Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
40 Cards in this Set
- Front
- Back
What parts make up the outer ear?
|
1) Pinna
2) External auditory canal |
|
What parts make up the middle ear?
|
1) Tympanic Membrane (Ear Drum)
2) Auditory Ossicles 3) Middle Ear Cavity 4) Eustachian Tube |
|
What parts make up the middle ear?
|
1) Oval Window
2) Round Window 3) Cochlea 4) Semi-circular canals |
|
What are the bones that make up the auditory ossicles?
|
Malleus, Incus, Stapes
|
|
What is the pinna?
|
The skin-lined outer structure that funnels sound into the ear canal
|
|
What is another name for the external auditory canal?
|
The ear canal
|
|
What are some facts pertaining to the ear canal?
|
1) 2.5 cm in length --> Ends at ear drum
2) Skin lining is very thin, small amount of inflammation leads to increased pain sensitivity 3) Has glands which secrete ear wax 4) Easily accessible for drug delivery |
|
What is serete cerumen?
|
Ear wax
Note: Not for consumption over the age of 6 |
|
What is the purpose of the ossicles?
|
To amplify and transmit sound into the inner ear
|
|
What are some facts pertaining to the middle ear?
|
1) It is a small, pea-sized chamber
2) It is filled with air, connected to the nasopharynx by eustachian tubes to equilibrate air pressure 3) Accessible to drug delivery only through the ear drum |
|
How does the cochlea work?
|
A snail shaped organ, full of fluid and cilated hair cells with are stimulated via fluid movement from sound vibrations. An electrical signal is then transmitted to the brain.
|
|
What happens when one has hearing loss?
|
It is a loss of hair cells due to excessive noise, drug toxicity and aging
|
|
What are some advantages to otic drug delivery?
|
1) Significantly higher concentration of drug at infection site
2) Avoids first pass effect 3) No systemic effect because of small dose administered 4) Less expensive 5) Patient compliance |
|
What are some disadvantages to otic drug delivery?
|
1) Effective delivery to the infected site may be difficult or impossible
2) Possible ototoxicity within the middle and/or inner ear 3) Sensitivity at the site of administration |
|
What are the classes of drugs used for ear infections and inflammations?
|
Antibiotics, Corticosteroids, Analgesics
|
|
Where does ear wax come from?
|
Dead skin and other debris combine with secretions from sebaceous and modified sweat glands to create earwax
|
|
What is the purpose of ear wax?
|
1) Lubricates ear canal
2) Removes debris and germs ("Self-Cleaning") |
|
What causes a buildup of ear wax?
|
1) Excessive accumulation due to overactive glands, narrow ear canal, excess hair in ear canal or inefficient chewing or talking (elderly)
2) Improper removal with q-tips, etc which push wax further into the ear canal |
|
What are some ear wax softening agents?
|
1) Carbamide Peroxide (releases oxygen --> Loosens wax)
2) Olive oil, mineral oil, glycerin, baking soda 3) Cerumenolytics - for severely impacted ear wax |
|
What is Otitis Externa?
|
"Swimmer's Ear" - Inflammation of the external ear canal caused by water accumulation, hot weather and humidity. Softening and swelling of the ear wax occurs which lowers its protective functions while increasing pH leading to bacterial invasion.
|
|
What is the organism which usually causes Otitis Externa?
|
Pseudomonas aeruginosa
|
|
What are the symptoms of Otitis Externa?
|
1) Itching
2) Pain 3) Discharge 4) Loss of hearing |
|
What is the treatment for Otitis Externa?
|
*No OTC Treatment*
Rx antibiotic/steroid combination, analgesics, local anesthetic |
|
How do you prevent Otitis Externa?
|
1) Drain water out of ear after swimming/showering
2) Use ear plugs if frequent occurrence 3) Dry ear with 50/50 solution of isopropyl alcohol and white vinegar |
|
What is Otitis Media?
|
An infection of the middle ear. It is the most common infection in children after the common cold.
|
|
What organism(s) typically causes Otitis Media?
|
S. pneumoniae and H. influenzae - most frequent upper respiratory organisms eater middle ear via eustachian tubes
|
|
What are the symptoms of Otitis Media?
|
1) Pain
2) Fever 3) Discharge 4) Decreased hearing |
|
What is the treatment for Otitis Media?
|
Oral antibiotics - Local administration not possible due to tympanic membrane
|
|
What is the eustachian tube?
|
Normalizes pressure on both sides of the ear drum.
|
|
What is the problem with eustachian tubes in children?
|
It is more horizontal limiting the movement of air and fluid. This allows it to trap bacteria, swell and push on the ear drum causing it to become red, swollen and painful.
|
|
What are nine facts to remember about ear drop solutions?
|
1) Ease of use, inexpensive
2) Poor residence time --> The drops drain out 3) pH, viscosity, tonicity influence bioavailability 4) Wide pH range (3.5-7.5) 5) Increase viscosity with propylene glycol, oils, polymers 6) Isotonicity not required, but preferred 7) Sterility to minimize risk of spreading infection 8) Preservatives for multi-dose products 9) Warm solution in hands to prevent vertigo |
|
What are other options for otic delivery?
|
1) Suspensions - For external infections
2) Ointments and powders Not common due to discomfort, irritation and hearing loss 3) Injection of drugs into the middle ear cavity 4) Fully implantable pumps 5) Biodegradable polymers |
|
What drugs can cause ototoxicity?
|
Aminoglycoside Antibiotics - Gentamicin, streptomycin, kanamycin, tobramycin, neomycin
|
|
Which drugs are toxic to the vestibular (Balance) portion of the inner ear?
|
Gentamicin and Streptomycin
|
|
What drug(s) are used to treat Meniere's Disease and how do they work?
|
Gentamicin - ablate hair cells to improve balance
|
|
Which drug(s) are toxic to the cochlear part of the inner ear?
|
Neomycin
|
|
What other component of otic drugs are ototoxic?
|
Formulation solvents (propylene glycol)
|
|
Describe the pain, hearing loss, bilateral symptoms and whether or not to self-medicate for impacted cerumen (ear wax)
|
Pain - Rarely
Hearing loss - Often Bilateral Symptoms - Rarely Self-Medication - Yes - Carbamide Peroxide |
|
Describe the pain, hearing loss, bilateral symptoms and whether or not to self-medicate for bacterial external otitis
|
Pain - Often
Hearing loss - Possibly Bilateral Symptoms - Possibly Self-Medication - Never |
|
Describe the pain, hearing loss, bilateral symptoms and whether or not to self-medicate for suppurative otitis media
|
Pain - Usually
Hearing loss - Possibly Bilateral Symptoms - Occasionally Self-Medication - Never |