Ear Examination

Question 1

Ear Examination

Answer 1

EOB
Inspection 
Palpation 
- Tenderness
- Lymph nodes: pre and post auricular 
Otoscope
Hearing 
- Basic 
- Weber's 
- Rinne's

Question 2

Inspection

Answer 2

Pinna 
Extra cartilage tags/ pre- auricular sinuses or pits 
Signs of trauma 
- Perichondral haematoma 
Lesions, masses and condition of skin 
Inflammation around the ear 
- Erysipelas, mastoiditis 
Discharge
Scars or previous surgery

Question 3

Palpation

Answer 3

Tenderness
- Tragus
- Mastoid 
- Pinna 
Lymph nodes
- Pre and post auricular

Question 4

Otoscope Method

Answer 4

Preparation
- Speculum 
- Turn on 
Insert
- Hold like pen 
- Gently pull pinna back 
- Stabilise on patient's temple 
- Gradual insert

Question 5

Otoscope Look for

Answer 5

Ear canal and external auditory meatus 
- Skin changes
- Foreign body 
- Wax 
- Discharge 
Tympanic membrane 
- Handle/ lateral process of the malleus 
- Light reflex/ cone of light 
- Pars tensa and pars flaccida (attic) 
Potential abnormalities 
- Otitis externa
- Otitis media 
- Cholesteatoma 
- Perforation 
- Tympanosclerosis

Question 6

Hearing Test

Answer 6

Basic
- Block one ear, whisper in the other
Rinne’s
- Mastoid to external auditory canal
- Positive: sensorineural/ normal (louder at air)
- Negative: conductive (louder at mastoid)
Weber’s
- Mid forehead
- Conductive localises to abnormal ear
- Sensorineural localises away from abnormal ear