Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Lip reading wikipedia , lookup
Hearing loss wikipedia , lookup
Sound localization wikipedia , lookup
Auditory system wikipedia , lookup
Noise-induced hearing loss wikipedia , lookup
Sensorineural hearing loss wikipedia , lookup
Audiology and hearing health professionals in developed and developing countries wikipedia , lookup
Chapter 12 Notes 6/18/2012 4:49:00 AM Chapter 12: Ears, Nose, and Throat Ear anatomy Cerumen –acidic- prevents micorganisms made in the distal esteral ear canal TM-Annulus- fiburous ring surrounding the TM- pars tens- bottom of TMpars flaccida- top of the TM Middle ear- Eustachian tube drains into posterior aspect of inf. Turbinate (nasopharynx) equilzes pressure so the TM can vibrate freely Inner ear curved cavityvestibule and semicircular canals= end organs for vestibular/ equilibrium fnx., to cerebellum cochlea (organ of Corti) to CNXIII vestibulochlear Nose Anatomy CN 1 olfactory Anterior septum should be thicker than posterior Bridge bones: frontal , maxillary Nasal floor: hard and soft palate Roof: frontal and shenoid Receptors for smell in olfactory epithelium Kiesselbach plexus Mouth Anatomy Stensens ducts-parotid gland opening near 2nd upper molar Wharton ducts- submandibular glands opening near frenulum Sublingual gland openings lateral to the wharton ducts in the sublingual fold Vermillion border: btw lips and skin buccal mucosa :is the lining of the cheeks and the back of the lips, inside the mouth where they touch the teeth Extra techniques Sinus transillumination – if infection is suspected Maxillary- place light near nose and look for glow in mouth Frontal – place light on supraorbital and look for glow above Should glow if opaque not good, or asymmetry Smiling with teeth clenched test for occlusion and facial nerve CN 7 Sticking out tongue test CN XII hypoglossal Gag response: Depressing tongue and saying “ah” also test CN IX glossopharyngeal and vagus X ( deviation of the uvula may indicate vagus paralysis) Describe the following findings and problems for which they may be indicative: ear pits, Preauricular pits are relatively common and are usually detected at birth. Some are complicated by infection as the child grows, and may need surgical attention at a later stage.While usually benign (and often familial), they may be associated with other ear and face anomalies and may be present in branchio-otorenal dysplasia (with external ear anomalies, branchial fistulae, hearing impairment, and renal anomalies). Ho indicated unless there are other risk factors for deafness. ear tags, These are most often benign, isolated minor anomalies, occurring mostly unilaterally but occasionally bilaterally. It is important however to examine the anatomic landmark s carefully. If the tags are associated with distortion of the pinna as noted in the photo graph of the left ear then it should trigger suspicion of associated pathology such as the possibility of hemifacial microsomia.Tags may also be seen as part of multiple dysmorphic features of infants with chromosomal anomalies. However, if isolated, no investigations are required and audiology referral is not necessary unless there are oth history of hearing loss. Pedunculated tags can be removed by tying them at the base should the parents wish but the parents need to be informed that tying the knot causes pain for a little while and will result in the tag changing colour, shrivelling up, and eventually falling of over the next week or so. Even if a tag is tied off, there may be a residual lump of soft tissue which may need subsequent cosmetic attention hearing loss, Some causes of hearing loss include damage to the inner ear, a buildup of earwax, infections and a ruptured eardrum instant= vascular disruption/autoimmune hours/days= viral adults= syphills, Genetic Meniere disease, presbycusis Children=hyperbilirubinemia, craniofcaical abnormalits, low birth weight nasal flaring, respiratory distress nasal discharge, Allergy- watery blue gray turbinities Cerebrospinal fluid- unilateral water dixcharge from head trauma Epixtaxis/ trauma- bloody Rhinitis URI- bilateral mucoid / purulent Foreign body- unilateral purulent thick greenish malodors color of nasal mucosa, deep pink shiny purulent = URI for foreign