EAR ASSESSMENT

EAR ASSESSMENT

NUR2173

LEARNING OBJECTIVES

At the end of this session, students should be
able to:

1. Describe the methods of ear assessment.
2. Measure the normal position of the ear.
3. Explain the types of tuning fork test:

i. Weber test
ii. Rinne test

METHODS OF EAR ASSESSMENT

• Inspection
• Palpation
• Otoscopic examination

PALPATION & PALPATE

• Use to assess auricle for masses, lesions,
deformity & placement.

– Move to check for pain.

• Assess for discharge.

OTOSCOPIC EXAMINATION

• Using otoscope with speculum.
• Use to assess ear canal:

– Normal = pink & intact
– May see Cerumen (ear wax)
– Check erythema & edema
– Check for tenderness

• Eardrum (Tympanic Membrane)

– Intact
– Color (pearly gray)

NORMAL EARDRUM

LOCATION OF THE EAR

NORMAL ABNORMAL

TUNING FORK TEST

• This test is useful in determining whether the
client has a conductive hearing loss (problem of
external or middle ear) or a perceptive hearing
loss (sensorineural).

• There are 2 types of test, 1)Rinne & 2) Weber
test.

• Using tuning fork.

WEBER TEST

1. Distinguishes between conductive and sensorineural
hearing.

2. Strike a 512 Hz tuning fork softly

3. Place the vibrating fork on the middle of the client's
head

4. Ask client if the sound is heard better in one ear or
the same in both ears

– If hearing is normal, the sound is symmetrical with no
lateralization

– Sound localizes toward the poor ear with a conductive loss
– Sound localizes toward the good ear with a sensorineural

hearing loss



NORMAL WEBER TEST

• Hear sounds equally in
both ears (No
Lateralization of sound)

CONDUCTION LOSS IN WEBER TEST

Sound localizes
toward the poor ear
with a conductive
loss

SENSORINEURAL LOSS IN WEBER TEST

Sound localizes toward
the good ear with a
sensorineural hearing
loss

RINNE TEST

1. Test compares air and bone conduction hearing.

2. Strike a 512 Hz tuning fork softly.

3. Place the vibrating tuning fork on the base of the mastoid
bone.

4. Ask client to tell you when the sound is no longer heard.

5. Note the time interval and immediately move the tuning
fork to the auditory meatus.

6. Ask the client to tell you when the sound is no longer heard..

7. Note the time interval and findings

– Normal hearing clients will note air conduction twice as long as bone
conduction (2:1)

– With conductive hearing loss, bone conduction sound is heard longer than or
equally as long as air conduction (BC>AC or BC=AC)

– With sensorineural hearing loss, air conduction is heard longer than bone
conduction in affected ear, but less than 2:1 ratio





NORMAL RINNE TEST

NORMAL Normal hearing clients
will note air conduction
twice as long as bone
conduction (2:1)

CONDUCTIVE LOSS IN RINNE TEST

With conductive
hearing loss, bone
conduction sound is
heard longer than or
equally as long as air
conduction
(BC>AC or BC=AC)

SENSORINEURAL LOSS IN RINNE TEST

With sensorineural
hearing loss, air
conduction is heard
longer than bone
conduction in
affected ear, but less
than 2:1 ratio