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Lecture Notes 15Special Senses:
Ears
Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding
2
Structure •Ear contains receptors for two senses: hearing and equilibrium (balance).•Ear consists of an external, middle, and inner part.
15 SPECIAL SENSES: EARS
3
Structure •External ear•Auricle (pinna)• External auditory canal
•Middle ear• Tympanic cavity• Tympanic membrane (eardrum)•Malleus, incus, and stapes
15 SPECIAL SENSES: EARS
4
Structure (continued)
• Inner ear •Complex system of communicating chambers and tubes called a labyrinth.•Contains the functional organs for hearing and equilibrium.
15 SPECIAL SENSES: EARS
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Structure and Function ExerciseQ: What is involved in the process of hearing?A: Transmission of vibrations and generation of nerve impulses. Q: What is the sequence of structures involved in the vibrations of
sound wave transmission?A: Sound waves enter the ear canal and vibrations are transmitted
by the following sequence of structures: eardrum, malleus, incus, stapes, oval window of the inner ear, perilymph and endolymph within the cochlea, and hair cells of the organ of Corti. When hair cells bend, they generate impulses that are carried to the auditory areas of the brain. It is here that sounds are heard and interpreted.
15 SPECIAL SENSES: EARS
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Structure and Function ExerciseQ: What is involved in the process of hearing?A: Transmission of sound waves to nerve fibers that carry impulses
for hearing to the auditory regions of the brain for interpretation of sound.
Q: What is the sequence of structures involved in the transmission of sound waves?
A: Sound waves enter the ear canal and are transmitted by the following sequence of structures: eardrum, malleus, incus, stapes, oval window of the inner ear, perilymph and endolymph within the cochlea, and hair cells of the organ of Corti. When hair cells bend, they generate impulses that are carried to the auditory areas of the brain. It is here that sounds are heard and interpreted.
15 SPECIAL SENSES: EARS
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Otitis MediaSigns and Symptoms• Most common symptom is an earache.• Accumulation of fluid within the structure of
the middle ear.• Most common among infants and young
children.• Chronic form of serous otitis media may
develop from acute condition, or it may result from overgrowth of adenoidal tissue or chronic sinus infections.
SPECIAL SENSES: EARS15
8
Otitis MediaSigns and Symptoms (continued)• Suppurative otitis media is caused by
introduction of pyogenic microorganisms into the middle ear. • Often follow the mumps, influenza, or colds and
may be induced by overly forceful nose blowing.• Swimming in contaminated water may result in a
middle ear infection.• If pus forms in the tympanic cavity, the eardrum
may rupture, thereby relieving pressure and pain.
SPECIAL SENSES: EARS15
9
Otitis MediaTreatment• Antibiotics and analgesics to relieve pain.• In severe cases, drainage may be
accomplished by myringotomy or needle aspiration.• Surgery, such as myringoplasty and
tympanoplasty to repair a ruptured tympanic membrane.• PE tubes are inserted surgically into the
tympanic membrane to equalize pressure between the atmosphere and the middle ear.
SPECIAL SENSES: EARS15
10
Clincally Related ExerciseQ: A 5-year-old is examined because of ear pain. The MA charts this
symptom as _________________.A: otodynia or otalgiaQ: Baby Molly’s mother asks the physician why infants and young children
are more at risk for developing otitis media.A: Eustachian tubes of children and infants are shorter and narrower than
adults, making them more susceptible to blockages and retention of fluid when they become inflamed from bacterial or viral infection.
Q: The mother of a 3-year-old girl ask the NP what complications can develop if otitis media is not treated.
A: Untreated ear infections may lead to short- or long-term hearing loss, ruptured eardrum, or mastoiditis. Also, there is a risk of the ear infection traveling to other parts of the head.
Q: Baby Johnny has a history of chronic otitis media. The physician recommends that tubes be surgically placed into the tympanic membrane to equalize pressure between the atmosphere and the middle ear. The abbreviation for these tubes is ________ tubes.
A: PE
SPECIAL SENSES: EARS15
11
Hearing LossSigns and Symptoms• Temporary or permanent loss of hearing
Treatment• Varies with the type and cause of
impairment• May include medication to treat infections
and dissolve cerumen• Stapedectomy, tympanoplasty, cochlear
implant, and myringotomy• Hearing aids or other effective means of
aiding communication
SPECIAL SENSES: EARS15
12
Clincally Related ExerciseQ: An 85-year-old male presents to the clinic with age-related hearing loss.
The MA charts this condition as _________________. A: presbycusisQ: John X is advised his hearing loss is due to a disorder characterized by
an abnormal hardening of bones in the middle ear. The doctor charts this medical condition as _____________________.
A: otosclerosisQ: A 7-year old male presents for a surgery that involves removing part of
the stapes and implanting a prosthetic device to allow sound waves to pass in the inner ear. The surgical procedure for removing part of the stapes is called _____________________.
A: stapedectomyQ: Mr. C presents for various diagnostic tests to assess his hearing. The
doctor explains that one of the tests involves a tuning fork to evaluate bone conduction of sound in both ears at the same time. This test is known as the __________________.
A: Weber tuning fork test
SPECIAL SENSES: EARS15
13
Medical Vocabulary•acoustic•anacusis•blepharoptosis•cholesteatoma•mucoserous•myringoplasty•otolaryngology
15 SPECIAL SENSES: EARS
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Medical Vocabulary(continued)• otosclerosis• presbycusis• tinnitus• vertigo
15 SPECIAL SENSES: EARS
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Word Building ExerciseQ: Act of measuring hearing:A: audiometryQ: Surgical repair of the tympanic membrane
(eardrum):A: tympanoplastyQ: Visual examination of the ear:A: otoscopyQ: Surgical repair of the ear:A: otoplastyQ: Abnormal condition of ear hardening:A: otosclerosisQ: Without hearing: A: anacusis
15 SPECIAL SENSES: EARS
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Medical and Surgical Procedures
• Cochlear implant
• Myringoplasty• Myringotomy• Incision of tympanic
membrane followed by insertion of a PE tube.
SPECIAL SENSES: EARS15
18
Clinically Related ExerciseQ: Joe is diagnosed with an ear infection and is scheduled for surgery. An
incision will be made into the ear followed by insertion of pressure-equalizing tubes. Incision of the eardrum is charted as a ______________.
A: myringotomy or tympanotomyQ: To restore hearing loss, an electronic transmitter will be surgically
implanted inside the inner ear. The hearing device produces sound by electrical stimulating nerves inside the inner ear. This surgical procedure is known as a (cochlear, auditory, PE) implant.
A: cochlearQ: Daniel requires surgery to repair a ruptured tympanic membrane.
Surgical repair of the tympanic membrane is called __________________.A: myringoplasty or tympanoplasty Q: Justin had a PE tube inserted into his right ear. PE is the abbreviation for
_______________ (tube).A: pressure equalizing
15 SPECIAL SENSES: EARS
20
Clinically Related ExerciseQ: To loosen and help remove impacted cerumen in 3-year-
old Johnny, the physician uses a (vertigo and motion sickness drug, wax emulsifier).
A: wax emulsifierQ: To combat the patient’s dizziness the physician
prescribes a (vertigo and motion sickness drug, wax emulsifier).
A: vertigo and motion sickness drugQ: The physician prescribes a (vertigo and motion sickness
drug, wax emulsifier) to reduce sensitivity of the inner ear to motion while Barbara is on a cruise.
A: vertigo and motion sickness drug
15 SPECIAL SENSES: EARS