EARS Flashcards
is a flashlight-type viewer used to visualize the eardrum and external ear canal
Otoscope
What is the equal bilateral size of the ears?
Normally 4-10 cm
Enlarged preauricular and postauricular
lymph nodes
Infection
Tophi (nontender, hard, cream-colored
nodules on the helix or antihelix, containing uric acid crystals)
Gout
Blocked sebaceous glands
postauricular cysts
Ulcerated, crusted nodules that bleed
Skin cancer (most often seen on the helix due to skin exposure)
Redness,swelling,scaling,or itching
Otitis externa
Pale blue ear color
Frostbite
which is a clinically insignificant projection, may be seen on the auricle
Darwins tubercle
A painful auricle or tragus is associated with
Otitis externa or postauricular cyst
Tenderness over the mastoid process suggests
Mastoiditis
Tenderness behind the ear may occur with
Otitis media
Colors of cerumen (earwax)
ROYBBG
Red, orange, yellow, brown,black, gray
Foul-smelling, sticky, yellow discharge
otitis externa or impacted foreign body
Bloody, purulent discharge
Otitis media with ruptured tympanic membrane
Blood or watery drainage (cerebrospinal
fluid)
Skull trauma
Impacted cerumen blocking the view
of the external ear canal
Conductive hearing loss
Abnormal findings in the ear canal may include:
• Reddened, swollen canals—otitis externa
•Exostoses(nonmalignant nodular swellings)
• Polyps may block the view of the ear drum
Red, bulging eardrum and distorted,
diminished, or absent light reflex
Acute otitis media
Yellowish, bulging membrane with
bubbles behind
Serous otitis media
Bluish or dark red color
Blood behind the eardrum from skull trauma
White spots
Scarring from infection
Perforations
Trauma from injection
Prominent landmarks
eardrum retraction from negative ear pressure resulting from an obstructed eustachian tube
Obscured or absent landmarks
eardrum thickening from chronic otitis media
asking the client to gently occlude the ear not being tested and rub the tragus with a finger in a circular motion. Start with testing the better hearing ear and then the poorer one. With your head 2 feet behind the client (so that the client cannot see your lips move), whisper a two-syllable word such as “popcorn” or “football.” Ask the client to repeat it back to you. If the response is incorrect the first time, whisper the word one more time. Identifying three out of six whispered words is considered passing the test. The whisper test has been studied in both pediatric and adult clients to evaluate hearing acuity and has been found to have a high sensitiv- ity and specificity (Pirozzo, Papinczak, & Glasziou, 2003).
Perform whisper test
The test helps to evalu-
ate the conduction of sound waves through bone to help distinguish between conductive hearing (sound waves transmitted by the external and middle ear) and sensorineural hearing (sound waves transmitted by the inner ear).
Perform webers test
conductive hearing
Sound waves transmitted by external and middle ear
sound waves transmitted by the inner ear)
Sensorineural hearing
Conductive hearing loss
With conductive hearing loss, the client reports lateralization of sound to the poor ear—that is, the client “hears” the sounds in the poor ear. The good ear is distracted by background noise and conducted air, which the poor ear has trouble hearing. Thus the poor ear receives most of the sound conducted by bone vibration.
sensorineural hearing loss,
the client reports lateralization of sound to the good ear. This is because of limited perception of the sound due to nerve damage in the bad ear, making sound seem louder in the unaf- fected ear.
This test compares air and bone conduction sounds. Strike a tuning fork and place the base of the fork on the client’s mastoid process
Rinnes test
occurs with damage to the inner ear (cochlea), or to
the nerve pathways between the inner ear and brain. This is the most common type of permanent hearing loss. It decreases one’s ability to hear faint sounds. Even loud speech may be muffled.
Sensorineural hearing loss
This tests the client’s equilibrium. Ask the client to stand with feet together, arms at sides, and eyes open, then with the eyes closed.
Romberg test
a gradual sensorineural hearing loss due to degeneration of the cochlea or vestibulocochlear nerve, is common in older (over age 50) clients.
Presbycusis
Perforation results from rupture caused by increased pressure, usually from untreated infection or trauma.
Perforated tympanic membrane
