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54 Cards in this Set
- Front
- Back
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What is the function of the ears?
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Senses hearing and equilibriums
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Which CN innervates the ear?
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CN VIII
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What are external ear structures?
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Auricle/pinna that consists of movable cartilage and skin.
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What are ear landmarks and when would you refer to them?
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helix, antihelix, tragus, antitragus
use them as reference points when documenting findings |
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In kids especially, what can an untreated ear infection become?
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mastoiditis
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What are the boundaries of the external ear?
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tympanic membrane and out
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What is cerumin?
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ear wax; lubricates and protects the ear
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What are the components of the middle ear?
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An airfilled cavity that contains the malleus, incus, and stapes
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What are the boundaries of the middle ear
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from the tympanic membrane until the bottom of the Eustachian tube
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What occurs to the Eustachian tube while you swallow or yawn?
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It opens/closes to equilize pressure
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If you were looking in the right ear, where should you see the reflection of the otoscope?
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right eardrum = 5 o'clock
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If you were looking in the left ear, where should you see the reflection of the otoscope?
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left eardrum= 7 o'clock
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What is otosclerosis?
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an abnormal spongy bone growth in the middle ear that causes hearing loss
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In which populations is otosclerosis most common?
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*it is the most common form of hearing loss in YOUNG adults (20-40 y/o)
-it occurs in more women and caucasians |
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What are risk factors for otosclerosis?
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1. pregnancy
2. family history |
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What is presbycusis?
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Age-related hearing loss
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What are possible causes of presbycusis?
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rock concerts, headphones
*ask your patient if he/she is exposed to loud noises |
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Describe the Eustachian tube of a kid.
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It is more horizonal .:. it drains less, making them more prone to ear infections
*if a baby lies down while drinking a bottle, the milk can go up into the ear |
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What are 2 different hearing pathways. Which is more efficient?
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1. air conduction*
2. bone conduction |
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What is tinnitis? What is it caused by?
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ringing in the ears
loud noise, too much aspirin |
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What is vertigo?
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feeling like the room is spinning; may cause N/V
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What are the 7 components of ear physical assessment?
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1. Assess gross hearing
2. Rinne and Weber tests if needed 3. Inspect auricle 4. Palpate mastoid process 5. Press tragus 6. Inspect canal 7. Inspect tympanic membrane |
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What are 3 ways to test hearing acuity?
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1. Conversation
2. Finger rubbing 3. Whisper test (close 1 ear, whisper word in the other) |
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How do you do the Weber test?
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-Place the 512 fork midline on the head
-ask if the sound is louder in one ear or the other -Norm: it should be heard equally -Abnormal: if it lateralizes right or left |
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What does the Rinne test assess?
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bone conduction vs air conduction
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How should you hold the tuning fork when testing for bone conduction?
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stem to mastoid
ask patient to say when he/she no longer hears sound |
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How should you hold the tuning fork when testing for air conduction?
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fork to mastoid
*norm: if the patient hears 2x longer for air than for bone |
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What is conductive hearing loss?
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Anything that blocks normal airway sound waves
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What are potential causes of conductive hearing loss?
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-too much cerumin
-m&ms -fluid in the middle ear from infection |
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In which ear will the sound be louder during the Weber test?
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Weber test: the sound will be louder in the BLOCKED ear
*blockage hinders air conduction, so the patient will be very aware of bone conduction |
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In the Rinne test, where do you hear the sound?
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in the good ear
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How can you know if there is a hearing problem by using the Rinne test?
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If air conduction time=bone conduction time
if air conduction time <bone conduction time if the nerve is completely dead, no hearing will occur! |
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What does gout look like on the external ear?
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chalky, white nodule
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What should you inspect the auricle for?
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-symmetry
-lesions -nodules |
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How can you determine if a patient's external ears are normal?
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-equal size
-no swelling or thickening -color consistent with facial color -no lesions, lumps |
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The upper attachment of the pinna should be in line with what?
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the lateral canthus of the eye
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Which 2 external ear parts should you palpate?
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1. tragus
2. mastolid process |
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Describe normal/abnormal mastoid palpation.
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Normal: no pain
Abnormal: pain; possibly otitis media or mastoiditis *pain may occur from ear infection tenderness from lymph nodes near the middle ear |
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Describe normal/abnormal tragus palpation
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normal: firm, painless
abnormal: painful -consider otitis externa (usually external, sometimes middle) |
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How should you hold the ear whil using the otoscope? (adult)
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pull the ear up and back
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How can you position a baby to look into the baby's ears?
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have the mom hold the baby with the ear against the chest
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When would you use the pediatric hold on the otoscope?
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when you are examining a child or patient with dementia
*gives you more stability |
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How should you hold a child's ear (age 2 and below) when you are using the otoscope?
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hold the pinna down
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What can impacted cerumin cause?
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-partial deafness
-tinnitus -dizziness *esp in older people |
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What is exostosis?
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-A discreet, hard, round or oval outcropping
-formation of new bone on the surface of a bone |
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Who often gets exostosis?
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swimmers and surfers
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What are the symptoms of exostosis?
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infections, pain, plugging, and hearing loss (rarely enough damage for hearing loss)
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What is otitis externa?
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"swimmer's ear"
-scaling or crusting, inflammation and discharge in the ear canal -pain occurs upon moving tragus or pressing the pinna -may have palpable nodes -ask about swimming or frequent ear cleaning |
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What is serous otitis media?
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The TM is retracted and has decreased mobility
A thin serious effusion gives a yellowish appearance (should normally be pearly gray) -bubbles are apparent if the Eustachian tube is blocked |
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How should you treat otitis media?
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anticongestants! not antibiotics
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What are possible causes of a perforated tympanic membrane?
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1. infection
2. Estachian tube breaks 3. loud noise 4. toothpicks/bobby pins in ear |
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Will a perforated TM heal?
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yes, with scarring and decreased hearing
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What does a scarred TM look like?
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white, chalky
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What is a tympanostomy tube?
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A tube that keeps the tympanic membrane open to the external ear to equilize pressure and primarily promote drainage of Eustachian tubes
-primarily used in kids with many infectiosn |
