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Clinical Medicine Exam 2 > Ears > Flashcards

Ears Flashcards

1
Q

What to look for when inspecting the external ear?

A

Size, shape, color of helix, antihelix, lobule, tragus, and concha

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2
Q

What to look for when inspecting external meatus?

A

presence of cerumen, discharge, foreign bodies, redness, edema, tenderness, or scaling

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3
Q

What tool can be used to remove excess cerumen from the external auditory meatus?

A

cerumen spoons

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4
Q

What to look for when inspecting tympanic membrane?

A

appearance of cone of light, umbo, and handle of malleus

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5
Q

Which way do you pull the auricle with adults?

A

up and back

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6
Q

Which way do you pull the auricle with children?

A

down and back

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7
Q

What information can you get from pneumatic otoscopy?

A

mobility of the tympanic membrane and the middle ear space

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8
Q

What is pneumatic otoscopy?

A

gentle puff of air that is sent through the head of the otoscope

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9
Q

What is a normal result when performing pneumatic otoscopy?

A

movement to positive and negative pressure and is noted by a change in the appearance of the cone of light

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10
Q

What is an abnormal result when performing pneumatic otoscopy and could be indicative of what?

A

no movement may indicate a perforation, or a sign of acute otitis media with or without effusion

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11
Q

What must you do when performing a pneumatic otoscopy?

A

a seal must be created between the otoscope speculum and the patient’s external auditory meatus

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12
Q

What does the tympanometer assess?

A

It is a reliable and objective way to assess the functioning of the ossicular chain, Eustachian tube, and tympanic membrane.

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13
Q

What does the tympanometer provide?

A

graphic presentation of the change in compliance of the middle ear system as air pressure is varied

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14
Q

What does the whisper test for?

A

used to test for significant hearing loss without using any tools

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15
Q

What is something simple you can do to differentiate between otitis externa from otitis media?

A

Palpate the tragus and pinna prior to insertion of otoscope for pain

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16
Q

How far away should you be standing behind the patient when performing the whisper test?

A

1-2 feet, and to the side of the patient of the ear you are testing

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17
Q

What does the patient do while you are performing a whisper test?

A

The patient places index finger in the ear canal that is not being tested and is continuously moving it throughout.

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18
Q

When performing the whisper test, what is the technique used to insure you are using a soft voice?

A

Exhale fully, THEN whisper

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19
Q

What are results of a normal whisper test?

A

the patient can correctly repeat the whispered letters/ numbers in both ears

20
Q

What can lead to a false normal whisper test?

A

the patient did not properly occlude the other ear and they were able to hear out of both ears

21
Q

What are results of a abnormal whisper test?

A

The patient is unable to correctly repeat all three numbers/letters. (Repeat in a medium or louder whisper if needed.)

22
Q

What does the Weber test for?

A

lateralization

23
Q

What tuning fork is used for the Weber test?

A

512 Hz

24
Q

What does the Weber test assess?

A

Assesses hearing and differentiates between neurosensory and conductive hearing loss

25
Q

How do you perform a Weber test?

A

Place vibrating fork in the middle of the patient’s vortex (top of the head), contacting the skull.
Ask patient where the sound is heard (both or particular ear)

26
Q

What are results of a normal Weber test?

A

patient should be able to hear the sound equally in both ears

27
Q

If the patient has an unilateral hearing loss, what ear will the patient hear the sound if the loss is neurosensory?

A

the sound is preferentially heard in the good ear

28
Q

If the patient has an unilateral hearing loss, what ear will the patient hear the sound if the loss is conductive?

A

the sound is preferentially heard in the bad ear

bone bad block

29
Q

When is the Weber test used?

A

It is only used in patients that are suspected of hearing loss

30
Q

Can patients with normal hearing also lateralize?

A

yes (that’s why the Weber test should only be performed when a patient is suspected of hearing loss)

31
Q

What does the Rinne test assess?

A

It assesses each individually to determine whether each ear detects sounds better through air or bone

32
Q

The ear is better adapted to hear through air or bone?

A

air

33
Q

When should the Rinne test be used?

A

used to determine origin of hearing loss and to distinguish between neurosensory hearing loss from conductive hearing loss

34
Q

Which test is more accurate to distinguish between neurosensory from conductive hearing loss? Weber or Rinne.

A

Rinne is more accurate

35
Q

What are the steps in conducting the Rinne test?

A

Bone conduction is tested by holding the stem of the vibrating tuning fork against the patient’s mastoid process, and ask the patient to tell you when they can no longer hear the sound. Be sure to note the time it takes.

Immediately move the tuning fork so that the vibrating tines are about 2.5 cm from the patient’s external auditory meatus, making the ‘U’ is facing the patient’s ear canal to maximize sound. Ask the patient to tell you when they no longer hear the sound. Note the time it takes.

Repeat in the other ear.

36
Q

What are results of a normal Rinne test?

A

when the patient can hear the sound longer through the air than through bone.

It’s often twice as long

37
Q

What are results of an abnormal Rinne test?

A

In conductive hearing loss, bone conduction will be heard longer in the affected ear.

In neurosensory hearing loss, air conduction will be heard longer than bone

38
Q

In which order should the hearing tests be performed?

A

Whisper, Weber, Rinne

39
Q

When is the Romberg test used for?

A

To test balance

40
Q

What does the Romberg test evaluate?

A

It evaluates cerebellar function in conjunction with muscles involved in posture, proprioception, joint position, and visual input.

41
Q

What can the Romberg test be indicative of?

A

Cerebellar dysfunction, vestibular dysfunction, or loss of position sense

42
Q

Conductive loss is indicative of what?

A

external or middle ear disorder

43
Q

What are causes of conductive loss?

A

Foreign body, otitis media, perforated eardrum, otosclerosis

44
Q

Sensorineural loss is indicative of what?

A

inner ear disorder involving CN VIII

45
Q

What are causes of sensorineural loss?

A

loud noise exposure, inner ear infections, trauma, acoustic neuroma, aging, familial disorders

46
Q

In conductive loss, sound lateralize to which ear?

A

Sound lateralizes to the affected ear

47
Q

In sensorimeural loss, sound lateralize to which ear?

A

Sound lateralizes to the good ear

Clinical Medicine Exam 2 (7 decks)

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