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health assessment
ears ch 17
| Question | Answer |
|---|---|
| ear structure | external ear middle ear inner ear |
| tympanic membrane | separate external/middle ear |
| external ear | pinna = auricle tragus earlobe helix ear canal tympanic membrane |
| ear lobe | pinna and auricle collect sound |
| middle ear | ossicles (malleus/incus/stapes) oval window and round window tympanic cavity eustachian tube |
| ossicles | 3 bone structure to amplify/conduct sound waves from tympanic membrane malleus (hammer) incus (anvil) stapes (stirrup) |
| inner ear | vestibular labyrinth (bony labyrinth + membranous labyrinth) cochlea (organ of corti) |
| assessment of ears | direct inspection otoscopic exam hearing acuity test |
| developmental consideration for children (ear) | short eustachian tube in children = more prone to ear infection eustachian tube is also horizontal |
| helix | part of pinna (auricle) outer edge of the ear |
| eustachian tube | aka pharyngotypanic tube middle ear cavity to nasopharynx equalize air pressure on both side of tympanic membrane |
| landmark of tympanic membrane | umbo cone of light pars flaccida pars tensa |
| vestibulocochlear nerve | CN VIII vestibular = proprioception (balance/eye movement) cochlear = hearing |
| bony labyrinth | cochlea vestibule semicircular canals |
| organ of corti | hair cells in cochlea that conduct vibration/sound to nerve impulse damage = sensorineural hearing loss |
| air conduction | sound waves traveling thru external ear more efficient |
| bone conduction | augmentation of normal pathways soundwaves conducted via bones |
| fluid conduction | inner ear soundwaves conducted via inner ear fluids |
| sensorineural hearing | perceptive hearing damage to this type of hearing usually occurs in the inner ear |
| conductive hearing | transmission of sound thru external/middle ear structure |
| dry vs wet cerumen | wet = european/african -> brown/sticky dry = east asian |
| subjective data collection | Hx of vertigo Hx of infection/trauma Surgical Hx FHx impact to daily life/socialization |
| tinnitus | ringing in ears often seen d/t medication use, high blood pressure, meniere's |
| otorrhea | ear drainage indicate inflammation of external and/or middle ear |
| otalgia | ear pain |
| ear related surgeries | tonsillectomy -> removal of tonsils adenoidectomy -> removal of adenoid (pharyngeal tonsil) PE tube (tympanostomy) -> pressure equalizing of TM |
| otosclerosis | oto (ear) -- sclerosis (abnormal hardening of body tissue) abnormal bone remodeling in the middle ear genetic predisposition |
| presbycusis | B/L age related hearing loss most common hearing loss cause |
| dizziness vs vertigo | biggest difference is room spinning sensation |
| dizziness | feeling faint, woozy, lightheaded, unsteady, off balance or weak commonly seen in BPPV, hypotension, dehydration or d/t medications |
| BPPV | benign paroxysmal positional vertigo |
| vertigo | feeling like you or surrounding is spinning or boat rocking back and forth intense = feeling like spinning mild = feeling like floating/rocking d/t inner ear disturbance like Meniere's disease |
| medical conditions causing hearing loss | DM/HTN/heart disease -> affect inner ear blood circulation causing damage Meniere's -> progressive hearing loss d/t pressure in inner ear meningitis/high fever -> damage inner ear |
| genetic condition causing hearing loss | FHx causing hearing loss ie otosclerosis |
| ototoxic drugs | high ASA dose chemotherapy certain Abx can cause temporary/permanent hearing loss |
| injury vs obstruction | TBI/head injury cerumen impaction infections (chronic) |
| hearing loss in infants/young children | birth hypoxia infections in pregnant mother (rubella/syphillis) neonatal jaundice ototoxic drug use in pregnancy infectious disease in childhood (meningitis/MMR) |
| cerumen clearance in ear canal | cilia will move earwax/cerumen out of ear canal avoid inserting objects into ear |
| weber test | tuning fork on forehead/top of head conductive hearing loss = sound lateralize to worse ear sensorineural hearing loss = sound lateralize to normal ear |
| rinne test | tuning fork comparison on mastoid bone vs near ear canal BC > AC = conductive hearing loss AC > BC = sensorineural hearing loss |
| romberg test | proprioception test for balance while standing with both feet together |
| older adult considerations for outer ear | often will have elongated earlobes w/ linear wrinkles |
| what does painful auricle, tragus and mastoid process suggest | associated with otitis externa or post auricular cyst |
| what does mastoid process tenderness suggest | mastoiditis |
| what does tenderness behind ear suggest | possible otitis media |
| inspection of external ear | inspect auricle/tragus/lobule (size/shape/position/lesion/discoloration/discharge) palpate auricle/mastoid for tenderness |
| normal tympanic membrane should look | shiny, translucent w/ pearly gray color cone of light at 5:00 (R) and 7:00 (L) sections of malleus can be seen |
| abnormal tympanic membrane | dark oval = possible perforation bulging = increase pressure redness = acute infection |
| pulling back ears for adult vs children | adults = pull up and back infants/children = pull down and back |
| pars flaccida | flaccid portion of tympanic membrane much smaller |
| pars tensa | tense portion of tympanic membrane much larger |
| conductive hearing loss | full/stuffy sensation in ear otorrhea dizziness pain/tenderness can be partially/completely reversed |
| sensorineural hearing loss | trouble hearing w/ background noise worse hearing w/ high pitched (children/female voice) muffled sounds can hear voice but can't understand them PERMANENT loss |
| exostosis | surfer's ear extra growth of bone extending outwards from existing bone reduce water drainage in ear -> infection |
| ear polyps | arise from constant ear canal/eardrum irritation commonly seen in chronic otitis externa noncancerous |
| gouty tophi | small, whitish/yellow, hard, nontender nodules in/near helix contains greasy/chalky uric acid material sign of gout |
| malignant lesions of outer ear/ear canal | ulcerated crusty nodules bleed commonly seen on helix d/t UV exposure |
| microtia | congenital underdevelopment of outer ear (auricle) |
| acute otitis media | red bulging membrane w/ distorted/diminished/absent light reflex |
| serous otitis media | yellowish and bulging TM with bubbles |
| scarred tympanic membrane | d/t infection or Hx of ear tubes (tympanostomy) |
| perforated tympanic membrane | d/t trauma from infection |
| retracted tympanic membrane | shows a prominent landmark TM is pulled inward d/t negative pressure ie eustachian tube obstruction |
Created by:
sleepingbear