Nurs 307 (exam 2): ears

External ear is called

auricle or pinna

Shape serves to funnel sound waves into its opening which is called the ______ ______ _______

external auditory canal

The auditor canal is line with glands that secrete ________

ceruman

t/f cerumen is suppose to be there

true

(external ear): inner _____ ______ consists of ______ covered by thin sensitive skin

two thirds

bone

Lymphatic drainage of ______ ______ flows to parotid, mastoid, and superficial cervical nodes

external ear

Tympanic Membrane is also called eardrum and separates ______ and ______ ear

external

middle

(Tympanic Membrane) is a _______ membrane with a pearly _______ color

translucent

gray

know anatomy of ear

(Middle Ear): to the outer ear and inner ear __________ tube

Eustachian tube

Eustachian tube connects _____ ____ with the ________ and allows passage of AIR

middle ear

nasopharynx

First function of the middle ear:

Conducts ______ vibrations from the OUTER EAR to central _______ apparatus in the inner ear

- sound

- hearing apparatus

Second function of the middle ear:

Protects inner ear by reducing _______ of loud sounds

amplitude

Third function of the middle ear:

Eustachian tube allows _________ of _____ ______ on each side of the TM so the it does not rupture

- equalization

- air pressure

Inner ear contains the ______ ________, which holds ______ organs for ____ and hearing

bony labyrinth

sensory

equilibrium

________ and the semicircular canals within the bony labyrinth compose the ______ ________

vestibule

vestibular appratus

although the inner ear is not accessible to direct examination, its function can be ______

assessed

(hearing)

the auditory system can be divided into three levels:

-

-

-

peripheral

brainstem

cerebral cortex

at PERIPHERAL level, ear transmit ______ and CONVERTS its vibrations into _____ ______, which can be analyzed by the BRAIN

- sound

- electrical impulses

Amplitude: is _______

loudness

Frequency: _______ or NUMBER of cycles per second

pitch

sound waves produce vibrations on _____ _____

TM

Numerous ______ along basilar membrane are receptor ____ CELLS of organ of Cortisones, the sensory organ of HEARING

fibers

hair cells

As hair cells ______, they mediate VIBRATIONS into _____ _____, which are conducted by auditory operation of CN ______ to brainstem

- bend

- electric impulses

- VIII

function at brain stem level is _____ interaction

binaural

Brainstem locates direction of a _____ in space, as well as identifying the _____

sound

sound

CN VIIII (acoustic) from each ear sends SIGNALS to both sides of brainstem, which are sensitive to differences in ______ and _____ of messages from two ears, depending on way HEAD is turned

intensity

timing

The function of the CORTEX is to ________ meaning of the ______ and begin appropriate response

interpret

sound

normal pathway of hearing is _______ ________ . it is the most efficient

air conduction

which pathway of sounds is most efficient?

air conduction

what is the alternate pathway of sound?

bone conduction

_____ of the _____ vibrate and are transmitted directly to inner ear and to CN _____

bones

skull

VIII (acoustic)

presbycusis

age related hearing loss

Conductive hearing loss: partial loss because a person is able to hear if ____ amplitude is ______ enough to reach normal elements in inner ear

sound amplitude

increased

sensorineural hearing loss: increase in ______ may not enable a person to understand ______

amplitude

words

________ holds the sensory organ for equilibrium and hearing)

labyrinth

_______ in inner ear constantly feeds information to the brain about body's position in space

labyrinth

How many semicircular canals are there?

three

If the labyrinth ever becomes inflamed, it feeds the wrong information to the brain, creating a staggering gait and a strong, spinning, whirling sensation called _________.

vertigo

in aging persons, _____ lining ear canal become coarse and stiff

cilia

the coarse and stiff cilia may cause cerumen to accumulate and oxidize, which greatly ________ hearing

reduces

cerumen is _____ because of atrophy of apocrine glands

drier `

true or false: impacted cerumen with hearing loss is not reversible

false

______: type of hearing loss that occurs with aging, even if people living in quiet enviroment

presbycusis

presbycusis onset usually occurs in _____s and slowly progresses

50

with Presbycusis, first notice a ____-___ tone loss

high frequency

ringing, roaring, buzzing in ears without external source

tinnitus

tinnitus occurs with which type of hearing loss?

sensorineural hearing loss

_____ - the room is spinning

vertigo

vertigo- room spinning is (_____ vertigo); environment is spinning around you

objective

vertigo - you're spinning (_____ vertigo

subjective

______ not steady, feels like you are losing your balance

dizzy

(indication of possible hearing loss):

