Chamberlain NR 511 Week 2 Quiz
Otalgia - ANSWER * Ear Pain
* Two types
1. Primary Otalgia
2. Referred Otalgia
Primary Otalgia - ANSWER Typically caused by:
* Otitis Externa
* Otitis Media
* Mastoiditis
* Auricular Infections
Differential Diagnosis for Otalgia - ANSWER * Otitis Externa
* Otitis Media
* Otitis Media with Effusion
* Eustachion Tube dysfunction
* Barotrauma
* Cerumen Impaction
* Dental Disease
* TMJ Joint dysfunction
* Perforated Tympanic Membrane
* Sunus Disease
* Cervical Lymphadenopathy
Differential Diagnosis for Hearing Loss - ANSWER * Presbycusis
* Noise Exposure
* Eustachian tube dysfunction
* Cerumen Impaction
* Chronic Middle Ear infection, Effusion
* Otosclerosis
* Tympanosclerosis
* Cholesteatoma
* Trauma
* Congenital disorders
Tinnitus - ANSWER a ringing, buzzing, or roaring sound in one or both ears
Differential Diagnosis for Tinnitus - ANSWER * Otologic : Hearing loss, Meniere's
disease, Acoustic Neuroma
,* Ototoxic medications or substances
* Neurologic: Multiple sclerosis, head injury
* Metabolic: thyrooid disorder, Hperlipidemia, vitamin b12 deficiency
* Pychogenic: depression, anxiety, fibromyalgia
Differential DX Mouth Sores - ANSWER * Food or Drug allergies
* Chemical irritation
* Dry Mouth
* Mechanical or thermal injury
* Infectious (Bacterial/Fungal)
* Host Immunosuppression
* Nutritional Deficiency
Pharyngitis (Sore throat) - ANSWER inflammation or infection of the pharynx
Differential Dx Pharyngitis - ANSWER * Streptococcal Infections
* Tonsillitis
* HSV Infection
* Gonococcus
* Candidiasis
* Aphthous ulceration
* Influenza
* Rhino virus, Adenovirus, Epstein-Barr Virus, Coxasckievirus
*Mycoplasma Infection
inner ear - ANSWER
Structure of the Ear - ANSWER
Sensorineural Hearing Loss - ANSWER Caused by a lesion in the organ of corti or
the central neural pathways of the ear, including CN VIII and auditory cortex
Conductive Hearing Loss - ANSWER Hearing loss or impairment resulting from
interference with the transmission of sound waves to the cochlea
Presbycusis - ANSWER * Age related hearing loss
* Usually after age 50 when otic hair cells degenerate
* High frequency hearing loss that is equal bilateral
Differential Dx Sensorineural Hearing Loss - ANSWER * Presbycusis
* Meniere's Disease
* Tumors (Acoustic Neuroma)
* Medications (Aminoglycocides, aspirin, Quinine)
* Disease (Syphilis, viral infections such as mumps, or bacterial infection)
Differential Dx Conductive Hearing Loss - ANSWER * Cerumen impaction
* Perforated Tympanic Membrane
* Chronic Infections
* Congenital Abnormalities
* Otosclerosis or tympanosclerosis
, * Temporal bone fractures
Meniere's disease - ANSWER Abnormal condition within the labyrinth of the inner
ear that can cause fluctuating loss of hearing. The symptoms are dizziness or
vertigo, hearing loss, and tinnitus (ringing in the ears).
Acoustic Neuroma - ANSWER Rare tumor on the auditory nerve (8th cranial nerve)
that causes unilateral vertigo, tinnitus, and hearing loss. Sometimes associated with
a headache. May also have neurologic changes such as facial weakness, tingling,
loss of taste and dysphagia.
Dysphagia - ANSWER difficulty swallowing
aphasia - ANSWER difficulty speaking
Subjective findings for hearing loss - ANSWER * Difficulty hearing
* Tinnitus
* Dizziness
* Vertigo
* Pain, Pressure, Popping in ears
Cholesteotoma - ANSWER a type of tumor that can occur in the middle ear and
cause a conductive hearing loss (keratonizing Squamous Epithelium)
Diagnostic tests for Hearing loss - ANSWER * CT or MRI - Identify acoustic
Neuromas or Tympanic Paragangliomas
* Audiometry speech testing, and middle ear pressure
* MRI may detect cholesteotoma
Differential Diagnosis Hearing Loss - ANSWER Determine if its sensorineural or
conductive
Cerumen Impaction Management - ANSWER * Place 1:1 mixture of warm
hydrogen pyroxide and mineral oil in external ear canal for 1 hour. Then lavage with
warm saline.
* or us Debrox (6.5% carbamide peroxide
* or use docusate sodium liquid
** press post and pre auricle then up and down to work the wax out, dry with warm
hair dryer.
