Professional Documents
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ENT Disorders14 1
ENT Disorders14 1
RVU WC
MSN I 3rd yr. Nursing Students
Ear nose & throat disorders
04/13/2024
By: Mamo S
By:Mamo S (BSc, MSc) 1
Objective
After the end of this session:
• Describe anatomical and physiological
overview of ENT
• Define each common ENT disorders
• Cause and pathophysiology of each
disorders
• Identify assessment , clinical identity and
diagnostic
• Nursing managements of each disorders
04/13/2024 By:Mamo S (BSc, MSc) 2
Anatomy and physiology of the ear
The structure of ear consists of three parts:
Outer
Middle
Inner ears.
Outer ear: collects sounds & funnels them through
auditory system.
It is composed of three parts
Pinna (or auricle)
External auditory canal (external auditory meatus)
Tympanic membrane (or eardrum)
Hammer (malleus)
Stirrup
A. Vestibule
- Round open space accesses various passage ways.
- The central structure within the inner ear.
C. Cochlea
- Dedicated to hearing.
Blood Supply
Posteriory auricular artery
Anteriory auricular artery
04/13/2024 By:Mamo S (BSc, MSc) 10
Nerve supply
Greater auricular(CN2-3)
Lesser occipital (C2)
Auricular branch of facial (Concha)
Lymphatic drainage
Mastoid tip
Pre-auricular
Deep cervical
Lesions
Discharge
Size
Symmetry and
Angle of attachment to the head
foreign objects
Exposure to dust, hair care products, or other irritants,
membrane
04/13/2024 By:Mamo S (BSc, MSc) 17
Clinical Manifestations EO
Pain
Occasionally fever,
Cellulitis
Lymphadenopathy.
Pruritus
On otoscopic examination,
be visible.
04/13/2024 By:Mamo S (BSc, MSc) 19
Diagnosis
Hx & P/E
Otoscopy examination
Culture & sensitivity
Medical Management
To relieve pain:
o Heat therapy to the periauricular region (heat lamp;
hot; wet compresses; heating pad)
o Analgesics like aspirin, acetaminophen, codein
04/13/2024 By:Mamo S (BSc, MSc) 20
Antibiotics
o If fever or regional cellulites develops
o Instillation of antibiotic ear drops
o Application of keratolytic or 2% salicylic acid in
cream containing nystatin to treat candidal organisms
– In chronic otitis external, primary treatment consists of
cleansing the ear & removing debris.
or shampooing.
Definition
- Is a hole or rupture in the eardrum, a thin membrane
that separates the ear canal and the middle ear.
- Often accompanied by decreased hearing & occasional
discharge.
- Pain is usually not persistent.
- Skull fracture
- Explosive injury
months to heal.
otorrhea or rhinorrhea
Surgical management
membrane) is used.
occurs
external canal.
AOM (Purulent)
Clinical manifestations
o Drainage from the ear (otorrhea),
o Fever
o Hearing loss
o Tinnitus
o Otalgia(pain)
o Redish tympanic membrane
o Bulged or perforated tympanic membrane
o Leukocytes may be present
04/13/2024 By:Mamo S (BSc, MSc) 36
AOM cont`d
Diagnostic evaluation
Clinical manifestation
Otoscopic examination
Fluid culture(tympanocentesis)
WBC analysis
mastoiditis
Cholesteatoma
Diagnostic evaluation
Otoscopic evaluation- may reveal
o Perforation
o Cholesteatoma (white mass behind the tympanic
Audiometric test
o Show conductive or mixed hearing loss in
case of cholesteatoma
04/13/2024 By:Mamo S (BSc, MSc) 44
COM cont`d
Medical Management
Tympanoplasty
Nursing Interventions
Reducing anxiety
Relieving pain
Preventing infection
Preventing injury
– Pneumococci / in children/
– Haemophilus influenza
– Beta hemolytic streptococci
– Staphylococci
– Gram negative organisms
Diagnostic evaluation
– X- ray shows
– Hearing occurs when sound waves stimulate the nerves of the inner ear
04/13/2024 By:Mamo S (BSc, MSc) 50
cont`d
Management
– Simple mastoidectomy
mastaid)
Examination of
Nasal endoscopy
the nose
Nasal speculum
Nasal endoscopy
Rhinometry
Sinus endoscopy
(antroscopy).
Sinus:
Air-filled extensions of the
respiratory part of the
nasal cavity into the ff
cranial bones:
– Frontal
– Ethmoid
– Sphenoid
– Maxillary
04/13/2024 By:Mamo S (BSc, MSc) 55
Rhinitis
Definition:- inflammation of the nasal mucosa.
Classification
1.Acute rhinitis: - also known as the common
cold, or coryza.
may be bacterial or viral in origin & it
usually lasts 5-7 days, with or without
treatment.
2. Allergic rhinitis:- most often as a seasonal
disorder
04/13/2024 By:Mamo S (BSc, MSc) 56
cont`d
Causes
o Tree pollen
o Grass pollen
o House dust
o Feather pillows
o Mold/decay
o Cigarette smoke
o Animal dander’s
04/13/2024 By:Mamo S (BSc, MSc) 57
cont`d
3. Vasomotor rhinitis: -
Cause the same c/m as those of acute & allergic rhinitis
4. Rhinitis medicamentosa: -
Is caused by abuse or over use of topical and
Paroxysmal sneezing
Fever
Head ache
04/13/2024 By:Mamo S (BSc, MSc) 59
cont`d
Complications:
Untreated allergic rhinitis may led to asthma
Recurrent otitis media with hearing loss
Sinusitis
Nasal or Sinusal polyps
Alveolar hypoventilation
Epistaxis
Diagnosis
Personal & family history of allergies
Physical finding
04/13/2024 By:Mamo S (BSc, MSc) 60
cont`d
Nursing intervention for acute rhinitis:
Humidification
Decongestants to reduce the edema of nasal mucosa
Increased fluids to prevent dehydration
Analgesics
Antibiotic to prevent secondary bacterial infection
Characterized by:
Nasal congestion,
Rhinorrhea, Sneezing,
population.
highly contagious because virus is shed for
about 2 days before the symptoms appear &
during the first part of the symptomatic phase.
Clinical manifestation
Low-grade fever,
Nasal congestion,
Medical management
and pains.
removal of secretions.
been demonstrated.
Nursing management
Teaching Patients Self-Care
Most viruses can be transmitted in several ways:
o Direct contact with infected secretions;
o Inhalation of large particles from others’ coughing or
sneezing
o Inhalation of small particles (aerosol) that may be
suspended in the air for up to an hour.
Hand washing (or use of alcohol-based antibacterial
cleaning agents)
04/13/2024 By:Mamo S (BSc, MSc) 69
Rhinosinusitis (sinusitis)
Sinus x-ray
sensitivity test
Treatment