OSCE 2: ENT Lab Flashcards
What are some external ear structures to visualize for?
Auricle Helix Antihelix Concha Antitragus Tragus Triangular fossa Lobule External auditory canal
What are some internal ear structures to visualize for?
Cone of light
Umbo
Malleus
Manubrium
Pars tensa: portion of drum inferior to pars flaccida
Pars flaccida: superior to malleus
Chorda Tympani Nerve: superior part near pars flaccida
When inspecting the ear canal in adults, what direction do you pull the ear?
Pull UP, out, and posterior
When inspecting the ear canal in children, what direction do you pull the ear?
Pull DOWN, out, and posterior
What should the normal tympanic membrane look like?
Translucent and pearly
What does conductive hearing loss mean?
Problem in external or middle ear
- sound will localize to affected ear
- louder in impacted ear
- Abnormal Weber and Rinne Test
What does sensorineural hearing loss mean?
Problem in internal ear, cochlear nerve, or central brain connections
- sound localized to opposite ear
- louder in unaffected ear
- Abnormal Weber Test and normal Rinne Test
Describe the Whisper test.
- Have patient occlude an ear with doctor behind patient
- Doctor whispers combination of letters/numbers
- Have patient repeat sequence: needs to minimum identify 3/6
- Repeat with other ear
What does the Weber Test test for?
Lateralization
Describe the Weber Test.
Vibrating tuning fork placed on top of patient’s head or on middle of forehead
● Normal: sound lateralizes to both ears equally
● Abnormal: Sound lateralizes to one ear - either conduction loss in that ear or sensorineural loss in the opposite ear.
What does the Rinne Test test for?
Compares air and bone conduction
Describe the Rinne Test.
Vibrating tuning fork placed on mastoid bone behind ear, level with canal. When patient no longer hears sound, place fork close to ear canal and inquire if they can hear the sound and for how long.
● Normal: AC>BC
● Abnormal: If AC=BC or BC>AC
If Weber test was abnormal and Rinne test was normal, what should you suspect?
Sensorineural loss in the opposite ear
What does it mean if Rinne test is abnormal?
Conductive loss to that ear.
What are some external nose structures to visualize for?
Ala nasi
Columella
Vestibule
Bridge