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Otoscopy Normal vs Pathology
Terms in this set (16)
What is the discipline?
> Look in EVERY ear EVERY time
> Ask the right questions (pain, discomfort etc)
> Do the right tests the right way
> Interpret every finding
> Pull it all together
What is the anatomy and physiology of our ear?
> Outer ear
> Middle ear
> Inner ear
> VIII cranial nerve
> Cortex and higher brain function
What is the basic evaluation for each patient and test?
For every patient, you should identify your overall purpose or goal.
For every test or procedure, you should identify your purpose as well.
Determine the site of lesion by
Determine where the pathology is
> this is critical when deciding whether the medical evaluation is needed
> This is also critical for medical diagnosis
> You should include this in every report
> Add, when possible, what disease or trauma the findings
are consistent with.
Based on your history, physical exam, test results, might the patient have a condition that could...
> That could improve with medical treatment
> That could have a condition that could worsen without medical treatment
> Note: you may be a gate-keeper to medical treatment
What is the goal for the agreement among case history, physical exam, and audiometry?
> If they do not agree, you need to try to find out why
> If you cannot find out why do they not agree, you must at least acknowledge and report the fact
For every report, you should include a prognosis statement. Consider:
> History: reported handicap and social/emotional
> Physical exam: Physical contraindications to hearing aid
> Test results: consider the various sub-skills of speech
> Limitations of hearing aids and other devices
What is the FDA criteria for medical referral?
> Visible congenital or traumatic deformity of the ear
> Active drainage within the past 90 days
> Sudden or progressive hearing loss within 90 days
> Acute or chronic dizziness
> Pain or discomfort in the ear
What are we looking for at the external ear in a physical exam?
> Skin lesion, infection
> Malformations, atresia, size, growths/ tags
> Trauma or surgical scars
> Position and angle of pinna
> stenosis and collapsible canal
Atresia (canal isn't there)
Stenosis (very narrow ear canal)
While doing otoscopy, what do we have to do?
> Tools: otoscope, specula, examiner's stool, patient's chair
> Holding the scope
> Approach the patient with confidence
> pulling the pinna up, back and out
> Course of the ear canal is typically anterior-superior, poster, anterior inferior
Permitting the light to pass through but diffusing it so that persons, objects, etc, on the opposite side are not clearly visible
Not transparent or translucent; impenetrable to light; not allowing light to pass through
What are the causes of the TM perforation?
> Sticking things in the ear (Q-tip, bobby pin, pencil)
> Getting slapped on the ear (hand, water)
> Welders may have have hot metal slag fly down the ear
canal (recommend ear protection)
> Being close to an explosion
> Skull fracture
> Ear infections
> pressure of pus/fluid behind the TM (rupture)
> Repeated middle ear infections
What causes retraction?
eustachian tube - not opening and closing correctly (if it is closed, all of the air isn't going anywhere)
Result: tube or slice in the TM to equalize pressure.
Doesn't need to be treated
can cause HL
typically unilateral and singles
come in multiples
can occur swimming in cold water
THIS SET IS OFTEN IN FOLDERS WITH...
Overview of AP 1
Overview of Sites of Lesion
Masking Pure Tones And Speech
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