Ch 16. Ears Flashcards
3 Functions of the Middle Ear
1) Conducts sound vibrations from the outer ear to the central hearing apparatus in the inner ear
2) Protects the inner ear by reducing the amplitude of loud sounds
3) Eustachian tube allows equalization of air pressure on each side of the tympanic membrane so that the membrane does not rupture
Visually the tympanic membrane
separates external from middle ear.
Trasclucent, pearly grey, can see “cone of light” and the mumbo
Should see no redness or drainage
2 Pathways of hearing
Air conduction
Bone conduction
Air conduction - most efficient
Bone conduction - vibration of the bones of the skull is transmitted directly to the inner ear and cranial nerve V111
The ears of Infants and children
Shorter, more horizontal eustachian tube
Lumen easily occluded
Greater risk for middle ear infections
Use of Digital Music Players, Earbuds, and Hearing Loss
Earbuds placed directly in the ear canal
No distortion in sound (digital)
Listeners tend to listen for hours continuously
60–60 rule recommended (no more than 60 minutes/day at 60% of max volume [“6”])
Use larger headphones/noise-cancelling headphones
Health History Ear Q’s
Earaches: Location, character, other symptoms, any related trauma? What relieves it?
Infections: When? How often? How were they treated?
Discharge: Appearance, odour, related to pain?
Hearing loss: Onset, character? In which situations? Family history? Any treatment? Coping strategies?
Environmental noise: Loud noise at home or work? Coping strategies?
Tinnitus: Ringing, crackling, buzzing? Louder at night? Any treatment?
Vertigo: Dizziness, room spinning, loss of balance?
Self-care behaviours: How do you clean your ears? Last time hearing was checked?
External ear Inspection
External ear—Inspect and palpate Size and shape Skin condition Tenderness External auditory meatus
External canal Colour Swelling Lesions/foreign bodies Discharge (colour, odour)
Whispered Voice Tests
Test Hearing Acuity
stand behind the patent, use 2 syllable words whispered into one ear while pushing the tragus in and out (masking other ear)
Tuning Fork Test (Weber, Rinne)
Test Hearing Acuity
Weber: can detect hearing loss, not if its conductive or sensory Stike tuning fork and hold above head. If they can hear in both ears no problems. If louder in one ear than other there’s a prob
Rinne: testing bone and air conductive. Hold tuning folk on mastodon process until they can’t hear it, then bring it forward and the other side is held away from ear canal so they can continue to hear sound. Normal. Should be able to hear through air twice as long as through bone. AC>BC(normal). BC>AC=conductive loss
Romberg Test
Tests ability of Vestibular apparatus.
Patients balance while standing. Eyes open for 30 sec then shut for 30 sec. Normal: If they can do it without taking a step that’s
Abnormalities Hearing/Ears in Older Adults
- Loss of elasticity of pinna
- Eardrum whiter, more opaque, duller
- Loss of hearing of high-tone frequencies and consonants in whispered voice test
- Isolation in groups
