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Ears - Coggle Diagram

- - - - Up and back >3yo
      - Down & out <3 yo
      - Check unaffected ear first
- - - - monitors equilibrium
    - - Transmits sound to 8th cranial nerve
- - - - Initial: itching in ear canal
      - Pain with movement of pinna/chewing
      - conductive hearing loss caused by exudate and swelling
      - Inspection: canal is red, edematous; TM obscured
    - - Sticking or cracking sound on yawning, no dizziness
      - feeling of fullness in ear
      - No discharge
      - Conductive hearing loss as middle ear fills with fluid
      - Inspection: TM is retracted or bulging, impaired mobility, yellowish; air-fluid level and/or bubbles
    - - Aburpt onset, fever, irritability
      - Deep-seated earache that interferes with ADL, pulling at ear
      - Conductive hearing loss as middle ear fills with pus
      - TM with distinct erythema, thickened or clouding; bulging; limited or absent movement to positive or negative pressure
  - - - Problem can be in auditory canal, tympanic membrane or in middle ear
      - Objective data
        
        bone conduction heard longer than air conduction with Rinne Test
        
        Loss of low-frequency sounds
      - Causes:
        
        cerumen impaction
        
        Otitis Media with effusion
        
        otitis externa
        
        Foreign body
        
        otosclerosis
      - Subjective:
        
        hears better in noisy environment
        
        Speaks softly
    - - Disorder of inner ear:
        cochlea, associated structrs ro cranial nerve VIII
      - Subjective:
        
        C/o people mumble
        
        speaks loudly
        
        unable to hear in a crowded room
      - Objective:
        
        Air conduction heard longer than bone conduction with Rinne Test
        
        Loss of high-frequency sounds
    - - Caused by genetic and environmental factors
      - Subjective:
        
        sudden onset of severe vertigo r/t moving the head
        
        Hearing loss
        
        Whistling or roaring in the ear
        
        episodic
      - Objective
        
        Hearing loss
        
        imbalance
        
        nystagmus
    - - Aminoglycosides
      - Aspirin
      - Loop diuretics (lasix)
      - some chemotherapy
      - NSAIDS
  - - - Subjective
        
        spontaneous episodes that is severe initlaly and lessens over a few days
        
        difficulty walking
        
        vomiting
      - Objective
        
        spontaneous horizontal nystagmus
        
        staggering gait
    - - Subjective
        
        Episode of vertigo with head or body movement
        
        Lasts <1 min
      - Objective:
        
        May have no physical findings