Otoscopic Examination

Question 1

the visual examination of the ear canal and tympanic membrane

Answer 1

Otoscopy

Question 2

What are the parts of the otoscope?

Answer 2

handle
battery
magnifying glass
speculum
light source
nose

Question 3

What are the forms of otoscopy? (4)

Answer 3

Basic
Pneumatic
Otomicroscopy
Video Otoscopy

Question 4

Surgical microscopic view of TM

Answer 4

Otomicroscopy

Question 5

Slight magnification of TM

Answer 5

Basic Otoscopy

Question 6

Continuous video feed of ear canal and TM

Answer 6

Video Otoscopy

Question 7

Air Pressure/Air movement change in the ear to assess if the ear drum is healthy with slight magnification

Answer 7

Pneumatic Otoscopy

Question 8

Advantages of Diagnosis via Otoscopy

Answer 8

Able to identify gross abnormalities
Video Otoscopy can store digital images for later (comparison)
Avoid misdiagnosis of the outer and middle ear

Question 9

Limitations of Diagnosis via Otoscopy

Answer 9

Subtle lesions are difficult to detect:
Chronic secretory otitis media
Retraction of the TM
Dark colored TM

Question 10

Steps to properly perform an Otoscopic Examination:

Answer 10

1. Hold the otoscope properly
2. Anchor your hand against the patient’s head
3. The patient’s head should be vertical
4. Pull the ear up and back with the opposite hand to open and straighten the ear canal
5. Use the largest speculum possible without touching the sides of the canal wall so you can allow as much light as possible.
6. Position the otoscope before you view (only the tip of the otoscope should be in the ear)

Question 11

What should a normal TM look like?

Answer 11

pearly white and translucent
often can see ossicles
landmarks: umbo of the maleus, manubrium of the maleus, cone of light (reflection)
canal: pink and clear of blockage

Question 12

Diagnosis: Behind the ear drum, no fluid due to perforation (caused by fluid build up and ear drum ruptures); likely from trauma

Answer 12

Perforation/Hole in the ear drum

Question 13

Diagnosis: Bubbles in fluid; can’t find ossicles (hidden); “red blushing” is visible (blood supply coming to try to fix the problem)

Answer 13

Retraction and Otitis Media

Question 14

Diagnosis: Very infected; patient is in increased acute pain - it’s possible it will burst and perforate; fluid behind ear drum so you can’t see the ossicles

Answer 14

Otitis Media (glue ear)

Question 15

Diagnosis: blue looking

Answer 15

Foreign Objects (crayon)

Question 16

Diagnosis: Build up of calcium under the skin in the ear canal; hard and swollen (too much can close the ear canal)

Answer 16

Exotoses (scuba diving)

Question 17

Diagnosis: Infection of the external ear canal (can be fungal or bacterial)

Answer 17

Otitis Externa

Question 18

Diagnosis: Dark spots, fungal spores

Answer 18

Fungal Infection

Question 19

Diagnosis: red bulbus tumor that grows in the middle ear, arterial supply (rare!)

Answer 19

Glomus Tumor

Question 20

Diagnosis: scarring from repeated ear infections

Answer 20

Plaque

Question 21

Diagnosis: disease, development is related to repeated ear infections; growth that occurs behind the middle ear that can completely destroy the ossicles

Answer 21

Cholesteatoma

Question 22

Diagnosis: surgical, ventilating tubes - allows air to be present behind the ear drum

Answer 22

PE Tube

Question 23

What are the four quadrants of the TM?

Answer 23

Posterior superior, Posterior inferior, Anterior superior, Anterior inferior

Question 24

Which direction does the right drum point towards?

Answer 24

My right side (Anterior superior and inferior are on the inside)

Question 25

Which direction does the left drum point towards? My left side

Answer 25

(Anterior superior and inferior are on the inside)