM
ABRUPT
ONSET
⟶
fever,
pain,
middle
ear
effusion
otalgia
(earache)
EAR
TUGGING
rhinorrhea
irritability/persistent
crying
sleep
disturbances
NVD
anorexia
bulging,
opaque,
red
tympanic
membrane
w/
distorted
light
cone s/s
of
OME
tinnitus,
popping
sounds
⟶
"What's
that
ringing?"
hearing
loss
⟶
may
not
respond
as
usual,
seems
behavioral
but
isn't
mild
balance
disturbances
⟶
trips
when
walking,
unsteady
dull
grey/yellow
tympanic
membrane
w/
visible
fluid
and
air
bubbles,
distorted
light
cone
what
to
assess
for
otitis
media
tympanic
membrane
w/
otoscope
⟶
at
onset
and
only
to
check
progress
pain
behavior
sleep
fever
complications
of
OM
middle
ear
damage
⟶
hearing
loss,
language
delay
perforation
OM:
associated
disorders/common
comorbidities
viruses,
esp
URI
allergic
rhinitis
adenoiditis
labs
for
OM
only
if
child
is
toxic,
has
immunodeficiency ,
or
hx
of
failed
abx
therapy
C&S
OME
medical
interventions
usually
resolves
on
own
in
1-3mos
comfort
measures
⟶
tylenol,
hot/cold
compress,
numbing
drops
surgery
if
recurrent
⟶
myringotomy
("ear
tubes") decongestants
or
antihistamines?
decongestants
decongestants
dry
by
draining,
antihistamines
dehydrates
fluid
into
ear
cement
AOM
medical
interventions
usually
resolves
on
own
in
48-72h
comfort
measures
⟶
tylenol,
hot/cold
compress,
numbing
drops
ABX
if
indicated
surgery
if
recurrent
⟶
myringotomy
("ear
tubes")
when
to
use
abx
w/
AOM
immunocompromised
⟶
immediately
infants/young
children
⟶
pain
&
fever
48h
older
children
⟶
severe
symptoms
most
common
acute
illness
in
infants/children
otitis
media
ABC
used
for
AOM
amoxicillin
5-10
days
cephalosporin
if
allergy
to
amoxicillin
purpose
of
myringotomy
allow
drainage
allows
air
exchange
to
bypass
eustachian
tubes
prevents
further
scarring
and
hearing
loss
medications
for
OM
ABX
if
indicate
⟶
amoxicillin
or
cephalosporin
tylenol
numbing
drops
1412
Exam
2
-
Respiratory
function
of
eustachian
tubes
allows
drainage
from
middle
ear
to
pharynx
equalize
air
pressure
between
middle
ear
and
outside
environment
eustachian
tubes
close
to
stop
infection
from
traveling
up
from
nasopharynx
to
middle
ear
eustachian
tubes
are
closed
except
when
draining
fluid
yawning
swallowing
chewing
patho
of
otitis
media
obstruction
of
eustachian
tubes
⟶
doesn't
allow
drainage
⟶
infection
in
fluid
(AOM)/pressure
and
pain
from
fluid
(OME)
common
causes/risk
factors
for
otitis
media
A&P
of
infant
and
toddler
ears
⟶
shorter,
wider,
more
horizontal
viruses,
esp
URI
daycare
attendance/siblings
⟶
↑
exposure
to
viruses
adenoiditis
⟶
edema
⟶
obstruction
allergic
rhinitis
exposure
to
cigarette
smoke
bottle
propping
most
common
age
for
otitis
media
6-20mos AOM
(acute
otitis
media)
is
an
infection
of
rapid
onset
w/
fever
and
ear
pain
OME
(otitis
media
w/
effusion)
is
fluid
in
the
middle
ear
space
w/o
symptoms
of
acute
infection
blockage
may
be
extrinsic
intrinsic
extrinsic
blockage
sources
enlarged
adenoids
nasopharyngeal
tumors
intrinsic
blockage
sources
infection
allergies
URI
additional
r/f
for
OME
recent
AOM
s/s
of
AOM
ABRUPT
ONSET
⟶
fever,
pain,
middle
ear
effusion
otalgia
(earache)
EAR
TUGGING
rhinorrhea
irritability/persistent
crying
sleep
disturbances
NVD
anorexia
bulging,
opaque,
red
tympanic
membrane
w/
distorted
light
cone s/s
of
OME
tinnitus,
popping
sounds
⟶
"What's
that
ringing?"
hearing
loss
⟶
may
not
respond
as
usual,
seems
behavioral
but
isn't
mild
balance
disturbances
⟶
trips
when
walking,
unsteady
dull
grey/yellow
tympanic
membrane
w/
visible
fluid
and
air
bubbles,
distorted
light
cone
what
to
assess
for
otitis
media
tympanic
membrane
w/
otoscope
⟶
at
onset
and
only
to
check
progress
pain
behavior
sleep
fever
complications
of
OM
middle
ear
damage
⟶
hearing
loss,
language
delay
perforation
OM:
associated
disorders/common
comorbidities
viruses,
esp
URI
allergic
rhinitis
adenoiditis
labs
for
OM
only
if
child
is
toxic,
has
immunodeficiency ,
or
hx
of
failed
abx
therapy
C&S
OME
medical
interventions
usually
resolves
on
own
in
1-3mos
comfort
measures
⟶
tylenol,
hot/cold
compress,
numbing
drops
surgery
if
recurrent
⟶
myringotomy
("ear
tubes") decongestants
or
antihistamines?
decongestants
decongestants
dry
by
draining,
antihistamines
dehydrates
fluid
into
ear
cement
AOM
medical
interventions
usually
resolves
on
own
in
48-72h
comfort
measures
⟶
tylenol,
hot/cold
compress,
numbing
drops
ABX
if
indicated
surgery
if
recurrent
⟶
myringotomy
("ear
tubes")
when
to
use
abx
w/
AOM
immunocompromised
⟶
immediately
infants/young
children
⟶
pain
&
fever
48h
older
children
⟶
severe
symptoms
most
common
acute
illness
in
infants/children
otitis
media
ABC
used
for
AOM
amoxicillin
5-10
days
cephalosporin
if
allergy
to
amoxicillin
purpose
of
myringotomy
allow
drainage
allows
air
exchange
to
bypass
eustachian
tubes
prevents
further
scarring
and
hearing
loss
medications
for
OM
ABX
if
indicate
⟶
amoxicillin
or
cephalosporin
tylenol
numbing
drops
