7 - Ear 1
7 - Ear 1
7 - Ear 1
NURSING INSTRUCTOR
AT THE END OF UNIT,STUDENTS WILL BE
ABLE TO
• Identify the component of health history
Leaning necessary for the examination of ears.
• Describe color, shape and location of
Objectives auricle, external ear canal and tympanic
membrane and gross hearing.
• Perform the examination of ear.
STRUCTURE
AND
FUNCTION
EAR
The ear is
the sense
organ of
hearing and
equilibrium.
1. Watch
2. Tuning
fork
3. Otoscope
Inspect the Auricle
➢ Normal Findings
• Ears are equal in
External size bilaterally (normally
Ear: 4–10 cm).
• The auricle aligns with
Inspection the corner of each eye.
& • Earlobes may be
free, attached, or
Palpation soldered.
• The skin is smooth, with no
lesions, lumps, or nodules.
Abnormal Findings
❑ MALIGNANT LESION
Malignant lesions, more
commonly referred to as cancer,
are lesions which may form and
develop in the bone but have the
capacity to spread to other areas
of the body and continue to
grow. On the ear, they are most
frequently found on the helical
rim or the external side of the
auricle.
Abnormal Findings
❑ OTITIS EXTERNA
Otitis externa is a condition that
causes inflammation (redness and
swelling) of the external ear canal,
which is the tube between the outer
ear and eardrum.
It can be due to exposure to water
which causes inflamation.
➢ Abnormal Findings
1. A painful auricle or
PALPATE tragus is associated
THE with otitis externa or a
postauricular cyst.
AURICLE
AND 2. Tenderness over the
mastoid process
MASTOID suggests mastoiditis.
PROCESS 3. Tenderness behind the
ear may occur with
otitis media.
Abnormal
Findings
❑ MASTOIDITIS
Mastoiditis is an
infection of the
mastoid bone of the
skull. The mastoid is
located just behind
the ear. It can due to
spread of infection
of middle ear to
mastoid bone.
Inspect the External Auditory
Canal
➢ Normal Findings
OTOSCOPIC • A small amount of odorless
EXAMINATION cerumen (earwax) is the only
discharge normally present.
• Cerumen color may be yellow,
orange, red, brown, gray, or
black.
• Consistency may be soft,
moist, dry, flaky, or even hard.
• The canal walls should be pink
and smooth, without nodules.
Abnormal Findings
❑ Build up of Cerumen in
ear canal.
Abnormal Findings
❑ POLYP
A polyp is a projecting
growth of tissue from a
surface in the body.It can be
due to genetic mutations.
Abnormal Findings
❑ EXOSTOSIS
A benign outgrowth of cartilaginous
tissue on a bone.
Common causes include injury,
chronic irritation of a bone, or a
family history of exostosis
INSPECT THE
TYMPANIC MEMBRANE
(EARDRUM)
1. The
tympanic membrane
should be pearly, gray,
shiny, and translucent,
with no bulging or
retraction.
2. It is slightly concave,
smooth, and intact.
Abnormal Findings
❑BLUE/DARK
RED TYMPANIC
MEMBRANE
• Indicates blood behind
eardrum due to trauma.
Abnormal Findings
❑PERFORATED
TYMPANIC MEMBR
ANE
Perforation results
from rupture caused
by increased
pressure, usually from
untreated infection or
trauma.
Abnormal Findings
❑SCARRED
TYMPANIC MEMBRA
NE
• White spots and streaks
indicate scarring from
infections.
Abnormal Findings
❑RETRACTED
TYMPANIC MEMBRANE
• Prominent landmarks are
caused by negative ear
pressure due
to obstructed
Eustachian tube or chronic
otitis media.
Hearing and Equilibrium Tests
Whisper Test
Weber’s Test
Rinne Test
Romberg Test
1. A simple and accurate test for detecting
hearing impairment. It is the only test of hearing
that requires no equipment.
ABNORMAL FINDINGS
1. With CONDUCTIVE HEARING LOSS, the
client reports lateralization of sound to the
poor ear—that is, the client “hears” the
sounds in the poor ear.
2. The good ear is distracted by background
noise, conducted air, which the poor ear
has trouble hearing.
3. Thus the poor ear receives most of the
sound conducted by bone vibration.
4. With SENSORINEURAL HEARING LOSS, the
client reports lateralization of sound to the
good ear. This is because of limited
perception of the sound due to nerve
damage in the bad ear, making sound seem
louder in the unaffected ear.
RINNE TEST PROCEDURE
1. Perform the Rinne test.
2. The Rinne test compares air and bone conduction sounds.
3. Strike a tuning fork and place the base of the fork on the
client’s mastoid process .
4. Ask the client to tell you when the sound is no longer heard.
5. Move the prongs of the tuning fork to the front of the
external auditory canal
6. Ask the client to tell you if the sound is audible after the fork
is moved.
NORMAL FINDINGS
Air conduction sound is normally heard longer
than bone conduction sound (AC > BC)
ABNORMAL FINDINGS
With conductive hearing loss, bone conduction sound
is heard longer than or equallyOas long as air
conduction sound (BC > AC).
With sensorineural hearing loss, air conduction sound
is heard equal to bone conduction sound (AC=BC).
ROMBERG TEST
NORMAL FINDINGS:
Client maintains position for 20
seconds without swaying or with
minimal swaying.
ABNORMAL FINDINGS:
Client moves feet apart to prevent
falls or starts to fall from loss of
balance. This may indicate a
vestibular disorder.
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