Chapter 11 - EARS

audiometer

After proper training, you may use an audiometer to test for hearing loss. The audiometer is an electronic device that generates sounds in different frequencies and intensities and can print out the patient's responses.

cochlea cochlear

An intricate combination of passages; used to describe the inner ear

whispered speech testing

Ask the patient to cover one ear. Stand 2 feet away from the uncovered ear, whisper words, and ask the patient to repeat them. If the patient cannot repeat the words, say the words more loudly. This is a simple, but unmeasured, screening method.

Meniere disease

Disorder of the inner ear with acute attacks of tinnitus, vertigo, and hearing loss

impacted

Immovably wedged, as with earwax blocking the external canal

stapes

Inner (medial) one of the three ossicles of the middle ear; shaped like a stirrup

incus

Middle one of the three ossicles in the middle ear; shaped like an anvil

malleus

Outer (lateral) one of the three ossicles in the middle ear; shaped like a hammer

meatus meatal (adj)

Passage or channel; also the external opening of a passage

tinnitus

Persistent ringing, whistling, clicking, or booming noise in the ears

otoscopic otoscopic

Pertaining to examination with an otoscope. exam shows a painful, red, swollen ear canal, sometimes with a purulent drainage.

rinne test

Place a high-frequency tuning fork against the patient's mastoid bone and ask the patient to tell you when the sound is no longer heard. Then, quickly place the tuning fork 1 to 2 cm from the auditory canal on the same side and ask the patient whether he can hear the tuning fork. With normal hearing, air conduction should be greater than bone, and the patient should hear the fork next to the pinna when he can no longer hear it when held against the mastoid. The reverse indicates a conductive hearing loss.

weber test

Place a vibrating tuning fork in the middle of the patient's forehead and ask whether the tone is louder in one ear or equal on both sides. This determines on which side a hearing loss is located.

crista ampullaris

R/ S/ R/ crista crest -aris pertaining to ampull- bottle-shaped Mound of hair cells and gelatinous material in the ampulla of a semicircular canal

nasopharynx nasopharyngeal (adj)

R/CF R/ S/ R/ nas/o- nose -pharynx throat -eal pertaining to -pharyng- pharynx Region of the pharynx at the back of the nose and above the soft palate Pertaining to the nasopharynx

otolith

R/CF R/ ot/o- ear -lith stone A calcium particle in the vestibule of the inner ear

auditory

Relating to hearing or the organs of hearing

paroxysmal

S/ R/ -al pertaining to paroxysm- sudden, sharp attack Occurring in sharp, spasmodic episodes

topical

S/ R/ -al pertaining to topic- local Medication applied to the skin to obtain a local effect

basilar

S/ R/ -ar pertaining to basil- base, support Pertaining to the base of a structure

irrigation

S/ R/ -ation process irrig- to water Use of water; e.g., to remove wax from the external ear canal

tympanic

S/ R/ -ic pertaining to tympan- eardrum Pertaining to the tympanic membrane (eardrum) or tympanic cavity

adenoid

S/ R/ -oid resembling aden- gland Single mass of lymphoid tissue in the midline at the back of the throat

mastoid

S/ R/ -oid resembling mast- breast Small bony protrusion immediately behind the ear

labyrinth labyrinthitis

S/ R/ Greek labyrinth -itis inflammation labyrinth -inner ear The inner ear Inflammation of the inner ear

vestibule vestibular (adj)

S/ R/ Latin entrance chamber -ar pertaining to vestibul- vestibule Space at the entrance to a canal Pertaining to the vestibule

perforated perforation

S/ R/ Latin to bore through -ion action perforat- bore through Punctured with one or more holes A hole through the wall of a structure

cerumen ceruminous

S/ R/ Latin wax -ous pertaining to cerumin- cerumen Waxy secretion of glands of the external ear Pertaining to cerumen

curette curettage

S/ R/ S/ -ette little cur- cleanse, cure -age pertaining to Scoop-shaped instrument for scraping or removal of new growths (or earwax) The use of a curette

ossicle

S/ R/CF -cle small oss/i- bone A small bone, particularly relating to the three bones in the middle ear

tympanostomy

S/ R/CF -stomy new opening tympan/o- eardrum Surgically created new opening in the tympanic membrane to allow fluid to drain from the middle ear

myringotomy

S/ R/CF -tomy surgical incision myring/o- tympanic membrane Incision in the tympanic membrane

cholesteatoma

S/ R/CF R/ -oma tumor, mass chol/e- bile -steat- fat Yellow, waxy tumor arising in the middle ear

otosclerosis

S/ R/CF R/CF -sis abnormal condition ot/o- ear -scler/o- hard Hardening at the junction of the stapes and oval window that causes loss of hearing

audiometer audiometric (adj)

