Lecture Notes A PowerPoint Presentation 16 Lecture Notes A PowerPoint Presentation Special Senses: Ears Classroom Activity to Accompany Medical Terminology Systems, Seventh Edition Barbara A. Gylys ∙ Mary Ellen Wedding

Structure and Function 16 SPECIAL SENSES: EARS Structure and Function Outer ear Auricle (pinna) — visible portion composed of folds of cartilage covered with skin External auditory canal (also called ear canal) Tympanic membrane 2 2

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Middle ear Extends from the tympanic membrane (eardrum) to the oval window Three tiny bones, called the ossicles, named for their shape Malleus (hammer) Incus (anvil) Stapes (stirrup) Eustachian (auditory) tube Oval window 3 3

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Inner ear Series of fluid-filled passages called the labyrinth Cochlea Organ of Corti, which contains tiny nerve endings called hair cells Vestibular apparatus Vestibule Semicircular canals Utricle Saccule 4 4

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Outer ear Sound conducted by displacement of air Sound transmitted from the auricle to the tympanic membrane via the external auditory canal Production of cerumen, a waxy yellow substance, used to entrap objects and prevent them from entering the middle ear 5 5

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Middle ear Sound conducted through ossicles Movement of ossicles causing stapes to exert gentle pumping action against the oval window 6 6

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Inner ear Cochlea Responsible for hearing Conversion of movement of hair cells into electrical signals Transmission of signals via the vestibulocochlear (eighth cranial) nerve to the brain Interpretation of signals by brain as sound 7 7

Structure and Function (continued) 16 SPECIAL SENSES: EARS Structure and Function (continued) Inner ear (continued) Vestibular apparatus Structures filled with endolymph and sensitive hair cells to maintain balance Semicircular canals — responsible for sending information to the brain regarding head orientation in order to maintain balance 8 8

Structure and Function Exercise 16 SPECIAL SENSES: EARS Structure and Function Exercise What two structures comprise the outer ear? What are the three bones of the middle ear? Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides. 9 9

Structure and Function Exercise 16 SPECIAL SENSES: EARS Structure and Function Exercise What two structures comprise the outer ear? The auricle (pinna) and external auditory canal, also called the ear canal What are the three bones of the middle ear? The malleus (hammer), incus (anvil), and stapes (stirrup) Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides. 10 10

Structure and Function Exercise 16 SPECIAL SENSES: EARS Structure and Function Exercise What is the cochlea? What is the function of the eustachian tube? Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides. 11 11

Structure and Function Exercise 16 SPECIAL SENSES: EARS Structure and Function Exercise What is the cochlea? Snail-shaped structure containing hair cells that, when stimulated, transmit impulses to the brain for interpretation of sound What is the function of the eustachian tube? Transmission of air in the throat to the middle ear to keep air pressure equal on both sides of the eardrum Pedagogical Note: Questions only are presented on the first slide. Questions with answers (in red) are presented on the following slide. For testing purposes, you may wish to use only the question slides. 12 12

Combining Forms Exercise 16 SPECIAL SENSES: EARS Combining Forms Exercise List the CF(s) for: ear: stapes: tympanic membrane: labyrinth (inner ear):

Combining Forms Exercise 16 SPECIAL SENSES: EARS Combining Forms Exercise ear: ot/o stapes: staped/o tympanic membrane: myring/o, tympan/o labyrinth (inner ear): labyrinth/o

Combining Forms Exercise 16 SPECIAL SENSES: EARS Combining Forms Exercise hearing: mastoid process: tubes (usually fallopian or eustachian [auditory]):

Combining Forms Exercise 16 SPECIAL SENSES: EARS Combining Forms Exercise hearing: acous/o, audi/o, audit/o mastoid process: mastoid/o tubes (usually fallopian or eustachian [auditory]): salping/o

Complete the Medical Word Exercise 16 SPECIAL SENSES: EARS Complete the Medical Word Exercise discharge from the ear: /o/ specialist in the study of ear and throat (disorders): /o/laryng/o/ rupture of the eardrum: tympan/o/ 17

Complete the Medical Word Exercise 16 SPECIAL SENSES: EARS Complete the Medical Word Exercise discharge from the ear: ot/o/rrhea specialist in the study of ear and throat (disorders): ot/o/laryng/o/logist rupture of the eardrum: tympan/o/rrhexis 18

Complete the Medical Word Exercise 16 SPECIAL SENSES: EARS Complete the Medical Word Exercise discharge or flow of pus from the ear: / / / /rrhea without or not hearing (deafness): an/ pain in the ear: /o/ 19

Complete the Medical Word Exercise 16 SPECIAL SENSES: EARS Complete the Medical Word Exercise discharge or flow of pus from the ear: ot/o/py/o/rrhea without or not hearing (deafness): an/acusia or an/acusis pain in the ear: ot/o/dynia 20

