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Comprehensive Ear Assessment and Analysis

Apr 27, 2025

Assessment of Ears

Prepared by: Group 2 (Salcedo, Locanas, Buan)

Learning Outcomes

  1. Functions and Structures of the Ears:
    • Discuss the functions and structures of the ears.
    • Understand auditory perception, equilibrium, and sound transmission.
  2. Physical Assessment:
    • Perform ear and hearing assessments using correct techniques.
  3. Normal vs Abnormal Findings:
    • Differentiate between normal and abnormal findings.
  4. Data Analysis:
    • Analyze data to formulate nursing diagnosis, collaborative problems, and referrals.
  5. Documentation and Reporting:
    • Document and report assessment findings accurately.

Functions of the Ears

  • Sensory Organs: Responsible for hearing and equilibrium.
  • Hearing (Auditory Perception):
    • Ability to perceive sounds.
    • Detects vibrations and pressure changes.
    • Relies on ears for transmission and interpretation.

Anatomy of the Ear

  • External Anatomy: Collects sound vibrations.
  • Internal Anatomy:
    • Eardrum vibrates from sound.
    • Vibrations move through auditory ossicles (malleus, incus, stapes).
    • Stapes vibrates the oval window, transmitting sound to the inner ear fluid.
    • Hair cells in the spiral organ of Corti stimulated, initiating nerve impulses.
    • Impulses travel via the acoustic nerve to the brain for interpretation.

Types of Hearing

  • Conductive Hearing: Sound transmission through external and middle ear.
  • Sensorineural Hearing: Sound transmission in the inner ear.

Bone and Air Conduction

  • Air Conduction (AC): Transmits sound through ear canal.
  • Bone Conduction (BC): Sound waves travel through skull bones.

Hearing Loss Types

  • Conductive Hearing Loss: Issues in external or middle ear (e.g., earwax, otitis media).
  • Sensorineural Hearing Loss: Problems in inner ear (e.g., Organ of Corti, cranial nerve VIII).

Importance of Hearing Assessment

  • Begins during initial client interaction.
  • Provides insight into environmental interaction capability.
  • Early detection of gradual changes.

Subjective Data Collection

  • Current Symptoms: Changes in hearing, ear discharge, ringing.
  • Past History: Previous ear problems, surgeries, hearing aids.
  • Family History: Genetic ear problems or hearing loss.
  • Lifestyle: Exposure to loud noise, use of ear protection.

Purpose of Ear and Hearing Examination

  • Evaluate external ear and ear canal condition.
  • Assess tympanic membrane status and sound conduction.
  • Test hearing acuity and equilibrium.

Assessment Methods

  • External Ear & Canal Inspection: Visual inspection.
  • Tuning Fork: Evaluate bone and air conduction.
  • Otoscope: Assess tympanic membrane structures.

Preparing the Client

  • Ensure comfortable seating.
  • Explain procedures to ensure understanding.
  • Address concerns to reduce anxiety.

Equipment Needed

  • Watch with second hand (for Romberg test).
  • Tuning fork (512 or 1,024 Hz).
  • Otoscope.

Examination Procedures

  • Inspection and Palpation:
    • Inspect auricle, tragus, lobule.
    • Note size, shape, and position.
  • Cultural Considerations:
    • Differences in earlobe attachment across ethnicities.
  • Older Adult Considerations:
    • Possible elongated, wrinkled earlobes.

Abnormal Findings

  • Small or large ears, malalignment, microtia, macrotia, lymph node enlargement, tophi, blocked sebaceous glands.

Otoscope Examination

  • Normal Findings: Small, odorless cerumen.
  • Abnormal Findings: Foul-smelling discharge, impacted cerumen, foreign objects.

Tympanic Membrane Inspection

  • Normal Findings: Pearly gray, shiny, translucent.
  • Abnormal Findings: Red, bulging TM, white spots, perforations.

Hearing and Equilibrium Tests

  • Whisper Test: Assess low pitch deficits.
  • Weber Test: Evaluate bone conduction.
  • Rinne Test: Compare air vs. bone conduction.
  • Romberg Test: Assess equilibrium.

References

  • Weber, J.R., & Kelley, J.H. (2022). Health Assessment in Nursing.
  • DAmico, D., & Barbarito, C. (2019). Health & Physical Assessment in Nursing.