ENT - hearing and otoscopy Flashcards
Which ear do you examine first?
The normal one
Examination of the ear?
Can use an otoscope as a light source, check around the tragus running into the EAM and behind the pinna as well as checking the pinna
Otoscope
Pull the ear up and back to obtain a better view
insert the otoscope
Structures to look for in otoscopy
Handle of the malleus
Umbo
Light reflex
Before beginning otoscopy..
check if the patient has any pain
When examining the patients right ear you use your … hand
right
How do you hold the otoscope?
Like a pencil
Normally the tympanic membrane should be…
translucent
What abnormal features may be present?
Redness of the TM (inflammation)
Perforated TM
Bulging of the TM or fluid level (otitis media)
Absent or distorted light reflex (Increased ear pressure- otitis media)
Scarring of the membrane (> hearing loss)
What tuning fork should you use?
512Hz
Rinne’s test
Ping the tuning fork and place it in front of the ear, then on the mastoid process
Ask the patient if they hear it better in front or behind
Positive Rinne’s test
Patient hears the sound best in front of the ear
Sensorineural deafness gives what result in a Rinne test?
positive- as both air and bone conduction are reduced so air conduction is still better than bone conduction
Conductive deafness gives what result in a Rinne test?
negative as bone conduction is better than air conduction
Weber test
Ping the tuning fork and place it in the centre of the forehead
Ask the patient where they hear the noise (in the middle, or to one or the other ear)
