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OTOSCOPIC EXAMINATION

..

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ANATOMY OF EAR

3 parts of ear

Pinna and external ear

Middle ear

Inner ear

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Pinna

External auditory canal

Inner ear

Middle earOuter ear

Tympanic membrane

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How to examine ears :

:Otoscopy:Tuning fork

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Otoscope :2 TYPES OF OTOSCOPE

DIAGNOSTIC OTOSCOPE THERAPEUTIC OTOSCOPE

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Assess TM mobility,

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EAR EXAMINATION : EAC, TM

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CONEHEAD

HANDLE

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ear speculum

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EAR SPECULUM

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CHILD ADULT

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HAMMER GRISP

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PENCIL GRISP

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OTOSCOPE

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NORMAL EAC

Normal ear

- - ear speculum (bony EAC)

TM

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NORMAL EAC

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ABNORMAL FINDINGS

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WHAT??.....

Tympanic membrane

-COLOR/TRANSPARENCY-POSITION

-LAND MARK

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AS

AI

PI

COLOR Colorless, red, amber, or yellowCrying or irritate with remove cerumen

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AS

AI

PI

POSITION NormalBulgingbulge around umbo = donut like apearance

Retracted

: lateral process of Malleus

long process of Incus is very prominent

M

I

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LIGHT REFLEX

MALLEUS

LAND MARKS

Lt.ear

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AS

AI

PS

PI

NORMAL TM : LT.EAR

Pars flaccida

Pars tensa

Lt.ear

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Round window

Oval window

Lt.ear

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ABNORMAL FINDINGS

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Tools : ear speculum, light

Technique: clean

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Tuning fork

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HEARING

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AC BC

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Hearing loss

CHL

SNHL

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TUNING FORK TEST

conductive hearing loss sensorineuralhearing loss otoscope

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TUNING FORK TEST

RINNE TEST

WEBER TEST

TUNING FORK

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TUNING FORK

512256128 1024 2048

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TUNING FORK TEST

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RINNE TEST: -

AC

BC

Counter act

Mastoid tip

2-3 .

( AC>BC)

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RINNE TEST

RESULT

Base on idea : hearing is more effeicient by

AC>BC

AC>BC : normal hearing or SNHL

BC>AC : CHL

AC=BC mild CHL (timing test)

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WEBER TEST

Counter act

incisor

pseu-doconductive hearing loss-

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WEBER TEST

RESULT

NO LATERALIZATION : normal

LATERALISATION:

To IPSILATERAL : CHL

To CONTRALATERAL : SNHL

SENSITIVE: Differnce of hearing 5dB +

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Hearing Weber (Boneonly)

Rinne (Air-bone)

Normal Not lateralized Positive(AC > BC)

Conductive Loss Lateralized topoorer ear

Negative (BC AC)

SensorineuralLoss

Lateralized tobetter ear

Positive (AC > BC)

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TUNING FORK TEST

Quick and easy

Subjective

Varies

noise

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THE EN

1003 otoscopic exam2013

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