_____ _____ or watching your ___ and __ rather than your eyes

lip reading

face

lips

(indication of possible hearing loss):

_____ or straining ______ to hear

frowning

forward

(indication of possible hearing loss):

posturing of head to catch sounds with better ____

ear

(indication of possible hearing loss):

_________ questions; frequently ask you to repeat questions

misunderstands

_____ or shows _____ reflex when you raise your voice

irritable

startle

(indication of possible hearing loss):

the person's speech sounds garbled, _____ sounds distorted

vowel

(indication of possible hearing loss):

inappropriately _____ voice

loud

(indication of possible hearing loss):____ , ____ tone of voice

flat

monotonus

(external noise questions):

Any loud noises at ______ or on the ___?

home

job

(external noise questions):

Are you hearing other noises such as _____ _____, loud persistent _____, or ____ in military or while HUNTING

-heavy machinery

-music

-gunshots

(coping strategies with external noise questions):

do you take any steps to ____ your ears, such as _____ or ______

protect

headphones

earplugs

inspect external ear:

- SIZE and SHAPE of auricle, ___ and ___ on head

position

alignment

inspect external ear:

check ____ and ____ for tenderness

auricle

tragus

inspect external ear:

ears are _____ size bilaterally with no swelling or thickening

equal

inspect external ear:

ears of unusual size and shape may be a ______ familial trait with no clinical significance

normal

Pinna and Tragus should feel ____ and movement should produce no pain

firm

palpating _____ ____ should also produce no pain

mastoid process

normal tympanic membrane should be: ____ and ____ with a ____-____ color

shiny

translucent

pearl-grey

_____ - _____ light reflex prominent in anteroinferior quadrant, a reflection of the otoscope light

cone-shaped

tympanic membrane with some adults may show scarring, which is a dense ____ patch on the TM, a sequence of repeated ear infections

white

screening for hearing acuity begins during ____; how well a person hears during conversational speech

-history

-how well a person hears during conversational speech

if a person answers yes to hearing difficulty, perform _____ testing or refer for _____ testing

audiometric

if a person answers no, screen using _____ ___ ___

whispered voice test

what is a passing score for Whispered Voice Test?

correct repetition of 4 of 6 number/letters

the whispered voice test is use to detect ______-____ /_____ frequency loss

high-tone

high

this test is to asses ability of vestibular apparatus in inner ear to help maintain standing balance

Romberg sign

(infants and young children):

top of the pinna should match an imaginary line extending from corner of ______ to the _______

eye

occiput

(testing hearing acuity for infants and childeren):

Newborn: _____ (_____)reflex, acoustic blink reflex

startle (Moro)

(behavioral manifestation of hearing loss infants and young children):

child is ______ in casual conversation

inattentive

(behavioral manifestation of hearing loss infants and young children):

____ _____ strained or puzzled

facial. expression

(behavioral manifestation of hearing loss infants and young children):

frequently asks to have statements ______

repeated

(behavioral manifestation of hearing loss infants and young children):

confuses words that _____ ______

sound alike

(behavioral manifestation of hearing loss infants and young children):

has accompanying ____ problem

speech

(behavioral manifestation of hearing loss infants and young children):

appears shy and with drawn and lives in his or her _____ world

own

(behavioral manifestation of hearing loss infants and young children):

frequently complains of _____

earaches

(behavioral manifestation of hearing loss infants and young children):

hears better at times when environment is more ____

conducive

(Aging adults):

high-tone frequency loss apparent for those affected with ____

presbycusis

(Aging adults):

difficulty hearing _____ during conversation.

consonants

(Aging adults):

difficulty hearing _____ words in voice tests

whispered

_______ ______ (swimmer's ear). this abnormal finding of external ear

Otitis externa

lumps and lesions on external ear could be a sign of _____

Carcinoma

abnormal finding in ear canal_____ ____

excessive cerumen

abnormal findings of the TM:

-

-

acute otitis media

perforation

(aging adults):

Gradual sensorineural loss caused by ____ _____ in inner ear or auditory nerve

nerve degeneration

(aging adults):

ability to localize _____ is impaired also

sound

(aging adults):

hearing loss is accentuated when unfavorable ______ noise is present

background

(TM):

Inspect TM and entire circumference of _______ for perforations

annulus

(TM)

Normal TM is ______

intact