Ear Health Assessment

Study Notes

Ear Health Assessment

External Ear Anatomy: Composed primarily of elastic cartilage, including the pinna (ear flap) and auditory canal. Collects and transmits sound to the middle ear.
Middle Ear Anatomy: Separated from the outer ear by the tympanic membrane (eardrum). The center (umbo) of the membrane is attached to the malleus. The malleus connects to incus and stapes. The eustachian tube connects middle ear to the nasopharynx, equalizing air pressure. Conducts sound vibrations to the inner ear.
Inner Ear Anatomy: Fluid-filled spaces within the temporal bone, containing the bony labyrinth (vestibule, semicircular canals, and cochlea). Receives vibrations from the middle ear, stimulating nerve impulses that travel to the brain for sound interpretation.
Subjective Data:
- History of hearing problems and use of hearing aids.
- Symptoms such as ringing in ears, drainage, or pain.
- Experience of dizziness, imbalance, or spinning sensation.
- Current use of ear medications, drops, or supplements.
External Observations:
- Assess ear position and symmetry.
- Inspect the auricle for lesions, drainage, nodules, or redness. Tenderness may suggest otitis externa.
- Inspect and palpate the mastoid area behind auricles for tenderness, redness, or warmth.
- Inspect the ear canal opening for discharge, redness, odor, or presence of nodules or cysts.
Otoscopic Examination: Visual internal examination. Inspect the tympanic membrane, pars flaccida, and bony structures for pearl, gray, glistening, transparent appearance. Look for bulging, retraction, bleeding, lesions, and perforations.
Abnormal Findings: Earache: Often due to external or middle ear disorders associated with infection, hearing loss, or otorrhea. Possible causes include cerumen (wax), foreign bodies, polyps, otitis media, otosclerosis (hardening of middle ear bones), or trauma.
Otitis Media: Inflammation of the middle ear, often resulting from eustachian tube dysfunction. Can be suppurative (pus-producing) or secretory. Acute otitis media has rapid onset and a short duration and infected fluid in the middle ear.
Otitis Media Symptoms (Children): Ear pain (especially when lying down), pulling at ear, trouble sleeping, excessive crying, trouble hearing or responding to sounds, loss of balance, fever (100°F/38°C or higher), drainage from ear, headache, loss of appetite.
Otitis Media Symptoms (Adults): Ear pain, drainage from ear, trouble hearing.

Nose Health Assessment

Nose Anatomy: Lower two-thirds of the external nose is flexible cartilage; upper one-third is rigid bone. Internally, it merges with the pharynx (nasopharynx, oropharynx, and laryngopharynx).
Assessment:
- Health History: Duration of symptoms, previous treatments, factors that improve/worsen symptoms, other health concerns.
- Patient Medications (if any).
- Signs of Sinus Infections: Long-term (chronic) yellow/greenish drainage, decreased sense of smell, facial pain/pressure, runny nose, headache.
- Nasal Allergies: Runny nose, sneezing, red/itchy eyes/nose.
- Nasal Blockage/Obstruction: Need to breathe through the mouth, one-sided breathing issues.
Physical Examination:
- Inspection: Observe the nose for position, shape, symmetry, color, variations (discoloration, swelling, deformity).
- Inspection (Discharge): Note nasal discharge color, quantity, consistency. Observe for nasal flaring and respiratory distress signs.
- Inspection (Internal): Using nasal speculum or otoscope to evaluate for exudate, moisture, color (pink/light red), lesions, and nasal polyps.
- Palpation: Assess for pain, tenderness, or swelling in/around the nose and sinuses. Check for swelling around the eyes, particularly over sinus areas.

Abnormal Findings: Nose

Possible Causes: (Symptoms like Epistaxis, flaring, stuffiness, discharge)
- Coagulation disorders (nosebleeds), trauma, hematologic disorders, renal disorders, hypertension (nosebleeds), respiratory distress (flaring), common colds, sinusitis, trauma, allergies, irritants, deviated septum (stuffiness, discharge).