The document discusses the anatomy and examination of the ear. It contains the following key points:
1. The ear is divided into three parts - the outer, middle, and inner ear. The outer ear collects sound and channels it inward, the middle ear conveys vibrations, and the inner ear houses receptors for hearing and equilibrium.
2. Common ear symptoms include itch, discharge and infection from the outer ear, pain and discharge from the middle ear, and deafness and balance issues from the inner ear.
3. Examination of the ear involves inspection, palpation, otoscopy, and tests of hearing and balance. The tympanic membrane and ear canal are inspected for issues like
The document discusses the anatomy and examination of the ear. It contains the following key points:
1. The ear is divided into three parts - the outer, middle, and inner ear. The outer ear collects sound and channels it inward, the middle ear conveys vibrations, and the inner ear houses receptors for hearing and equilibrium.
2. Common ear symptoms include itch, discharge and infection from the outer ear, pain and discharge from the middle ear, and deafness and balance issues from the inner ear.
3. Examination of the ear involves inspection, palpation, otoscopy, and tests of hearing and balance. The tympanic membrane and ear canal are inspected for issues like
The document discusses the anatomy and examination of the ear. It contains the following key points:
1. The ear is divided into three parts - the outer, middle, and inner ear. The outer ear collects sound and channels it inward, the middle ear conveys vibrations, and the inner ear houses receptors for hearing and equilibrium.
2. Common ear symptoms include itch, discharge and infection from the outer ear, pain and discharge from the middle ear, and deafness and balance issues from the inner ear.
3. Examination of the ear involves inspection, palpation, otoscopy, and tests of hearing and balance. The tympanic membrane and ear canal are inspected for issues like
hear or listen Telinga : HEARING AND EQUILIBRIUM 1. Anatomy 2. Physiology of hearing 3. Describe the auditory and equilibrium pathways. 1.Anatomy (1) the external ear, which collects sound waves and channels them inward
EAR (2)the middle ear,
which conveys sound vibrations to the oval window;
(3)the internal ear ,
which houses the receptors for hearing and equilibrium. EXAMINATION ANATOMY Common Symptoms of Ear Disease
Common Symptoms of Ear Disease
History Patients may have symptoms from any of the three parts of the ear: 1. Outer ear: symptoms : itch, erythema and discharge (perforated drum and infection or otitis externa). The pinna can be damaged by trauma or affected by acquired or inherited diseases of cartilage. Otorrhoea is a more chronic scanty but offensive discharge. It may be due to a cholesteatoma. This is a growth of stratified squamous epithelium that begins in the middle ear or mastoid. It is a benign, slowly growing lesion that destroys bone and ear tissue as it grows. When perforation of the tympanic membrane occurs, cheesy white discharge can occur. It results in loss of hearing if the ossicles are involved. Accumulations of ear wax are a cause of deafness. 2. Middle ear: symptoms : infection, which is common in children, and causes pain and, if the eardrum ruptures, a purulent discharge. Otosclerosis is an inherited abnormality that affects the ossicles and causes deafness. Middle ear tumours and chronic middle ear infection are a cause of deafness. 3. Inner ear: deafness and balance problems: vertigo are the usual symptoms of inner ear disease. Tinnitus, which is usually described as a EXAMINATION METHOD Ear examination consists of : - inspection - Palpation - Otoscopy - tuning fork assessment - testing hearing - peripheral vestibular examination. Inspect - The position of the pinna and note its size and shape. Note any scars or swelling around the ears. - Look for an obvious accessory auricle (separate piece of cartilage away from the pinna), cauliflower ears (haematomas from recurrent trauma, which obscure the normal anatomical features of the pinna) and bat ears (protrusion of the ears from the side of the head). - Look for inflammation externally and any obvious ear discharge. Inspect the auditory meatus and outer ear. Inspect There are four types of otitis externa, a condition associated with inflammation of the skin of the external canal: 1. Acute localised otitis externainvolves the outer third of the auditory canal where the skin overlies cartilage and hair follicles are present. Itis a form of furunculosis and is usually a result of 2. S. aureusinfection. Acute diffuse otitis externais often called swimmers ear although it occurs in people who have not been swimming. Excessive moisture, heat and humidity, loss of protective cerumen and an increase in pH are responsible for skin maceration and irritation. Infection may occur with Pseudomonas aeruginosa. The initial symptom is itching, which can progress to pain and is made worse by movement of the pinna. The appearance on examination ranges from mild erythema to severe erythema and swelling. There may be a small amount of white, clumpy discharge. Inspect 3. Chronic otitis externais usually the result of repeated local irritation. This may be due to persistent drainage of a chronic middle ear infection but can also be caused by the insertion of foreign bodies into the ear (e.g. cotton swabs, ear picks). Itch is a more prominent symptom than pain. The appearance is of scaly erythematous dermatitis. It must be distinguished from other forms of dermatitis such as psoriasis, atopic dermatitis and seborrhoeic dermatitis. 4. Malignant (invasive) otitis externais an aggressive and sometimes life-threatening condition. It affects elderly diabetics and immunocompromised patients. It begins in the external auditory canal and spreads slowly inwards. Untreated it can cause osteomyelitis of the base of the skull and reach the meninges and the brain. Pseudomonasinfection is the most common cause but other organisms can be responsible. Deep otalgia is the most predominant symptom. The appearance at first is like that of severe chronic otitis externa. On examination there is discharge and the canal Then look for signs of gouty tophi(nodular, firm, pale and non-tender chalky depositions of urate in the cartilage of the ear, specific but not sensitive for gout) Palpate thepinnafor swelling or nodules. Pull down the pinna gently; the manoeuvre is often painful when there is infection of the external canal.
Otoscope examinationof the ears requires use of an earpiece that fits
comfortably in the ear canal to allow inspection of the ear canal and tympanic membrane. This examination is essential for any patient presenting with an upper respiratory tract infection, any symptom related to the ears, dizziness, facial weakness or head injury. Always examine both ears! Inspect the tympanic membrane(ear drum) by introducing the speculum further into the canal in a forward but downward direction. The normal tympanic membrane is a pearly grey colour. It is ovoid in shape and semi-transparent (see Figure38.15). The upper fifth is called the pars flaccida and the lower four-fifths are called the pars tensa. The handle of the malleus is often visible near the centre of the pars tensa. From thelower end of the handle a bright cone of light should be visible: the light reflex. The presence or absence of the light reflex is not a sensitive or a specific sign of disease (see Figures38.16 and 38.17). Note the colour, transparency and any evidence of dilated blood vessels (hyperaemiaa sign of otitis media; see Figure 38.17). Look for bulging or retraction of the tympanic membrane. Bulging can suggest underlying fluid or pus in the middle ear. Retraction means a reduction in pressure in the middle ear and is a sign of a blocked Eustachian tube. Perforation of the tympanic membrane should be noted (see Figure38.18). If a middle ear infection is suspected, pneumatic auriscopycan be useful. Use a speculum large enough Ear: with the same organ, understand your position, Equilibrium Source: G. tortora & b. derrickson principles of anatomy & physiology (12th ed)