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1. Unit-V
Nursing management of patients with
disorders and disease of ear, nose and
throat
By
Garima Srivastava
Nursing tutor

2. EAR
ANATOMY AND PHYSIOLOGY
Ear is considered with the functions of hearing and
equilibrium. The ear is divided into three: outer, middle
and inner section.

4. External ear
It is the only part which lies outside the skull.
It contains the following structure:
1. Pinna or auricle-
 funnel shaped organ
 Made of elastic fibrocartilage.
 Helps to collect sound waves.

5. Cont…
2. External auditory meatus-
 Small channel lined by skin and wax
 Conveys the vibrations of sound to the tympanic membrane

6. Middle ear
Small cavity in temporal bone.
It contains:
1. Tympanic membrane or ear drum
2. Two foramina in inner or medial wall( oval window and round
window)
3. Eustachian tube through which middle ear communicate with
nasopharynx.
4. Auditory ossicles (malleus, incus and stapes)

7. Inner ear
The inner ear contains:
1. Bony labyrinth- contains a fluid called perilymph.
2. Membranous labyrinth- contain a fluid called endolymph.
It contains 3 structures:
 vestibule
 cochlea (the organ of hearing)
 semicircular canals (organ of equilibrium)

8. Cont…….
VESTIBULES:
 Central part
Lies between cochlea in front and semicircular canals behind.
COCHLEA
Spiral canal which look like shell of snail.
Modiolus
Basilar membrane
Organ of corti

9. Cont……….
SEMILUNAR CANALS
Each ear has 3 semilunar canals which are placed at right angle to
each other. They are posterior, superior and lateral semilunar
canals.

10. MECHANISM OF HEARING

12. ASSESSMENT- HISTORY
 Obtain client’s appraisal of his or her hearing, including whether the client
experiences tinnitus.
• Observe for actions that suggest a hearing problem such as leaning forward,
turning the head, or cupping a hand to the ear to hear better.
• Document the use of a hearing aid.
• Ask client about allergies, a history of upper respiratory and middle ear
infections, high fevers, or exposure to loud sounds, because all these can cause
hearing loss.

13. Cont………
 Inspect external ear for signs of infection, such as swelling, redness,
drainage, or evidence of trauma.
•Shine a penlight into the ear to grossly inspect the ear canal;
straighten the ear canal by gently pulling the ear up and back for an
adult and downward and backward for small children.
•Palpate the areas in front of and behind the ear lobe for tenderness
and swelling.
• Perform a basic hearing acuity test.

14. EAR EXAMINATION
Basic Auditory Acuity Tests

15. Otoscopic Examination

16. Tuning Fork Tests

17. Romberg Test

18. DIAGNOSTIC STUDIES
Audiometry
Caloric Stimulation Test
Electronystagmography