Ear Assessment

Question 1

External Ear includes

Answer 1

external auditory canal and tympanic membrane

Question 2

external auditory canal

Answer 2

opening of external ear

Question 3

tympanic membrane

Answer 3

ear drum; translucent membrane with a pearly gray color

separates the external and middle ear

Question 4

Middle Ear

Answer 4

tiny ear filled cavity inside the temporal bone

Question 5

Middle Ear includes

Answer 5

malleus, incus, stapes, and eustachian tube

Question 6

malleus

Answer 6

tiny ear bones or auditory ossicles

Question 7

incus

Answer 7

tiny ear bones or auditory ossicles

Question 8

stapes

Answer 8

tiny ear bones or auditory ossicles; opens to TM

Question 9

Eustachian tube

Answer 9

connects middle ear with nasopharynx and allows passage of air
tube is normally closed, but it opens with swallowing or yawning

Question 10

Functions of the Middle Ear

Answer 10

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

Question 11

Inner Ear consists of a

Answer 11

bony labyrinth and cochlea

Question 12

Bony Labyrinth

Answer 12

holds sensory organs for equilibrium and hearing

Question 13

Bony Labyrinth consists of

Answer 13

vestibules and semicircular canals

Question 14

vestibule

Answer 14

compose the vestibular apparatus

Question 15

semicircular canals

Answer 15

compose the vestibular apparatus

Question 16

cochlea

Answer 16

contains the central hearing apparatus

Question 17

Hearing: Peripheral

Answer 17

ear transmits sound and converts its vibrations into electrical impulses which can be analyzed by the brain

Question 18

Hearing: Brain Stem

Answer 18

binaural interaction

permits locating the direction of a sound in space as well as identifying the sound

Question 19

Hearing: Cerebral Cortex

Answer 19

Interpret the meaning of the sound and begin the appropriate response

Question 20

Pathway of Hearing

Answer 20

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

Question 21

Hearing Loss

Answer 21

Anything that obstructs the transmission of sound impairs hearing

Question 22

Two types of hearing loss

Answer 22

conductive hearing loss and sensorineural (or perceptive) hearing loss

Question 23

conductive hearing loss

Answer 23

involves a mechanical dysfunction of the external or middle ear

Question 24

sensorineural (or perceptive) hearing loss

Answer 24

pathology of inner ear, cranial nerve VIII or the auditory areas of the cerebral cortex

Question 25

Equilibrium

Answer 25

labyrinth (inner ear) constantly feeds information to your brain about your body's position in space ex) vertigo

Question 26

vertigo

Answer 26

strong, spinning, whirling sensation

Question 27

Transcultural Considerations

Answer 27

otitis media and cerumen

Question 28

Transcultural Considerations: otitis media

Answer 28

increased incidence and severity with exposure to second-hand smoke, daycare attendance, bottle fed infants in supine position, fall/winter months

Question 29

Transcultural Considerations: cerumen

Answer 29

Asians and Native Americans usually have a dry flaky cerumen; Caucasian and African Americans/Blacks usually have wet/moist cerumen

Question 30

History (subjective)

Answer 30

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

Question 31

Physical Exam/Assessment of Ears (Objective)

Answer 31

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

Question 32

Otoscopic Examination

Answer 32

1. External Canal - note any redness, swelling, lesions foreign bodies or d/c 2. Tympanic Membrane - color & characteristic, LR, landmarks, position

Question 33

Hearing Acuity

Answer 33

audiometry or crude test with conversation

Question 34

Voice Test

Answer 34

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

Question 35

Tuning Fork Test

Answer 35

not routinely performed anymore as evidence has show to be inaccurate

Question 36

Ear Abnormalities

Answer 36

``` Otitis Externa Otitis Media Serous Otitis Media Sebaceous Cyst Perforation Darwin's Tubercle Tophi Ceruminosis Foreign Body ```

Question 37

Otitis Externa

Answer 37

- swimmer's ear; infection of the outer ear with severe swelling of the canal, inflammation and tenderness. - hearing normal or slightly diminished

Question 38

Otitis Media

Answer 38

inflammation of the middle ear

Question 39

Serous Otitis Media

Answer 39

collection of non-infected fluid in the middle ear space.

Question 40

Sebaceous Cyst

Answer 40

usually located behind lobule in the postauricular fold. | Filled with waxy sebaceous material and painful if it becomes infected.

Question 41

Perforation

Answer 41

Hole or rupture in the eardrum | occurs when acute otitis media is not treated or through trauma. the drum may rupture from increased pressure.

Question 42

Darwin's Tubercle

Answer 42

small bump on the inside of their upper ear.

Question 43

Tophi

Answer 43

small, whitish yellow, hard, nontender nodules in or near helix or antihelix. Sign of gout.

Question 44

Ceruminosis

Answer 44

obstruction of the ear canal with wax

Question 45

Foreign Body

Answer 45

presence of foreign object in the ear