western path week 9 HEENT

What are the parts of the outer ear?

The ear canal.

What are the parts of the middle ear?

The tympanic membrane, three bones (ossicles), and the eustachian tube.

What are the parts of the inner ear?

Cochlea and semicircular canals.

What are the three ear bones (ossicles)?

1. Malleus (Hammer), 2. Incus (Anvil), 3. Stapes (Stirrup).

What is the function of the ossicles?

They act as a lever system to transmit sound vibrations from the tympanic membrane to the cochlea.

How does the cochlea work in hearing?

Sound causes tiny hairs along it to vibrate, sending electrical impulses to the brain.

What is the job of the semicircular canals?

They are fluid-filled tubes that help maintain balance and awareness of body position in space.

What are the three types of hearing loss?

1. Sensory-neural (inner ear), 2. Conductive (outer ear), 3. Mixed (both sensory-neural and conductive).

What are the causes of sensory-neural hearing loss?

1. Age-related, 2. Excessive noise, 3. Head trauma, 4. Ototoxic medications, 5. Systemic diseases - affects INNER EAR

What are the causes of conductive hearing loss?

1. Fluid, 2. Foreign objects, 3. Allergies, 4. Ruptured tympanic membrane, 5. Impacted earwax - affects OUTER EAR

What are the causes of mixed hearing loss?

1. Genetic disorders, 2. Infections, 3. Head trauma. affects INNER and OUTER EAR

What is sudden hearing loss?

An otologic emergency, also known as idiopathic sudden sensory-neural hearing loss, may be treated with corticosteroids

What are the two types of ear infections?

1. Otitis externa, 2. Otitis media (AOM - acute otitis media).

What are the causes of otitis externa?

Trapped water, bacteria or fungi leading to inflammation and infection in the outer ear canal.

What are the risk factors for acute otitis media (AOM)?

1. Age, 2. Allergies, 3. Environmental irritants, 4. Family history, 5. Reflux, 6. Daycare, 7. Immunodeficiency, 8. Upper respiratory infections.

How does an upper respiratory infection lead to AOM?

Eustachian tube blockage leads to fluid buildup in the middle ear, trapping bacteria.

What is otitis media with effusion (OME)?

Also known as glue ear, it involves fluid buildup in the middle ear due to eustachian tube blockage.

What are the causes of tinnitus?

1. Exposure to loud noises, 2. Impacted earwax, 3. Ear infections, 4. Neurological or vascular diseases, 5. Medication side effects.

How is tinnitus diagnosed?

Based on presentation, history, and differential diagnosis for underlying disorders.

What are the signs and symptoms of tinnitus?

Ringing in ears (high-pitched, humming, hissing), difficulty concentrating, hearing others, and sleep issues.

What is Meniere's disease?

An inner ear disorder characterized by vertigo, one-sided hearing loss, tinnitus, and a feeling of fullness in the ear.

What are the risk factors for Meniere's disease?

Family history, autoimmune conditions, allergies, and head/ear trauma.

How is Meniere's disease diagnosed?

Clinical presentation, hearing tests, and MRI to rule out brain tumors.

What is the treatment for Meniere's disease?

Stress reduction, nausea medications, low salt diet, hearing aids, and avoidance of alcohol, smoking, and caffeine.

What is the fovea?

A small area of the retina at the center of the macula, where vision is sharpest,

What is the retina?

A layer of light-sensitive cells (130 million photoreceptors!) in the eye that send impulses to the optic nerve.

what is the macula?

area at the center of the retina with high cone density, responsible for central vision, allows you to see small details directly in front of you

What is AMD?

Age-related macular degeneration, a leading cause of irreversible vision loss, especially after age 50.

What are the risk factors for AMD?

Smoking, hypertension, cardiovascular disease, poor diet, and diabetes.

What is dry AMD?

The most common type of AMD, characterized by drusen on the retina and gradual vision loss.

What are drusen?

Small yellow deposits in the retina characteristic of dry AMD.

