Chapter 16: Ears Flashcards
Eustachian Tube
Drains into the sinuses;
Adults = tube curves for better drainage
Children = no curve, which makes them more susceptible to ear/sinus infection (otitis media)
Hearing
Air conduction (AC) is more efficient than bone conduction (BC); when assessing conductive hearing, AC should be better than BC by 2:1
Cerumen
Ear wax
Sensorineural Hearing Loss
Sign of inner ear problems
Subjective Data
Ask the patient about history of or recurring:
Earache
Infections
Discharge (color, thickness, smell)
Hearing loss
Tinnitus
Vertigo
Environmental noise (occupation, music, etc)
Common Ear Symptoms (that bring people in)
Hearing loss
Vertigo
Tinnitus
Otalgia
Inspection of the Ears
Symmetry
Skin for lesions (especially top of ear bc it is exposed to the sun)
Palpation of the Ears
Feel the auricle, pinna, tragus, and mastoid process
How do we assess CN VIII (vestibulocochlear)
Whisper Test; stand 2 feet behind the patient…isolate one ear. Whisper a series of words to the isolated ear and have the patient repeat back to you
How do we assess conductive hearing?
Rinne’s Test; hit the tuning fork and put it against the patient’s mastoid process (this assesses BC)…once the patient cannot hear the humming, move the fork in front of their ear (this assesses AC)…patient should be able to continue to hear the humming for twice as long as the BC
How do we assess sensorineural hearing?
Weber’s Test; hit the tuning fork and place on the top of the head…patient should be able to hear the humming equally in both ears
How do we assess the tympanic membrane?
Otoscopic Evaluation; TM should be pearly gray and shiny…the cone of light should be at 5 o’clock in the right ear (RR) and at 7 o’clock in the left ear (LL)
External Otitis
Swimmer’s ear; inflammation and puss
Perforated Tympanic Membrane
Complete absence of cone of light; should be able to see internal ear structures
Acute Otitis Media
TM is red, inflamed, and possibly necrotic
