1-9.
EXAMINATION OF THE EAR
a. The auditory canal is examined by means of an otoscope and ear speculum.
The patient normally sits in an upright position for the exam. The lighted otoscope is
inserted, using the largest speculum that will fit comfortably into the patient's external
ear canal.
b. Look through the eyepiece and examine the external ear canal for:
(1)
Discharge.
(2)
Impacted cerumen.
(3)
Inflammation.
(4)
Masses.
(5)
Foreign bodies.
c. Examine the tympanic membrane for:
(1)
Luster.
(2)
Transparency.
(3)
Integrity.
(4)
Scarring.
(5)
Color.
1-10.
AUDIOMETRY
a. Hearing tests are conducted with a device called an audiometer. This
apparatus produces sounds of specific frequencies and intensities. The patient sits in a
soundproof room and listens to the sounds over a set of earphones. Sounds of varying
frequency and intensity are than transmitted to each ear separately. The patient signals
when a sound is heard by raising his hand or pressing a button to indicate which ear
heard the sound. When a sound is transmitted and the patient does not signal, the
examiner records that the sound was not heard.
b. When this equipment is not available, a gross examination can be performed
using "field expedient techniques." Have the patient sit with eyes closed and ask him to
identify sounds made by an examiner moving in a perimeter around the patient. The
patient should identify from which direction the sound originated and the type of sound
heard. Sounds can be created by whistling, whispering, tapping, playing a radio, and so
forth.
MD0919
1-10