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S. Y. SALID
GARDEN CITY UNIVERSITY
KUMASI
Pinna
Ear Drum
Auditory
Canal
Diagram Showing The Parts Of the Outer Ear
SemiCircular
Canal
Cochlea
Eustachia
n
Tube
Equipment
Examination gloves
Otoscope
Largest speculum
that will fit into the
auditory canal
Tuning fork (512
cps)
History
Find out the following from the patient:
Tinitus?
Diziness or vertigoe ?
Occupational noise exposure ?
Discharge from ear ?
Infections ?
Otalgia ?
Hearing problems-one or both ears,
onset, duration ?
History
When was last hearing test?
What were the results?
Does hearing seem better in one ear
than the other?
If so, which ear is better?
Has any member family had ear
problems or hearing loss?
Physical Assessment
Inspections
TPR/BP
Skin of ear-colour, tone texture
Auricle-position and shape(normal height 410cm)
Auditory meatus-characteristics such as
erythema,s welling, narrowing, foreign body
or discharge
Ear position and alignment with eyes
Discharge-one or both ears, characteristics
Physical Assessment 2
Otoscopic Examination
Ear canal-colour, characteristics, cerumen
Evaluate serumen-black or brown
cerumen will be noted in dark skin clients,
the colour of fresh cerumen is light yellow
or pink, older cerumen is darker yellow.
Tympanic membrane-colour, Intactness
and land mark
Physical Assessment 3
Physical Assessment 4
Palpation
Palpate the Pinna, tragus, mastoid
process for -(tenderness,
inflammation, masses)
HEARING/AUDITORY ACUITY
Whisper testAsk client to occlude one ear by gently placing the
fingers against the opening of the auditory canal
Stand 30 to 60 cm (1 or 2 feet) away from clients
occluded ear
Stand behind client to prevent lip reading or let
client close the eyes if you prefer to stand in front
Softly whisper numbers the client is to repeat
Repeat for the other ear
Whisper test
Expected Findings
Ears positioned on head with pinna at height of
corner of eye.
External ear: without exudate or lesions.
Ear canal: without cerumen, inflammation, or
lesions.
Tympanic membrane: landmarks clearly visible,
cone of light visible, tympanic membrane intact.
Whisper test: accurate phrase identification.
Rinne test: air conduction is twice as long as
bone conduction.
Unexpected Findings
External Ear
Flaking, abrasions, lesions, or erosions of
external ear skin may be due to skin cancer
from sun exposure
Nodules, calculi, or tophi on auricle rim.
Tenderness of external ear on palpation or
movement may to due to trauma or infection.
Redness, purulent drainage and
inflammations may be due to infections
Ottitis Media