Pathophysiology of hearing loss in meningitis w 135,clip on earrings at macy,www tintumon jokes malayalam - Tips For You

To establish a Digital Library where worldwide health professionals can share their presentations and communicate their ideas to those with similar interests. The middle ear is a crucial component in the transmission of sound from the external world to the inner ear. Although we have seen that the acoustic properties of the outer ear and external canal substantially increase sound pressure at the eardrum above that in a free sound field for the middle frequency range, the middle ear constitutes another important mechanism to increase auditory sensitivity. The middle ear acts as a kind of hydraulic press in which the effective area of the eardrum is about 21 times that of the stapes footplate. The tympanic membrane moves in and out under the influence of the alternating sound pressure. The tensor tympani and stapedius tensor muscles in the middle ear contract reflexly in response to loud sounds. In order to understand the physiological implications of several kinds of pathological change which can occur in sound conduction in the middle ear it is helpful to consider some of the basic properties of a vibrating mechanical system, which the middle ear ossicles are one example. If the stiffness of the system is increased with the mass and friction remaining unchanged, the resulting amplitude is reduced for frequencies below the resonant frequency and the resonant frequency is increased (Figure IV-2B).
The principles of acoustics outlined above can be applied to the vibrating system composed of the eardrum, ossicular chain and supporting ligaments. Disorders of the middle ear and mastoid arise from maldevelopment, inflammatory and degenerative processes, trauma, or neoplastic disease.
Congenital malformations are often related to malformations of the pinna and external ear canal. Perforations of the tympanic membrane is a common serious ear injury that may result from a variety of causes including projectiles or probes (e.g. The various injurious mechanisms associated with the tympanic membrane apply to the ossicles as well, occasionally even without rupture to the membrane itself. Inflammatory diseases of the middle ear are related and the occurrence of one often leads to the other. Otitis media evolves from the common cold, allergies, cigarette smoke exposure, or anything that can cause obstruction of the Eustachian tube.
Negative pressure within the middle ear, if left unrelieved, will lead to fluid accumulation in the normally air-filled middle ear space (Figure IV-6). The disease can develop rapidly into an acute suppurative otitis media as organisms migrate to the middle ear from the nasopharynx.


Because of the relationships between the middle ear cavity and the mastoid pneumatic channels there is a wide range of possible complications that involve areas outside of the middle ear itself. Left untreated (or if unresponsive), Eustachian tube dysfunction may lead to chronic otitis media and cholesteatoma. Q-tips, pencils, paper clips, etc.), concussion from an explosion or a blow to the ear, rapid pressure change (barotrauma), temporal bone fractures, and other miscellaneous causes.
The area of retracted tympanic membrane forms a closed pocket or cyst where epithelial debis from the lining of the tympanic membrane collects. It appears as hard nodules in the helix or antihelix and may discharge chalky white crystals through the skin.
Histologi- cally, it is usually either (1) an epidermoid cyst, common on the face and neck, or (2) a pilar (trichilemmal) cyst, com- mon in the scalp. They are classified as central perforations, which do not extend to the margin of the drum, and marginal perforations, which do involve the margin. The more common central perforation is illustrated here.
A reddened ring of granulation tissue surrounds the perforation, indicating chronic infection. It is typical of tympanosclerosis: a deposition of hyaline material within the layers of the tympanic membrane that sometimes follows a severe episode of otitis media. It does not usually impair hearing and is seldom clinically significant. Other abnormalities in this eardrum include a healed perforation (the large oval area in the upper posterior drum) and signs of a retracted drum. A retracted drum is pulled medially, away from the examiner’s eye, and the malleolar folds are tightened into sharp outlines.
The eustachian tube cannot equalize the air pressure in the middle ear with that of the outside air. Air is partly or completely absorbed from the middle ear into the bloodstream, and serous fluid accumulates there instead.
Symptoms include fullness and popping sensations in the ear, mild conduction hearing loss, and perhaps some pain. Amber fluid behind the eardrum is characteristic, as in this patient with otitic barotrauma.
A fluid level, a line between air above and amber fluid below, can be seen on either side of the short process. Redness is most obvious near the umbo, but dilated vessels can be seen in all segments of the drum. Spontaneous rupture (perforation) of the drum may follow, with discharge of purulent material into the ear canal. Hearing loss is of the conductive type.


Symptoms include earache, blood-tinged discharge from the ear, and hearing loss of the conductive type. In this right ear, at least two large vesicles (bullae) are discernible on the drum.
The inner ear or cochlear nerve is less able to transmit impulses regardless of how the vibrations reach the cochlea. It may be due to nutritional deficiency or, more commonly, to overclosure of the mouth, as in people with no teeth or with ill-fitting dentures.
The lip loses its normal redness and may become scaly, somewhat thickened, and slightly everted. It may appear as a scaly plaque, as an ulcer with or without a crust, or as a nodular lesion, illustrated here. This, together with fever and enlarged cervical nodes, increases the probability of group A streptococcal infection or infectious mononucleosis. The throat is dull red, and a gray exudate (pseudomembrane) is present on the uvula, pharynx, and tongue. Petechiae in the buccal mucosa, as shown, are often caused by accidentally biting the cheek. The extensive example shown on this buccal mucosa resulted from frequent chewing of tobacco, a local irritant. The gingival margins are reddened and swollen, and the interdental papillae are blunted, swollen, and red. Then the destructive (necrotizing) process spreads along the gum margins, where a grayish pseudomembrane develops.
Note here the erosion of the enamel from the lingual surfaces of the upper incisors, exposing the yellow- brown dentin.
The upper central incisors of the permanent (not the deciduous) teeth are most often affected.



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09.09.2014 admin



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