3. SESSION 3.3: Ears

Question 1

What is the ear (3)

Answer 1

SENSORY organ for HEARING and EQUILIBRIUM.

Question 2

External ear structure

• Name (2)
• Composition (2)
• Landmarks (4)

Answer 2

• Called “Auricle” or “Pinna”
• Consists of movable cartilage and skin
• Helix, antihelix, tragus, antitragus

Question 3

What is the purpose of the external ear?

Answer 3

To funnel sound waves to the tympanic membrane

Question 4

What is the function of the middle ear (3)?

Answer 4

• To conduct sound vibrations
• To reduce the amplitude of sound
• Equalization of air pressure

Question 5

What is the function of the inner ear?

Answer 5

Sensory organ for hearing and equilibrium.

Question 6

When looking at the tympanic membrane with the odoscope, light should be shining at _____ at the right ear and ______ at the left ear.

Answer 6

5: 00 at the right ear
7: 00 at the left ear

Question 7

Children get more ear infections because their ________ are _________. (Especially if they…)

Answer 7

• Eustachian tubes, horizontal

- Lay down with their bottle

Question 8

What is ostosclerosis?

Answer 8

An abnormal spongey bone growth in the middle ear that causes hearing loss.

Question 9

What is the name for age-related hearing loss?

Answer 9

Presbycusis

Question 10

What are the two pathways of hearing?

Answer 10

• Air conduction pathway

- Bone conduction pathway

Question 11

What are the 8 health history questions for the EAR?

Answer 11

1) Earaches
2) Infections
3) Discharge
4) Hearing loss
5) Environmental Noise
6) Tinnitus
7) Vertigo
8) Self-care behaviors

Question 12

What are the 7 steps of physical examination of the ear?

Answer 12

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

Question 13

What are four tests of hearing acuity?

Answer 13

• Conversational
• Finger Rubbing
• Whisper test
• Weber and Rinne

Question 14

Describe how to conduct the Weber test.

Answer 14

• Place 512 fork in the midline of the head
• Ask if the sound is louder in one ear or the other.
• Result is that it either lateralizes midline, favors right or favors left.

Question 15

Describe how to conduct the Rinne test.

Answer 15

Test bone conduction verses Air conduction. Air conduction should be stronger, if not there may be a problem.

Question 16

For the Weber test, the ___ conduction will be stronger in the ___ ear. Why?

Answer 16

• Bone conduction, stronger in bad ear.

- Because all the other sound in the room is masked, so they hear sound through the bone better.

Question 17

Inspect auricle for… (3)

Answer 17

Symmetry, lesions, nodules

Question 18

Describe a normal external ear (5)

Answer 18

• Equal size
• No swelling or thickening
• Color consistent with facial color
• No lesions / lumps
• Upper attachment of pinna should be in line with the lateral canthus of eye.

Question 19

If there is pain while palpating the mastoid process, consider _______ or _____

Answer 19

otitis media or mastoiditis (middle ear infection) or infection that’s already gone to the bone.

Question 20

If tragus palpation is painful, consider ________

Answer 20

otitis externa

Question 21

When using the otoscope, pull ____ up and back, ____, THEN ____.

Answer 21

Pinna, insert, THEN look.

Question 22

Four components of a normal right tympanic membrane

Answer 22

• Pearly gray
• Semi transparent
• Flat but pulled at center
• May see malleous

Question 23

What is insufflation

Answer 23

If you have pt hold their nose and swallow, you will see the tympanic membrane move.

Question 24

Results of impacted cerumen (3)

Answer 24

• Partial deafness
• Tinnitus
• Dizziness

Question 25

What is exostosis? What is the cause? What can it result in?

Answer 25

• Formation of new bone on the surface of a bone. Discreet, hard, round or oval cropping.
• Cause: Lots of outer / middle ear infections (Swimmers, surfers)
• Can result in infections, pain, plugging, hearing loss.

Question 26

• What is otitis externa?
• Will cause pain when moving _____
• May have _______
• Caused by (2)

Answer 26

• Scaling or crusting, inflammation and discharge in canal.
• Pain when moving tragus
• Palpable nodes
• Swimming, frequent ear cleaning.

Question 27

What is serous otitis media? 3 components

Answer 27

• Tympanic membrane is retracted, has decreased mobility
• Thin serous effusion gives yellowish appearance
• Bubbles apparent if eustacian tube is blocked.