What is wet AMD?

A less common but more severe form of AMD involving abnormal blood vessel growth beneath the retina.

What are the symptoms of AMD?

Blurry vision, difficulty recognizing faces, seeing straight lines as wavy, dark spots in vision, and loss of central vision.

What is an Amsler Grid?

A grid image used to assess visual distortions when diagnosing AMD.

What is the treatment for dry AMD?

No cure, but treatments include zinc, copper, vitamin C, vitamin E, lutein, zeaxanthin, beta carotene supplements - aka anti-oxidants/phyto-nutrients (caution beta carotene increases LU cancer risk in smokers/former)

What is the treatment for wet AMD?

No cure, but treatments include intravitreal injections of anti-VEGF medications to preserve vision.

What are cataracts?

Clouding of the lens of the eye, leading to BLURRY vision impairment and the leading cause of blindness.

What are the causes and risk factors for cataracts?

Age-related, smoking, diabetes, excessive X-ray exposure, chronic UV exposure, and malnutrition.

What are the symptoms of cataracts?

blurring vision, glare around lights, needing more light to see, loss of contrast in vision

What is the treatment for cataracts?

surgery: degenerated material inside the lens is removed by suction, damaged lens replaced by artificial intraocular lens

What is diabetic retinopathy?

Damage to the blood vessels of the retina, such as hemorrhages, abnormal growth of blood vessels, aneurysms, etc., due to uncontrolled diabetes

What are complications of diabetic retinopathy?

Diabetic macular edema, leading to diminished central vision and potential blindness.

what is the treatment for diabetic retinopathy?

Early detection by annual dilated eye exam! Control of blood sugar and blood pressure, anti VEFG medications to decrease macular swelling - like wet AMD

What is glaucoma?

A group of eye disorders characterized by progressive damage to the optic nerve and increasing intraocular pressure (IOP), leading to irreversible vision loss.

What are the two types of glaucoma?

Open angle glaucoma and angle closure glaucoma.

What is open angle glaucoma?

The most common form where drainage canals are clogged and fluid pressure builds up, leading to gradual increase in IOP.

What is angle closure glaucoma?

A less common form where the angle between the iris and cornea is too narrow - iris bulges > blocks the drainage angle, causing fluid buildup and increased IOP

What are the risk factors for glaucoma?

Age > 60, high IOP, genetic predisposition (especially in Black, Asian, and Hispanic populations), diabetes, hypertension, sickle cell anemia, thin corneas, extreme nearsightedness or farsightedness, eye injury, and prolonged corticosteroid use.

What are the symptoms of open angle glaucoma?

No symptoms in early stages; later symptoms include blind spots, blurred vision, and halos around lights.

What are the symptoms of angle closure glaucoma?

In the acute stage, symptoms include severe headache, eye pain, nausea, vomiting, blurred vision, halos, red eyes, and sudden loss of sight.

What is the treatment for glaucoma?

Prescription eye drops to improve fluid drainage and decrease eye pressure, and possibly laser or other surgery.

What is conjunctivitis?

Inflammation or infection of the mucous membrane lining the sclera and eyelids, which can be acute or chronic.

What are the causes of conjunctivitis?

Viral or bacterial infections (most commonly viral), dry eyes, allergies, irritants, and trauma.

What are the symptoms of conjunctivitis?

Redness, itching, gritty feeling, tearing, burning, discharge, photophobia, and purulent discharge.

What is the treatment for conjunctivitis?

Prescription drops for bacterial cases, along with hygiene measures like washing hands and using washcloths.

What is the upper respiratory system composed of?

Nasal cavity, oral cavity, pharynx, and larynx.

What is the lower respiratory system composed of?

Trachea, bronchi, and lungs.

What is infectious rhinitis (the common cold)?

A viral infection of the upper respiratory tract, commonly caused by rhinovirus, adenovirus, para-influenza, and coronavirus.

What are the characteristics of infectious rhinitis?

