EAR

PARTS OF PINNA (AURICLE) -HELIX -CRUX OF HELIX -ANTIHELIX -CRURA OF ANTIHELIX -TRAGUS -ANTITRAGUS -INTERTRAGIC NOTCH -TRIANGULAR FOSSA -SCAPHOID FOSSA -CONCHAE OF AURICLE -LOBULE -EXTERNAL AUDITORY MEATUS

1.

INSPECT (TELL PATIENT IT IS PAINLESS)

PINNA (ANT and POST) -color -shape -size -symmetry

normal Same as the facial skin normal N Auricle aligned with outer canthus of the eye (10 deg from vertical) -

abnormal Redness, cyanosis/bluish/pallor cauliflower Small-microtia Large-macrotia Asymmetrical; low-set ears

-Signs of inflammation infections

Redness, swelling Herpes zoster/impetigo/acute or relapsing perichondritis/erysipelas/infected

-ulcers -deformities -lumps

-

-lesions

-

-Scars hairs EXTERNAL AUDITORY MEATUS patency -color -cerumen -swellng -tenderness -Skin lesions -blood -discharge ---color ---consistency ---clarity

-

earring tract Ear mold pressure ulceration Darwin¶s tubercle/cupped appearance/accessory auricle Nodules/pre-auricular tag/pit/sinus/cyst/auricular pseudocyst/post traumatic epidermal inclusion cyst/epidermal cysts/gouty tophus Scaly, flaky skin/ traumatic seroma/subperichondrial hematoma/solar keratosis/frostbite/creased lobule/elongated earring hole/split lobule/contact dermatitis/milia/neurodermatitis/neglect keratosis/seborrheic keratosis/psoriasis/ Chondrodermatitis nodularis helicus chronica (Winkler¶s nodule)/solar lentigo/solar keratosis (Cutaneous horn)/pigmented nevus/verruca vulgaris/keratoacanthoma/capillary hemangioma/AV malformation/BCC/verrucous carcinoma/squamous cell carcinoma Previous surgery/trauma scars/hypertrophic scar/keloid Hairy tragus/pinna/ Hypertrichosis lanuginose acquisita

patent Same as the facial skin Normal (dry ± greyish-tan; wet ± brown) -

Atresia/stenosis/sagging of the posterosuperior meatal wall redness Excessive/obstruction Inflammatory/neoplastic scaling

Mucoid, purulent, hemorrhagic,watery

2.

PALPATE Normal firm Pinna recoil after it is folded Non-tender Non-tender mobile Same as body temp Abnormal

Pinna -texture -Elasticity -tenderness ---tragus -mobility -temperature

tender tender Warmth, cold

Mastoid Bone -tenderness

Not tender

Tender

OTOSCOPY Pull pinna upwards and backwards (child- horizontal backwards) -Tympanic membrane ----color ----gloss/transparency ----integrity ----hemorrhage ----bullae ---position ----mobility/retractions ----landmarks -------umbo -------Cone of light ------Pars tensa ------Pars flaccida

Pearly-gray color Semitransparent (translucent) intact -

Pink/red/yellow/amber/white/blue Opaque/dull surface Perforated- marginal, central, site, size
+

+

3.

Hearing Test normal abnormal

Voice tone Tick test Weber Rinne¶s

equal AC>BC

Unequal (louder in affected earCHL; louder in normal ear SHL) BC>AC

4.

Eustachian Tube Function

valsalva Toynbee¶s test Politzer¶s

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