Build Medical Words Exercise 16 SPECIAL SENSES: EARS Build Medical Words Exercise inflammation of the ear: instrument to examine the ear(s): inflammation of the mastoid process: 21 21

Build Medical Words Exercise 16 SPECIAL SENSES: EARS Build Medical Words Exercise inflammation of the ear: ot/itis instrument to examine the ear(s): ot/o/scope inflammation of the mastoid process: mastoid/itis 22 22

Build Medical Words Exercise 16 SPECIAL SENSES: EARS Build Medical Words Exercise incision of the labyrinth (inner ear): hearing (loss) due to old age: instrument to measure hearing: 23 23

Build Medical Words Exercise 16 SPECIAL SENSES: EARS Build Medical Words Exercise incision of the labyrinth (inner ear): labyrinth/o/tomy hearing (loss) due to old age: presby/cusis, presby/acusia instrument to measure hearing: audi/o/meter 24 24

Diseases and Conditions 16 SPECIAL SENSES: EARS Diseases and Conditions Otitis Media Inflammation of the middle ear Possibly caused by bacteria or virus Possibly acute or chronic Accumulation of fluid within the middle ear Common disorder among infants and young children because of their short eustachian tube, which provides a pathway for bacteria to enter from the nasopharynx

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Otitis Media (continued) Signs and symptoms Earache (most common) Bulging and reddening of eardrum Presence of pyogenic microorganisms (in suppurative otitis media)

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Otitis Media (continued) Treatment Antibiotics to treat infection Analgesics to relieve pain Myringotomy or needle aspiration in severe cases to drain built-up fluid Surgery, such as myringoplasty, to repair a ruptured tympanic membrane (eardrum) Surgical insertion of pressure-equalizing (PE) tubes in the tympanic membrane to equalize pressure between the atmosphere and the middle ear Pedagogical Note: To tailor the slide presentation to your individual needs, simply delete or add slides and textual material. Numerous sources are available for illustrations and information on various web sites.

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise The parents of Baby L. ask the physician why otitis media is common in young children. The physician explains that children have a shorter (ear canal, pinna, eustachian tube) that allows bacteria to enter from the nasopharynx. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 28 28

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise The parents of Baby L. ask the physician why otitis media is common in young children. The physician explains that children have a shorter (ear canal, pinna, eustachian tube) that allows bacteria to enter from the nasopharynx. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 29 29

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise The mother of a 2-year-old girl is concerned about complications of untreated otitis media. The physician tells her that untreated otitis media may lead to a ruptured tympanic membrane or degeneration of the bones of the middle ear, resulting in permanent hearing loss. The mastoid process may also become infected, a condition known as (encephalitis, mastoiditis, meningitis). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 30 30

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise The mother of a 2-year-old girl is concerned about complications of untreated otitis media. The physician tells her that untreated otitis media may lead to a ruptured tympanic membrane or degeneration of the bones of the middle ear, resulting in permanent hearing loss. The mastoid process may also become infected, a condition known as (encephalitis, mastoiditis, meningitis). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 31 31

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Baby J. has a history of chronic otitis media. The physician recommends surgical placement of tubes into the tympanic membrane to help decrease the incidence of this disease. These tubes are called (aeration tubes, pressure equalizing tubes, drainage tubes). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 32 32

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Baby J. has a history of chronic otitis media. The physician recommends surgical placement of tubes into the tympanic membrane to help decrease the incidence of this disease. These tubes are called (aeration tubes, pressure equalizing tubes, drainage tubes). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 33 33

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Hearing Loss Impairment or inability to apprehend sound Temporary or permanent Types Sensorineural Failure of inner ear nerves to transmit sound impulses properly to the brain Causes Old age (presbycusis) Noise damage Medications (ototoxic) Pedagogical Note: To tailor the slide presentation to your individual needs, simply delete or add slides and textual material. Numerous sources are available for illustrations and information on various web sites.

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Hearing Loss (continued) Types (continued) Conductive Obstructions in outer or middle ear Causes Otitis Perforation of eardrum Otosclerosis Pedagogical Note: To tailor the slide presentation to your individual needs, simply delete or add slides and textual material. Numerous sources are available for illustrations and information on various web sites.