Highly contagious, more frequent in children, spreads through respiratory droplets or contaminated objects, and can lead to secondary bacterial infections.

What are the symptoms of infectious rhinitis?

Nasal congestion, rhinorrhea, sneezing, watery eyes, fever, cough, and malaise.

What is the treatment for infectious rhinitis?

Rest, hydration, as antibiotics do not treat these viral infections.

What are the four paranasal sinuses?

Frontal, sphenoid, ethmoid, and maxillary.

What is sinusitis?

Inflammation of the paranasal sinuses, classified as acute, subacute, recurrent, or chronic.

What are the risk factors for sinusitis?

Allergic rhinitis, nasal polyps, nasogastric or nasotracheal tubes, immunocompromised status, long ICU stays, severe burns, and cystic fibrosis.

What are the symptoms of sinusitis?

Nasal obstruction, yellow/green purulent discharge, facial pain, frontal headache, toothache, malaise, diminished smell, halitosis, productive cough, and possible fever.

How is sinusitis diagnosed?

Clinically for acute cases; CT scan for chronic cases.

What is the treatment for sinusitis?

Steam inhalation, nasal irrigation, hot compresses, decongestants, corticosteroid nasal sprays, and antibiotics.

What is allergic rhinitis?

Hay fever, affecting 20-30% of adults and 40% of children, . *annual cost of $6 billion in the US due to lost productivity, TX, etc

What are mast cells?

Immune cells from bone marrow that alert the body to pathogens and toxins.

How do mast cells work in allergic reactions?

Unlike other WBC's, mast cells do not destroy pathogens but get activated and create IgE antibodies and release histamine leading to allergic symptoms

How do allergies develop in the body?

Allergen enters bloodstream, B cells produce antibodies, antibodies attach to mast cells, allergen binds to antibodies, and histamine is released.

What are common seasonal causes of allergic rhinitis?

Pollen, spores, flowering plants, ragweed, and mold.

What are year-round causes of perennial allergic rhinitis?

Dust, household mites, air pollution, and pet dander.

What are the signs and symptoms of allergic rhinitis?

Itchy eyes, nose, mouth, sneezing, rhinorrhea, and nasal obstruction.

How is allergic rhinitis diagnosed?

Through physical exam, patient history, and allergy testing.

What is RAST?

Serum radioallergosorbent test that measures IgE antibodies in the blood to various allergens.

What are helpful hints for managing environmental allergies?

Shower after being outdoors, change clothes, use nasal lavage, and HEPA air purifiers.

What is the concept of total load in health?

The cumulative impact of multiple stressors over time that can lead to health problems.

What are examples of factors in total load?

Stress, nutritional deficiencies, infections, environmental toxins, food sensitivities, and genetic predisposition.

What are the treatments for allergic rhinitis?

Intranasal corticosteroid sprays, antihistamines, and decongestants.

What are antihistamines?

Medications that stop the histamine response of mast cells, such as Benadryl, Zyrtec, Claritin, and Allegra.

What factors are relevant in choosing allergy medication?

Onset time, frequency of dosing, potential for drowsiness, side effects, and cost.

What are common local causes of epistaxis?

Inflammation, anatomical irregularities, local trauma, excessive nasal spray use, and tumors.

What are systemic causes of epistaxis?

Hypertension, vascular malformations, cardiovascular disease, and bleeding disorders.

How is epistaxis evaluated?

Through history of present illness (HPI), review of systems, and past medical history.

What causes pharyngitis?

Respiratory viruses, bacterial infections (like streptococci), voice overuse, allergies, acid reflux, and chemical irritation.

What is dysphagia?

Difficulty swallowing, often a symptom of underlying conditions, more common in older adults.

What are the symptoms of dysphagia?

Choking on food or drink, coughing during or after swallowing, and food sticking in the throat.

What do we need to know about dysphagia for this test?

Probably just that it could be caused by a lot of different diseases and conditions so figure that out with DDX!!!!