APEA 3P Pathophysiology - Head, Eyes,
Ears, Nose & Throat
acute otitis media - ANS - s/s: unilateral otalgia (ear pain) and decreased or
muffled hearing
diagnosis is by otoscopy, which reveals a bulging tympanic membrane with
reduced mobility. often, the tympanic membrane is erythematous.
otitis media with effusion presents with yellow, clear fluid behind the tympanic
membrane with or without viscous bubbles and/or retraction of the tympanic
membrane
The most causative organisms in acute otitis media are S. pneumoniae, H.
influenzae, and M. catarrhalis.
\acute primary angle glaucoma - ANS - s/s: headache, severe eye pain, visual
disturbances, halos around lights, conjunctival redness, cloudy cornea, n/v
clinical signs that suggest a rapid increase in intraocular pressure include
conjunctival redness, corneal edema or cloudiness, a shallow anterior chamber,
and a mid-dilated pupil (4 to 6 mm) that reacts poorly to light. Diagnosis begins
with emergent examination of both eyes by an ophthalmologist, including the
following tests: visual acuity, evaluation of the pupils, measurement of
intraocular pressure, slit-lamp examination of the anterior segments, visual field
testing, gonioscopy, and undilated fundus examination
\adenopathy (lymphadenopathy) - ANS - enlarged or swollen lymph nodes
\afferent pupillary defect - ANS - an abnormal finding of dilation of the pupil
instead of constriction in response to a shining light
associated with optic neuritis
refer to neurologist
\allergic rhinitis - ANS - an allergic reaction to airborne allergens that causes an
increased flow of mucus
The first-line treatment for allergic rhinitis is a topical nasal steroid spray, which
is used once or twice per day. Allergic rhinitis can be seasonal (e.g., due to
, ragweed, mold, or pollens), or it can be due to an indoor allergen, such as dust
mites. If it is severe or accompanied by asthma, referral to an allergist for allergy
testing is helpful. Topical nasal decongestant spray (e.g., Afrin) is for short-term
use only because it can result in a rebound effect with worsening of symptoms
(rhinitis medicamentosa).
\arteriovenous nicking - ANS - Indentations or pinched appearances where veins
and arteries cross.
associated with mild hypertensive retinopathy
\audiometry - ANS - the use of an audiometer to measure hearing acuity
\auricular hematoma - ANS - bleeding in the auricular cartilege
cause: direct, blunt trauma commonly seen in wrestlers, boxers, MMA fighters
tx: hematoma needs drained or it can result in cauliflower ear
\avulsed tooth - ANS - considered a dental emergency for permanent teeth
the sooner the avulsed tooth is reimplanted, the better the outcome
tx:
-avoid touching the root, handle only the crown
-rinse tooth in normal saline, irrigate the socket with normal saline
-reimplant the tooth
-have the pt bite down on gauze and refer to dentist as soon as possible
-store the tooth in cold milk or saline or store inside the cheek (buccal sulcus) if
unable to reimplant
\basilar skull fracture - ANS - temporal bone is commonly fractured - linear
fracture is most common followed by depressed and basilar skull fractures
causes: falls, assaults, car collisions, penetrating missiles
s/s: periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle sign)
appear in 1-3 days following trauma; physical exam does not show these signs
immediately
assessment:
-clear rhinorrhea or otorrhea (discharge from ear or nose suggesting CSF leak)
-hemotympanum (blue-purple color of tympanic membrane [TM]) caused by blood
accumulation in the middle ear
Ears, Nose & Throat
acute otitis media - ANS - s/s: unilateral otalgia (ear pain) and decreased or
muffled hearing
diagnosis is by otoscopy, which reveals a bulging tympanic membrane with
reduced mobility. often, the tympanic membrane is erythematous.
otitis media with effusion presents with yellow, clear fluid behind the tympanic
membrane with or without viscous bubbles and/or retraction of the tympanic
membrane
The most causative organisms in acute otitis media are S. pneumoniae, H.
influenzae, and M. catarrhalis.
\acute primary angle glaucoma - ANS - s/s: headache, severe eye pain, visual
disturbances, halos around lights, conjunctival redness, cloudy cornea, n/v
clinical signs that suggest a rapid increase in intraocular pressure include
conjunctival redness, corneal edema or cloudiness, a shallow anterior chamber,
and a mid-dilated pupil (4 to 6 mm) that reacts poorly to light. Diagnosis begins
with emergent examination of both eyes by an ophthalmologist, including the
following tests: visual acuity, evaluation of the pupils, measurement of
intraocular pressure, slit-lamp examination of the anterior segments, visual field
testing, gonioscopy, and undilated fundus examination
\adenopathy (lymphadenopathy) - ANS - enlarged or swollen lymph nodes
\afferent pupillary defect - ANS - an abnormal finding of dilation of the pupil
instead of constriction in response to a shining light
associated with optic neuritis
refer to neurologist
\allergic rhinitis - ANS - an allergic reaction to airborne allergens that causes an
increased flow of mucus
The first-line treatment for allergic rhinitis is a topical nasal steroid spray, which
is used once or twice per day. Allergic rhinitis can be seasonal (e.g., due to
, ragweed, mold, or pollens), or it can be due to an indoor allergen, such as dust
mites. If it is severe or accompanied by asthma, referral to an allergist for allergy
testing is helpful. Topical nasal decongestant spray (e.g., Afrin) is for short-term
use only because it can result in a rebound effect with worsening of symptoms
(rhinitis medicamentosa).
\arteriovenous nicking - ANS - Indentations or pinched appearances where veins
and arteries cross.
associated with mild hypertensive retinopathy
\audiometry - ANS - the use of an audiometer to measure hearing acuity
\auricular hematoma - ANS - bleeding in the auricular cartilege
cause: direct, blunt trauma commonly seen in wrestlers, boxers, MMA fighters
tx: hematoma needs drained or it can result in cauliflower ear
\avulsed tooth - ANS - considered a dental emergency for permanent teeth
the sooner the avulsed tooth is reimplanted, the better the outcome
tx:
-avoid touching the root, handle only the crown
-rinse tooth in normal saline, irrigate the socket with normal saline
-reimplant the tooth
-have the pt bite down on gauze and refer to dentist as soon as possible
-store the tooth in cold milk or saline or store inside the cheek (buccal sulcus) if
unable to reimplant
\basilar skull fracture - ANS - temporal bone is commonly fractured - linear
fracture is most common followed by depressed and basilar skull fractures
causes: falls, assaults, car collisions, penetrating missiles
s/s: periorbital ecchymosis (raccoon eyes), mastoid ecchymosis (Battle sign)
appear in 1-3 days following trauma; physical exam does not show these signs
immediately
assessment:
-clear rhinorrhea or otorrhea (discharge from ear or nose suggesting CSF leak)
-hemotympanum (blue-purple color of tympanic membrane [TM]) caused by blood
accumulation in the middle ear
