Ear Exam Flashcards by Emily Ulrich

The ear exam can be focused on problems related to

Ear
Head
Hearing
Vestibular problems

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What is the role of the RVT in an ear exam

Assist with history
Predict tests and procedures
Assist sample collection and tests
Perform/teach cleaning and medicating to the client

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What are the non emergent complaint related to the ear

Scratching at ears
Wounds/redness/discharge/smell
Masses/growths

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What are the emergent complaints related to the ear

Swollen ear
Head shaking
Head tilt
Loss of balance
Horner’s syndrome
Loss of hearing

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How many cones do you need to perform an ear test with an otoscope

2 -one per ear

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What is Horner’s syndrome

Droopy ear and eyelid
Raised 3rd eyelid
Miosis

A collection of changes caused by damage to the sympathetic nerve feeding the ear, eye and face

Many causes including lesions in the middle ear, middle ear infections, reactions to topical medications

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Who is most sensitive to ear medications

Cats

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True or false

A hematoma requires a same day emergency/surgery

True

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How do you visualize the tympanic membrane

With an otoscope (direct down the cheek)

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True or false

You can put a medication in the ear without seeing the tympanic membrane

FALSE
never put a medication into the ear without confirming the TM is intact. If you have to then it must be one that is made to be safe if there is a damaged TM

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What is AS, AD and AU

AS: left ear
AD: right ear
AU: both ears

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What is stenosis of the ear

Construction of the ear

Swollen, excess tissue

Canal may be closed off

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Define pruritic

Itchy

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What are the different discharges/exudate descriptions used

Slight/moderate/copious

Back/brown, cream coloured, yellow, frank blood

Wet/dry/glandular

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What are the rules during an ear exam of the tympanic membrane

The animal cannot move (major)

Do not occlude the canal by putting pressure on the neck while restraining

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What does pulling on the pinna do for an ear exam

Elongates the canal to make it easier to find the tympanic membrane

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What shape does the vertical and horizontal canals of the ear make

An L

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Which way should you direct the otoscope in the ear

Towards the check

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What is a cotton tipped applicator used for in an ear swab

Clean but not sterile, used for swabs for cytology and cleaning around the pinna

What is a sterile culturette used for in ear swabs

Culture and sensitivity tests

Stores in transport media or tube

If the ear is dry, for an ear swab what can you do

Moisten swab with saline

What is cytology tests used for

Testing for presence of:

Epithelials, bacteria, yeast and WBCs

What is the hint for waxy ears and diff quick stains

Leave longer in #3 (1min)

If rods and recurrent otitis is present what should you test for before cleaning the ear

Sterile swab to test for culture and sensitivity

Who are ear mites more common in

Cats

Otodectes cyanotic mites may be seen in the ear in ____ | What does this mean?

Various life stages Means it needs a longer treatment to treat all life stages

True or false | With ear mites you don’t need to check other pets in the hose because they are easily spreadable

False | There are very contagious. Always ask if there are other pets in the household

What are the reasons for cleaning the ear

``` Otitis externa Discharge Facilitating examination of the ear Removes microbes/foreign bodies Exposes lining to topical meds Prevents inactivation if topical meds ```

What is the normal a mount of discharge from the ear

NONE

What are the rules for ear cleaning and medications

Do all tests and examination before Must confirm TM Never use alcohols or antiseptics Purulent discharge can inactivate meds (must clean before meds) Medications must reach sites of infection Very painful/stenotic ear may need systemic treatment first

When giving medications, where should you rub to increase tolerance

Rub the cheek and back of skull below the ear (over the horizontal canal)

True or false | Fill ear to the “brim” with cleaners

True

Why do you not want to release pressure on dispenser while in the ear

Noise/wind stresses dogs out

Why is massaging for 30-60 seconds recommended after putting in medications and cleaners

Agitates cleaner and breaks up discharge Increases tolerance

True or false | Never let the patient shaken it’s head after giving cleaner solutions in the ear

False | Always let them shake to bring up discharge

How long should you wait after cleaning the ears before giving medications

15 minutes

Why should you not use Q tips in the ears

Packs debris into the canal Risk of perforating the TM

What are the different types of ear cleaners

Surfactant/foaming: mild detergent Cerumenolytic: softens/breaks down ear wax Drying solutions: removes excess moisture (swimming dogs) EDTA: good for purulent discharge, sensitive ears, base for topical meds, and ruptured tympanic membranes Sterile saline

True or false | You can never over clean the ear

FALSE

What is the exception to cleaning the ear everyday besides for bacteria

Regular swimmers

How often do you clean the ear for treating otitis externa

2-3x a week

How often do you clean the ear for maintenance

Once a week

Describe an ear flush

Ears are cleaned with a solution under mild pressure using a catheter placed into the canal Only performed under anesthesia (needs an inflated cuff when intubated to prevent contamination of the respiratory tract if there is a rupture tympanic membrane) Indicated when the patients ears are too painful or swollen or obstructed with debris

Most topical ear medications consist of

Anti inflammatories Antibiotics Antifungals

How to increase effectiveness and reduce drug resistance with ear medications

Only use medications when it is necessary and use proper medications for bacteria/viruses/fungus Use as prescribed for prescribed duration and frequency Only use drugs if the infection has be confirmed

What are some adverse reactions from ear medications

Pain Head tilt Loss of hearing

Revisits to assess infections and treatment are done in

10-14 days