Ear assessment
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This document discusses assessing the ears. It outlines the structures and functions of the auditory system, including the external, middle, and inner ear. It describes performing a physical exam of the ears, including inspection of the auricles and outer canals, palpation for tenderness, and otoscopic examination of the tympanic membranes. It also explains how to perform the Weber test to assess bone conduction and the Rinne test to differentiate conductive and sensorineural hearing loss. Finally, it lists various diagnostic tests for evaluating aural structures, auditory function, and laboratory tests that can be used in assessing ear issues.
Ear assessment
- 1. ASSESSMENT OF THE EARS DEPARTMENT OF MEDICAL SURGICAL NURSING
- 2. Learning objectives • At the end of this lecturer, students should be able to: • know the structures and functions of the auditory system • discuss the assessment of the ear • describe the physical assessment findings in the healthy adult • state the weber test and Rinne test . • enlist the diagnostic tests.
- 3. STRUCTURES AND FUNCTIONS OF THE AUDITORY SYSTEM • External Ear • Middle Ear • Inner Ear
- 5. Transmission of Sound: Sound waves are conducted by air Picked up by the auricles , auditory canal. The tympanic membrane is struck by the sound waves, causing it to vibrate.
- 6. GLOSSARY • Acute Otitis media: inflammation in the middle ear of short duration. • Cholesteatoma: benignin tumor of the middle ear and or mastoid. • Chronic otitis media: repeated episodes of acute otitis media
- 7. • Dizziness: altered sensation of orientation in space. • Exostoses: small, hard, bony protrusion in the lower posterior • Labyrinthitis: inflammation of the labyrinth of the inner ear.
- 8. Meniere’s disease: condition of the ear characterized by a triad symptoms: episodic vertigo, tinnitus and fluctuating sensorineural hearing loss. Middle ear effusion: fluid in the middle ear without evidence of infection.
- 9. • Myringotomy (tympanotomy): incision in the tympanic membrane. • Ossiculoplasty: surgical reconstruction of the middle ear bones to restore hearing. • Otalgia: sensation of fullness or pain in the ear. • Otitis external (external Otitis): inflammation of the external auditory canal.
- 10. • Otorrhea: drainage from the ear. • Otosclerosis: abnormal spongy bone formation around the stapes. • Tinnitus: unwanted noises in the head or ear. • Tympnoplasty: surgical repair of tympanic membrane.
- 11. ASSESSMENT OF THE EAR Otologic history includes demographic data, current clinical manifestations, past health history, family health history, psychosocial history, and review of systems. childhood illnesses or abnormalities
- 12. PHYSICAL EXAMINATION - Assessment of hearing acuity, balance, equilibrium. - External ear to assess abnormalities - it is easy to identify anatomic landmarks - The eardrum reveals important information regarding the middle ear.
- 13. Physical Assessment Findings In The Healthy Adult Inspection: Auricles symmetrical, superior portion level with outer canthus of eye. Outer canals clear. Preauricular and postauricular areas without swelling, masses, or lesions. AC > BC, bilaterally. No lateralization. Whisper heard at 3 feet.
- 14. • Palpation: Tenderness over tragus and mastoid absent. No masses. • Otoscopic Examination: Soft cerumen present in canals. No discharge. TMs intact • Cone of light at 4:00 in right ear and at 7:00 in left ear. Landmarks visualized.
- 15. Inspection and Palpation External Ear • Ear Canal - Direct Observation. - Otoscopy - Test for Auditory Acuity
- 16. Weber Test Assess conduction of sound through bone. Set the tuning fork into vibration by striking the tines on your hand. Place the rounded tip of the handle on the center of the client's forehead or nasal bone.
- 17. Cont… -Placement on the teeth is reliable option. - Does the client hear the tone --in the center of the head, -the right ear, or the left ear? -Normally the sound is heard equally -in both ears by bone conduction.
- 18. Rinne Test -Compares air conduction to bone conduction - Differentiate conductive from sensorineural hearing loss. - Shift the vibrating tuning fork between - two positions: first against the mastoid bone - for bone conduction and then 2 inches - from ear canal for air conduction.
- 19. DIAGNOSTIC TESTS • Tests for Aural Structure • Computed Tomography • Magnetic Resonance Imaging • Arteriography
- 20. Test for Auditory Function • Audiometric Tests. • Audiography. • Tympanometry. • Tests for Brain Stem Response. • Electrocochleography • Otoacoustic Emissions
- 21. Laboratory Tests • Blood tests • Cultures • Tests for the Presence of Cerebrospinal Fluid • Tissue Specimens
- 22. SUMMARY So far, today we have discussed about: • structures and functions of the auditory system • assessment of the ear • physical assessment findings • weber test and Rinne test . • diagnostic tests.
- 23. Bibliography • Lewis et al, Medical Surgical Nursing, Mosby Elsevier,7th edition. • Joyce.M.Black et al, Medical Surgical Nursing, Saunders publication. • Brunner and Siddhartha, Medical Surgical Nursing, Lippincott Williams and Wilkins.
- 24. THANK YOU