This is a physical examination of the external air and the tympanic membrane,
and the first thing that i'm gonna do before we get started is ask her a
couple of questions. Do you feel any pain or pressure? No. How about any
tenderness? No. Ok before we get started you want to make sure that you wash
hands and also that your equipment is clean. The next thing I'm gonna do is
I'm going to ask her to smile for me. Go ahead and smile. Ok.
What we're looking for here is any facial asymmetry. The facial nerve runs
through the middle ear so if there's facial asymmetry that can be an indication that
she has a middle ear infection
simply because that facial nerve runs through the middle ear, Ok the next thing I'm going
to do is going to turn my otoscope on and you do that by pressing this little
green button and twisting just like that. It turns on and you can see the little
light. Now what I'm going to do is I'm going to just shine a light on her external ear which is
called her pinna or Oracle and what I'm doing is just looking on this the front side
also looking behind her ear and i'm looking for any abnormalities and her
skin color, shape of her pinna, and also if there's any swelling or any growths or
anything like that.
Also, I wanted to show you different landmarks on the pinna,
so right here is the helix, right here is that anti helix, here is the lobule
the tragus is right here the antitragus,
concha is right here. Following the examination of the pinna we're going
to examine the external auditory canal and the tympanic membrane. Now what I'm
gonna do with put the speculum on the otoscope and it just twists on just like that,
turn it on again like that. What you what you want to do for this is an
adult's you want to pull the pinna superiorly and posterioly so up
and back, and then children you would want to pull inferiorly and posterior
early so down and back. What that does is that just straightens the
external auditory canal so you can view the tympanic membrane a little bit
better. So I'm gonna do that, also there is different sizes of speculum and you want
to choose the speculum that is the widest but still fits in the external auditory
canal comfortably for the patient. Now tell me if you feel any discomfort ok?
now what I'm gonna do with them and I pray for my pinky gonna pull up and back
and i'm looking for is looking for bodies in the inflammation redness blood
anything in there like that then also I'm looking at the tympanic membrane and
what i'm looking for on the tympanic membrane as several different landmarks.
First you'll see the cone of light on the tympanic membrane and that is just
basically a light reflex from the otoscope light and on the right ear is about five
o'clock and then the left ear it's about seven o'clock. Then also you will see
at the bottom of the base of the tympanic membrane the pars tempa at the
top of the tympanic membrane you'll see the pars flaccida then you'll also see
the shadow of the malleus and the incus,
and then after you're finished examining the external auditory canal on this side
you're gonna do the exact same thing on the other side.