UrSCE Mark Scheme

Ear Examination
F BP P
Introduction
W I P E R
Asks the patient if there has been any change in hearing of late
- Characteristics bilaterally, onset, duration, severity etc
- Associated features tinnitus, vertigo, pain, discharge etc
- Possible causes trauma, infection, antibiotics, FH etc
Inspection
Pinna (shape, sie and deformity!, skin changes (erythema,
cancer!
"ooks preauricularly for scars
"ooks postauricularly (behind ear! for scars or hearing aid
"ooks for any discharge
Palpation
Pull gently on ear after consenting and asks if painful otitis
e#terna
Palpates the area in front of the tragus and asks for pain
temporo-mandibular $oint disease
Otoscopy
%urns light source on
&nsures the speculum on the auroscope is clean
Holds the auroscope in the correct manner
'ight hand for right ear
(ently pulls the pinna )ith the left hand up)ards and back)ards
straightens out the cartilagenous part of the canal allo)ing
easier passage of scope
Places tip in opening before looking into the )indo)
*lo)ly advances scope )hilst looking through it
+nspects skin of auditory canal infection, )a#, F,
&#amines tympanic membrane and state-
- Colour of the drum
- Presence of light refle#
- Patency of drum
- "ook out for effusions, cholesteatomata, grommets etc
%hanks the patient and ensures comfortable
Asks if the patient has any .uestions
ia!nosis
Presents findings and a differential diagnosis
Finishin! O""
/ffers to do a We##er and Rinne test
Extra Points $ask 1 only%
0escribe ho) to carry out a 1ebber2'inne test3
1hat pathology are the above tests used to distinguish4
O&erall Impression