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Assessment of the Ears

This article provides an overview of ear anatomy and the assessment process for the ears. It includes subjective data, objective data, and testing methods for assessing hearing acuity.

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Assessment of the Ears

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  1. Assessment of the Ears NUR123 Spring 2009 K. Burger, MSEd, MSN, RN, CNE PPP by: Victoria Siegel, RN, MSN, CNS Sharon Niggemeier RN MSN Revised by: Kathleen Burger

  2. Ear Anatomy • Sensory organ of the body • Used for hearing and maintaining equilibrium • Composed of 3 sections • External ear • Middle ear • Internal ear

  3. Assessment of the Ears • Subjective Data- • Hx Earaches • Infections • Discharge (otorrhea) • Hearing loss • Environmental noise • Tinnitus • Vertigo • Self care behaviors • Coping methods

  4. Assessment of theEar • Objective data: • Inspect and palpate external ear: • Note color, lesions, tenderness, discharge • If S/S of ear infection, inspect unaffected ear first to avoid transferring infected material.

  5. Otoscopic Examination • Insert otoscope and examine ear canal noting: redness, swelling, lesions, discharge or foreign bodies • Inspection of Tympanic Membrane normally TM - Pearly gray, shiny, translucent • Flat, slightly pulled in at center • Skin intact, no redness/ discharge • Canal- clear, no obstructions

  6. Figure 3-6. • Anatomy of the Tympanic Membrane

  7. Conductive Mechanical dysfunction of external /middle ear Examples include: impacted cerumen, foreign body, pus or perforated TM otosclerosis Sensorineural Pathology of inner ear, CNVIII Example: presbycusisgradual nerve degeneration Hearing Loss

  8. Hearing Acuity • Without Audiometry, other tests are crude measures. • Whisper test: • Test one ear at a time • Alternate Press/release on tragusof opposite ear • Whisper 2 syllablewords from 1-2 ft. away • Person should be able to repeat back the words

  9. Weber Test • Valuable when person reports hearing better with one ear. • Strike tuning fork and place on midline of skull • Tone should be equally loud bilaterally • Conductive loss = person will hear less sound in normal ear • Sensorineural loss = person will hear less sound in affected ear

  10. Rinne Test • Strike and place tuning fork on mastoid process. (Sound heard via bone conduction = BC) • Instruct person to signal when sound stops. • Quickly reposition fork in front of ear close to ear canal (sound heard via air conduction=AC) • Instruct person to signal when sound stops. • Normally sound is heard twice as long by AC as by BC. • Recorded as AC > BC

  11. Summary • Assessment of the ear includes: • Inspection & palpation of external ear • Otoscopic exam including ear canal and tympanic membrane • Testing hearing acuity

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