Ears Flashcards
Ask the patient to_______ from the ear being assessed.
Tip the head away
If hair obstructs visualization,_____ the speculum with water.
Moisten
Ask the patient to tip the head away from the ear being assessed.
Select a speculum that would fit comfortably the patient.
Hold the otoscope securely in the dominant hand, with the handle held like a pencil between the thumb and the forefinger.
Rest the back of the dominant hand on the right side of the patient’s head.
Use the free hand to pull the right ear in a manner that will straighten the canal.
If hair obstructs visualization, moisten the speculum with water.
Slowly insert the speculum into the canal, looking as the speculum passes.
Assess the canal for inflammation, exudates, lesions and foreign bodies.
Procedure of assessing the ears
Visualize the tympanic membrane
COLOR
PERFORATIONS
LESIONS
BULGING OR RETRACTION
DILATION OF BLOOD VESSELS
BUBBLES
FLUIDS
Note the_____ of the TM while asking the patient to pinch the nose closed and blow gently.
Movement
Normal findings of ear canal
no redness, swelling, tenderness, lesions, drainage, foreign bodies or scaly surface areas.
varies in amount, consistency and color. Cerumen is white, dry, and flaky in patients of Asian and Native American descent and honeycolored and sticky in whites and African Americans.
Normal findings of cerumen
Normal findings of Tympanic membrane
Is pearly gray with clearly defined landmarks and a distinct cone-shaped light reflex. Should move when the patient blows against resistance.
Normal findings of blood vessels
seen only in the periphery, and the membrane does not bulged, retracted or have any evidence fluid behind it.
Abnormal findings of ear
EXTERNAL AUDITORY CANAL FOREIGN BODY
HARD, DARK CERUMEN
OTITIS EXTERNA
FURUNCULOSIS
OTITIS EXTERNA
EXOSTOSIS
SEROUS OTITIS
OTITIS MEDIA
ACUTE OTITIS MEDIA
PERFORATED EARDRUM
ACUTE PURULENT OTITITS MEDIA
HEMOTYMPANUM
PERFORATED TM
BLACK OR BROWN SPORES
AIR BUBBLES IN THE TYMPANIC MEMBRANE
Redness, swelling, scaling, or itching
of ear canal
OTITIS EXTERNA
deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue.
FURUNCULOSIS
“surfers ear”
EXOSTOSIS
yellowish membrane with fluid and air bubbles visible behind TM
Serous otitis
reddish TM with absent or distorted light reflex
OTITIS MEDIA
Note the red, bulging membrane; decreased or absent light reflex.
ACUTE OTITIS MEDI
blue to black TM from bleeding
HEMOTYMPANUM
round/oval dark area
Perforated TM
Greet the patient and explain the assessment.
Use a quiet room that will be free from interruptions.
Ensure adequate lighting
Place the patient in an upright sitting position.
Always compare the right and left sides of ears, nose, mouth and throat.
General approaches of hearing and equilibrium test
mainly used to establish a diagnosis in patients with unilateral hearing loss to distinguish between conductive and sensorineural hearing loss.
Test for lateralization
Weber test
a. Hold the handle of a 512 Hz tuning fork and strike the tine on the ulnar border of the palm to activate it.
b. Place the stem of the fork firmly against the middle of the patient’s forehead, on the top of the head at the midline, or on the front of the teeth.
c. Ask the patient if the sound is heard centrally or toward one side.
Weber test
Normal findings in weber test
The patient should perceive the sound equally in both ears or in the middle and there is no lateralization of sound.
The patient reports lateralization of sound to the poor ear-the client “hears” the sound in the poor ear.
The good ear is distracted by background noise, conducted air, which the poor ear has trouble hearing.
IN CONDUCTIVE HEARING LOSS
In conductive hearing loss, the poor ear receives most of the sound conducted by
Bone vibration