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Assessment of the Ears

Assessment of the Ears. NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel, RN, MSN, CNS Sharon Niggemeier RN MSN Revised by: Kathleen Burger. Ear Anatomy. Sensory organ of the body Used for hearing and maintaining equilibrium

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Assessment of the Ears

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  1. Assessment of the Ears NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel, RN, MSN, CNS Sharon Niggemeier RN MSN Revised by: Kathleen Burger

  2. Ear Anatomy • Sensory organ of the body • Used for hearing and maintaining equilibrium • Composed of 3 sections • External ear • Middle ear • Internal ear

  3. Assessment of the Ears • Subjective Data- • Hx Earaches • Infections • Discharge (otorrhea) • Hearing loss • Environmental noise • Tinnitus • Vertigo • Self care behaviors • Coping methods

  4. Assessment of theEar • Objective data: • Inspect and palpate external ear: • Note color, lesions, tenderness, discharge • If S/S of ear infection, inspect unaffected ear first to avoid transferring infected material.

  5. Otoscopic Examination • Insert otoscope and examine ear canal noting: redness, swelling, lesions, discharge or foreign bodies • Inspection of Tympanic Membrane normally TM - Pearly gray, shiny, translucent • Flat, slightly pulled in at center • Skin intact, no redness/ discharge • Canal- clear, no obstructions

  6. Figure 3-6. • Anatomy of the Tympanic Membrane

  7. Conductive Mechanical dysfunction of external /middle ear Examples include: impacted cerumen, foreign body, pus or perforated TM otosclerosis Sensorineural Pathology of inner ear, CNVIII Example: presbycusisgradual nerve degeneration Hearing Loss

  8. Hearing Acuity • Without Audiometry, other tests are crude measures. • Whisper test: • Test one ear at a time • Alternate Press/release on tragusof opposite ear • Whisper 2 syllablewords from 1-2 ft. away • Person should be able to repeat back the words

  9. Weber Test • Valuable when person reports hearing better with one ear. • Strike tuning fork and place on midline of skull • Tone should be equally loud bilaterally • Conductive loss = person will hear less sound in normal ear • Sensorineural loss = person will hear less sound in affected ear

  10. Rinne Test • Strike and place tuning fork on mastoid process. (Sound heard via bone conduction = BC) • Instruct person to signal when sound stops. • Quickly reposition fork in front of ear close to ear canal (sound heard via air conduction=AC) • Instruct person to signal when sound stops. • Normally sound is heard twice as long by AC as by BC. • Recorded as AC > BC

  11. Summary • Assessment of the ear includes: • Inspection & palpation of external ear • Otoscopic exam including ear canal and tympanic membrane • Testing hearing acuity

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