lecture notes 15 special senses: ears classroom activity to accompany medical terminology systems,...

Lecture Notes 15Special Senses:

Ears

Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

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Structure •Ear contains receptors for two senses: hearing and equilibrium (balance).•Ear consists of an external, middle, and inner part.

15 SPECIAL SENSES: EARS

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Structure •External ear•Auricle (pinna)• External auditory canal

•Middle ear• Tympanic cavity• Tympanic membrane (eardrum)•Malleus, incus, and stapes


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Structure (continued)

• Inner ear •Complex system of communicating chambers and tubes called a labyrinth.•Contains the functional organs for hearing and equilibrium.


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Structure and Function ExerciseQ: What is involved in the process of hearing?A: Transmission of vibrations and generation of nerve impulses. Q: What is the sequence of structures involved in the vibrations of

sound wave transmission?A: Sound waves enter the ear canal and vibrations are transmitted

by the following sequence of structures: eardrum, malleus, incus, stapes, oval window of the inner ear, perilymph and endolymph within the cochlea, and hair cells of the organ of Corti. When hair cells bend, they generate impulses that are carried to the auditory areas of the brain. It is here that sounds are heard and interpreted.


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Structure and Function ExerciseQ: What is involved in the process of hearing?A: Transmission of sound waves to nerve fibers that carry impulses

for hearing to the auditory regions of the brain for interpretation of sound.

Q: What is the sequence of structures involved in the transmission of sound waves?

A: Sound waves enter the ear canal and are transmitted by the following sequence of structures: eardrum, malleus, incus, stapes, oval window of the inner ear, perilymph and endolymph within the cochlea, and hair cells of the organ of Corti. When hair cells bend, they generate impulses that are carried to the auditory areas of the brain. It is here that sounds are heard and interpreted.


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Otitis MediaSigns and Symptoms• Most common symptom is an earache.• Accumulation of fluid within the structure of

the middle ear.• Most common among infants and young

children.• Chronic form of serous otitis media may

develop from acute condition, or it may result from overgrowth of adenoidal tissue or chronic sinus infections.

SPECIAL SENSES: EARS15

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Otitis MediaSigns and Symptoms (continued)• Suppurative otitis media is caused by

introduction of pyogenic microorganisms into the middle ear. • Often follow the mumps, influenza, or colds and

may be induced by overly forceful nose blowing.• Swimming in contaminated water may result in a

middle ear infection.• If pus forms in the tympanic cavity, the eardrum

may rupture, thereby relieving pressure and pain.


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Otitis MediaTreatment• Antibiotics and analgesics to relieve pain.• In severe cases, drainage may be

accomplished by myringotomy or needle aspiration.• Surgery, such as myringoplasty and

tympanoplasty to repair a ruptured tympanic membrane.• PE tubes are inserted surgically into the

tympanic membrane to equalize pressure between the atmosphere and the middle ear.


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Clincally Related ExerciseQ: A 5-year-old is examined because of ear pain. The MA charts this

symptom as _________________.A: otodynia or otalgiaQ: Baby Molly’s mother asks the physician why infants and young children

are more at risk for developing otitis media.A: Eustachian tubes of children and infants are shorter and narrower than

adults, making them more susceptible to blockages and retention of fluid when they become inflamed from bacterial or viral infection.

Q: The mother of a 3-year-old girl ask the NP what complications can develop if otitis media is not treated.

A: Untreated ear infections may lead to short- or long-term hearing loss, ruptured eardrum, or mastoiditis. Also, there is a risk of the ear infection traveling to other parts of the head.

Q: Baby Johnny has a history of chronic otitis media. The physician recommends that tubes be surgically placed into the tympanic membrane to equalize pressure between the atmosphere and the middle ear. The abbreviation for these tubes is ________ tubes.

A: PE


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Hearing LossSigns and Symptoms• Temporary or permanent loss of hearing

Treatment• Varies with the type and cause of

impairment• May include medication to treat infections

and dissolve cerumen• Stapedectomy, tympanoplasty, cochlear

implant, and myringotomy• Hearing aids or other effective means of

aiding communication


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Clincally Related ExerciseQ: An 85-year-old male presents to the clinic with age-related hearing loss.

The MA charts this condition as _________________. A: presbycusisQ: John X is advised his hearing loss is due to a disorder characterized by

an abnormal hardening of bones in the middle ear. The doctor charts this medical condition as _____________________.

A: otosclerosisQ: A 7-year old male presents for a surgery that involves removing part of

the stapes and implanting a prosthetic device to allow sound waves to pass in the inner ear. The surgical procedure for removing part of the stapes is called _____________________.

A: stapedectomyQ: Mr. C presents for various diagnostic tests to assess his hearing. The

doctor explains that one of the tests involves a tuning fork to evaluate bone conduction of sound in both ears at the same time. This test is known as the __________________.

A: Weber tuning fork test


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Medical Vocabulary•acoustic•anacusis•blepharoptosis•cholesteatoma•mucoserous•myringoplasty•otolaryngology


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Medical Vocabulary(continued)• otosclerosis• presbycusis• tinnitus• vertigo


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Diagnostic Procedures•Audiometry•Otoscopy•Rinne and Weber hearing tests


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Word Building ExerciseQ: Act of measuring hearing:A: audiometryQ: Surgical repair of the tympanic membrane

(eardrum):A: tympanoplastyQ: Visual examination of the ear:A: otoscopyQ: Surgical repair of the ear:A: otoplastyQ: Abnormal condition of ear hardening:A: otosclerosisQ: Without hearing: A: anacusis


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Medical and Surgical Procedures

• Cochlear implant

• Myringoplasty• Myringotomy• Incision of tympanic

membrane followed by insertion of a PE tube.


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Clinically Related ExerciseQ: Joe is diagnosed with an ear infection and is scheduled for surgery. An

incision will be made into the ear followed by insertion of pressure-equalizing tubes. Incision of the eardrum is charted as a ______________.

A: myringotomy or tympanotomyQ: To restore hearing loss, an electronic transmitter will be surgically

implanted inside the inner ear. The hearing device produces sound by electrical stimulating nerves inside the inner ear. This surgical procedure is known as a (cochlear, auditory, PE) implant.

A: cochlearQ: Daniel requires surgery to repair a ruptured tympanic membrane.

Surgical repair of the tympanic membrane is called __________________.A: myringoplasty or tympanoplasty Q: Justin had a PE tube inserted into his right ear. PE is the abbreviation for

_______________ (tube).A: pressure equalizing


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Pharmacology•Vertigo and motion sickness drugs•Wax emulsifiers


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Clinically Related ExerciseQ: To loosen and help remove impacted cerumen in 3-year-

old Johnny, the physician uses a (vertigo and motion sickness drug, wax emulsifier).

A: wax emulsifierQ: To combat the patient’s dizziness the physician

prescribes a (vertigo and motion sickness drug, wax emulsifier).

A: vertigo and motion sickness drugQ: The physician prescribes a (vertigo and motion sickness

drug, wax emulsifier) to reduce sensitivity of the inner ear to motion while Barbara is on a cruise.

A: vertigo and motion sickness drug


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