Assessment Case History and Otoscopy

Question Answer
Audiologist are often the point of entry into the health care system for many patients. Why is this The auditory system is sensitive to other parts of the body especially neuro areas (brain) and may give info about heart attacks, strokes, or tumors so audiologist are often first health care professional to evaluate for a hearing leading to other areas
T or F hearing does not stop at the ears true
what is the purpose of the case history establish rapport/relaxed atmosphere and to gather information (probable hearing levels, possible etiology, probable rehabilitative needs)
T or F if an audiologist cries with patients, gives them a hug, or holds their hand they are crossing the "professional" line false
Do rehabilitative needs always mean fitting somebody with a hearing aid? No, we may need to retrain the brain
How can a case history be gathered 1. throughout the evaluation procedure 2. direct, highly specific, briefly stated questions 3. general questions before eval 4. more specific questions during or after eval if warranted
Is hearing loss a medical emergency Yes if it is a sudden onset
What are the parts of the adult case history ID info (name, age, occ), chief complaint/referral, audiologic/comm hist (onset, better ear, progressive, family hist, exposure, sp/lang), otologic hist (surgery, pain, tinnitus, dizzy, infection), current/recent med hist (disease, head injury, meds)
T or F ringing is the only sound classified as tinnitus False, may also be a wooshing from the carotid artery, or clicking of TMJ
If a patient says they are not experiencing dizziness we should clarify that they are not experiencing other sensations such as what off-balance, spinning, or light-headedness
T of F if there is something else going on with the patient that they believe is impacting their hearing such as seizures we should not be concerned with those things False, we need to take all bits of info into consideration
How do adult and child case history different child we are not asking about the work place but we will be concerned about their birth, development, and educational history
child case history should include what components chief complaint.referral, medical and otologic history, all adult things and pre & perinatal history, developmental history, and educational history
Audiologist are often the point of entry into the health care system for many patients. Why is this The auditory system is sensitive to other parts of the body especially neuro areas (brain) and may give info about heart attacks, strokes, or tumors so audiologist are often first health care professional to evaluate for a hearing leading to other areas
T or F hearing does not stop at the ears true
what is the purpose of the case history establish rapport/relaxed atmosphere and to gather information (probable hearing levels, possible etiology, probable rehabilitative needs)
T or F if an audiologist cries with patients, gives them a hug, or holds their hand they are crossing the "professional" line false
Do rehabilitative needs always mean fitting somebody with a hearing aid? No, we may need to retrain the brain
How can a case history be gathered 1. throughout the evaluation procedure 2. direct, highly specific, briefly stated questions 3. general questions before eval 4. more specific questions during or after eval if warranted
Is hearing loss a medical emergency Yes if it is a sudden onset
What are the parts of the adult case history ID info (name, age, occ), chief complaint/referral, audiologic/comm hist (onset, better ear, progressive, family hist, exposure, sp/lang), otologic hist (surgery, pain, tinnitus, dizzy, infection), current/recent med hist (disease, head injury, meds)
T or F ringing is the only sound classified as tinnitus False, may also be a wooshing from the carotid artery, or clicking of TMJ
If a patient says they are not experiencing dizziness we should clarify that they are not experiencing other sensations such as what off-balance, spinning, or light-headedness
T of F if there is something else going on with the patient that they believe is impacting their hearing such as seizures we should not be concerned with those things False, we need to take all bits of info into consideration
How do adult and child case history different child we are not asking about the work place but we will be concerned about their birth, development, and educational history
child case history should include what components chief complaint.referral, medical and otologic history, audiologic/comm history, current/recent medical history as well as per & perinatal history, developmental history, and educational history
Why is prenatal history so important some medications the mother was on could be ototoxic, maternal disease may have an impact, and rubella immunization (rubella was once leading cause of deafness)
perinatal history may include what conditions congenital infections, low birth weight, hyperbilirubinemia (jaundice), asphyxia, congenital cranio-facial abnormalities
what is a quick and easy way to find out from the parent if there were abnormalities when the baby was born ask if they were given the baby right away, if they were not given the baby right away there were abnormalities, can ask about APGAR but most wont remember the scores
What do we want to know about a child's developmental history speech-language milestones, motor milestones (sitting up/walking), auditory milestones
What are some of the big questions we want to know about a child's educational history are they on an IEP, did they repeat a grade, do they have trouble with spelling, reading, or math, how is their overall performance in school, do they have a learning disability
a child with a CAPD will often have trouble with what areas in school reading, spelling, or math
when a child has normal hearing but they are struggling in other areas in school where should we look next and why look beyond the ears at the brain/CAS
what is the fist step when doing otoscopy and why is this step so important inspecting and palpating the pinna and periauricular structures including the mastoid and lymph nodes to feel for any lumps or swelling (swelling of lymph nodes may indicate cancer), also look on top and behind the ears for melanoma
during otoscopy what should the inside of the ear look like canals should be clear but we are looking for anything that might be weird or alter the fitting of a hearing aid
what is congenital aural atresia a birth defect that is characterized by hypoplasia of the EAC and often associated with deformities of the auricle, middle ear, and occasionally the inner ear structures
if a person has a pit on their ear what could possibly happen it may be open or closed, if open it may lead all the way to the meninges of the brain and it could allow for infection to get in causing brain damage
if an infant has a tag or a pit should we be concerned yes
what is the shape of the TM, what are the 3 layers of tissue, and what are the 2 parts of the TM oval and slightly concave, 3 layers are 1.cutaneous layer 2.mucosal layer 3.fibrous layer, made up of the pars tensa (larger portion) and pars flaccia
what bone connects to the TM malleus
If the TM is healthy what ossicular landmarks should we be able to see umbo, manbrium of malleus, and short process of incus
what are some of the landmarks of the tympanic membrane annulus and cone of light
T or F if an ear is full of clear serous fluid it can be hard to tell that there is anything wrong and will often go away without an antibiotic true
T or F when the ear is filled with pussy green fluid there must be an antibiotic to help it recover true
when an ear is full of serous fluid what is often recommended watch and wait for 3 months
what is the only 100% way to cure otitis media and what might happen if you opt for a different option only way to cure is to punch a hold in the TM (tubes) while watching and waiting may cause sensory deprivation in kids because they are missing out on a lot
what is a cholesteotoma tissue growth in the ear after injury to the TM where the tissue grows back on itself and could eventually even fill the whole canal or even begin to break down the bone and reach the brain
what is atelectasic TM when there is negative pressure in the ear causing the TM to be sucked in and adhere to the ossicles (saranwrap ear)
T of F if a child has tubes and there is blood and puss draining out of their ears it is abnormal and we should take them to have it checked out false, its job is to get that stuff out of the ear
Where is cerumen produced in the ear ONLY in the lateral-most cartilaginous portion of the ear
what is the function of cerumen to be stick and catch things from going into the ear
Until December 7, 2016 all people had to have what before they could get a hearing aid and why was this required they were required to have an examination by a doctor or they could waive the exam unless they had one of 8 red flags, this was due to federal law that was passed in 1977
what are the 8 red flags the must be checked before getting a hearing aid vis congen/traumatic deform ear, hist active drainage last 90, hist sudden or rapidly progressive loss in last 90, acute or chronic diz, unilat loss of sudden or recent onset, ABG>equal 15DB 500 1/2K, vis cerumen accumulation/foreign body, pain/discomfort
FDA now says what about getting a haring aid they do not need medical clearance
T or F children must still be checked to get a hearing aid true
T or F hearing aid dispensers do not even need to make the list of red flags available to patients false

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