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Hearing Loss (continued) Signs and symptoms Inability to hear clearly Frequent requests for repetition Avoidance of social situations

Diseases and Conditions (continued) 16 SPECIAL SENSES: EARS Diseases and Conditions (continued) Hearing Loss (continued) Treatment Varied with type and cause of impairment Possibly medication to treat infections and dissolve cerumen Stapedectomy, tympanoplasty, cochlear implant, or myringotomy Hearing aid or other means of assisting in communication

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. B. is an 85-year-old male with age- related hearing loss. The physician charts this condition as . The physician advises Mr. X. that his hearing loss is due to an abnormal hardening of bones in his middle ear, especially the stapes. The physician charts this medical condition as . Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 38 38

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. B. is an 85-year-old male with age- related hearing loss. The physician charts this condition as presbycusis. The physician advises Mr. X. that his hearing loss is due to an abnormal hardening of bones in his middle ear, especially the stapes. The physician charts this medical condition as otosclerosis. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 39 39

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. J. is having difficulty hearing. Otoscopy reveals a large mass of earwax blocking the ear canal. The physician charts the cause of his hearing loss as impacted . Mr. C.’s eardrum ruptures from an explosion and he will undergo tympanoplasty to correct a large hole in his tympanic membrane. The physician charts the cause of hearing loss as a(n) (infected, perforated, hardened) eardrum. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 40 40

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. J. is having difficulty hearing. Otoscopy reveals a large mass of earwax blocking the ear canal. The physician charts the cause of his hearing loss as impacted cerumen. Mr. C.’s eardrum ruptures from an explosion and he will undergo tympanoplasty to correct a large hole in his tympanic membrane. The physician charts the cause of hearing loss as a(n) (infected, perforated, hardened) eardrum. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 41 41

Vocabulary Challenge Exercise 16 SPECIAL SENSES: EARS Vocabulary Challenge Exercise cerumen: deaf: hard of hearing: Pedagogical Note: To customize the medical vocabulary, simply add or delete the terms on the slide. Also, numerous images are available from the image bank and/or other resources if you want to add illustrations. You may also wish to use this slide in a group project activity during class.   42 42

Vocabulary Challenge Exercise 16 SPECIAL SENSES: EARS Vocabulary Challenge Exercise cerumen: ear wax deaf: condition of being unable to hear well enough to rely on hearing as a means of processing information* hard of hearing: condition of having some hearing and the ability to communicate with reasonable comfort * As defined by the National Association of the Deaf (NAD) Pedagogical Note: To customize the medical vocabulary, simply add or delete the terms on the slide. Also, numerous images are available from the image bank and/or other resources if you want to add illustrations. You may also wish to use this slide in a group project activity during class.   43 43

Vocabulary Challenge Exercise 16 SPECIAL SENSES: EARS Vocabulary Challenge Exercise cochlear implant: tinnitus: vertigo:   44 44

Vocabulary Challenge Exercise 16 SPECIAL SENSES: EARS Vocabulary Challenge Exercise cochlear implant: electronic device that bypasses the cochlea and directly stimulates the auditory nerve to provide some degree of hearing tinnitus: perception of ringing, buzzing, or hissing in the ear in the absence of external stimulus vertigo: feeling that either the individual or his immediate environment is spinning in the absence of actual movement   45 45

Medical and Surgical Procedures 16 SPECIAL SENSES: EARS Medical and Surgical Procedures Myringotomy Small surgical incision of the eardrum Performed to allow drainage and relieve pressure of the middle ear Typically performed with pressure-equalizing (PE) tube insertion (See illustration.) 46

Medical and Surgical Procedures (continued) 16 SPECIAL SENSES: EARS Medical and Surgical Procedures (continued) Mastoidectomy Removal of infected hair cells of the mastoid process, usually caused by chronic otitis media or any inflammatory disease of the middle ear Surgical goal of having mastoid process completely free from infection 47

Medical and Surgical Procedures (continued) 16 SPECIAL SENSES: EARS Medical and Surgical Procedures (continued) Cochlear implant Insertion of a device that bypasses the cochlea and directly stimulates the auditory nerve External microphone that captures sound waves Internal device that consists of a receiver and electrodes Production of a “mechanical” sound that enables the individual to hear speech and environmental sounds 48

Medical and Surgical Procedures (continued) 16 SPECIAL SENSES: EARS Medical and Surgical Procedures (continued) Ear irrigation Low-pressure stream of water directed at the top of the ear canal to dislodge cerumen (See illustration.) 49

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. H. is diagnosed with an ear infection and is scheduled for surgery. The surgeon will make an incision into the ear and insert pressure-equalizing (PE) tubes. The physician charts the incision of the eardrum as . Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 50 50

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Mr. H. is diagnosed with an ear infection and is scheduled for surgery. The surgeon will make an incision into the ear and insert pressure-equalizing (PE) tubes. The physician charts the incision of the eardrum as myringotomy or tympanotomy. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 51 51

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise To restore her hearing, Ms. C. will undergo surgical implantation of a device inside her inner ear. The device produces sound by electrically stimulating nerves inside the inner ear. This surgical procedure is known as (cochlear, auditory, PE) implant. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 52 52

