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• AIR CONDUCTION is the primary mechanism of hearing
• Sound waves through external auditory canal
• Vibrations to inner ear structures
• Helix of ear is level with imaginary line drawn through inner and outer canthus to occiput. Ears should be rotated from 0–15 degrees posteriorly
• Microtia - Ears less than 4 cm vertical height in adults seen in some genetic disorders
• Macrotia - Ears greater than 10 cm vertical height in adults
• Missing or Malformed Landmark - Associated with hearing deficit
• Creased Earlobes - Associated with heart conditions
• creases - frank's sign or deepcrease, an indication that your patient is at risk of stroke deep crease, or at risk of a cardiovascular problem
• Bloody – trauma
• Pus – infection
• Clear Drainage – spinal fluid, head injury
• Impacted Cerumen - Excessive cerumen secretion
• Redness - Inflammation may indicate infection, fever
• Otitis Externa○ -Ear pain, especially with movement of the tragus or pulling of ear lobe - Redness of external auditory canal or auricle of external ear
• Acute Otitis Media - Ear pain with reddened TM - Signs of conductive hearing loss
• proprioception (ability to accurately senseone’s body position) (awareness of movement andposition of the body)
• Meniere's Disease - Chronic, progressive disease of inner ear that leads to permanent hearing loss - Affects proprioception - Characterized by a sensation of fullness or pressure in the ears and recurrent episodes of vertigo, tinnitus,and hearing loss, lasting from a few minutes to several hours
• Cysts - May occur when oils are produced in a skin gland faster than they can be released from the gland
• Otoscope - A flashlight type viewer used to visualize the eardrum and external ear canal
• WHISPER TEST - For LOW – PITCH deficits - Have patient cover opposite ear being tested - Stand about 1–2 ft behind patient,and whisper
• WATCH - TICK TEST - For HIGH – PITCH Deficits - Have patient cover opposite ear being tested - Hold ticking watch within 5 inches from ear
• CONDUCTIVE HEARING-sound waves transmitted by theexternal and the middle earthe external
• SENSORINEURAL HEARING-sound waves transmitted by the middle ear
• WEBER TEST - This test helps to evaluate the conduction soundwaves through bone to help distinguish between conductive sensorineural hearing
• conductive hearing loss - the client “hears” the sound in the poorer the good ear is distracted by background noise and conducted air which the poor ear has trouble hearing thus the poor ear receives most of the sound conducted by bone vibration
• Sensorineural hearing loss - lateralization of sound to the good ear - making sound seem louder in the unaffected ear
• sensorineural hearing loss - the client “hears” the sound in the goodear○there is a limited perception of the sound due to nerve damage in the poorer
• 90% of reported hearing loss is sensorineural hearing loss
• RINNE TEST - Compares air and bone conduction sounds - the tuning fork base is placed first on the mastoid process after which the prongs are moved to the front of the external auditory canal
• Air conduction (AC) sound is normally twice as long for bone conduction or normally heard longer
• CONDUCTIVE HEARING LOSS - AC less than twice BC - BC sound is heard longer than or equally as longas AC sound (BC ≥ AC), possibly due to
• ROMBERG’S TEST - Test the client's equilibrium / innerear vestibular function