The Ears Dr. Zyad Saleh - PowerPoint Presentation

Slide1

The Ears

Dr. Zyad Saleh Slide2

Subjective Data

Concerning symptoms of the ear are:

Hearing loss

Earache (otalgia)

Discharge (

otorrhea

)

Tinnitus

Vertigo

During

data

collection, the

examiner should be alert to signs of hearing

loss such

as inappropriate answers, frequent requests for

repetition, etc

.Slide3

EaracheOtitis

media: medical term for middle ear infectionSlide4

Otitis externa: inflammation of the outer ear and ear canal. Slide5

Subjective Data

Drainage (otorrhea

)



infection.

Purulent, bloody drainage  infection of the external ear (external otitis). Purulent drainage associated with pain and a popping sensation  otitis media with perforation of the tympanic membrane.Slide6

Subjective Data

Earache (otalgia)



ear

infections, cerumen blockage, sinus infections, or teeth

and gum

problems.Slide7

Tinnitus:

ringing, roaring or crackling  no external stimulus



excessive

earwax buildup, high blood pressure,

or certain

ototoxic medicationsSlide8

Vertigo: refers to perception of rotating or spinning. (an

inner-ear problem.) It is termed subjective vertigo when clients feel that they are spinning around

objective

vertigo when clients

feel that

the room is spinning around them

.. It is important to distinguish vertigo from dizzinessSlide9

Past history:Congenital hearing loss

Removal of cerumenEar surgeryTraumaInfectionExposed to hazardous noise levelsDescribe any past treatmentsSlide10

Family history:Hearing loss

Lifestyle habits:live in an area with frequent or continuous loud noisetime

spent in swimming or in water

 Otitis

externa

hearing loss affected

ability to carehearing loss affected socializinglast hearing examinationwear a hearing aidcare for earsSlide11

Objective Data

Inspect and palpate the external ear:Slide12

Objective Data

Inspect and palpate the external ear:Size and shape and ear alignment: ears are equal size bilaterally with no swelling or thickening

Skin Condition: skin color is consistent with facial skin color, skin intact, with no lump or lesions.

Enlarged

preauricular

and

postauricular lymph nodes—infectionRedness, swelling, or itching—otitis externaSlide13

Objective Data

Palpate the auricle and mastoid process

A painful auricle or tragus



otitis

externa

Tenderness over the mastoid process  mastoiditis.Tenderness behind the ear  otitis media.Slide14

Objective Data

Inspect the external auditory canal. (Note any discharge along with the color

and consistency of

cerumen)Slide15

Objective Data

Inspect the external auditory canal.

External

auditory meatus:

A

small amount of

odorless cerumen appearance-color varies from yellow to brown or black; moist and waxy to dry. Any other discharge? Inflammation?Slide16

Objective Data

Inspect the external auditory canal.

Observe the color and consistency

of the

ear canal walls and inspect

the character

of any nodules.The canal walls should be pink and smooth, without nodules.Slide17

Objective Data

Inspect the external auditory canal.

(abnormal)

Reddened, swollen

canals

Foul-smelling

, sticky, yellow discharge— otitis externa Bloody, purulent discharge—otitis mediaBlood or watery drainage (cerebrospinal fluid)—skull traumaSlide18

Inspect the eardrum (tympanic membrane):

Color: shiny and translucent with a pearl-gray color.no bulging or retraction.

slightly

concave, smooth, and

intact.

Cone-shaped light reflex.Slide19

Inspect the eardrum:

Red, bulging eardrum and distorted, diminished, or absent light reflex—acute otitis media

Yellowish

, bulging membrane

with bubbles

behind—serous otitis

mediaBluish or dark red color—blood behind the eardrum from skull trauma Perforations—trauma from infectionSlide20

Hearing and Equilibrium Tests:

Whisper-Voice test.ask pt to close her other ear, stand behind the pt, whisper softly toward unoccluded ear, increase intensity of sound if necessary.

Able

to correctly repeat the two-syllable word

as whispered.

 hearing lossSlide21

#testing of ear and bone conduction is done if the patient has problems in hearing… Weber test:

evaluate the conduction of sound waves through bone to help distinguish between conductive hearing (

sound waves

transmitted by the external

and middle

ear) and sensorineural

hearing (sound waves transmitted by the inner ear).Slide22

#testing of ear and bone conduction is done if the patient has problems in hearing… Weber test:

Vibrations are heard equally well in both ears. No lateralization of sound to either ear.Slide23

Weber test: With conductive hearing loss, the

client reports lateralization of sound to the poor ear  the poor ear receives most of the sound conducted

by bone vibration.

With sensorineural hearing loss, the

client reports

lateralization of sound to the

good ear  nerve damage in the bad earSlide24

Rinne’ test: compare air conduction (AC) with bone conduction (BC). Place vibrating tuning fork on the mastoid bone, when the pt can no longer hear the sound, quickly place the fork close to the ear, and ask if the sound can be heard again.

Air conduction sound is normally heard longer than bone conduction sound (AC > BC).Slide25

Conductive hearing loss: BC=AC, or BC>AC. Sensorineural hearing loss: AC>BC. Slide26

Romberg test: Test-assesses the ability of the vestibular apparatus in the inner ear to help maintain standing balance. Slide27

Romberg test:.Ask patient to stand up with feet together. When stable have pt close eyes wait about 20 seconds; slight swaying may occur.Positive Romberg’s –loss of balance that occurs when closing eyes.