Ch 16 (Ears health)

T

Q: What are the three levels of the hearing process?

Peripheral, brainstem and cerebral cortex.

Q: What are the three levels of the hearing process?: Peripheral

ear transmits sound → CN VIII

Q: What are the three levels of the hearing process?: Brain stem

Locates direction, identifies sound

Q: What are the three levels of the hearing process?: Cerebral cortex

Interprets meaning and response

Q: What is conductive hearing loss?

A: Mechanical dysfunction of external/middle ear (cerumen, foreign body, fluid). Louder sound may help

Q: What is sensorineural hearing loss?

A: Pathology of inner ear, CN VIII, or cortex. Louder sound may not help

Q: What causes vertigo?

A: Inflammation of labyrinth/semicircular canals → incorrect signals → spinning sensation, staggering gait

Q: What is otosclerosis? Who is most at risk?

A: Abnormal bone remodeling in middle ear → impaired sound conduction. Most common in White middle-aged women

Q: What is presbycusis?

A: Age-related sensorineural loss. High-frequency loss first, consonants harder than vowels, words sound garbled, worse with background noise

Q: What subjective data should be collected for ear assessment?

A: Earaches, infections, discharge, hearing loss, noise exposure, tinnitus, vertigo, ear care, hearing aids

Q: Why ask about cold symptoms with ear pain?

A: Ear pain may be secondary to URI, sinus, or dental infection

Q: Why ask about trauma with earache?

A: Trauma can rupture the tympanic membrane

Q: What medications may cause tinnitus?

A: Aspirin, furosemide (Lasix), vancomycin

Q: What are signs of hearing difficulty during an exam?

A: Lip reading, leaning forward, head turned, asking to repeat, garbled speech, loud voice

Q: What should be inspected on the external ear?

A: Size/shape, skin condition, lymph nodes, cysts/keloids, tenderness, cerumen

Q: What should the tympanic membrane normally look like?

Pearly white, slightly concave

Q: What do abnormal ear drainage colors indicate?

A: Purulent = otitis, bloody/watery = trauma or CSF leak

Q: What tests check hearing acuity?

A: Whispered voice test (high-tone loss), tuning fork tests (distinguish conductive vs sensorineural), audiometric testing if needed

Q: How does the external ear change with aging?

A: Pendulous lobes, linear wrinkles, coarse wiry hair, opaque/dull/thick eardrum

Q: What is presbycusis often described as by patients?

High-tine frequency hearing loss

A: “People are mumbling”