Ears

Question 0

What are the components involved in the first part of the ear exam, inspection of external ear?

Answer 0

Size and shape of auricle

Position and alignment on head

Note skin condition- colour, lumps, lesions

Check for tenderness

Check for movement of auricle and tragus for tenderness

Evaluate external auditory meatus - size, swelling, redness, discharge, cerumen, lesions, foreign bodies

Question 1

What are the five major elements of an ear exam?

Answer 1

1) inspect external ear
2) otoscope exam
3) inspect tympanic membrane
4) test hearing acuity
5) vestibular apparatus

Question 2

What are the components of the second portion of the ear exam, the otoscope examination?

Answer 2

Examination of external canal

Examination of cerumen, discharge, foreign bodies, lesions

Redness or swelling of canal wall

Question 3

What are the components of the third part of the ear exam, inspection of tympanic membrane?

Answer 3

Inspect colour and characteristics

Note positions (flat, bulging, retracted)

Check integrity of membrane

Question 4

What are the components of the fourth part of the ear exam, testing hearing acuity?

Answer 4

Note the behavioural response to conversational speech

Whispered voice test

Question 6

What is the fifth component of the ear exam, the Vestibular apparatus examination?

Answer 6

The Romberg test

Question 7

what is inspected about the external ear?

Answer 7

• size and shape of auricle
• position and alignent on head
• skin colour and condition
• note any lumps or lesions (Darwin’s Tubericle normal finding)
• check for tendernes by moving pinna and auricle, pushing on tragus and palpating mastoid process
• evaluate external auditory meatus (size, swelling, redness, discharge, cerumen, lesions, foreign bodies)

Question 8

what is done during an otoscopic exmination

Answer 8

• external canal is looked at (size of auditory meatus) and largest speculum chosen
• pinna is pulled up and back before insertion of otoscope
• look into otoscope with the eye of the corresponding side and with the otoscope held upside down, in your hand on the corresponding side (dorsa to patient’s face)
• have patient tilt head slightly away from you
• inspect tympanic membrne (colour should be grey & shiney, cone of light present & pointing nasaly, membrane should be intact)
• have patient perform Valsal Maneuver or swallow with nose plugged, membrane should flutter

Question 9

how is hearing acuity tested

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Answer 9

first by observation of patients ability to behave and respond normally in conversational speech

• whispered voice test
• press tragus, whisper, covering mouth with hand, 30 cm from opposite ear
• say three, 2 syllable words
• test other ear