Otoscopic Examination Flashcards
the visual examination of the ear canal and tympanic membrane
Otoscopy
What are the parts of the otoscope?
handle battery magnifying glass speculum light source nose
What are the forms of otoscopy? (4)
Basic
Pneumatic
Otomicroscopy
Video Otoscopy
Surgical microscopic view of TM
Otomicroscopy
Slight magnification of TM
Basic Otoscopy
Continuous video feed of ear canal and TM
Video Otoscopy
Air Pressure/Air movement change in the ear to assess if the ear drum is healthy with slight magnification
Pneumatic Otoscopy
Advantages of Diagnosis via Otoscopy
Able to identify gross abnormalities
Video Otoscopy can store digital images for later (comparison)
Avoid misdiagnosis of the outer and middle ear
Limitations of Diagnosis via Otoscopy
Subtle lesions are difficult to detect:
Chronic secretory otitis media
Retraction of the TM
Dark colored TM
Steps to properly perform an Otoscopic Examination:
- Hold the otoscope properly
- Anchor your hand against the patient’s head
- The patient’s head should be vertical
- Pull the ear up and back with the opposite hand to open and straighten the ear canal
- Use the largest speculum possible without touching the sides of the canal wall so you can allow as much light as possible.
- Position the otoscope before you view (only the tip of the otoscope should be in the ear)
What should a normal TM look like?
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
Diagnosis: Behind the ear drum, no fluid due to perforation (caused by fluid build up and ear drum ruptures); likely from trauma
Perforation/Hole in the ear drum
Diagnosis: Bubbles in fluid; can’t find ossicles (hidden); “red blushing” is visible (blood supply coming to try to fix the problem)
Retraction and Otitis Media
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
Otitis Media (glue ear)
Diagnosis: blue looking
Foreign Objects (crayon)
Diagnosis: Build up of calcium under the skin in the ear canal; hard and swollen (too much can close the ear canal)
Exotoses (scuba diving)
Diagnosis: Infection of the external ear canal (can be fungal or bacterial)
Otitis Externa
Diagnosis: Dark spots, fungal spores
Fungal Infection
Diagnosis: red bulbus tumor that grows in the middle ear, arterial supply (rare!)
Glomus Tumor
Diagnosis: scarring from repeated ear infections
Plaque
Diagnosis: disease, development is related to repeated ear infections; growth that occurs behind the middle ear that can completely destroy the ossicles
Cholesteatoma
Diagnosis: surgical, ventilating tubes - allows air to be present behind the ear drum
PE Tube
What are the four quadrants of the TM?
Posterior superior, Posterior inferior, Anterior superior, Anterior inferior
Which direction does the right drum point towards?
My right side (Anterior superior and inferior are on the inside)
Which direction does the left drum point towards? My left side
(Anterior superior and inferior are on the inside)
