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71 Cards in this Set
- Front
- Back
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External auditory canal
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Extends from auricle to tympanic membrane
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Tympanic membrane
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Found between the external and middle ear
Function Transmits sound waves through vibration |
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middle ear functions
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Transmits sound vibrations
Protection from intense vibration Equalizes air pressure |
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middle ear bones
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Malleus, incus, and stapes
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Eustachian tube
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Connects middle ear to nasopharynx
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inner ear Bony labyrinth
components |
Vestibule
Semicircular canals Cochlea Central hearing apparatus |
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inner ear bony labyrinth Function:
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Conducts sounds to CN VII
Transmits signals for body balance and position |
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Levels of auditory system for hearing
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Peripheral
Converts sound vibrations into electrical impulses Brainstem Locates the direction of a sound in space and sound identification Cerebral cortex Interprets the meaning of the sound to determine response |
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Pathways of hearing
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Air conduction- most effective
Bone conduction Bones of the skull vibrate vibrations transmitted directly to the inner ear to CNVIII |
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Conductive hearing loss
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Mechanical dysfunction of external or middle ear; can still hear sound if amplitude is increased
Examples: cerumen impaction, perforated TM |
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Sensorineural (perceptive)
hearing loss |
Pathologic disorder of the inner ear, CN VIII, or auditory areas of the cerebral cortex
Usually manifests as gradual and progressive bilateral deafness with a loss of high-pitched tones; cannot increase amplitude to hear Clients have difficulty filtering background noise, making listening difficult Most common cause: Loss of hair cells in the organ of Corti Example: presbycusis (progressive hearing loss with aging) Accounts for 90% of hearing loss |
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Equilibrium
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Vertigo – spinning sensation
Example: Labyrinthitis (inner ear infection) |
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Equipment
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Otoscope with bright light
Pneumatic bulb attachment (sometimes needed with infants or young children) Tuning forks in 512 and 1024 Hz |
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external ear - size, shape, tenderness
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Manipulate pinna, check for tenderness
Apply pressure to tragus Palpate mastoid process |
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External auditory meatus
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Look for discharge, inflammation, redness
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Tympanic membrane
color, characteristics, position |
pearly grey, clear, bony landmarks
Cone of light seen at 5 o’clock in right and 7 o’clock in left; if distorted tympanic membrane may be bulging or retracted Position Flat and mobile |
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Test hearing acuity - Whispered voice test
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Cover one ear position yourself about 2 ft away whisper a 2 syllable word
High-frequency test (baseball, day of week) test each ear separately |
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Weber test
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Used when c/o unilateral hearing problem
Place fork on skull ask if tone is equal or louder on one side |
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Rinne test – bone vs air (air should be longer)
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Place fork on mastoid process client indicates when sound is no longer heard fork then placed close to external ear canal
Bone heard longer = conductive hearing loss |
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conductive hearing loss
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weber- sound goes to poorer ear (less background noise can be heard)
rinne - hear longer by bone conduction than air |
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sensorineural hearing loss
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weber - sound goes to better ear
rinne - normal ratio, but hearing is poor both ways |
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Tophi
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Whitish-yellow, small, hard, nontender nodules on or near the helix
Seen with gout |
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Otitis media with effusion (OME)
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Inflammation of middle ear space resulting in accumulation of serous fluid in middle ear
Clinical manifestations: Popping, hearing loss, muffled sound, fullness sensation Amber-yellowish, dull, color, may see fluid/air bubbles, retracted TM |
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Acute otitis media
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Infection of the middle ear
Red, bulging TM, loss of light reflex, hypomobility Clinical manifestations: Otalgia, fever, hearing loss |
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Perforation
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Seen with untreated AOM or trauma
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Insertion of tympanostomy tubes
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Placed when recurrent AOM or chronic OME
Allows for drainage of fluid and alleviate middle ear pressure |
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Scarred drum
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White areas on eardrum
Seen with recurrent OM and/or T-tube placements |
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Fungal infection (otomycosis)
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Tiny, multiple white and/or black dots on ear drum or canal walls
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External nose
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Nostrils (nares)
Composed of bones and cartilage Bones: Nasal, frontal, maxillary Cartilage: Lateral, septal, and alar |
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nasal cavity function
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Clean, warm, and moisten inhaled air
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Clean, warm, and moisten inhaled air
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Divides the nose
Joins the nasopharynx posteriorly |
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Turbinates (superior, middle, and inferior)
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Mucosa projections within the nasal cavity to increase surface area
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Paranasal sinuses
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Openings in skull bones that surround the nasal cavity
Lined with mucus-producing epithelium |
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Paranasal sinuses
functions |
Warm and moisten inhaled air
Resonates sound |
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4 different paranasal sinuses:
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Frontal: Above the eyebrows
Able to exam Maxillary: Inferior to eyes on the cheeks Present at birth Able to exam Ethmoid: Deep, between the orbits Present at birth Sphenoid: Deep, behind the nose |
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mouth Function:
