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Ear Examination
Heather Nelson, RN
Ears
 Inspect auricles for size, shape, symmetry,
landmarks, color, and position on head.
 Inspect external auditory canal for discharge
and note any odor.
 Palpate auricles and mastoid area for
tenderness, swelling, or nodules.
Otoscopic Exam
 Otoscope is used to inspect the external audiotry canal and
middle ear.
 Tilt the patient’s head toward the opposite shoulder and
pull the patient’s auricle upward and back as the speculum
is inserted.
 Slowly insert the speculum to a depth of 1.0 to 1.5 cm (1/2
inch).
 Note discharge, scaling, excessive redness, lesions,
foreign bodies, and cerumen.
 Inspect the tympanic membrane for landmarks, color,
contour, and perforations.
Auditory Assessment
 Hearing evaluation begins when the patients
responds to your questions and directions.
 Whisper test---Check the patient’s response to
your whispered voice, one ear at a time.
 The tuning fork is used to compare hearing by
bone conduction with that by air conduction.
Weber and Rinne Tests
 Any patient with unexpected findings should be
referred for a thorough auditory evaluation.
Conductive Loss
 Results when sound transmission is
impaired through the external or middle ear.
 Causes:
– obstruction
– otitis media
– perforated TM
– bony overgrowth of ossicles
Sensorineural Loss
 Results from a defect in the inner ear that leads to
distortion of sound and misinterpretation of
speech.
 Causes:
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sustained exposure to loud noise
Drugs
Infections
Trauma
Tumors
congenital disorders
aging