1. Lecture Notes 15 Special Senses: Ears Classroom Activity to Accompany Medical Terminology Systems, Sixth Edition Barbara A. Gylys ∙ Mary Ellen Wedding

2. 2 Structure Ear contains receptors for two senses: hearing and equilibrium (balance). Ear consists of an external, middle, and inner part. 15 SPECIAL SENSES: EARS

3. 3 Structure External ear Auricle (pinna) External auditory canal Middle ear Tympanic cavity Tympanic membrane (eardrum) Malleus, incus, and stapes 15 SPECIAL SENSES: EARS

4. 4 Structure (continued) Inner ear Complex system of communicating chambers and tubes called a labyrinth. Contains the functional organs for hearing and equilibrium. 15 SPECIAL SENSES: EARS

5. 5 Structure and Function Exercise Q: 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. 15 SPECIAL SENSES: EARS

6. 6 Structure and Function Exercise Q: 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. 15 SPECIAL SENSES: EARS

7. 7 Otitis Media Signs 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: EARS 15

8. 8 Otitis Media Signs 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. SPECIAL SENSES: EARS 15

9. 9 Otitis Media Treatment 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. SPECIAL SENSES: EARS 15

10. 10 Clincally Related Exercise Q: A 5-year-old is examined because of ear pain. The MA charts this symptom as _________________. A: otodynia or otalgia Q: 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 SPECIAL SENSES: EARS 15

11. 11 Hearing Loss Signs 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 SPECIAL SENSES: EARS 15

12. 12 Clincally Related Exercise Q: An 85-year-old male presents to the clinic with age-related hearing loss. The MA charts this condition as _________________. A: presbycusis Q: 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: otosclerosis Q: 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: stapedectomy Q: 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 SPECIAL SENSES: EARS 15

13. 13 Medical Vocabulary acoustic anacusis blepharoptosis cholesteatoma mucoserous myringoplasty otolaryngology 15 SPECIAL SENSES: EARS

14. 14 Medical Vocabulary (continued) otosclerosis presbycusis tinnitus vertigo 15 SPECIAL SENSES: EARS

15. 15 Diagnostic Procedures Audiometry Otoscopy Rinne and Weber hearing tests 15 SPECIAL SENSES: EARS

16. 16 Word Building Exercise Q: Act of measuring hearing: A: audiometry Q: Surgical repair of the tympanic membrane (eardrum): A: tympanoplasty Q: Visual examination of the ear: A: otoscopy Q: Surgical repair of the ear: A: otoplasty Q: Abnormal condition of ear hardening: A: otosclerosis Q: Without hearing: A: anacusis 15 SPECIAL SENSES: EARS

17. 17 Medical and Surgical Procedures Cochlear implant Myringoplasty Myringotomy Incision of tympanic membrane followed by insertion of a PE tube. SPECIAL SENSES: EARS 15

18. 18 Clinically Related Exercise Q: 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 tympanotomy Q: 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: cochlear Q: 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 15 SPECIAL SENSES: EARS

19. 19 Pharmacology Vertigo and motion sickness drugs Wax emulsifiers 15 SPECIAL SENSES: EARS

20. 20 Clinically Related Exercise Q: 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 emulsifier Q: To combat the patient’s dizziness the physician prescribes a (vertigo and motion sickness drug, wax emulsifier). A: vertigo and motion sickness drug Q: 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 15 SPECIAL SENSES: EARS