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise To restore her hearing, Ms. C. will undergo surgical implantation of a device inside her inner ear. The device produces sound by electrically stimulating nerves inside the inner ear. This surgical procedure is known as (cochlear, auditory, PE) implant. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 53 53

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Ms. O. has impacted cerumen in her ear. She will have it flushed out with warm water at the physician’s office. This procedure is an ear (cleansing, bath, irrigation). Mrs. B.’s 5-year-old son will have a PE tube inserted into his right ear. PE is the abbreviation for . Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 54 54

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Ms. O. has impacted cerumen in her ear. She will have it flushed out with warm water at the physician’s office. This procedure is an ear (cleansing, bath, irrigation). Mrs. B.’s 5-year-old son will have a PE tube inserted into his right ear. PE is the abbreviation for pressure equalizing. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 55 55

Diagnostic Procedures 16 SPECIAL SENSES: EARS Diagnostic Procedures Rinne test Comparison of sound conduction through bone (mastoid) and air using a tuning fork (See illustration: (A) Bone conduction. (B) Air conduction.) Used to different conductive and sensorineural hearing loss 56 56

Diagnostic Procedures (continued) 16 SPECIAL SENSES: EARS Diagnostic Procedures (continued) Webber test Screening test used to determine unilateral hearing loss (air conduction and sensorineural) Use of tuning fork, with patient identifying which side provides the loudest sound (See illustration.) 57 57

Diagnostic Procedures (continued) 16 SPECIAL SENSES: EARS Diagnostic Procedures (continued) Audiometry Screening test used to determine type and degree of hearing loss Performed in a soundproof booth with the patient using earphones Record of patient’s response to various pitches and intensities Possible additional evaluation of the patient’s ability to hear and understand speech Possible additional assessment of bone conduction using a tuning fork 58 58

Diagnostic Procedures (continued) 16 SPECIAL SENSES: EARS Diagnostic Procedures (continued) Tympanotomy Evaluation of the eardrum’s ability to move in response to various air-pressure changes applied to the ear canal Information provided on the movement of the ossicles of the middle ear Helps differentiate air conduction or sensorineural hearing loss when Rinne and Webber tests are inconclusive 59 59

Build a Medical Word Exercise 16 SPECIAL SENSES: EARS Build a Medical Word Exercise act of measuring hearing: surgical repair of the tympanic membrane (eardrum): visual examination of the ear: 60 60

Build a Medical Word Exercise 16 SPECIAL SENSES: EARS Build a Medical Word Exercise act of measuring hearing: audi/o/metry surgical repair of the tympanic membrane (eardrum): tympan/o/plasty visual examination of the ear: ot/o/scopy 61 61

Build a Medical Word Exercise 16 SPECIAL SENSES: EARS Build a Medical Word Exercise surgical repair of the ear: abnormal condition of ear hardening: without (lack of) hearing: 62 62

Build a Medical Word Exercise 16 SPECIAL SENSES: EARS Build a Medical Word Exercise surgical repair of the ear: ot/o/plasty abnormal condition of ear hardening: ot/o/sclerosis without (lack of) hearing: an/acusis or an/acusia 63 63

Pharmacology Medications to treat vertigo and motion sickness 16 SPECIAL SENSES: EARS Pharmacology Medications to treat vertigo and motion sickness Wax emulsifiers Antiemetics Otic analgesics 64 64

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise To loosen and help remove impacted cerumen in a 2-year-old patient, the physician uses a(n) (otic analgesic, wax emulsifier, antiemetic). Mr. J. experiences dizziness. To combat this, the physician prescribes a(n) (vertigo and motion sickness drug, wax emulsifier, otic analgesic). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 65 65

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise To loosen and help remove impacted cerumen in a 2-year-old patient, the physician uses a(n) (otic analgesic, wax emulsifier, antiemetic). Mr. J. experiences dizziness. To combat this, the physician prescribes a(n) (vertigo and motion sickness drug, wax emulsifier, otic analgesic). Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 66 66

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Before Mrs. G. embarks on an extended cruise, her physician prescribes a medication that controls nausea and vomiting. This type of medication is an (antiemetic, antivertigo drug, otic analgesic). Mrs. R.’s 2-year-old boy has acute otitis media. The physician prescribes an antibiotic to treat the infection and eardrops to relieve pain, called otic . Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 67 67

Clinically Related Exercise 16 SPECIAL SENSES: EARS Clinically Related Exercise Before Mrs. G. embarks on an extended cruise, her physician prescribes a medication that controls nausea and vomiting. This type of medication is an (antiemetic, antivertigo drug, otic analgesic). Mrs. R.’s 2-year-old boy has acute otitis media. The physician prescribes an antibiotic to treat the infection and eardrops to relieve pain, called otic analgesics. Pedagogical Note: You may wish to add other clinical scenarios from actual medical reports or web site resources to tailor these sections to suit your classroom needs. 68 68

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