S/ R/CF S/ -meter measure audi/o- hearing -metric pertaining to measurement Instrument to measure hearing Pertaining to the measurement of hearing

otoscope otoscopy otoscopic (adj)

S/ R/CF S/ S/ -scope instrument for viewing ot/o- ear -scopy to examine -ic pertaining to Instrument for examining the ear Examination of the ear Pertaining to examination with an otoscope

tympanic cavity

is immediately behind the tympanic membrane. It is filled with air that enters through the eustachian tube, and the cavity is continuous with the mastoid air cells in the bone behind it. The cavity contains small bones called ossicles.

Acute otitis media (AOM)

is the presence of pus in the middle ear with ear pain, fever, and redness of the tympanic membrane. AOM occurs most often in the first 2 to 4 years of age. If the infection is viral, it will go away on its own; if it's bacterial, oral antibiotics may be necessary.

conductive hearing loss

occurs when sound is not conducted efficiently through the external auditory canal to the tympanic membrane and the ossicles. Causes of this include: A middle-ear pathology, like acute otitis media, otitis media with effusion, or a perforated eardrum; An infected external auditory canal; or The presence of a foreign body in the external canal.

Chronic otitis media

occurs when the acute infection subsides but the eustachian tube is blocked. The fluid in the middle ear caused by the infection cannot drain, and it gradually becomes stickier.

tympanic membrane (eardrum)

rests at the inner end of the external auditory canal. It vibrates freely as sound waves hit it. It has a good nerve supply and is very sensitive to pain. When examined through the otoscope, it is transparent and reflects light (Figure 11.29).

vertigo

sensation of spinning or whirling

implant

to insert material into tissues; or the material inserted into tissues

four components of the middle ear

tympanic membrane three ossicles - malleus, incus, stapes eustachian (auditory) tube

ear tubes (different names)

tympanostomy tubes, pressure-equalization tubes, and, most commonly, PE tubes

ossicles

—the malleus, incus, and stapes—work to amplify sounds and are attached to the tympanic cavity wall by tiny ligaments. The malleus is attached to the tympanic membrane and vibrates with the membrane when sound waves hit it. The malleus is also attached to the incus, which vibrates, too, and passes the vibrations onto the stapes. The stapes is attached to the oval window, an opening that transmits the vibrations to the inner ear.

sensorineaural hearing loss

Today, the most common cause of hearing loss is damage to the fine hairs in the cochlea by repeated loud noises—from the work-related use of jackhammers or leaf blowers to the leisure-related exposure to amplified music at concerts, personal listening devices, and motorcycles.

eustachian tube

Tube that connects the middle ear to the nasopharynx

coryza

Viral inflammation of the mucous membrane of the nose

ampulla

dialated portion of a canal or duct

conductive hearing loss

hearing loss in the outer ear or middle ear

Otitis externa

is a bacterial or fungal infection of the external auditory canal lining.

Ostosclerosis

is a complication of chronic otitis media with fluid or effusion (OME). Chronically inflamed middle ear cells multiply and collect into a tumor. They damage the ossicles and can spread to the inner ear. Surgical removal is required.

cholesteatoma

is a complication of chronic otitis media with fluid or effusion (OME). Chronically inflamed middle ear cells multiply and collect into a tumor. They damage the ossicles and can spread to the inner ear. Surgical removal is required.

auricle or pinna

is a wing-shaped structure that directs sound waves into the ear canal through the external auditory meatus.

chronic otitis media with effusion (OME)

and produces hearing loss because the sticky fluid prevents the ossicles from vibrating. You can see the fluid through the otoscope

inner ear for equilibrium and balance

The inner ear contains the organs in your body responsible for maintaining the true sense of balance. The vestibule and the three semicircular canals (Figures 11.36 and 11.37) in the inner ear maintain an individual's balance. These are the true organs of balance. Inside the fluid-filled vestibule are two raised, flat areas covered with hair cells and a jelly-like material. This gelatinous material contains calcium and protein crystals called otoliths. The position of the head alters the amount of pressure this gelatinous mass applies to the hair cells. The hair cells respond to horizontal and vertical changes and send impulses to the brain relating how the head is tilted.

inner ear for hearing

The inner ear is a labyrinth of complex, intricate passage systems. The passages in the cochlea, a part of the labyrinth (Figure 11.34), contain receptors that convert vibrations into electrical nerve impulses so the brain can interpret them as different sounds.

auricle

The shell-like external ear