*Umbo not umdo

• MISO: malleous → incus → stapes → oval window

Subjective measures of hearing loss

• How loud is the patient speaking?
• Are they asking you to repeat the question?

Inspect

• Prominence/Protrusion
• Erythema
• Edema
• Pus, crested?
• Comment on the landmarks
• Cauliflower ear

Examine the pinna

• Pull the pinna:

  • Up and back (adults)

    

  • Down and back (children)

Palpate

• Tug on the pinna – is it painful?
  • Painful - external ear infection
• Palpate the mastoid tip
  • !Mastoiditis

Otoscopy

• Preparation