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Ear Examination Heather Nelson, RN
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Ears Inspect auricles for size, shape, symmetry, landmarks, color, and position on head. Inspect external auditory canal for discharge and note any odor. Palpate auricles and mastoid area for tenderness, swelling, or nodules.
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Otoscopic Exam Otoscope is used to inspect the external audiotry canal and middle ear. Tilt the patient’s head toward the opposite shoulder and pull the patient’s auricle upward and back as the speculum is inserted. Slowly insert the speculum to a depth of 1.0 to 1.5 cm (1/2 inch). Note discharge, scaling, excessive redness, lesions, foreign bodies, and cerumen. Inspect the tympanic membrane for landmarks, color, contour, and perforations.
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Auditory Assessment Hearing evaluation begins when the patients responds to your questions and directions. Whisper test---Check the patient’s response to your whispered voice, one ear at a time. The tuning fork is used to compare hearing by bone conduction with that by air conduction. Weber and Rinne Tests Any patient with unexpected findings should be referred for a thorough auditory evaluation.
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Conductive Loss Results when sound transmission is impaired through the external or middle ear. Causes: –obstruction –otitis media –perforated TM –bony overgrowth of ossicles
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Sensorineural Loss Results from a defect in the inner ear that leads to distortion of sound and misinterpretation of speech. Causes: –sustained exposure to loud noise –Drugs –Infections –Trauma –Tumors –congenital disorders –aging
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