EAR ASSESSMENT

• External canal is normally clear with minimal cerumen.
• Tympanic membrane is normally gray in color and intact.
• Hold the helix of the ear and gently pull the pinna upward and back toward the occiput to straighten the external canal.
• Rinne Test (Normal): Air > Bone
• Conductive: Bone > Air
• The examiner stands at arm's length (0.6 m) behind the patient (to prevent lip reading).
• Whisper 2 - syllable words.
• A patient with normal hearing can hear a whispered word from approximately arm's length and a watch from 30 cm (12 inches).
• WEBER TEST: Test for lateralization of vibration.
• RINNE TEST: Compares air and bone conduction.
• Place vibrating tuning fork on the mastoid process behind the ear and have the patient tell you when the vibration stops.
• Then quickly hold the vibrating end of the tuning fork near the opening of the ear canal (2 inches away) and ask if the patient can hear it.
• Normally, sound should be heard after vibration can no longer be fell, that is, air conduction (AC) is better than bone conduction (BC).
• Otalgia: earache.
• Otorrhea: ear discharge.
• Presbycusis: hearing loss due to old age.
• Tinnitus: Is ringing of the ears.
• Vertigo: Feels like room spins or the person feels like he/ she spins.
• Microtia: Small ears; smaller than 4 cm. vertically.
• Macrotia: Large ears; larger than 10 cm. vertically.
• Impacted cerumen: Hardened ear wax.
• Otitis Media: Infection of the middle ear.
• Otitis Externa: Infection of the external ear.
• External canal: with an otoscope, inspect the canal for discharge, impacted cerumen, inflammation, masses, or foreign bodies.
• Pinna: examine for size, shape, color, lesions, and masses.
• Tympanic membrane: examine for color, luster, shape, position, transparency, integrity and scarring.