Chapter 16 Ear Assessment

Question 1

Air conduction

Answer 1

Normal pathway by which sounds travel to the inner ear

Question 2

audiogram

Answer 2

test for auditory acuity conducted by an audiologist in a soundproof room.

Question 3

bone conduction

Answer 3

pathway for sound transmission that bypasses the external ear and delivers sound waves/vibrations directly to the inner ear via the skull

Question 4

cerumen

Answer 4

waxy substance secreted by glands in the ear

Question 5

cochlea

Answer 5

part of the bony labyrinth that includes the portions of the inner ear responsible for hearing

Question 6

conductive hearing loss

Answer 6

hearing loss that results when sound wave transmission through the external or middle ear is disrupted

Question 7

equilibrium

Answer 7

condition of a system in which competing influences are balanced. the sense of a balance present in humans and animals.

Question 8

eustachian tube

Answer 8

conduit that connects the middle ear to the nasopharynx and allows for pressure regulation of the middle ear.

Question 9

incus

Answer 9

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.

Question 10

Malleus

Answer 10

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.

Question 11

Organ of Corti

Answer 11

also called spiral organ; contains the auditory sensory cells (hair cells) in the inner ear of mammals

Question 12

Otalgia

Answer 12

Pain in or around the ear

Question 13

Otosclerosis

Answer 13

common conductive hearing loss resulting from slow fusion of any combination of the ossicles in the middle ear (commonly found in elderly population)

Question 14

presbycusis

Answer 14

natural sensorineural loss

Question 15

rinne test

Answer 15

test conduction with a tunning fork to examine the differentiation between bone conduction (BC) and air conduction (AC)

Question 16

semicircular canals

Answer 16

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.

Question 17

Sensorineural hearing loss

Answer 17

hearing loss that results from a problem somewhere beyond the middle ear; from inner ear to auditory cortex

Question 18

stapes

Answer 18

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.

Question 19

Tinnitus

Answer 19

perception of buzzing or ringing in one ear or both ears that does not correspond with an external sound.

Question 20

Tympanic membrane

Answer 20

oblique, multilayered, translucent, and pearly gray barrier between the external auditory canal and middle ear.

Question 21

vertigo

Answer 21

type of dizziness, where there is a feeling of motion when one is stationary

Question 22

vestibular function

Answer 22

proprioception and equilibrium

Question 23

vestibule

Answer 23

central part of the labyrinth, as used in the vestibular system

Question 24

Weber’s Test

Answer 24

use of a tuning fork to help to differentiate the cause of unilateral hearing loss

Question 25

whisper test

Answer 25

test in which an examiner whispers a sentence and asks the patient to repeat it to evaluate loss of high-frequency sounds

Question 26

Inspect the ears

Answer 26

Normal: they are symmetrical, equal in size, and fully formed.

Abnormal: Microtia, macrotia, edematous ears, cartilage pseudomonas infection, carcinoma on auricle, cyst, frostbite

Question 27

inspect the face

Answer 27

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.

Question 28

Palpate the auricle.

Answer 28

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)

Question 29

Perform the whisper test.

Answer 29

Normal: Patient repeats the entire sentence to you without errors.

Abnormal: Patient cannot repeat the sentence clearly or misses components.

Question 30

Use a tuning fork to perform the Rinne test.

Answer 30

Normal: Air Conduction is twice as long as Bone Conduction.

Abnormal: Bone Conduction is longer or the same as Air Conduction.

Question 31

Use a tuning fork to perform the Weber test.

Answer 31

Normal: Pt. hears the sound in both ears at equal intensity.

Abnormal: Unilateral identification of the sound.

Question 32

Inspect the external meatus and canal with an appropriately sized speculum.

Answer 32

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.

Question 33

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.

Answer 33

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.

Question 34

Use the bulb insufflator attached to the head of the otoscope to observe tympanic membrane movement.

Answer 34

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.

Question 35

Assess equilibrium by using the Romberg test.

Answer 35

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.

Question 36

Diagnosis and related factors: disturbed auditory sensory perception related to hearing loss

Answer 36

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

Question 37

diagnosis and related factors: pain related to inflammation of ear canal

Answer 37

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.

Question 38

diagnosis and related factors: risk for infection

Answer 38

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.