Chapter 16 Ear Assessment Flashcards
Air conduction
Normal pathway by which sounds travel to the inner ear
audiogram
test for auditory acuity conducted by an audiologist in a soundproof room.
bone conduction
pathway for sound transmission that bypasses the external ear and delivers sound waves/vibrations directly to the inner ear via the skull
cerumen
waxy substance secreted by glands in the ear
cochlea
part of the bony labyrinth that includes the portions of the inner ear responsible for hearing
conductive hearing loss
hearing loss that results when sound wave transmission through the external or middle ear is disrupted
equilibrium
condition of a system in which competing influences are balanced. the sense of a balance present in humans and animals.
eustachian tube
conduit that connects the middle ear to the nasopharynx and allows for pressure regulation of the middle ear.
incus
anvil-shaped small bone or ossicle in the middle ear that connects the malleus to the stapes. In conducts the sound to the inner ear.
Malleus
also call the hammer; a hammer-shaped small bone or ossicle or the middle ear that connects with the incus and is attached to the inner surface of the eardrum.
Organ of Corti
also called spiral organ; contains the auditory sensory cells (hair cells) in the inner ear of mammals
Otalgia
Pain in or around the ear
Otosclerosis
common conductive hearing loss resulting from slow fusion of any combination of the ossicles in the middle ear (commonly found in elderly population)
presbycusis
natural sensorineural loss
rinne test
test conduction with a tunning fork to examine the differentiation between bone conduction (BC) and air conduction (AC)
semicircular canals
Three half-circular, interconnected tubes inside each ear that are filled with a fluid called endolymph and a motion sensor with little hairs (cilia) whose ends are embedded in a gelatinous structure called cupula. As the skull twists in any direction, the endolymph is thrown into different sections of the canals. The cilia detect when the endolymph rushes past, and a signal is then sent to the brain.
Sensorineural hearing loss
hearing loss that results from a problem somewhere beyond the middle ear; from inner ear to auditory cortex
stapes
also called the stirrup; the stirrup-sharpped small bone or ossicle in the middle ear that attaches the incus to the fenestra ovalis, the “oval window” which is adjacent to the vestibule of the inner ear. It is the smallest and lightest bone in the human body.
Tinnitus
perception of buzzing or ringing in one ear or both ears that does not correspond with an external sound.
Tympanic membrane
oblique, multilayered, translucent, and pearly gray barrier between the external auditory canal and middle ear.
vertigo
type of dizziness, where there is a feeling of motion when one is stationary
vestibular function
proprioception and equilibrium
vestibule
central part of the labyrinth, as used in the vestibular system
Weber’s Test
use of a tuning fork to help to differentiate the cause of unilateral hearing loss
whisper test
test in which an examiner whispers a sentence and asks the patient to repeat it to evaluate loss of high-frequency sounds
Inspect the ears
Normal: they are symmetrical, equal in size, and fully formed.
Abnormal: Microtia, macrotia, edematous ears, cartilage pseudomonas infection, carcinoma on auricle, cyst, frostbite
inspect the face
normal: tone is uniform with the ears. skin is intact. small painless nodules on the helix are a variation of nomral anatomy known as Darwin’s tubercle.
Abnormal: Broken skin, ears disproportionate to face, obvious deformities.
Palpate the auricle.
Ears are firm without lumps, lymph tissue is not palpable, ears are nontender, and no pain is elicited with palpation or mainipulation or the auricle. No pain occurs with palpation of hte mastoid process.
Abnormal: Enlarged lymph nodes; pain with auricle movement or tragus palpation (indicates otitis externa or furuncle)
Perform the whisper test.
Normal: Patient repeats the entire sentence to you without errors.
Abnormal: Patient cannot repeat the sentence clearly or misses components.
Use a tuning fork to perform the Rinne test.
Normal: Air Conduction is twice as long as Bone Conduction.
Abnormal: Bone Conduction is longer or the same as Air Conduction.
Use a tuning fork to perform the Weber test.
Normal: Pt. hears the sound in both ears at equal intensity.
Abnormal: Unilateral identification of the sound.
Inspect the external meatus and canal with an appropriately sized speculum.
Normal: The canal has fine hairs; some cerumen lining the wall skin is intact, with no discharge.
Abnormal: Redness, swelling of the external auditory canal and discharge.
Visualize the tympanic membrane. Visualize portions of the malleus, umbo, manubrium, and short process through the translucent membrane. A well-aerated middle ear allows visualization of part of the incus as well.
Normal: Tympanic membrane is intact and translucent and allows visualization of the short process of the malleus. The cone of light is visible in the anterior inferior quadrant. A variation of normal is a tympanic membrane with white areas (sclerosis)
Abnormal: Swelling of bulging of the tympanic membrane; a diffuse cone of light; a perforated tympanic membrane.
Use the bulb insufflator attached to the head of the otoscope to observe tympanic membrane movement.
Normal: The tympanic memrane moves inward when inflated and outward with release.
Abnormal: Movement of the tympanic membrane is different form normal pattern or the membrane fails to move.
Assess equilibrium by using the Romberg test.
Normal: Findings are within normal limits (Oh, isn’t this helpful!!)
Abnormal: Failure of the Romberg test may indicate dysfunction in the vestibular portion of the inner ear, semicircular canals, and vestibule.
Diagnosis and related factors: disturbed auditory sensory perception related to hearing loss
point of differentiation: aleterations in the way the person interprets, uses, or organizes sensory (especially hearing-related) stimuli
assessment characteristics: change in responses to environment, impaired communication, difficulty with concentration
diagnosis and related factors: pain related to inflammation of ear canal
point of differentiation: unpleasant sensory and emotional experience from skin or tissue damage.
assessment characteristics: self report of pain is subjective. expressions are variable and include facial grimace, guarding, muslce tension, tachycardia, tacypenea, and nausea.
diagnosis and related factors: risk for infection
point of differentiation: at risk for pathogenic organisms due to break in skin or tissue, the body’s primary defense.
assessment characteristics: break in skin integrity, tubes and procedures, exposure to pathogens, malnutrition, inadequate immunity, chronic disease.
