What are the two types of pathways of hearing?
- Air conduction
- sound waves travel through air and hit tympanic membrane
- Bone conduction
- sounds heard directly by inner ear
What is this type of hearing loss:
Conductive (air)
- What typically causes it?
Usually temporary disruption of sound waves
Infections, occlusion
What is this type of hearing loss:
Sensorineural
When causes it?
More permanent hearing loss that directly affects boney ossicles
- Usually occurs naturally as someone ages
What considerations would you make for children considering hearing loss?
More prone to ear infections; shorter eustachian tubes
What considerations would you make for older adults considering hearing loss?
Speak in low tone/slowly as to ensure they understand you
- Stand on side in which their hearing is better
What are some subjective data findings you would collect for ears?
- Earaches
- Infections
- discharge
- Hearing loss
- Environmental risks
- self-care behaviors
If patient reports hearing loss what follow up questions would you ask?
- Onset?
- Risk factors (exposure)
- Any treatments/equipment
What are expected findings of the ears?
No hearing loss,
no earaches, infections, discharge
no tinnitus or vertigo
When preparing to assess the ear, what should you do?
Check for obstructions; use ear irrigation to remove excessive earway if necessary
What equipment do you use when assessing the ear?
Otoscope to inspect
Pneumatic bulp for infants
If patient repeatedly replies with yea (repeated answers),
what does this possibly indicate?
What should you do?
Possibly can’t hear/understand you.
Perform a whisper test
How do you perform a whisper test?
Stand about a foot away
Whisper something
Have patient repeat back
If patient fails a whisper test, what is the next test you should perform?
Use tuning forks
When assessing ears for objective data, what do you check?
Size and shape
Skin condition (color, lesions)
Tenderness
Palpate external auditory meatus
What are expected findings for objective data when assessing ear?
- Intact skin with no lesions
- Same color as face
- Ear is firm/movable with no pain
When doing an otoscopic examination, how would you position the pinna?
Adults: Pull pinna up and back
Children: Down and back
What are expected findings of the tympanic membrane?
Pearly gray
flat and intact
Has light reflection towards nose
What does this Weber test (tuning fork) do/test?
What are the results?
Tests bone conduction hearing loss
Fork placed on top of head; if patient hears sound=negative
What does this Rinne test (tuning fork) do/test?
What are the results?
Tests air conduction hearing loss
- Test bone conduction: hold fork up to mastoid; time how long they hear
- test air conduction: Hold fork up to ear; time how long they hear
- Air conduction should be 2 times longer than bone
What is this abnormal finding of the tympanic membrane:
Retracted drum:
Ear drum is “sucked in”:
ossicles are prominent and has distorted light reflex
What is this abnormal finding of the tympanic membrane:
Otitis media with effusion (OME)
Yellow ear drum
Feeling of fullness/popping sounds
What is this abnormal finding of the tympanic membrane:
Acute otitis media
Red, bulging tympanic membrane
Absent light reflex
What is this abnormal finding of the tympanic membrane:
Perforation
Darkened area on the drum
What is this abnormal finding of the tympanic membrane:
Cholesteatoma
Pearly white, cheesy appearance
Hearing loss on one side
