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Transcript
Lecture Notes
A PowerPoint Presentation
Classroom Activity to
Accompany Medical
Terminology Systems,
Seventh Edition
Barbara A. Gylys ∙ Mary Ellen Wedding
16
Special Senses:
Ears
16
SPECIAL SENSES: EARS
Structure and Function
•Outer ear
• Auricle (pinna) — visible
portion composed of folds
of cartilage covered with
skin
• External auditory canal (also
called ear canal)
• Tympanic membrane
2
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Middle ear
• Extends from the tympanic
membrane (eardrum) to the
oval window
• Three tiny bones, called the
ossicles, named for their
shape
• Malleus (hammer)
• Incus (anvil)
• Stapes (stirrup)
• Eustachian (auditory) tube
• Oval window
3
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Inner ear
• Series of fluid-filled
passages called the labyrinth
• Cochlea
• Organ of Corti, which contains
tiny nerve endings called hair
cells
• Vestibular apparatus
•
•
•
•
Vestibule
Semicircular canals
Utricle
Saccule
4
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Outer ear
• Sound conducted by displacement of air
• Sound transmitted from the auricle to the tympanic
membrane via the external auditory canal
• Production of cerumen, a waxy yellow substance,
used to entrap objects and prevent them from
entering the middle ear
5
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Middle ear
• Sound conducted through ossicles
• Movement of ossicles causing stapes to exert
gentle pumping action against the oval window
6
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Inner ear
• Cochlea
• Responsible for hearing
• Conversion of movement of hair cells into
electrical signals
• Transmission of signals via the
vestibulocochlear (eighth cranial) nerve to the
brain
• Interpretation of signals by brain as sound
7
16
SPECIAL SENSES: EARS
Structure and Function (continued)
•Inner ear
(continued)
• Vestibular apparatus
• Structures filled with endolymph and sensitive
hair cells to maintain balance
• Semicircular canals — responsible for sending
information to the brain regarding head
orientation in order to maintain balance
8
16
SPECIAL SENSES: EARS
Structure and Function Exercise
1. What two structures comprise the outer ear?
2. What are the three bones of the middle ear?
9
16
SPECIAL SENSES: EARS
Structure and Function Exercise
1. What two structures comprise the outer ear?
The auricle (pinna) and external auditory
canal, also called the ear canal
2. What are the three bones of the middle ear?
The malleus (hammer), incus (anvil), and
stapes (stirrup)
10
16
SPECIAL SENSES: EARS
Structure and Function Exercise
3. What is the cochlea?
4. What is the function of the eustachian tube?
11
16
SPECIAL SENSES: EARS
Structure and Function Exercise
3. What is the cochlea? Snail-shaped structure
containing hair cells that, when stimulated,
transmit impulses to the brain for
interpretation of sound
4. What is the function of the eustachian tube?
Transmission of air in the throat to the
middle ear to keep air pressure equal on
both sides of the eardrum
12
16
SPECIAL SENSES: EARS
Combining Forms Exercise
List the CF(s) for:
1. ear:
2. stapes:
3. tympanic
membrane:
4. labyrinth
(inner ear):
13
16
SPECIAL SENSES: EARS
Combining Forms Exercise
1. ear: ot/o
2. stapes:
staped/o
3. tympanic membrane:
myring/o, tympan/o
4. labyrinth
(inner ear): labyrinth/o
14
16
SPECIAL SENSES: EARS
Combining Forms Exercise
5. hearing:
6. mastoid process:
7. tubes (usually fallopian or eustachian
[auditory]):
15
16
SPECIAL SENSES: EARS
Combining Forms Exercise
5. hearing: acous/o, audi/o, audit/o
6. mastoid process: mastoid/o
7. tubes (usually fallopian or eustachian
[auditory]): salping/o
16
16
SPECIAL SENSES: EARS
Complete the Medical Word Exercise
1. discharge from the ear:
/o/
2. specialist in the study of ear and throat
(disorders):
/o/laryng/o/
3. rupture of the eardrum: tympan/o/
17
16
SPECIAL SENSES: EARS
Complete the Medical Word Exercise
1. discharge from the ear: ot/o/rrhea
2. specialist in the study of ear and throat
(disorders): ot/o/laryng/o/logist
3. rupture of the eardrum: tympan/o/rrhexis
18
16
SPECIAL SENSES: EARS
Complete the Medical Word Exercise
4. discharge or flow of pus from the ear:
/ /
/ /rrhea
5. without or not hearing (deafness): an/
6. pain in the ear:
/o/
19
16
SPECIAL SENSES: EARS
Complete the Medical Word Exercise
4. discharge or flow of pus from the ear:
ot/o/py/o/rrhea
5. without or not hearing (deafness): an/acusia
or an/acusis
6. pain in the ear: ot/o/dynia
20
16
SPECIAL SENSES: EARS
Build Medical Words Exercise
1. inflammation of the ear:
2. instrument to examine the ear(s):
3. inflammation of the mastoid process:
21
16
SPECIAL SENSES: EARS
Build Medical Words Exercise
1. inflammation of the ear: ot/itis
