3. Lesions
Drainage: Cerumen or wax is the only normal drainage.
Examination with otoscope: visual examination of the
auditory canal and tympanic membrane using an otoscope.
4. Hearing acuity : hearing tests
Whisper test: Ask the patient to obstruct one ear with the index
finger. The nurse should whisper some words. Have the patient
repeat the words heard.
Watch tick test:
5. Tunning fork test:
Weber test : The Weber test assesses lateralization of sound. To
perform the test, place a vibrating tuning fork on top of patient’s
head or forehead. Ask the patient if the vibration sounds is same
in both ears or different. Normally, the vibration is heard equally
in both ears.
6. Rinne test:
This test is used to compare air conduction and bone
conduction.
To perform this test, place a vibrating tuning fork on
patient’s mastoid process.
When the sound is no longer heard, immediately place
the vibrating fork about 1 inch in front of the external
auditory canal and continue until the patient can no
longer hear the sound.
Normally, air conduction > bone conduction
7.
8. Romberg’s test: Make patient to stand with
feet together, eyes opened, and then eyes
closed. Note patient’s ability to maintain
balance.
11. Sinuses: Inspect frontal sinuses above the
eyes and maxillary sinuses below the eyes.
Normal finding is no evidence of swelling
12. Palpation
Palpate external nose: Cartilaginous portion is slightly mobile.
Non tender, no masses.
Nasal septum: Midline placement is normal. Deviated nasal
septum is abnormal.
Nasal patency: Occlude each nostril and check patency.
13. Sinuses
Palpate frontal sinuses by pressing upward just
below eyebrows.
Palpate maxillary sinuses by pressing below eyes.
14. Inspection
Have the patient sit with the head tilted
backward and the mouth opened wide.
Oropharynx : Inspect for color, lesions, and drainage.
Inspect the oropharynx using a tongue depressor and penlight.
Tonsils: Check for color and size.
Uvula: Have patient say “AH!” and note symmetrical rise of the
uvula. Normally it is midline, pink, moist, without lesions.
Gag reflex: Elicit the gag reflex by pressing the posterior
tongue with a tongue depressor.
THROAT
15. Palpation
Lymph nodes: Palpate the nodes using finger pads
around neck. Normally not palpable.