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Health Assess Ch15
Ears
| Question | Answer |
|---|---|
| Air Conduction (AC) | Normal pathway of hearing; most effecient, transmitted thru ear canal and middle ear |
| Bone Conduction (BC) | Bones of the skull vibrate, transmitted directly to inner ear and CN VIII |
| Conductive Hearing Loss | Involves a mechanical dysfunction of the external or middle ear, partial loss |
| Causes of Conductive Hearing Loss | Impacted cerumen, foreign bodies, perforated TM, pus/serum in ear, and otosclerosis |
| Sensorineural (or Perceptive) Loss | Signifies pathology of the inner ear, CN VIII, or auditory areas of cerebral cortex |
| Causes of Sensorineural Loss | Presbycusis and ototoxic drugs |
| Presbycusis | A gradual nerve degeneration that occurs with aging |
| Vertigo | A staggering gait and a strong, spinning, whirling sensation |
| What is the difference between a child and an adult's eustachian tube? | Child- shorter, wider and more horizontal than adult's which is sloped |
| Otosclerosis | Common cause of conductive loss, ages 20-40; gradual hardening of stapes to oval window |
| Otitis Media (OM) | Middle ear infection, most commone illnesses in children |
| Who is more prevalent to dry cerumen, which is gray and flaky? | Asian and American Indians |
| Who is more prevalent to wet cerumen, which is honey to dark brown and moist? | Blacks and Whites |
| Tinnitus | Ringing, crackling, or buzzing in ear |
| Objective signs of hearing loss | Lip reading, frowning or straining forward to hear, frequently asks to repeat, loud voice |
| Tympanic membrane (TM) | Ear drum, translucent, pearly gray w/cone of light (reflection of scope light) |
| What should you do when inspecting an adult's ear with an otoscope? | Pull the pinna up and back, helps straighten the S-shape of the canal |
| What shoulf you do when inspecting a child under 3 years of age with an otoscope? | Pull the pinna down |
| Where should the cone of light be in the right ear? | 5 o'clock |
| Where should the cone of light be in the left ear? | 7 o'clock |
| Whispered Voice Test | Test one ear, mask hearing in other, whisper two-syllable words(Tuesday),they repeat aloud |
| How should you activate a tuning fork? | Hold it by the stem and strike on the back or heel of your hand |
| Weber Test | Place tuning fork in middle of skull and ask if sound is heard the same in both ears equally |
| Rinne Test | Compares AC & BC; place fork on mastoid process and then near ear when sound is gone |
| What is the normal response or positive Rinne Test? | Sound is heard twice as long by AC as by BC; AC > BC |
| Romberg Test | Assess ability to maintain standing balance; close eyes and stand in one spot |
| What should the position of the ear be? | Top of pinna should match imaginary line from/to corner of eye; 10 degrees vertically |
| What does low-set ears or deviation in alignment indicate? | Mental retardation or a genutourinary malformation |
| Frostbite | Reddish blue discoloration and swelling; extreme cold exposure; pain, tender, necrosis |
| Otitis Externa (Swimmer's Ear) | Outer Ear Infection; painful/redness of pinna, more common w/ humid weather or in water alot |
| Cerebrospinal Fluid Otorrhea | Associated w/ severe head trauma; skull fracture- fluid leak from canal into concha |
| Tophi | Small, whitish-yellow, hard, nontender nodules in or near helix; sign of gout |
| Keloid | Overgrowth of scar tissue, more common in dark-skinned people |
| Carcinoma | Ulcerated crusted nodule with indurated base that fails to heal; on pinna or ear canal |
| Excessive Cerumen | B/c of narrow canal or poor cleaning; totally blocking- ear fullnes and sudden hearing loss |
| Foreign Body | Beans, corn, cereals, jewelry beads, small stones, cotton, live insects |
| Scarred Drum | Dense whire patches on eardrum b/c repeated ear infections, do not affect hearing |
| Blue Drum (Hemotympanum) | Indicates blood in middle ear |
| What indicates conductive loss with the Weber Test? | Sound lateralize to poorer ear from background noise, which masks hearing in normal ear |
| What indicates sensorineural loss with the Weber Test? | Sound lateralize to better ear, poor ear is unable to perceive the sound |
| What indicates conductive loss with the Rinne Test? | Sound is heard as long by BC (AC=BC)or even longer than AC (AC |
| What indicates sensorineural loss with the Rinne Test? | Normal ratio (AC>BC), but reduced overall; hear poorly both ways |
| Insertion of Tympanostomy tubes | Relieve middle ear pressure and promote drainage of recurrent infections, fall out |
Created by:
Futuredoctor09
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