*** Use for 1 week before returning for ear canal disimpaction
**** Do not disimpact if tympanic membrane is perforated
Cerumen impaction complication - ANSWER If trauma to canal during
disimpaction:
Treat with cortisporin otic, 4 drops 3 to 4 times daily for 5 to 7 days)
Referal for sensorineural hearing loss - ANSWER * ENT -> perforation of TM,
damage to Oscicles, tympanosclerosis, otosclerosis, tumor, temporal bone injury,
Menier's disease, acoustic neuromas
* Audiology -> hearing loss
Otalgia - ANSWER * Ear Pain
* Two types
1. Primary Otalgia
2. Referred Otalgia
Primary Otalgia - ANSWER Typically caused by:
* Otitis Externa
* Otitis Media
* Mastoiditis
* Auricular Infections
Differential Diagnosis for Otalgia - ANSWER * Otitis Externa
* Otitis Media
* Otitis Media with Effusion
* Eustachion Tube dysfunction
* Barotrauma
* Cerumen Impaction
* Dental Disease
* TMJ Joint dysfunction
* Perforated Tympanic Membrane
* Sunus Disease
* Cervical Lymphadenopathy
Differential Diagnosis for Hearing Loss - ANSWER * Presbycusis
* Noise Exposure
* Eustachian tube dysfunction
* Cerumen Impaction
* Chronic Middle Ear infection, Effusion
* Otosclerosis
* Tympanosclerosis
* Cholesteatoma
* Trauma
* Congenital disorders
Tinnitus - ANSWER a ringing, buzzing, or roaring sound in one or both ears
Differential Diagnosis for Tinnitus - ANSWER * Otologic : Hearing loss, Meniere's
disease, Acoustic Neuroma
,* Ototoxic medications or substances
* Neurologic: Multiple sclerosis, head injury
* Metabolic: thyrooid disorder, Hperlipidemia, vitamin b12 deficiency
* Pychogenic: depression, anxiety, fibromyalgia
Differential DX Mouth Sores - ANSWER * Food or Drug allergies
* Chemical irritation
* Dry Mouth
* Mechanical or thermal injury
* Infectious (Bacterial/Fungal)
* Host Immunosuppression
* Nutritional Deficiency
Pharyngitis (Sore throat) - ANSWER inflammation or infection of the pharynx
Differential Dx Pharyngitis - ANSWER * Streptococcal Infections
* Tonsillitis
* HSV Infection
* Gonococcus
* Candidiasis
* Aphthous ulceration
* Influenza
* Rhino virus, Adenovirus, Epstein-Barr Virus, Coxasckievirus
*Mycoplasma Infection
inner ear - ANSWER
Structure of the Ear - ANSWER
Sensorineural Hearing Loss - ANSWER Caused by a lesion in the organ of corti or
the central neural pathways of the ear, including CN VIII and auditory cortex
Conductive Hearing Loss - ANSWER Hearing loss or impairment resulting from
interference with the transmission of sound waves to the cochlea
Presbycusis - ANSWER * Age related hearing loss
* Usually after age 50 when otic hair cells degenerate
* High frequency hearing loss that is equal bilateral
Differential Dx Sensorineural Hearing Loss - ANSWER * Presbycusis
* Meniere's Disease
* Tumors (Acoustic Neuroma)
* Medications (Aminoglycocides, aspirin, Quinine)
* Disease (Syphilis, viral infections such as mumps, or bacterial infection)
Differential Dx Conductive Hearing Loss - ANSWER * Cerumen impaction
* Perforated Tympanic Membrane
* Chronic Infections
* Congenital Abnormalities
* Otosclerosis or tympanosclerosis
, * Temporal bone fractures
Meniere's disease - ANSWER Abnormal condition within the labyrinth of the inner
ear that can cause fluctuating loss of hearing. The symptoms are dizziness or
vertigo, hearing loss, and tinnitus (ringing in the ears).
Acoustic Neuroma - ANSWER Rare tumor on the auditory nerve (8th cranial nerve)
that causes unilateral vertigo, tinnitus, and hearing loss. Sometimes associated with
a headache. May also have neurologic changes such as facial weakness, tingling,
loss of taste and dysphagia.
Dysphagia - ANSWER difficulty swallowing
aphasia - ANSWER difficulty speaking
Subjective findings for hearing loss - ANSWER * Difficulty hearing
* Tinnitus
* Dizziness
* Vertigo
* Pain, Pressure, Popping in ears
Cholesteotoma - ANSWER a type of tumor that can occur in the middle ear and
cause a conductive hearing loss (keratonizing Squamous Epithelium)
Diagnostic tests for Hearing loss - ANSWER * CT or MRI - Identify acoustic
Neuromas or Tympanic Paragangliomas
* Audiometry speech testing, and middle ear pressure
* MRI may detect cholesteotoma
Differential Diagnosis Hearing Loss - ANSWER Determine if its sensorineural or
conductive
Cerumen Impaction Management - ANSWER * Place 1:1 mixture of warm
hydrogen pyroxide and mineral oil in external ear canal for 1 hour. Then lavage with
warm saline.
* or us Debrox (6.5% carbamide peroxide
* or use docusate sodium liquid
** press post and pre auricle then up and down to work the wax out, dry with warm
hair dryer.
*** Use for 1 week before returning for ear canal disimpaction
**** Do not disimpact if tympanic membrane is perforated
Cerumen impaction complication - ANSWER If trauma to canal during
disimpaction:
Treat with cortisporin otic, 4 drops 3 to 4 times daily for 5 to 7 days)
Referal for sensorineural hearing loss - ANSWER * ENT -> perforation of TM,
damage to Oscicles, tympanosclerosis, otosclerosis, tumor, temporal bone injury,
Menier's disease, acoustic neuromas
* Audiology -> hearing loss