body redness= infection localized redness= furuncle(boil) Blusish gray, plale, swollen, boggy= allerfies cheilosis, dry cracked lips, wind hydration normal things Cheilosis, deep fissures at the corner of the mouth indicates riboflavin (B2)deficiency Tropi- crystals on external associated with gout Angioedema- swelling of the lips Parotitis(mumps)- red spot on the oping of the Stensen duct malocclusion, -under/ over bites, crooked teeth class 1molars good but front teeth twisted class 2 under bite class 3 lower molars medial to upper molars aphthous ulcers, on buccal mucosa white, round, oval lesions with a red halo also know as a canker sore aren't contagious. They can be painful, however, and can make eating and talking difficult. geographic tongue, is an EXPECTED /normal variant. hairy tongue, elongated black/ yellow papillae can appear after antibiotic therapy. Hairy tongue is a harmless condition in which the tongue looks hairy or furry. The disorder usually goes away with antibiotics. smooth tongue,=Glossitis red with slick appears = vit b12 streptococcal pharyngitis : tonsillar enlargement and exudates and engorged cervical nodes pharyngeal erythema cleft palate, most common craniofacial congenital malformation lip failing to fuse during embryonic development prior to 13th week of gestation make cause under weight babies because they cannot suck well bifid uvula. Is a benign condition that is a normal variant in some Native American s, but may be a sign of submucous cleft palate Atresia is a condition in which a body orifice or passage in the body is abnormally closed or absent Edentulous= without teeth Koplik spots white speck with red base on buccula mucosa opposite 1st and 2nd molar= rubeola( meases) Presbycusis- sensory neural hearing loss with age Xerostomia- dry oral tissues Use table 12-1 as a resource. Describe findings that may be associated with the following conditions: B12 deficiency (look at the tongue), smooth slick red tongue tonsillar infection, Acute tonsillitis is an infection of the tonsils caused by one of several possible types of bacteria or viruses. Chronic tonsillitis is a persistent infection of the tonsils and can cause tonsil stone formation. .Symptoms of tonsil or adenoid infection include sore throat, fever, bad breath, difficulty swallowing, and swollen glands in the front of the neck. Peritonsillar abscess is a collection of pus behind the tonsils. acute otitis media, Inflammation in middle ear associated w/ middle ear effusion that becomes infected with bacteria otitis media with effusion, itis of middle ear resulting in collection of serous muciod w/ TM still intact; Eustachian tube doesn’t work is is blocked by lymph tissue in nasopharnx perforated TM, TM with not move with bulb pressure. When the eardrum can no longer stretch, it bursts or tears. Frequently, the pain gets better, because the pressure is now relieved, however, sometimes the pain can get worse Pain is the most common symptom of a perforated eardrum. It can range from general discomfort to immediate or intense pain, or the patient may just feel as if there is something not right with the ear. Other common symptoms of perforated eardrum include: Vertigo (spinning sensation) ;Hearing change or loss; Often with ringing, buzzing, or clicking ; Fluid or blood draining from the ear cerumen impaction.=earwax remove with instrument or irrigation may present as conductive hearing loss otitis externa acute otitis media itching in ear Abrupt onset; fever ;feeling sticking/cracking blockage;anorexia;irritablity whenswallowing/yawing; dizziness; vomiting;feelling full Intes w/ chewing Deep ear ach prevents sleep discomfort Watery then purulent discharge Discharge only if TM ruptures uncommon Conductive hearing loss Conductive hearing loss ear fills w pus Conductive hearing loss ear fills w fluid Canal is red TM w/ erythema ; bulging; limited to no movement TM is retracted( sometimes bulging); with bulb pressure yellowish.’ Air-filled fluid behind TM. movement w/ negative press with bulb pressure Webber otitis media w effusion Normal Conductive Sensorineural No lateralization; lateralizes to To affected ear To opposite of affected ear Air< bone in affected ear Air>bone covered ear Rinne Air> bone 6/18/2012 4:49:00 AM 6/18/2012 4:49:00 AM