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Entry of digestive tract
Airway for the respiratory system |
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Palates
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Hard—Composed of bone located in the anterior portion of mouth
Soft—Composed of muscle posterior to hard palate that is mobile |
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Tongue
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Muscle used for mastication, swallowing, cleansing, speech, and taste
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Salivary glands
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Parotid
Submandibular Sublingual |
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Teeth
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32 permanent teeth
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Oropharynx
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Located posterior to the oral cavity
Function: Common passageway for food and air Tonsils (palatine and lingual) are located within |
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Laryngopharynx
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Located inferior to the oropharynx and extends downward to larnyx
Function: Common passageway for food and air |
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Nasopharynx
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Located posterior to nose
Function: Passageway of air Closes during swallowing to prevent food aspiration Adenoids are located within |
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External nose
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Symmetrical with inflammation, lesions, redness
Test nares for patency |
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Nasal cavity (nasal septum and turbinates)
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Appears red, smooth, and moist
Look for inflammation, discharge, foreign bodies Turbinates Light red color Look for polyps Nasal septum Look for deviation, perforation, or bleeding |
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Frontal and maxillary sinuses
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Observe for inflammation
Palpate for tenderness |
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Transillumination
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Helps diagnosis of sinusitis
Darken the room place light under the area of the frontal or maxillary sinus cover your hand look for generalized red glow No light with inflammation |
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Lips
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Look for color, moisture, cracking, or lesions
Note signs of cyanosis, cherry red lips Note cheilitis |
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Teeth and gums
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Teeth should be white and firmly in place
Gums should appear pink with well defined margins at teeth Note any dental carries, lesions or ulcerations, bleeding |
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Tongue
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Look at color, surface characteristics, and moisture
Note any lesions, dryness, tongue enlargement Ask client to stick out tongue should protrude midline Should see tastebuds, look under tongue |
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Buccal mucosa
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Look at surface characteristics, color, and moisture
Should appear, pink, smooth, and moist |
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Palate and uvula
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Hard palate appears whitish with rugae
Soft palate is pink, smooth, and mobile Uvula should be midline Have client say ‘ahhh’ –soft palate and uvula should rise (testing CN X—vagus nerve) |
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Should appear pink and cryptic
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Note enlargement, exudate, petechiae, or halitosis
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Tonsils grading
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– exudate on tonsils; grade with number, petechiae
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Use of tongue blade
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Press ½ way back to avoid the gag reflex
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Posterior pharyngeal wall
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Note color, exudate, or lesions
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Epistaxis
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Most common site is Kiesselbach’s plexus
Causes: trauma, bleeding/clotting disorders, manipulation, rhinitis One nostril or both |
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Foreign body
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Unilateral, foul-smelling, purulent drainage
Risk for aspiration |
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Perforated septum
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Causes: drug use, chronic infection, trauma
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Acute rhinitis
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Inflammation of the nasal mucosa
Clinical Manifestations: Clear, watery discharge that becomes purulent, inflammation, turbinates become dark red and swollen |
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Allergic rhinitis
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Rhinorrhea, pruritic nose and eyes, watery eyes, nasal congestion, sneezing, cough, turbinate inflammation that are pale and smooth
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Sinusitis
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Inflammation and infection as a result of pooling secretions within sinuses
Reddened and swollen nasal mucosa and turbinates, pain over sinus areas or ‘tooth’ pain, fever, sweats/chills, fatigue, purulent drainage |
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Nasal polyps
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Smooth, gray, nodules
Common cause: chronic allergic rhinitis |
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Carcinoma
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Whitish-gray, nontender lesion with scan unilateral bloody discharge
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Cleft lip and palate
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Most common congenital deformity of head and neck
Cleft meaning a fissure or gap Most common in Asians and Native Americans |
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Herpes simplex I
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Caused by herpes simplex virus (HSV-1)
Clinical Manifestations: Prodromal burning, tingling, or pain sensation before outbreak of lesions Formation of clear vesicles that become pustules which rupture, weep, and crust over |
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Gingivitis
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Hyperplasia, reddened, swollen gums, easily bleed
Usually r/t poor dental hygiene or Vitamin C deficiency |
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Aphthous ulcers
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“Canker sore”
Starts as a vesicle becomes a painful ulceration with white base and a red halo Cause is unknown |
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Leukoplakia
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Chalky, thick, raised patches with well-defined borders
Precancerous Firmly attached and does not scrape off Causes: chronic irritation |
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Candidiasis (thrush)
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Oral infection caused by Candida albicans
Soft white plaques on buccal mucosa and tongue Able to scrape off leaving a macerated area Seen in infants, with antibiotic use and steroid use, and immunosuppressed persons |
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Acute tonsillitis and pharyngitis
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Can be bacterial, viral, allergic
Clinical manfiestations: Reddened, swelling tonsils and posterior pharynx, dysphagia, pain with swallowing, exudate, anterior cervical node enlargement, fever |