2. instrument to examine the ear(s):
ot/o/scope
3. inflammation of the mastoid process:
mastoid/itis
22
16
SPECIAL SENSES: EARS
Build Medical Words Exercise
4. incision of the labyrinth (inner ear):
5. hearing (loss) due to old age:
6. instrument to measure hearing:
23
16
SPECIAL SENSES: EARS
Build Medical Words Exercise
4. incision of the labyrinth (inner ear):
labyrinth/o/tomy
5. hearing (loss) due to old age: presby/cusis,
presby/acusia
6. instrument to measure hearing:
audi/o/meter
24
16
SPECIAL SENSES: EARS
Diseases and Conditions
Otitis Media
•Inflammation of the middle ear
•Possibly caused by bacteria or virus
•Possibly acute or chronic
•Accumulation of fluid within the middle ear
•Common disorder among infants and young
children because of their short eustachian
tube, which provides a pathway for bacteria to
enter from the nasopharynx
25
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Otitis Media
(continued)
•Signs and symptoms
•Earache (most common)
•Bulging and reddening of eardrum
•Presence of pyogenic microorganisms (in suppurative
otitis media)
26
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Otitis Media
(continued)
•Treatment
•Antibiotics to treat infection
•Analgesics to relieve pain
•Myringotomy or needle aspiration in severe cases to
drain built-up fluid
•Surgery, such as myringoplasty, to repair a ruptured
tympanic membrane (eardrum)
•Surgical insertion of pressure-equalizing (PE) tubes in
the tympanic membrane to equalize pressure
between the atmosphere and the middle ear
27
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. The parents of Baby L. ask the physician
why otitis media is common in young
children. The physician explains that
children have a shorter (ear canal, pinna,
eustachian tube) that allows bacteria to
enter from the nasopharynx.
28
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. The parents of Baby L. ask the physician
why otitis media is common in young
children. The physician explains that
children have a shorter (ear canal, pinna,
eustachian tube) that allows bacteria to
enter from the nasopharynx.
29
16
SPECIAL SENSES: EARS
Clinically Related Exercise
2. The mother of a 2-year-old girl is
concerned about complications of untreated
otitis media. The physician tells her that
untreated otitis media may lead to a
ruptured tympanic membrane or
degeneration of the bones of the middle
ear, resulting in permanent hearing loss.
The mastoid process may also become
infected, a condition known as
(encephalitis, mastoiditis, meningitis).
30
16
SPECIAL SENSES: EARS
Clinically Related Exercise
2. The mother of a 2-year-old girl is
concerned about complications of untreated
otitis media. The physician tells her that
untreated otitis media may lead to a
ruptured tympanic membrane or
degeneration of the bones of the middle
ear, resulting in permanent hearing loss.
The mastoid process may also become
infected, a condition known as
(encephalitis, mastoiditis, meningitis).
31
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Baby J. has a history of chronic otitis media.
The physician recommends surgical
placement of tubes into the tympanic
membrane to help decrease the incidence of
this disease. These tubes are called (aeration
tubes, pressure equalizing tubes, drainage
tubes).
32
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Baby J. has a history of chronic otitis media.
The physician recommends surgical
placement of tubes into the tympanic
membrane to help decrease the incidence of
this disease. These tubes are called (aeration
tubes, pressure equalizing tubes, drainage
tubes).
33
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Hearing Loss
•Impairment or inability to apprehend sound
•Temporary or permanent
•Types
•Sensorineural
•Failure of inner ear nerves to transmit sound impulses
properly to the brain
•Causes
• Old age (presbycusis)
• Noise damage
• Medications (ototoxic)
34
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Hearing Loss
•Types
(continued)
(continued)
•Conductive
•Obstructions in outer or middle ear
•Causes
• Otitis
• Perforation of eardrum
• Otosclerosis
35
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Hearing Loss
(continued)
•Signs and symptoms
•Inability to hear clearly
•Frequent requests for repetition
•Avoidance of social situations
36
16
SPECIAL SENSES: EARS
Diseases and Conditions (continued)
Hearing Loss
(continued)
•Treatment
•Varied with type and cause of impairment
•Possibly medication to treat infections and dissolve
cerumen
•Stapedectomy, tympanoplasty, cochlear implant, or
myringotomy
•Hearing aid or other means of assisting in
communication
37
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. Mr. B. is an 85-year-old male with agerelated hearing loss. The physician charts
this condition as
.
