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Pediatric Physicall Examination
Ears Chapter 12
37
Nursing
Graduate
05/30/2012

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Cards

Term
Mondini's deformity
Definition
Arrest in development of the cochlea development during the fourth week of gestation resuting in a common bony abnormaility of the inner ear assciated with congential sensorineural hearing loss
Term
Schibe deformity
Definition
The most common congenital abnormality of the cochlear duct, resulting in sensorineural hearing loss
Term
equilbrium
Definition
sensory cells needed for equilbrium attain adult size be 23rd week gestation
Term
Preterm Ear Physiological Variations
Definition
Vulnerable to hearing loss, patricularly before 33 weeks, from noise exposure, hypoxia, ototoxic drugs, hyperbilirubineima, persistnet pulmonary hypertension
Term
Newborn Ear Physiological Variations
Definition

At birth typmanic membrane is almost adult size but lies in a more horizontal plane compared to adult ear, which alters visual assessment.

Intrauterine positioning may resultin disfigurinign of the pinna, which will usualy resolve after birth with proper postiiong because of the elastic quality of ear cartilage

Whiteish material including vernix caseosa covers the extrenal auditory canal

Term
Infant Physiologcial Variations of the Ear
Definition
Fluid easily trapped in the middle ar causing eustachian tube dysfunction, particularly common in infants with down syndrome, preterm infants, and in any infant with craniofacial abnormalities
Term
Toddler Physiological Variations of the Ear
Definition
External auditory canal ossifies by 2 years of age, straightening the canal and improving visualization fo the tympanic membrane
Term
Preschooler Physiological Variations of the Ear
Definition
The pinna is approx 80% of the adult size in the 4- to 5- year old
Term
School-age child Physiolgocial variations of the ear
Definition
In a 9-year-old the pinna and external auditory canal have attained adult size. The canal measures 2.5 cm and has become somewhat S shaped
Term
helix
Definition
outer portion
Term
antihelix
Definition
medial and parllel to helix
Term
tragus
Definition

firm protuberance on anterior portion foo ear just at the entrance of auditory canal

pain on tragus could mean external auditory canal infection

Term
concha
Definition
cavity leading to opening of external ear canal
Term
antitragus
Definition
accross fom the tragus ont he border of the antihelix
Term
pars flaccida
Definition
part of the tympanic membrane that is superior to the lateral process of malleus
Term
pars tensa
Definition
comprises the majority fo the tympanic membrane inferior to the lateral process of the malleus
Term
Prussak's space
Definition
in tympanic membrane is most common spot of retraction pockets and congential or acquired cholesteatoma, an asymptomatic white mass in the mdidle ear that is throught to arise from the continued growth of epidermoid layer over the tympanic membrane
Term

 

 

 

 

Tympanosclerosis

Definition
thickening and scarring of the tympanic membrane seen after chronic ear infections
Term

 

 

 

three ossicles of the inner ear

Definition

 

 

malleus, incus, stapes:smallest bones int he body, transmit movment of the tympanic membrane to the oval window and to the 8th (acoustic) cranial nerve

Term

 

 

eustachian tube

Definition

 

the drainage and ventilatory structure for the middle ear.

Adult 35mm

Infant 17.5mm

Term

 

 

Inner ear contains:

Definition

 

vestibule, semicircular canals, cochlea

Term
Ear examination technique in a child
Definition

pulling auricle out and down or

pulling the tragus foward

Term
Inspection of auricles
Definition
size, shape, color
Term
palpation of auricle
Definition
any masses or areas of tenderness, if movment of auricle results in pain examiner should suspect otitis media, otitis externa, or other inflammation of the auditory canal.
Term
Ear Pseudomonas
Definition
Foul-smelling cheesy discharge commonly found with otitis externa
Term
Ear Inspection
Definition
canal for patency, discharge, odor, foreign bodies.
Term
Inspection of internal ear canal
Definition
tympanic membrane for contour (normally concave), intactness (no perforations, tympanostomy, or myringotomy tubes), color (normally gray or silver), translucency (normally translucent without scarring or opacity), and presence of visible landmarks (umbo, handle of malleus and light reflex).
Term
Mobility of tympanic membrane
Definition
important indication of middle ear pressure, if flutters means tympanic membrane pressure is equalized. Decreased or limited movment means increased negative pressure in middle ear ie)infection
Term
Dry cerumen
Definition
gray flaky found in asians and native americans
Term
wet cerumen
Definition
honey-colored to dark brown found in whites and blacks
Term
Auditory brainstem response
Definition
Measures electrical acitivy via scalp electrodes in the auditory nerve to midbrain level in response to sound delivered by air conduction or bone conduction
Term
Otoacuoustic emissions
Definition
records sounds in the ear cnal that are generated by the cochlea; absence of otoacoustic emissions ounds may indicate a nonpatent ear canal,  nonaerated middle ear, or lack of normal out hair cell funciton needed for auditory nerve function
Term

 

 

 

Weber test

Definition

performed by placing a vibrating tuning fork midline on th skull, making sure the examiners hand does not touh the prongs of the tuning fork or child head. The child/adolescent is then asked if he/she hears the sound of the tuning fork better on one side or the other or equaly well on both sides. If the chid indicates the sound is heard better on one side it is called lateralization and indicates a conductive hearing deficit int he ear perceived as hearing the tuning fork better.

 

not done until school age

Term

 

 

Rinne test

Definition

compares air conduction to bone conduction. a vibrating tuning fork is placed on the mastoid process when sound is no longer heard tuning fork should b moved to a position 1-2 cm fromt he external auditory canal. air conduction should be twice as long as bone

not done until school age

Term

 

 

conductive hearing loss

Definition
caused by an abnormality in the transmission of soun wves through the ear canal, by the tympanic membrane, middle ear space, or middle ear ossicles.
Term

 

 

Sensorineural hearing loss

Definition
caused by abnormalities of the cochlea, auditory nerve, or the auditory pathways, which traverse the brainstem ending in the auditory cortex of the brain.
Term
Syndromes that include sensorineural hearing loss
Definition

Alport's

Jervell

Lange-Nielsen

Usher's Syndromes

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