Visual (otoscopy) inspection flashcards |

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visual (otoscopic) inspection is performed before

tymponometry

purpose of otoscopy procedure is to

assess outer ear, TM, and middle ear

atypical things looked for in an otoscopy procedure

-structural defects in ear, head or neck
-ear canal abnormalites
-tympanic membrane abnormalities

ear canal abnormalities

-blood
-inflammation
-excessive cerum or foreign object

tympanic membrane abnormalities

-color
-bulging or retraction
-fluid line or bubbles
-perforation
-mass

purpose of immittance testing

-detecting middle ear disorder (tympanometry and reflexes)
-differentiationg different types of middle-ear pathology (tympanometry and reflexes)
-differentiating cochlear from retrocochlear pathology (reflexes, and reflex decay)
-facial nerves (reflexes) and eustachian tube (tympanometry)

immitance

combination of two words: impedence +admittance

impedance

opposition to flow of acoustic energy at middle ear

admittance

acoustic energy passed by tympanic membrane into middle ear

tests of immittance

-tympanometry
-acoustic reflex thresholds

tympanometry

-peak admittance
-physical volume (ear canal volume)
-peak pressure

acoustic reflex threshold

stapedial muscle reflex (stiffening middle ear system when elicited by high intensity sounds)

TM vibrates most easily and best when air pressure is

equal on wither side:~0daPa

probe tone in tympanometry uses ____ frequency

226 Hz

in tympanometry, microphone measures

how much sound is absorbed (admitted) and how much is reflected back into ear canal

in normal middle ear, acoustic energy is passed at

0 daPa

tympanometry determines

admittance of sound into middle-ear at varying degrees of positive and negative pressure in external auditory canal

tympanometry is related to

compliance of TM and ossicular chain

tympanometry has limited value w/ children younger than

7 mo

peak admittance is related to

mobility of middle ear

normal peak admittance

.3 ml to 2.0 ml

high >2.ml peak admittance

excessive compliance; flaccidity of TM/ossicles

low<.3 ml peak admittance

low compliance; stiffness of middle ear system

low peak admittance may be linked to

serous otitis media

peak pressure is shown by

where tympanogram peak falls horizontally

peak pressure is related to

air pressure in middle ear

normal peak pressure

100 to -150 daPa

negative pressure<-150 daPa reflects

middle ear pressure is negative rative to outer air pressure
-usually Eustachian tube dysfunction

ear canal volume value is provided on

screen or printout

physical volume

volume of ear canal beyond probe

normal ear canal volume

.6 to 2.5 mL
-TM is intact

small ear canal volume

obstruction of ear canal or improper probe placemet

large ear canal volume

Tm isn't intact; maybe perforated

tympanometry measures volume of

EAC and middle ear space

type A

normal middle ear function
-normal shape, peak pressure, peak admittance

type As

stiffined middle-ear system:
-normal shape, peak pressure low peak admittance (<.3 ml)

type Ad

excessively compliant middle ear; normal shape, peak pressure, high peak admittance (2.5 ml)

normal tympanometry reflecs ____ _____ ______, not ______ ______

middle ear function

type B

flat tympanogram, no peak, low admittance

to interpret type B tympanogram,

check ear canal volume

normal physical volume

intact TM, no ear canal obstruction, but little to no mobility of TM

type B tympanogram with normal physical volume can often reflect

otitis media/ effutions

physical volume is too small

ear canal obstruction or misplaced probe tip

physical volume too large

TM is not intact; peforation

type c tympanogram

normal shape, normal peak admittance, excessively negative peak pressure
(<-150 daPa)

type C tympanogram reflects

eustachan tube dysfunction or oncoming/resolving otitits media

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