Ear Examination Ear Examination

Heather Nelson, RNHeather Nelson, RN

EarsEars

Inspect auricles for size, shape, symmetry, Inspect auricles for size, shape, symmetry, landmarks, color, and position on head.landmarks, color, and position on head.

Inspect external auditory canal for discharge Inspect external auditory canal for discharge and note any odor. and note any odor.

Palpate auricles and mastoid area for Palpate auricles and mastoid area for tenderness, swelling, or nodules.tenderness, swelling, or nodules.

Otoscopic ExamOtoscopic Exam

Otoscope is used to inspect the external audiotry canal and Otoscope is used to inspect the external audiotry canal and middle ear.middle ear.

Tilt the patient’s head toward the opposite shoulder and Tilt the patient’s head toward the opposite shoulder and pull the patient’s auricle upward and back as the speculum pull the patient’s auricle upward and back as the speculum is inserted.is inserted.

Slowly insert the speculum to a depth of 1.0 to 1.5 cm (1/2 Slowly insert the speculum to a depth of 1.0 to 1.5 cm (1/2 inch).inch).

Note discharge, scaling, excessive redness, lesions, Note discharge, scaling, excessive redness, lesions, foreign bodies, and cerumen. foreign bodies, and cerumen.

Inspect the tympanic membrane for landmarks, color, Inspect the tympanic membrane for landmarks, color, contour, and perforations.contour, and perforations.

Auditory AssessmentAuditory Assessment

Hearing evaluation begins when the patients Hearing evaluation begins when the patients responds to your questions and directions.responds to your questions and directions.

Whisper test---Check the patient’s response to Whisper test---Check the patient’s response to your whispered voice, one ear at a time. your whispered voice, one ear at a time.

The tuning fork is used to compare hearing by The tuning fork is used to compare hearing by bone conduction with that by air conduction. bone conduction with that by air conduction. Weber and Rinne TestsWeber and Rinne Tests

Any patient with unexpected findings should be Any patient with unexpected findings should be referred for a thorough auditory evaluation.referred for a thorough auditory evaluation.

Conductive LossConductive Loss

Results when sound transmission is Results when sound transmission is impaired through the external or middle ear.impaired through the external or middle ear.

Causes: Causes: – obstructionobstruction– otitis media otitis media – perforated TM perforated TM – bony overgrowth of ossiclesbony overgrowth of ossicles

Sensorineural LossSensorineural Loss

Results from a defect in the inner ear that leads to Results from a defect in the inner ear that leads to distortion of sound and misinterpretation of distortion of sound and misinterpretation of speech.speech.

Causes: Causes: – sustained exposure to loud noisesustained exposure to loud noise– DrugsDrugs– InfectionsInfections– TraumaTrauma– TumorsTumors– congenital disorderscongenital disorders– agingaging