2. The physician advises Mr. X. that his hearing
loss is due to an abnormal hardening of
bones in his middle ear, especially the
stapes. The physician charts this medical
condition as
.
38
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. Mr. B. is an 85-year-old male with agerelated hearing loss. The physician charts
this condition as presbycusis.
2. The physician advises Mr. X. that his hearing
loss is due to an abnormal hardening of
bones in his middle ear, especially the
stapes. The physician charts this medical
condition as otosclerosis.
39
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Mr. J. is having difficulty hearing. Otoscopy
reveals a large mass of earwax blocking the
ear canal. The physician charts the cause of
his hearing loss as impacted
.
4. Mr. C.’s eardrum ruptures from an explosion
and he will undergo tympanoplasty to correct
a large hole in his tympanic membrane. The
physician charts the cause of hearing loss as
a(n) (infected, perforated, hardened) eardrum.
40
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Mr. J. is having difficulty hearing. Otoscopy
reveals a large mass of earwax blocking the
ear canal. The physician charts the cause of
his hearing loss as impacted cerumen.
4. Mr. C.’s eardrum ruptures from an explosion
and he will undergo tympanoplasty to correct
a large hole in his tympanic membrane. The
physician charts the cause of hearing loss as
a(n) (infected, perforated, hardened) eardrum.
41
16
SPECIAL SENSES: EARS
Vocabulary Challenge Exercise
1. cerumen:
2. deaf:
3. hard of hearing:
42
16
SPECIAL SENSES: EARS
Vocabulary Challenge Exercise
1. cerumen: ear wax
2. deaf: condition of being unable to hear well
enough to rely on hearing as a means of
processing information*
3. hard of hearing: condition of having some
hearing and the ability to communicate with
reasonable comfort
* As defined by the National Association of the Deaf (NAD)
43
16
SPECIAL SENSES: EARS
Vocabulary Challenge Exercise
4. cochlear implant:
5. tinnitus:
6. vertigo:
44
16
SPECIAL SENSES: EARS
Vocabulary Challenge Exercise
4. cochlear implant: electronic device that
bypasses the cochlea and directly stimulates
the auditory nerve to provide some degree of
hearing
5. tinnitus: perception of ringing, buzzing, or
hissing in the ear in the absence of external
stimulus
6. vertigo: feeling that either the individual or
his immediate environment is spinning in the
absence of actual movement
45
16
SPECIAL SENSES: EARS
Medical and Surgical Procedures
•Myringotomy
•Small surgical incision of
the eardrum
•Performed to allow
drainage and relieve
pressure of the middle ear
•Typically performed with
pressure-equalizing (PE)
tube insertion (See
illustration.)
46
16
SPECIAL SENSES: EARS
Medical and Surgical Procedures
(continued)
•Mastoidectomy
•Removal of infected hair cells of the mastoid process,
usually caused by chronic otitis media or any
inflammatory disease of the middle ear
•Surgical goal of having mastoid process completely
free from infection
47
16
SPECIAL SENSES: EARS
Medical and Surgical Procedures
(continued)
•Cochlear implant
•Insertion of a device that bypasses the cochlea and
directly stimulates the auditory nerve
•External microphone that captures sound waves
•Internal device that consists of a receiver and
electrodes
•Production of a “mechanical” sound that enables the
individual to hear speech and environmental sounds
48
16
SPECIAL SENSES: EARS
Medical and Surgical Procedures
(continued)
•Ear irrigation
•Low-pressure stream of
water directed at the top of
the ear canal to dislodge
cerumen (See illustration.)
49
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. Mr. H. is diagnosed with an ear infection
and is scheduled for surgery. The surgeon
will make an incision into the ear and insert
pressure-equalizing (PE) tubes. The
physician charts the incision of the eardrum
as
.
50
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. Mr. H. is diagnosed with an ear infection
and is scheduled for surgery. The surgeon
will make an incision into the ear and insert
pressure-equalizing (PE) tubes. The
physician charts the incision of the eardrum
as myringotomy or tympanotomy.
51
16
SPECIAL SENSES: EARS
Clinically Related Exercise
2. To restore her hearing, Ms. C. will undergo
surgical implantation of a device inside her
inner ear. The device produces sound by
electrically stimulating nerves inside the
inner ear. This surgical procedure is known
as (cochlear, auditory, PE) implant.
52
16
SPECIAL SENSES: EARS
Clinically Related Exercise
2. To restore her hearing, Ms. C. will undergo
surgical implantation of a device inside her
inner ear. The device produces sound by
electrically stimulating nerves inside the
inner ear. This surgical procedure is known
as (cochlear, auditory, PE) implant.
