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what should you look for when Inspecting the external ear?
What are normal findings when inspecting the external ear?
- Ears are aligned with eyes
- ears are symmetrical
- no redness, no lesions, no drainage
palpation assessment of external ear
- Assess tenderness and lesions
- palpate tragus & mastoid process
- pull helix forward b4 inserting otoscope
- proceed carefully
how should the otoscope exam of external ear be completed?
- have pt tilt head to opposite side
- use largest shortest speculum that will fit
- pull pinna up and back for adult
- pull pinna down and back for child
- always look into the ear canal b4 inserting the otoscope
- insert .5 in adult .25inches child
what to look for during the external ear canal exam
- drainage-cerumen in normal
- foreign body
scientific name for ear drum
assessment of tympanic membrane
- note position of landmarks (cone od light)
- ears are mirror images cone of light should be at 7 o'clock in right, 5 o'clock left
- note intactness, lesions
- color, and exudates.
what should a normal tympanic membrane look like
- pearly gray
- intact (no tears, holes)
- no lesions, or exudates
- no bulging or retraction
how do you check gross hearing
use whispered voice test to assess for low pitch deficits (1-2 feet from ear)
what test is used to check for bone conduction hearing?
- Weber Test Place tuning fork on top of head.
- sound should be heard equally thru both ears.
- if it lateralizes, sound is heard better in impaired ear thru bone
What test check bone conduction and air conduction
- Rinne Test
- place the tuning fork on the mastoid bone behind until no longer heard, then move it in front of the ear to see if hey can hear it.
weber test results
normal- the tuning fork is heard the same bilaterally
abnormal- the sound of the tuning fork lateralizes. Sound is heard better in the impaired ear.
Rinne Test results
- normal- sound transmission through air is twice as long as through bone
what does the Romberg test check
Romberg Test checks balance
how do you perform the Romberg test
- walk straight line
- touch finger to tip of nose
- stand still with eyes closed
- checks for balance