Joint and muscle receptors also

are important in maintaining balance. the brain processes the information from these systems to control balance.

responsible for the sensations

of balance and motion. It uses the same kinds of fluids and detection cells (hair cells) as the cochlea uses, and sends information to the brain about the attitude, rotation, and linear motion of the head.

Normal Hearing
In a normal ear, sound is funneled by the

auricle, or "outer ear", through the ear canal to the eardrum. Movts of the eardrum are transferred to the ossicles, the small bones of the middle ear. The eardrum and ossicles act as an amplifier and transducer, changing sound into a mechanical energy.

At the end of this chain, the

stapes vibrates in and out of the oval window, a thin membrane between the airfilled middle ear and fluidfilled inner ear.

The vibration of the stapes sets up a

wave of movement of the inner ear fluids. This, in turn, stimulates the fine sense organs (the hair cells) of the inner ear, which then stimulate the auditory (hearing) nerve, which carries the sound energy to the brain.

 video

Decibels

Example 0- Faintest sound heard by human ear 30- Whisper, quiet library 60- Normal conversation, sewing machine, typewriter 90- Lawnmower, shop tools, truck traffic (8 hours per day is the maximum exposure without protection*)

 100- Chainsaw, drill, snowmobile (2 hours

per day is the maximum exposure without protection) 115- Sandblasting, loud rock concert, automobile horn (15 minutes per day is the maximum exposure without protection) 140- Gun muzzle blast, jet engine (noise causes pain, and even brief exposure injures unprotected ears; injury may occur even with hearing protectors) 180- Rocket launching pad

NURSING ASSESSMENT OF

THE EAR: Obtain clients appraisal of his/her ear. Observe for actions that suggest a hearing problem. Document the use of a hearing aid.

Ask client about allergies, history

of upper respiratory and middle ear infections, high fever or exposure to loud sounds. Inspect external ear for signs of infections. Shine a penlight into the ear to grossly inspect the ear canal. Palpate the areas in front & behind the earlobe.

1. Basic Auditory Acuity Test:

Whisper Test: General method used to assess a clients gross auditory acuity test. Stand 1-2 feet behind client so they can not read your lips. Instruct client to place one finger on tragus of left ear to obscure sound.

Whisper word with 2 distinct

syllables towards client's right ear. Ask client to repeat word back. Repeat test for left ear. Client should correctly repeat 2 syllable word.

2. Otoscopic Examination

Involves inspecting the external acoustic canal & tympanic membrane using an otoscope.