Pediatric Assessment: Ears

Graduate Nursing 536 with Powell at Emory University

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By: Amanda Lutin
Created: 2011-08-24
Size: 29 flashcards
Views: 54

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Anatomy of the Ear

Definition

Anatomy: Components of the external ear

1. External auditory canal: funnels sound and transmits sound to the TM
2. 1/3 outer portion is cartilage
3. Inner 2/3 in bone

Function of the Tympanic membrane

1. Separates the external ear from the middle ear
2. Transmits sound from the air to the ossicles of the middle ear

Anatomy of Otoscopic view of TM

Definition
Normal appearance is pearly gray

Components of the Middle Ear

Ossicles:
1. Malleus
2. Incus
3. Stapes

Function of the Middle Ear

Sound Conduction

Components of the Inner Ear

Sensory Organ in a bony labyrinth
1. Vestibule
2. Semicircular canals
3. Cochlea

Function of the Inner Ear

1. Regulates equilibrium
2. Labyrinth acts as a plumb line for balance

What affects balance

1. Visual and vestibular sense
2. Brainstem disorders
3. Retinal lesions
4. Labyrinths

Cranial nerve responsible for hearing

VIII: Vestibulocochlear

Conductive Hearing Loss

Caused by any disorder affecting the external or middle ear (OM, tumors, foreign bodies)

Sensorineural Hearing Loss

Caused by anything affecting the cochlea in the inner ear (Meniere's disease, DM, syphillis)

Variations in Pediatric Hearing/Anatomy

1. Inner ear develops during the 4th week of gestation, so first trimester Rubella can damage organ of Corti
1. Lumen surrounded by lymphoid tissue
2. Horizontal and smaller eustation tubes->allows for ear infections to develop easier in children
3. Children have lower immunity

Development of Ear

1. The inner ear develops during the 4th week of gestation
2. 1st trimester rubella can damage the organ of corti

Common Ear Abnormalities

1. Ear pits

2. Skin tags
3. External OM
3. Acute OM
4. OM with Effusion (fluid behind the ear)
5. Vertigo: dizziness
6. Tinnitus: ringing
7. Otalgia: ear pain
8. Otorrhey: drainage
9. Labrythitis
10. Mastoiditis: complication of otitis externa. Infection of the mastoid

What is Involved in the Assessment of the External Ear

Inspection of ears for size, position, ear pits, tags
Palpation of auricles, mastoid process, lymph nodes, tenderness

What is Involved in the Otoscopic Exam

Observe external ear canal for polyps, foreign bodies, cerumen, and tumors

TM: color, landmarks, cone of light, retraction, bulging, perforation, scarring, fluid levels, air bubbles behind the TM (allows drainage)

Assessment of Hearing: Whispered voice

Detects hearing impairment by someone whispering a word and having the patient repeat it. Cannot do with infants

Rinne test

Compares air conduction to bone conduction. Air should be 2x as long

Place a tuning fork on the mastoid bone
Have the patient tell you when they cannot hear it

Weber Test

Assesses bone conduction by testing lateralization of sound

Place tuning fork on top of the patient's hear
Lateralizes sound to the bad ear first by conducting through bones

Rhomberg Test

Tests vestibular function

Have the patient stand with his/her eyes close and watch for balance problems

Abnormalities: Ear Malformation

Can be congenital
Can be part of a genetic syndrome

Abnormalities: Foreign Body in the Ear

Definition

Otitis Media

Infection/Inflammation of the middle ear
Occurs between TM and inner ear including the eustation tubes
Can see a non-distinct cone of light
Can see pus behind the TM
Note: red does not always mean infected
Often accompanies a viral infection

Ear Perforation

Ruptured TM
Caused by ear infection and fluid build up behind the TM, causing pressure and the TM to rupture
Caused by loud noises or injury to ear
Caused by foreign body in the ear or inserting cotton swabs
Hearing process is interrupted
n

Tympanosclerosis

Calcification or scarring of the middle ear
Increased fibroblastic activity results in deposits of collagen. Calcium phosphate plaques form in the lamina propria of the TM
Caused by ear infections or tympanostomy tubes

Tympanostomy Tube

Placed due to recurrent or chronic otitis media

Cholesteatoma

White papule
Mass of cellular debris that grows
If you put air in, the TM will move around it because the mass is in the middle ear
Can be congenital or a build up of cholesterol
Painless
Can grow into the brain and should be surgically removed

About this deck

By: Amanda Lutin
Created: 2011-08-24
Size: 29 flashcards
Views: 54

About StudyBlue

“I have been getting MUCH better grades on all my tests for school. Flash cards, notes, and quizzes are great on here. Thanks!”
Kathy