53
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Ms. O. has impacted cerumen in her ear. She
will have it flushed out with warm water at
the physician’s office. This procedure is an
ear (cleansing, bath, irrigation).
4. Mrs. B.’s 5-year-old son will have a PE tube
inserted into his right ear. PE is the
abbreviation for
.
54
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Ms. O. has impacted cerumen in her ear. She
will have it flushed out with warm water at
the physician’s office. This procedure is an
ear (cleansing, bath, irrigation).
4. Mrs. B.’s 5-year-old son will have a PE tube
inserted into his right ear. PE is the
abbreviation for pressure equalizing.
55
16
SPECIAL SENSES: EARS
Diagnostic Procedures
•Rinne test
• Comparison of sound
conduction through bone
(mastoid) and air using a
tuning fork (See
illustration: (A) Bone
conduction. (B) Air
conduction.)
• Used to different
conductive and
sensorineural hearing loss
56
16
SPECIAL SENSES: EARS
Diagnostic Procedures (continued)
•Webber test
• Screening test used to
determine unilateral
hearing loss (air conduction
and sensorineural)
• Use of tuning fork, with
patient identifying which
side provides the loudest
sound (See illustration.)
57
16
SPECIAL SENSES: EARS
Diagnostic Procedures (continued)
•Audiometry
• Screening test used to determine type and degree
of hearing loss
• Performed in a soundproof booth with the patient
using earphones
• Record of patient’s response to various pitches
and intensities
• Possible additional evaluation of the patient’s
ability to hear and understand speech
• Possible additional assessment of bone
conduction using a tuning fork
58
16
SPECIAL SENSES: EARS
Diagnostic Procedures (continued)
•Tympanotomy
• Evaluation of the eardrum’s ability to move in
response to various air-pressure changes applied
to the ear canal
• Information provided on the movement of the
ossicles of the middle ear
• Helps differentiate air conduction or
sensorineural hearing loss when Rinne and
Webber tests are inconclusive
59
16
SPECIAL SENSES: EARS
Build a Medical Word Exercise
1. act of measuring hearing:
2. surgical repair of the tympanic membrane
(eardrum):
3. visual examination of the ear:
60
16
SPECIAL SENSES: EARS
Build a Medical Word Exercise
1. act of measuring hearing: audi/o/metry
2. surgical repair of the tympanic membrane
(eardrum): tympan/o/plasty
3. visual examination of the ear: ot/o/scopy
61
16
SPECIAL SENSES: EARS
Build a Medical Word Exercise
4. surgical repair of the ear:
5. abnormal condition of ear hardening:
6. without (lack of) hearing:
62
16
SPECIAL SENSES: EARS
Build a Medical Word Exercise
4. surgical repair of the ear: ot/o/plasty
5. abnormal condition of ear hardening:
ot/o/sclerosis
6. without (lack of) hearing: an/acusis or
an/acusia
63
16
SPECIAL SENSES: EARS
Pharmacology
•Medications to treat vertigo and motion
sickness
•Wax emulsifiers
•Antiemetics
•Otic analgesics
64
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. To loosen and help remove impacted
cerumen in a 2-year-old patient, the
physician uses a(n) (otic analgesic, wax
emulsifier, antiemetic).
2. Mr. J. experiences dizziness. To combat
this, the physician prescribes a(n) (vertigo
and motion sickness drug, wax emulsifier,
otic analgesic).
65
16
SPECIAL SENSES: EARS
Clinically Related Exercise
1. To loosen and help remove impacted
cerumen in a 2-year-old patient, the
physician uses a(n) (otic analgesic, wax
emulsifier, antiemetic).
2. Mr. J. experiences dizziness. To combat
this, the physician prescribes a(n) (vertigo
and motion sickness drug, wax emulsifier,
otic analgesic).
66
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Before Mrs. G. embarks on an extended
cruise, her physician prescribes a medication
that controls nausea and vomiting. This type
of medication is an (antiemetic, antivertigo
drug, otic analgesic).
4. Mrs. R.’s 2-year-old boy has acute otitis
media. The physician prescribes an antibiotic
to treat the infection and eardrops to relieve
pain, called otic
.
67
16
SPECIAL SENSES: EARS
Clinically Related Exercise
3. Before Mrs. G. embarks on an extended
cruise, her physician prescribes a medication
that controls nausea and vomiting. This type
of medication is an (antiemetic, antivertigo
drug, otic analgesic).
4. Mrs. R.’s 2-year-old boy has acute otitis
media. The physician prescribes an antibiotic
to treat the infection and eardrops to relieve
pain, called otic analgesics.
68
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69