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Flashcards in evaluations Deck (20)
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1
Q

first step

A

otoscopic evaluation

2
Q

otoscopic eval

A
  • make sure ears are clear of wax, foreign body, drainage from middle ear infection
  • if able to visualize TM, make sure its not red, irritated, no perforations
  • can you see cone of light?
3
Q

middle ear eval

A

if EAM is clear, perform tymps/immitence testing

4
Q

tymps

A

allow us to examine the middle ear functioning by using measures of pressure and movement of middle and outer ear

5
Q

3 principles of tymps

A

pressure (air pressure behind ear drum)
compliance (how much the TM moves)
volume (how much space is in the inner ear)

6
Q

tymp probe tip

A
  • placed at opening of ear canal
  • has air pump to change pressure
  • sends out 220 hz tone and also has mic to record how ear reacts to tone
  • pressure is varied from -200-200 hz
7
Q

tymp pressure

A
  • values are indicative of amount of pressure in middle ear cavity
  • measurements made in decapascals
  • normal middle ear cavity maintains a pressure that approximates normal atmospheric pressure
8
Q

tymp compliance

A
  • values indicative of amount of mobility

- measured in cubic cm or mm

9
Q

what can cause change in compliance?

A
  • scarring
  • hole
  • fluid
  • ossicles fused together (otosclerosis)
10
Q

what if compliance is too high?

A
  • disarticulation of ossicular chain

- hypermobile drum (stretched out over time)

11
Q

tymps volume

A
  • measures estimated volume of ear canal from probe tip to the drum
  • range of normal varies
12
Q

large volume is suggestive of…

A

patent/open tubes

13
Q

small volume is suggestive of…

A

clogged tubes/ not functioning properly

14
Q

tymps with normal pressure

A

Ad
As
A

15
Q

Ad

A

high compliance normal pressure

  • compliance greater than 2.0
  • may show hearing loss
16
Q

As

A

limited mobility/compliance, normal pressure

  • compliance below .25 for child
  • below .3 for adult

-often accompanied with hearing loss

17
Q

A

A

normal

18
Q

C

A

looks like type A, but pressure is abnormal

  • pressure less than -150
  • reflects retraction of ear drum and a system of negative pressure in middle ear space
  • can be caused by partially blocked e-tube
  • often seen with allergies or resolution of ear infection
19
Q

B

A
  • flat pattern, no peak at all
  • ear canal volume is important
  • if large volume, need to see if person has perforated tubes
  • if small volume, maybe wax
  • OFTEN associated with conductive HL
20
Q

reflex

A

occurs in response to high intensity sounds

  • works during gunshot, alarm
  • used clinically to distinguish between cochlea vs retro cochlea and malingering