Ch.16 Ears Flashcards
What is the recommended position for the patient during an ear assessment?
Upright, head at eye level
What should be ensured about the ear canal before assessment?
Visible and clear of cerumen
What substances can be used to clean the ear canal if no infection is present?
Mineral oil & hydrogen peroxide
What equipment is needed for an ear assessment?
Otoscope with bright light, pneumatic bulb for infants/children
What is Microtia?
Small ears
What is Macrotia?
Large ears
What skin condition should be observed in the external ear?
Should match facial color, intact, no lesions
What are signs of abnormal skin condition in the external ear?
Redness, crusts, scaling, lumps
What does tenderness during ear palpation indicate?
Possible otitis externa, mastoiditis, or furuncle
What should the external auditory meatus look like during inspection?
Clear, with no swelling or discharge
What are signs of otitis externa?
Sticky discharge, impacted cerumen
What are common symptoms of Otitis Externa (Swimmer’s Ear)?
Painful movement of pinna and tragus, redness, swelling, discharge
What are the risk factors for Otitis Externa?
Hot, humid weather, swimming
What preventive measure can be taken after swimming to avoid Otitis Externa?
Use rubbing alcohol or 2% acetic acid eardrops
What symptoms characterize Cellulitis of the Ear?
Redness, warmth, pain, thickening, hardness of auricle
What may precede the symptoms of Cellulitis of the Ear?
Fever, chills, malaise
What is the cause of Cellulitis of the Ear?
Chronic inflammation or infection of deep dermis and subcutaneous tissue
What is the proper technique for inspecting the ear with an otoscope?
Tilt head away, pull pinna up/back for adults, down for infants
What is cerumen?
A waxy substance secreted by glands in the ear canal
What is the normal appearance of cerumen?
Varies from gray to yellow, moist to dry, present in small amounts
What can excessive cerumen lead to?
Blockage of the ear canal and hearing loss or discomfort
What symptoms indicate impacted cerumen?
Ear fullness, discomfort, hearing loss
What causes excessive cerumen?
Narrow, tortuous ear canal or poor cleaning methods
What can happen when the ear canal is 95%-100% occluded?
Ear fullness and sudden hearing loss
What are the symptoms of Otitis Externa (Swimmer’s Ear)?
Severe swelling, inflammation, and tenderness of the ear canal; canal narrowed to one-fourth of its normal size.
What should be checked during an external canal inspection?
Redness, swelling, lesions, foreign bodies, or discharge.
What is a precaution for hearing aid users during external canal inspection?
Check for irritation from poorly fitting ear molds.
What does purulent discharge suggest?
Otitis externa or otitis media (OM) if the drum is ruptured.
What does blood or clear drainage indicate?
Possible skull fracture (immediate referral).
What are the normal characteristics of a tympanic membrane (TM)?
Shiny, translucent, pearl gray; cone-shaped light reflex at 5 o’clock (right ear) or 7 o’clock (left ear); malleus visible.
What are abnormal findings in the tympanic membrane examination?
Yellow-amber color (OM with effusion), red color (acute OM), absent or distorted landmarks.
What does a retracted tympanic membrane indicate?
Vacuum or blocked eustachian tube.
What does a bulging tympanic membrane indicate?
Increased pressure in otitis media (OM).
What should be inspected for in the integrity of the tympanic membrane?
Perforations or scarring.
What is the position of a normal tympanic membrane?
Flat, slightly pulled in at the center.
What do vesicles on the tympanic membrane indicate?
Possible abnormality or pathology.
What is a key technique when examining both ears?
Switch otoscope hands to stabilize against the cheek.
What is the first question to ask during hearing acuity screening?
Do you have difficulty hearing now?
What indicates a need for audiometric testing?
Positive response to difficulty hearing.
What is the whispered voice test procedure?
Stand 2 feet behind the patient, mask one ear, and whisper 3 random numbers/letters.
What is the passing criteria for the whispered voice test?
Correctly repeat 4 out of 6 items.
True or False: A negative response to difficulty hearing means no further testing is needed.
False.
Fill in the blank: The _______ appears whiter at the periphery of the tympanic membrane.
Annulus
What is the function of the Vestibulocochlear Nerve (Cranial Nerve VIII)?
Sensory nerve for hearing and balance.
Hearing is managed by the cochlear branch, while balance is managed by the vestibular branch.
What does the Whispered Voice Test assess?
Hearing ability by having the nurse whisper numbers and letters.
This test is part of the assessment of the cochlear branch of the Vestibulocochlear Nerve.
What is the purpose of the Rinne and Weber Tests?
Evaluate air and bone conduction for hearing loss.
These tests are conducted using a tuning fork.
What does the Romberg Test assess?
Vestibular function and balance.
It checks the patient’s ability to maintain balance with eyes closed.
What is the procedure for audiometric testing using a Pure Tone Audiometer?
Patient raises a finger when they hear the tone.
The test is conducted for each ear separately.
What indicates a need for referral in audiometric testing?
Failure to hear 1000 Hz or 2000 Hz in both ears or one ear.
These frequencies are critical for normal hearing.
What is the primary purpose of Tuning Fork Tests?
Differentiate between conductive and sensorineural hearing loss.
The Weber Test checks lateralization of sound.
What does a normal result in the Rinne Test indicate?
Sound is heard twice as long by air conduction (AC) as by bone conduction (BC).
This is referred to as a ‘positive’ Rinne.
Define Conductive Hearing Loss.
Occurs when sound is not conducted efficiently through the outer or middle ear.
It is characterized by mechanical dysfunction.
What are common causes of Conductive Hearing Loss?
[“Impacted cerumen”, “Otitis media”, “Perforation of the eardrum”, “Foreign bodies”, “Otosclerosis”]
What are symptoms of Conductive Hearing Loss?
[“Difficulty hearing low-pitched sounds”, “Muffled hearing”, “Ear fullness or pressure”, “Speech may sound distorted”]
What does the Weber Test indicate in cases of Conductive Hearing Loss?
Sound lateralizes to the affected ear.
This indicates poorer hearing in the affected ear.
Define Sensorineural Hearing Loss.
Occurs due to damage to the inner ear or auditory nerve.
This affects the ability to transmit sound signals to the brain.
What are common causes of Sensorineural Hearing Loss?
[“Aging”, “Noise exposure”, “Ototoxic medications”, “Head trauma”, “Genetic factors”]
What are symptoms of Sensorineural Hearing Loss?
[“Difficulty hearing high-pitched sounds”, “Speech sounds distorted”, “Ringing in the ears (tinnitus)”]
What does a normal result in the Rinne Test indicate for Sensorineural Hearing Loss?
Air conduction (AC) is heard longer than bone conduction (BC).
This is indicative of sensorineural loss.
What is Tinnitus?
Perception of sound in the ears or head without an external source.
Often described as ringing, buzzing, or hissing.
What are common causes of Tinnitus?
[“Noise exposure”, “Age-related hearing loss”, “Ear infections”, “Medication side effects”]
What are the symptoms of Tinnitus?
Ringing, buzzing, or hissing sounds in the ear.
Symptoms can be constant or intermittent, often worse in quiet environments.
What physical changes occur in the aging adult’s ear?
[“Pendulous earlobes”, “Coarse hairs at the ear canal”, “Eardrum may appear whiter and duller”]
What is Presbycusis?
High-tone frequency hearing loss due to aging.
It often leads to difficulty hearing consonants during speech.
What impact does Presbycusis have on social interactions?
Feelings of isolation in social settings or family groups.
This can occur due to difficulty in communication.
