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41 Multiple choice questions

  1. -swimmer's ear
    -white cottage cheese looking
    -Drops help return the pH to normal, good for swimmers.
  2. reflection from the otoscope, if not there the TM is not pulled back properly
  3. -the ear itself
    -Look for malformations
    In development, there are hillocks. (if they're are not joined together well)
    -If one ear is higher/lower or smaller/larger than the other -→ developmental problem.
    -Can be craniofacial problems or issues with the cochlea.
    -Too small/big (check children)
    -Cupped shape = too small →from craniofacial abnormalities
    -Older males tend to have large ears because of excessive cartilage.
    -Looking for sores and potential signs skin cancer (e.g. crusty melanomas).
  4. -May not have an ear canal, or only have a partial one
    -Auricle malformations (cupped, partially developed, etc.)
  5. -Seen if a patient with otitis externa has a compromised immune system (diabetes or auto immune disorder, HIV positive).
    -Causes fungus to become aggressive and starts eating the tissue in the ear b/w cartilage and bone (eats cranial nerves).
    -Looks like bloody cottage cheese and lies at the bottom of the ear
  6. -Speculum (adult or child tip)
    -Viewing window
  7. •Manubrium of the Malleus
    •Lateral process
    •Cone of light
    •Pars Flaccida
    •Pars Tensa
  8. in the center; connects to the TM
  9. a form of bone overgrowth in the middle ear that causes progressive hearing loss
  10. • Cannot see the tympanic membrane at all because of
    cerumen impaction
    • Blood in the ear canal
    • Discharge in the ear canal
    • Object in the ear canal
    • Hole in the ear canal (perforation)
  11. 1. Bridge (if you don't bridge 1st you will FAIL test)
    2. Pull to straighten E.C. (Child: down and back; Adult: up and back)
    3. Insert: look while inserting to check if partial atreria
    4. Look at eye level: find umbo then follow up malleus, then circle and look around outside edge
    5. Reverse: same order but backwards! REMOVE BRIDGE LAST!!!!
  12. smelly discharge that comes out from the ear common w/ otitis externa
  13. -area in front of ear
    -Look to see if there are any pits (or holes), tags that are hanging on (excessive skin), sores.
    -Look behind ears too
  14. -Atresia
    -Otitis Externa
    -Necrotizing Otitis Externa
    -Cerumen blockage
    -Foreign bodies
    -Rashes, sores
    -Carcinomas (or neoplasms; cancer)
  15. outside layer of skin

    •Can get dry or flakey, especially from swimming
    •Grows from the center of tympanic membrane and spreads out.
  16. -The rest of the TM
    -TM is more stiff in this portion to be able to send info
  17. small or partial auricle
  18. -Epithelial
  19. •Congruent with all the middle ear space
  20. -blisters between the fibrous and epithelial layer of eardrum. Like a blood blister, hurts very badly.
    -Most common way to get it is trauma (e.g. q-tip) , candling, hot water, etc.
  21. -Surfer's ear
    -abnormal growth of bone
  22. no auricle
  23. 1. To inspect the outer ear
    2. To determine if we can see the eardrum and all landmarks look to be normal
    3. To give us an idea if we should proceed with testing
  24. will probably see this 1st; look towards the middle to find the umbo
    •Right ear: 1 o'clock
    •Left ear: 11 o'clock
  25. gives elasticity

    •Fibers crisscross each other
    •This is the layer that makes the TM appears more translucent, and not clear.
    •Can be stiff or flaccid; opaque or translucent, but not perfectly clear
  26. -no ear canal
    -Can have a partial ear canal, the bone is there but not the cartilage, or vice versa
  27. •Otosclerosis
    •Chain discontinuity
  28. small triangular portion at the top of the TM; more flaccid than the rest of the TM
  29. -Little white bump at the top of the malleus
    -Not attached to the TM, but pushes it out
  30. Inspection of the outer ear and ear canal using a otoscopic light
  31. •Positive Pressure
    •Negative Pressure (retraction)
    •Fluid or Otitis Media
    •Skin Graph
    •P.E. tubes
  32. -behind ear
    -Back area could be caved in where the mastoid is; there could be a scar, etc.
  33. -looks like scar tissue and hard to see through
    -takes part of the ear canal wall to fix the big hole.
  34. -boney growths
  35. If you are performing otoscopy correctly you should see the
    following landmarks:

    • Tympanic Membrane
    • Pars Flaccida (Membrane of the eardrum)
    • Handle of the Malleus (the first ossicle)
    • Umbo of the Malleus
    • Short process of the Malleus (hard to see for most people)
    • Cone of light
  36. -Cauliflower ear
    -Preauricular cysts
  37. • Need to see the main landmarks (from the previous slide)
    • Having clear visualization of the tympanic membrane is the most important
    • Some cerumen (earwax) is normal as long as you can visualize some part of the eardrum
  38. -Ear canal gets very narrow.
    -Cerumen can completely build up the canal.
  39. -Pre-Auricular area
    -Post-Auricular area
    -Ear Canal
  40. -if TM stays pulled back for a long period of time, the skin will start to peel and fall to the bottom of the E.C.
    -Looks like little white lumps or pearls
    -Very acidic; eats decaying skin, but can also eat through the TM, ossicles, bone, etc.
  41. -Calcium deposits will stick to eardrum on the backside of the TM; means they've had a lot of ear infections
    -Could attach to ossicles themselves