Ear Assessment Flashcards
External Ear includes
external auditory canal and tympanic membrane
external auditory canal
opening of external ear
tympanic membrane
ear drum; translucent membrane with a pearly gray color
separates the external and middle ear
Middle Ear
tiny ear filled cavity inside the temporal bone
Middle Ear includes
malleus, incus, stapes, and eustachian tube
malleus
tiny ear bones or auditory ossicles
incus
tiny ear bones or auditory ossicles
stapes
tiny ear bones or auditory ossicles; opens to TM
Eustachian tube
connects middle ear with nasopharynx and allows passage of air
tube is normally closed, but it opens with swallowing or yawning
Functions of the Middle Ear
a. Conducts sound vibrations from the outer ear to the central hearing apparatus in the inner ear
b. Protects the inner ear by reducing the amplitude of loud sounds
c. Eustachian Tube - allows equalization of air pressure on each side of the TM so that the membrane does not rupture
Inner Ear consists of a
bony labyrinth and cochlea
Bony Labyrinth
holds sensory organs for equilibrium and hearing
Bony Labyrinth consists of
vestibules and semicircular canals
vestibule
compose the vestibular apparatus
semicircular canals
compose the vestibular apparatus
cochlea
contains the central hearing apparatus
Hearing: Peripheral
ear transmits sound and converts its vibrations into electrical impulses which can be analyzed by the brain
Hearing: Brain Stem
binaural interaction
permits locating the direction of a sound in space as well as identifying the sound
Hearing: Cerebral Cortex
Interpret the meaning of the sound and begin the appropriate response
Pathway of Hearing
normal pathway of hearing is air conduction; alternate route of hearing is by bone conduction (bones of the skull vibrate - vibrations are transmitted directly to inner ear and to cranial nerve VIII
Hearing Loss
Anything that obstructs the transmission of sound impairs hearing
Two types of hearing loss
conductive hearing loss and sensorineural (or perceptive) hearing loss
conductive hearing loss
involves a mechanical dysfunction of the external or middle ear
sensorineural (or perceptive) hearing loss
pathology of inner ear, cranial nerve VIII or the auditory areas of the cerebral cortex
Equilibrium
labyrinth (inner ear) constantly feeds information to your brain about your body’s position in space
ex) vertigo
vertigo
strong, spinning, whirling sensation
Transcultural Considerations
otitis media and cerumen
Transcultural Considerations: otitis media
increased incidence and severity with exposure to second-hand smoke, daycare attendance, bottle fed infants in supine position, fall/winter months
Transcultural Considerations: cerumen
Asians and Native Americans usually have a dry flaky cerumen; Caucasian and African Americans/Blacks usually have wet/moist cerumen
History (subjective)
A. Ear aches, ear pain, hx of ear infections - adult, childhood, frequency, tx.
B. Ear d/c or difficulty hearing.
C. Any trouble/difficulty hearing
D. Loud noise exposures, environmental noise - home or work exposures
E. Hx Tinnitus
F. Hx Vertigo
G. Self Care - how are ears cleaned, last time hearing evaluated
Physical Exam/Assessment of Ears (Objective)
A. Inspect & palpate the size and shape of the external ear
B. Observe for tenderness with external palpation
C. Otoscopic Examination
D. Hearing Acuity
E. Voice Test
F. Tuning Fork Test
Otoscopic Examination
- External Canal - note any redness, swelling, lesions foreign bodies or d/c
- Tympanic Membrane - color & characteristic, LR, landmarks, position
Hearing Acuity
audiometry or crude test with conversation
Voice Test
whisper 2 syllable word at 2 feet distance - cover lips/mouth, ask patient to repeat back or whisper slowly (with lips/mouth covered) a set of 3 random numbers and letters at 2 feet distance, ask patient to repeat back
Tuning Fork Test
not routinely performed anymore as evidence has show to be inaccurate
Ear Abnormalities
Otitis Externa Otitis Media Serous Otitis Media Sebaceous Cyst Perforation Darwin's Tubercle Tophi Ceruminosis Foreign Body
Otitis Externa
- swimmer’s ear; infection of the outer ear with severe swelling of the canal, inflammation and tenderness.
- hearing normal or slightly diminished
Otitis Media
inflammation of the middle ear
Serous Otitis Media
collection of non-infected fluid in the middle ear space.
Sebaceous Cyst
usually located behind lobule in the postauricular fold.
Filled with waxy sebaceous material and painful if it becomes infected.
Perforation
Hole or rupture in the eardrum
occurs when acute otitis media is not treated or through trauma. the drum may rupture from increased pressure.
Darwin’s Tubercle
small bump on the inside of their upper ear.
Tophi
small, whitish yellow, hard, nontender nodules in or near helix or antihelix.
Sign of gout.
Ceruminosis
obstruction of the ear canal with wax
Foreign Body
presence of foreign object in the ear
