Assessments Ch 15 Ears

Outer fibrous rim encircling the eardrum

Congenital absence or closure of ear canal

The normal pathway of hearing; most efficient.

Bones vibrate and transmit sound signals directly to the inner ear and CN8.

Yellow waxy material that lubricates and protects the ear canal: Often sticky and brown or honey colored in Caucasians and blacks; often dry, gray and flaky in American Indians and Asians.

Inner ear structure containing the central hearing apparatus

Involves and mechanical dysfunction of the external or middle ear: commonly caused by impacted earwax.

Connects the middle ear with the nasopharynx and allows passage of air

Bridges the pinna to the eardrum.

"Anvil" - middle of the 3 ossicles of the middle ear

"Hammer" - first of the 3 ossicles of the middle ear; The umbo, manubrium, and short process can be seen through the eardrum.

Bony prominence of the skull located just behind the ear

Sensory organ of hearing

Pain in the ear; Can be referred pain coming from teeth or oralpharynx.

Inflammation of the outer ear and ear canal

Inflammation of the middle ear and tympanic membrane; Common in babies and children. Higher rates associated with absence of breast-feeding, second-hand smoke, daycare attendance, male sex, pacifier use, fall and winter seasons, and bottlefeeding in supine position.

Discharge from the ear

aspirin, aminoglycosides: -gentamicin, -tobramycin -amikacin, ethacrynic acid, furosemide, Indomethacin, Naproxen, quinine, vancomycin.

Type of hearing loss involving gradual sensorineural deficit caused by nerve degradation in the inner ear; starts in the in the 50s age group. Starts with the loss of high frequency sounds such as consonants in speech.

Small, slack, superior section of tympanic membrane

Thick, taut, central-inferior section of tympanic membrane

aka auricle, is the outer ear. Has flexible cartilage and skin in the shape of a funnel to guide sound waves into its opening.

"Stirrup" - inner of the 3 ossicles of the middle ear.

Signifies pathology of the inner ear, CN8 or the auditory areas of the cerebral cortex: impacted earwax, foreign bodies, stabbed eardrum, middle ear puss, otoclerosis.

Ringing in the ears

"Eardrum" - thin, translucent, pearly gray, oval membrane that stretches across the ear canal and separates the outer ear from the middle ear. When viewed with an otoscope, it shows the light as a cone shaped reflection.

Knob of the malleus that shows through the tympanic membrane

A spinning, twirling sensation. Objective- feels as if the room spins. Subjective-feels as if he or she spins

Indicates serum or pus. Could be: Otitis media with effusion or chronic otitis media.

Indicates retraction of drum. Could be a vacuum in the middle ear from an obstructed Eustachian tube.

Indicates serous fluid. Could it be otitis media with effusion

Indicates infection in middle ear. Could be acute otitis media.

Indicates blood behind the drum. Could be trauma or skull fracture.

Indicates perforation. Could be drum rupture.

Indicates scarring. Could be sequelae of infections.

Indicates thickened eardrum. Could be chronic otitis media.

Indicates colony of growth. Could be a fungal infection.

Indicates bulging of eardrum. Could be acute otitis media.

Air Conduction, AC: the normal pathway of hearing; it is the most efficient. Bone Conduction, BC: Alternate route of hearing; bone of the skull vibrate; these vibrations are transmitted directly to the inner ear and to cranial nerve VIII.

otosclerosis - hardening causing foot plate of stapes to become fixed. prebycusis - gradual sensorineural loss caused by nerve degeneration in the inner ear.

The low set Eustachian tube is angled upwards, shorted, wider and more horizontal than adults. This does not allow fluids to drain easily.

*Stand arm's length (2 ft.) behind the person *Test one ear at a time while masking hearing in the other ear to prevent sound transmission around the head: done by placing one finger on the tragus and pushing in and out of the auditory meatus. *Exhale fully and whisper slowly a set of 3 random numbers and letters (ex. "5,B,6") * The person repeats each number/letter correctly * If the response is not correct, repeat the whispered test using a different combination of 3 numbers/letters *A passing score is at least 3 correct out of 6 items whispered

The top of the pinna should match an imaginary line extending from the corner of the eye to the occiput. The ear should also be positioned within 10 degrees of vertical.

otosclerosis- hardening causing foot plate of stapes to become fixed. prebycusis - gradual sensorineural loss caused by nerve degeneration in inner ear.

For infants, the pinna is pulled down and back. For adults, the pinna is pulled up and back.

-Darwin's tubercle - small painless nodule at helix. -sebaceous cyst - filled with sebaceous material and can be painful if infected. -tophi - small, whitish, yellow, hard, non-tender nodules in or near helix that contains greasy, chalky, material. -chondrodermatitis - painful nodules develope on rim of helix. --small, indurated, dull red, poorly defined and very painful. --result of repetitive mechanical pressure or environmental trauma. -keloid- overgrowth of scar tissue which invades original site of trauma. -carcinoma - ulcerated, crusted nodule with indurated base that fails to heal bleeds intermittently.

-osteoma - single, stoney hard, rounded nodule that obscures the drum: nontender, benign. -exostosis - small, boney hard, rounded nodules of hypertrophic bone, convered with normal epithelium; frequently in cold water swimmers; no treatment needed -furuncle - painful, reddened, infected hair follicle. -polyp - arises in canal from mucosal tissue; bleeds easily; indicates chronic ear disease; Benign.

-yellow-amber color tympanic membrane - otitis media with effusion. -pearly gray color tympanic membrane - normal tympanic membrane. -air-fluid level tympanic membrane - serous otitis media. -distorted light reflex tympanic membrane - acute otitis media. -red color tympanic membrane - actute purulent otois media. -dense white areas on tympanic membrane - sequelae of infections. -oval dark areas tympanic membrane - drum rupture. -black or white dots on drum - fungal functions. -blue drum - Trauma, skull fracture.

Test on the ear while masking hearing in the other to prevent sound transmission around the head

-External auditory meatus -tragus -antitragus -lobule -location of mastoid process -antihelix -helix

-external auditory canal -mastoid process -tympanic membrane -round window -eustachian tube -inner ear -conchlea -cranial nerve VIII -vestibule -semicircular canals -stapes in oval window -incus -malleus -skull bone -cartilage

-Posterior fold -incus -umbo -annulus -pars tensa -cone of light -manubrium of malleus -short process of malleus -anterior fold -pars flaccida

C. pearly gray

A. gradual nerve degeneration

D. Pinna, tragus, and mastoid process

B. pulls the pinna down

C. up and back

D. A congenital, painless nodule at the helix.

B. tilted away from the examiner

D. Cochlea

B. pathology in the semicircular canals

A. Impacted cerumen

B. absent light reflex, reddened drum, bulging drum

D. Eliminating smoke in the house and car

C. watch for head turning when saying the child's name

B. assess for the presence of glucose in the drainage