HA LEC

• Otoscope


  An instrument used for examining the interior of the ear, especially the eardrum, consisting essentially of a magnifying lens and a light
• Parts of the ear assessed


  • External ear
  • Middle ear
  • Inner ear
• Mastoid


  A bony prominence behind the ear that should also be included in ear assessment
• Cerumen


  Earwax that lubricates and protects the ear canal
• Eustachean tube


  Part of middle ear that connects to the nasopharynx
• Conductive Hearing loss


  The result of interrupted transmission of sound waves through the outer and middle ear structures
• Sensorineural hearing loss


  The result of damage to the inner ear, the auditory nerve or the hearing center in the brain
• Mixed Hearing loss


  A combination of conduction and sensorineural loss
• Normal findings on inspection of the ear

  • Color the same as facial skin
  • Symmetrical
  • Auricle aligned with outer canthus of the eye
  • No discharges
• Abnormal findings on inspection of the ear

  • Bluish color of the ear lobes (cyanosis)
  • Pallor- suggestive of frostbite
  • Excessive redness- suggestive of inflammation or fever
  • Low-set ears- the auricle is not aligned with the outer canthus of the eye, associated with Down Syndrome
  • Presence of redness and discharge
  • Excessive cerumen obstructing canal
• Impacted cerumen


  Hardened, dried cerumen that obstructs the ear canal that sometimes affects hearing
• Otitis Media


  A middle ear infection common among children, manifested by the presence of foul odor ear discharges and ear pain as a result of cold, sore throat or respiratory infection
• Otosclerosis


  Hardening of the bones in the middle era
• Cholesteatoma


  Abnormal skin growth or epithelial cyst in middle ear that usually results from repeated ear infections
• Perforation


  Hole in tympanic membrane caused by chronic negative middle ear pressure, inflammation or trauma
• Normal findings on palpation of the ear

  • Pinna recoils after it is folded
  • Outer ear is mobile and firm
• Abnormal findings on palpation of the ear


  • Lesions- flaky, scaly skin (seborrhea)
  • Tenderness when moved or pressed which may indicate inflammation or infection
• Gross Hearing Acuity Test


  Assesses response of clients to normal tone of voice
• Whisper test


  Assess high-frequency hearing. Occlude one ear and whisper phrase or words to patient
• Weber's Test


  Assess bone conduction hearing loss, the lateralization or sideward transmission of sounds. Uses tuning fork in the assessment
• Rinne Test


  Compares air conduction to bone conduction
• Presbycusis


  Generalized hearing loss common among older adults
• Tinnitus


  The perception of sound that does not have external source commonly described as ringing sound
• Nasal Speculum


  An instrument that helps to expand the opening of the nostrils to provide a better view of the anterior nasal passageway
• Normal findings on inspection of the nose


  • External nose is symmetric, straight, no flaring uniform in color and no discharges
  • Air moves freely on both nares
  • Mucosa is pink and no lesions
  • No lesions
  • Nasal septum is intact and in midline
  • Facial and maxillary sinuses are not tender
• Abnormal findings on inspection of the nose

  • Asymmetric
  • Discharge from nares (pus, mucous)
  • Air movement is restricted in one or both nares
  • Mucosa is red, edematous
  • Tenderness on palpation. Presence of lesions (polyps)
  • Septum deviated to the right or to the left
  • Tenderness in one or more sinuses
• Epistaxis


  Nose bleed that can occur in one or both nostrils. May result from hypertensive disease or other arterial vessel changes
• Kiesselbach Plexus


  A network of blood vessels that supplies the nose with a large quantity of blood in order to adjust the temperature of air entering the body. The common site of nose bleeds
• Rhinorrhea


  Runny nose
• Anosmia


  Loss of the ability to smell
• Hyposmia


  Decreased sense of smell
• Parosmia


  Distorted sense of smell
• Normal findings on inspection of the lips

  • Symmetrical, uniform in color, soft, moist, smooth texture, ability to purse lips
• Abnormal findings on inspection of the lips

  • Pallor, cyanosis, with blisters (sores), generalized or localized swelling, fissures, crusts, or scales, inability to purse lips (may indicate nerve damage), leukoplakia (white patches)
• Normal findings on inspection of the buccal mucosa

  • Uniform pink color, no lesions, smooth, elastic texture, glistening
• Abnormal findings on inspection of the buccal mucosa

  • Excessive dryness, mucosal cysts, irritations from dentures, abrasions, ulcerations, nodules
• Stomatitis


  Inflammation of the oral mucosa
• Xerostomia


  Dry mouth, common among older adults
• Normal findings on inspection of the teeth

  • 32 adult teeth, smooth, white, shiny tooth enamel, pink gums
• Abnormal findings on inspection of the teeth


  • Missing teeth, ill-fitting dentures, Dental caries (brown or black discoloration of the enamel)