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

16Special Senses:

Ears

Lecture NotesA PowerPoint Presentation

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

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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

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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

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•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

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•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

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•Middle ear• Sound conducted through ossicles• Movement of ossicles causing stapes to exert

gentle pumping action against the oval window

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•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

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•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

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Structure and Function Exercise

1. What two structures comprise the outer ear?

2. What are the three bones of the middle ear?

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1. What two structures comprise the outer ear? The auricle (pinna) and external auditory canal, also called the ear canal

2. What are the three bones of the middle ear? The malleus (hammer), incus (anvil), and stapes (stirrup)

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3. What is the cochlea?

4. What is the function of the eustachian tube?

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3. What is the cochlea? Snail-shaped structure containing hair cells that, when stimulated, transmit impulses to the brain for interpretation of sound

4. 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

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Combining Forms Exercise

List the CF(s) for:

1.ear:

2.stapes:

3.tympanic membrane:

4.labyrinth(inner ear):


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1. ear: ot/o

2. stapes: staped/o

3. tympanic membrane: myring/o, tympan/o

4. labyrinth(inner ear): labyrinth/o


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5. hearing:

6. mastoid process:

7. tubes (usually fallopian or eustachian [auditory]):


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5. hearing: acous/o, audi/o, audit/o

6. mastoid process: mastoid/o

7. tubes (usually fallopian or eustachian [auditory]): salping/o


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Complete the Medical Word Exercise

1. discharge from the ear: /o/

2. specialist in the study of ear and throat (disorders): /o/laryng/o/

3. rupture of the eardrum: tympan/o/


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1. discharge from the ear: ot/o/rrhea

2. specialist in the study of ear and throat (disorders): ot/o/laryng/o/logist

3. rupture of the eardrum: tympan/o/rrhexis


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4. discharge or flow of pus from the ear:/ / / /rrhea

5. without or not hearing (deafness): an/

6. pain in the ear: /o/


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4. discharge or flow of pus from the ear:ot/o/py/o/rrhea

5. without or not hearing (deafness): an/acusia or an/acusis

6. pain in the ear: ot/o/dynia


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Build Medical Words Exercise

1. inflammation of the ear:

2. instrument to examine the ear(s):

3. inflammation of the mastoid process:

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1. inflammation of the ear: ot/itis

2. instrument to examine the ear(s): ot/o/scope

3. inflammation of the mastoid process: mastoid/itis

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4. incision of the labyrinth (inner ear):

5. hearing (loss) due to old age:

6. instrument to measure hearing:

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4. incision of the labyrinth (inner ear): labyrinth/o/tomy

5. hearing (loss) due to old age: presby/cusis, presby/acusia

6. instrument to measure hearing: audi/o/meter

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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


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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)


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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


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Clinically Related Exercise

1. 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.

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1. 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.

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2. 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).

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2. 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).

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3. 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).

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3. 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).

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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)


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Hearing Loss (continued)

•Types (continued)•Conductive

•Obstructions in outer or middle ear•Causes

• Otitis• Perforation of eardrum• Otosclerosis


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•Signs and symptoms•Inability to hear clearly•Frequent requests for repetition•Avoidance of social situations


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•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


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1. Mr. B. is an 85-year-old male with age-related hearing loss. The physician charts this condition as .

2. 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 .

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1. Mr. B. is an 85-year-old male with age-related hearing loss. The physician charts this condition as presbycusis.

2. 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.

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3. 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 .

4. 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.

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3. 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.

4. 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.

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Vocabulary Challenge Exercise

1. cerumen:

2. deaf:

3. hard of hearing:

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1. cerumen: ear wax

2. deaf: condition of being unable to hear well enough to rely on hearing as a means of processing information*

3. 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)

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4. cochlear implant:

5. tinnitus:

6. vertigo:

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4. cochlear implant: electronic device that bypasses the cochlea and directly stimulates the auditory nerve to provide some degree of hearing

5. tinnitus: perception of ringing, buzzing, or hissing in the ear in the absence of external stimulus

6. vertigo: feeling that either the individual or his immediate environment is spinning in the absence of actual movement

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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.)


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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


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•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


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•Ear irrigation•Low-pressure stream of water directed at the top of the ear canal to dislodge cerumen (See illustration.)


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1. 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 .

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1. 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.

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2. 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.

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2. 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.

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3. 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).

4. Mrs. B.’s 5-year-old son will have a PE tube inserted into his right ear. PE is the abbreviation for .

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3. 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).

4. Mrs. B.’s 5-year-old son will have a PE tube inserted into his right ear. PE is the abbreviation for pressure equalizing.

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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

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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.)

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•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

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•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

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Build a Medical Word Exercise

1. act of measuring hearing:

2. surgical repair of the tympanic membrane (eardrum):

3. visual examination of the ear:

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1. act of measuring hearing: audi/o/metry

2. surgical repair of the tympanic membrane (eardrum): tympan/o/plasty

3. visual examination of the ear: ot/o/scopy

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4. surgical repair of the ear:

5. abnormal condition of ear hardening:

6. without (lack of) hearing:

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4. surgical repair of the ear: ot/o/plasty

5. abnormal condition of ear hardening: ot/o/sclerosis

6. without (lack of) hearing: an/acusis or an/acusia

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Pharmacology•Medications to treat vertigo and motion sickness•Wax emulsifiers•Antiemetics•Otic analgesics

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1. To loosen and help remove impacted cerumen in a 2-year-old patient, the physician uses a(n) (otic analgesic, wax emulsifier, antiemetic).

2. Mr. J. experiences dizziness. To combat this, the physician prescribes a(n) (vertigo and motion sickness drug, wax emulsifier, otic analgesic).

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1. To loosen and help remove impacted cerumen in a 2-year-old patient, the physician uses a(n) (otic analgesic, wax emulsifier, antiemetic).

2. Mr. J. experiences dizziness. To combat this, the physician prescribes a(n) (vertigo and motion sickness drug, wax emulsifier, otic analgesic).

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3. 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).

4. 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 .

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3. 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).

4. 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.

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

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