Ears Asessment Flashcards by Kayla Williams

The middle ear acts as a?

Volume dampener to protect the inner ear

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External Ear

Auricle or pinna
Made up of flexible cartilage and skin
Design is to guide sound waves into meatus of external auditory canal

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Eustachian tube

Conduit that connects the middle ear to the nasopharynx and allows for pressure regulation of the middle ear

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Inner ear is responsible for?

Translation of sound to cranial nerve VII which transmit it to the brain stem

Only section responsible for vestibular function

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Organ of corti

Transfers the signal into electrical impulses for the auditory nerve

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Sound is perceived in two ways

Air conduction and bone conduction, compromise in either causes hearing loss

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Conductive hearing loss

Occurs when sound wave transmission through the external or middle ear is disrupted

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Sensorimotor hearing loss

Results from a problem somewhere beyond the middle ear 
Sites of dysfunction:
Cochlea
Organ or corti
Auditory nerve
Auditory cortex

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Presbycusis

Results from gradual degeneration of of nerves and sensory hair cells of the organ of corti
Can be from aging or ototoxic drugs

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Tinnitus

Perception of buzzing or ringing in one or both ears that does not correspond with external sound

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Illness in the labyrinth can cause

Loss of equilibrium and sense of vertigo

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Menier’s disease

Vertigo, sever nausea and vomiting, exacerbation so that can last up to 24 hours

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Vertigo is pregnant women can result from?

Increased vascularity and edema

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Infants and children are susceptible to?

Otitis media,

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Infants and children’s Eustachian tube is different how?

Shorter, wider and more horizontal

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In children, Enlarged adenoids related to nasal allergies often obstruct?

Outlets for the eustachian tube to drain

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Otis media can cause?

Severe discomfort, difficulty feeding, sleeping, and general fussiness and rarely causes hearing loss
Normal for fluid to remain in ears for three months

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Repeated infections or persistent middle ear effusion causes?

Temporary conductive earring loss which can delay onset or advancement of speech

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Otosclerosis

Common conductive hearing loss in older adults resulting from slow fusion of any combination of the ossicles in the middle ear

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Presbycusis

Loss of higher pitch sounds, garbled or mumbled speech

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Immediate attention for ear problems

Button battery in ear canal, foul smelling drainage, ear trauma, sudden hearing loss

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Cholesteatoma

Abnormal accumulation of squamous epithelium within the middle ear

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Common ear symptoms

Hearing loss
Vertigo
Tinnitus
Otalgia

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Whisper test

Evaluates for loss of high frequency sounds. Have patient cover opposite ear. Whisper a simple sentence from 18” back, have pt repeat sentence

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Weber's test

Helps to differentiate the cause of unilateral hearing loss

Placement of external ear on the skull in infants

Superior portion of the pinna should be congruent with the outer canthus of the eye

Weber's test

Helps to differentiate the cause of unilateral hearing loss | place tuning fork on midline of parietal bone

Macrotia

Excessive enlargement of the auricle; usually congenital

Microtia

Small or deformed auricle that may be associated with a blind or absent auditory canal

Edematous ears

External ear canal that is swollen with inflammation or infection

Cartilage staphylococcus

Painful reddened ear usually surrounds incisions, piercings, area of traumatic injury

Carcinoma on auricle

Common site of carcinoma Related to sun exposure Either basal cell or squamous cell rumors

Cyst

Sac or pouch with membranous lining filled with fluid or solid material

Tophi

Uric acid crystals associated with gout, may appear as hard nodules on ear

External Otis

Inflammatory and infectious discharge in external ear canal

TM rupture

``` To rupture a non intact TM Clear, purulent or bloody discharge Hearing loss Buzzing Ear pain ```

Acute Otis media

Acute infection in middle ear Sudden onset Fever and pain Fluid may be in middle ear Can be viral or bacterial

Tympanostomy tube

Indicated for chronic Otis media and it's complications

Most common hearing test in primary care offices and schools are done with a device called?

audiometer: headphone and box that delivers tones in different frequencies

Special considerations for older adults?

cartilage and skin around the external ear may be less pliable stiff hairs in the ear canal TM may seem more opaque and less mobile

Abnormal findings for infants and children

Lack of moro reflex inability to locate sound lack of understandable language by 24 months

If a child has a tympanostomy tubes placed, the tube should be in the?

Inferior portion of the TM with the lumen of the tube patent

Failure of Romberg's test may indicate dysfunction in the?

vestibular portion of the ear, semicircular canals, and vestibule

The most accurate way to evaluate hearing is by?

Audiogram

Signs of external otis

redness, swelling of external auditory canal, and discharge

Conductive hearing loss on one side may indicate?

external or middle ear disease

Patients with conductive hearing loss should have an assessment of?

auricle and external auditory canal to look for blockage

TM is assessed to ensure?

no middle ear abnormality or TM perforation

pain with auricle movement or tragus palpitation indicates?

otitis externa or furunucle

Otalgia usually indicates?

ear dysfunction, most commonly otitis media or otitis externa

Severe pain followed by drainage indicates?

ruptured TM

pain in the ear can be referred to?

pharynx

Children who frequently have otitis media are at risk for?

TM rupture, scarring and hearing loss

Risk factors

age, gender, hereditary, family history, lifestyle choices, environmental

Nonverbal cues for hearing loss

leaning forward, positioning head for "good ear", concentrating on lip movement instead of eye contact, mumbling answers, giving answers not congruent with questions, asking to repeat questions frequently, responding with loud voice, monotone conversational voice

Patients with ear trauma also need evaluation for injury to surrounding structures, which include?

brain injury, basilar skull fracture, neck injury

hemotympanum, otorrhea or TM rupture may indicate?

barotrauma from pressure changes or basilar skull fracture

cholesteatoma

abnormal accumulation of squamous epithelium in the middle ear-growth can erode auditory ossicles and cause damage to patient's hearing

Patients with foul smelling ear drainage, try to wick the fluid from the external ear with?

cotton wick or wisp of cotton

Grey to white cerumen is often mistaked as?

eczema

The middle ear acts as a perfect reservoir because?

it is dark, warm and moist

Semicircular canals and vestibules provide the body with?

equilibrium and proprioception, contains specialized cells for sensing position

symptoms of Menier's disease

vertigo with severe nausea and vomiting

People with hearing loss are at risk for?

depression, decreased satisfaction with life, reduced functional health, withdrawal from social activities

four openings to the middle ear

TM Cochlear window oval window eustachian tube

Ears Asessment Flashcards

(65 cards)