Ears, Nose, Throat

Otalgia

pain in the ear

Otitis externa

inflammation of the outer ear and ear canal

Otitis media

inflammation of the middle ear and tympanic
membrane

Pinna

Auricle or outer ear

Otorrhea

discharge from the ear

Vertigo

a spinning, twirling sensation

Epistaxis

Nosebleed, usually from anterior septum

Candidiasis

white, cheesy, curd like patch on buccal mucosa due to
superficial fungal infection

Caries

Decay in the teeth

Pharyngitis

Inflammation of the throat

Rhinitis

Red, swollen inflammation of the nasal mucosa

External Ear

Auricle, helix, lobe, tragus, mastoid

Ear sensory organ

hearing and maintaining equilibrium

External, middle, and inner ear

tympanic membrane

Auricle/pinna

Movable cartilage and skin

Three level of hearing

Peripheral, brainstem, cerebral cortex

sound, vibrations, electrical impulses, brain

Conductive hearing loss

Mechanical dysfunction in external or middle ear (cerumen buildup, otosclerosis, ototoxic)

Sensorineural/perceptive hearing loss

Pathological condition on inner ear, CN VIII, auditory areas of cerebral cortex, presbycusis

Mixed hearing loss

Combination of conductive and sensorineural causes

AC hearing

Air conduction

BC hearing

Bone conduction

Equilibrium

Inner ear: 3 semicircular canals/labyrinth feed info to brain about position of body

Infants and children ears

Eustachian tube (shorter/wider, more horizontal, increase risk of pathogens enter)

Otitis media (60% of children)

1-2 pull pinna straight back, 2-3 pull pinna up and back

Is baby babbling and responding to sounds

Tympanic Membrane

Pearly grey, white

Aging Adult Ears

Cartilage growth, cerumen buildup, presbycusis

Subjective Data Ear

Earache, infections, discharge, hearing loss, environmental noise, tinnitus, vertigo, patient-centered care

Ear Exam

Inspect and palpate external ear, no swelling of external auditory meatus, inspect with otoscope, testing hearing/balance (tunning fork test), Whisper test

Tympanic Membrane examination

Color/characteristic (shiny, translucent), cone shape of light (5 o’clock on right, 7 o’clock on left)

Signs and symptoms of hearing loss

Repeated statements, lip reads/watch faces closely, flat monotonous tone of voice, speech sounds are garbled, vowel sounds are distorted, inappropriately loud voice

Paranasal Sinuses

Frontal, maxillary, ethmoid, sphenoid

Salivary glands

Parotid, submandibular, sublingual

Pharynx

Oropharynx, nasopharynx, tonsils

Developmental Changes Mouth Children

2 ½ 20 deciduous teeth, teeth loss 6-12

Developmental Changes Mouth pregnant women

Nasal stuffiness, epistaxis, increase vascularity

Developmental Changes Mouth Aging adults

Decrease sense of smell/taste, decrease salvia production, tooth loss

Subjective Data mouth

Sores/lesions, sore throat, bleeding gums, toothache, hoarseness, dysphagia, altered taste, smoking/alcohol, dental

Objective Data Nose

Inspect/palpate nose (external nose; patency, Nasal Cavity: Rhinitis, Nasal septum , polypus?) Use thumbs to palpate sinus areas (under eyebrows below cheekbones

Objective Data mouth

Lips, teeth gums, tongue, palate, uvula, tonsils

Tonsil Grade +1

Visible

Tonsil Grade +2

Halfway between tonsillar pillars and uvula

Tonsil Grade +3

Touching the uvula

Tonsil Grade +4

Touching one another

Cleft lip

split/opening at top lip

Posterior Pharyngeal wall

Gag reflex: CN IX, X (glossopharyngeal, vagus) Halitosis

Thrush

Fungal infection on tongue

Oral cancer

Sore/ulcer

Harry Tongue

Brown on the tongue

Atrophic Glossitis

Loss of taste buds