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Otoscopy - Normal
Terms in this set (54)
What three parts are looked at during a normal otoscopy
Variations with age
Hairy ear / tragus
Visual examination of the pinna, ear canal, and tympanic membrane.
what type of instrument does an otoscopic exam use?
Usually includes use of an instrument with lighting and magnifying systems.
Illumination is paramount!
The batteries are often located in the handle of the otoscope. Many use rechargeable batteries.
Use the ____________ earpiece that you can fit in to the ear canal.
Small earpieces limit the visual field.
Hold the otoscope nearer the eyepiece, like a pencil.
Holding the otoscope at the end may cause _____________ or injury if you move your hand suddenly or if the patient moves his or her head.
Hold the otoscope in the hand corresponding to the ear you are looking in (right hand / right ear; left hand / left ear).
Brace the back of your fingers on the patient's temple. This will keep the tip from jamming into the ear canal if somebody moves unexpectedly.
The ear canal usually has a slight bend, making it more difficult to see the ___________ part.
The canal may be partly straightened by pulling the pinna _____________ and _____________. (In infants pull the pinna more horizontally backwards.)
backwards and upwards
which ear should you examine first?
always try to exam the good ear first
why should you examine the good ear first? three reasons?
1) Prevents the spread of infection into an unaffected ear,
2) May allow you to see normal anatomy with which to compare the other side
3) Keeps you from relaxing once you have identified one abnormality, failing to see less obvious but often more important findings.
GET IDEA OF WHAT THEIR NORMAL IS
Introduce the __________ gently into the canal.
Remember the ear canal is very sensitive! It is easily scratched and irritated. In some patients, touching the ear canal stimulates the ________________ of the vagus, introducing coughing.
do ears stay the same throughout life?
ears grow with age
cartilage gets stiff, fragile and hard to pull on due to becoming more rigid with age
Darwin's tubercle (picture)
darwin's tubercle (info)
Common. Cartilaginous protuberance. No significance to hearing.
Cartilaginous protuberance commonly seen in primates
Autosomal dominant with
Present in approximately 10.4% of the population
some have it and some don't
Prominent ears aka
Common; due to autosomal dominant gene. No adverse effect on hearing.
prominent ears can be:
Abnormally protruding human ear may be unilateral or bilateral.
Concha is large with poorly developed antihelix. Result of malformation of cartilage during ___________________.
when do prominent ears occur?
occur during birth
if have surgery due to cosmetic purposes, when is that done?
Pre auricular tag (picture)
Small accessory skin tag; common near triages. no hearing problem
Pre auricular tag
when are preauricular tags prevalent?
Skin tags and pits commonly seen in newborn infants.
in pre auricular tags, most are normal; however,
can be associated with other medical conditions
can be sign of genetic syndrome or sinus tract problem
tell them to go to doctor to get it checked
Preauricular pit/sinus (picture)
pre auricular pit/sinus
Variable manifestation, from shallow pit to deep sinus. Embryological developmental failure.
which gender mostly has this
Can interfere with normal migration of wax, leading to
does hair have effect on hearing?
hair doesn't affect hearing because it's not too dense and air is able to get through it
No effect on hearing.
cartilaginous ear canal takes up how much:
1/3 of ear canal
bony ear canal takes up how muchL
2/3 pf ear canal
2.5cm x 0.7cm
resonance frequency 2.6 kHz, contributes to gain of
cartilaginous ear canal
Contains hair follicles
bony ear canal
. Flaky, and light colored. More common in those of Asian and Native American decent.
Moist, soft, & brown. More common in those of Caucasian and African decent.
Larger deposits may obscure the view of the drum, but does not necessarily imply hearing loss. The canal needs to be completely obstructed to cause loss.
easy to get out
when looking at otoscopy, how do you know which is the right ear?
the handle of the malleus points to the right
some ear drums are more ________ than others, can see malleus easily
what is Tympanosclorosis
Patches of calcification on TM
Tympanosclorosis is commonly associated with
Commonly associated with ventilation tubes (50-60%), perforations, repeated ear infections. Typically does not affect hearing.
does it affect hearing
if have had numerous problems with your ear, you can get a buildup of scar tissue which could lead to
typmanicarosis scar tissue adds mass so sometimes it doesn't vibrate as well —
vcan cause slight loss of hearing in low frequency but not enough to hinder basic speech
Allows continuous aeration of the middle ear, bypassing the dysfunctional eustation tube. This style of tube called a grommet or bobbin. Functional life of 6-12 months.
permanent hole in ear drums
go in ears when have chronic ear infection
had ear infections in June, July, August when not cold season, so needed to get the tube done —- that's when you need one
what does PE mean
pressure equalization tube
Ventelation tube. Style known as a "T-tube"
Longer functional life, usually years.
if falling out too quickly put in the T-tube it's longer than the button tube so it doesn't fall out
t tube must be surgery to remove
kids one who go under for surgery while adults normally do in-office
Most tubes spontaneously extrude after a period of time. Hopefully the child no longer needs the tubes. 30-40% require another set of tubes.
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