By Wayne Rodrigues, M.ED., ATC , EMT-P Purpose is to look for - PowerPoint PPT Presentation

By Wayne Rodrigues, M.ED., ATC , EMT-P

 Purpose is to look for  Fluid  Perforations  Foreign Objects  Excessive Cerumen  Inflammation  Redness  Swelling Cuppett, 2012

 Translucent  Pearly gray in color  Concave in nature Cuppett, 2012

 Otitis Media  Viral infection of the middle ear  Often accompanies upper respiratory problems  Signs and symptoms  ear pain w/out tenderness to touch, fever, pressure- feeling, loss of hearing and dizziness  Required referral and treated with antibiotics and analgesics O’Conner, 2008 http://www.hearingprofessionals.co.nz/Images/The-Human- Ear.gif

MOI:   Growth of bacteria or fungus in outer ear resulting in outer ear infection.  Predisposing factors: dark wet environment and/or over- cleaning ears. S/s:   C/c constant pain and pressure in ear w/ associated itchiness. May c/o of hearing loss, dizziness. Ear canal appears red and irritated upon inspection. (+) Tug Test Mgt:   Refer for physician evaluation www.fpnotebook.com/ EntOtomycosis.jpg  Antibiotics Cuppet, 2012

 Symptoms are similar to otitis externa:  Canal swelling & errythemia itching, pain and decrease in hearing,  May be removed either by physician with tool or suctioning the object. http://images.medicinenet.com/images/illustrations/ear_wax.jp http://stallgeriatrics.com/education/KeyPrinciple2-EarWax.jpg

Normal Soft Cerumen Impacted soft brown cerumen Veil of cerumen eac.hawkelibrary.com/

MOI:   Sudden change in air pressure or impaled object S/s:   Excruciating pain in middle ear that radiates. Tinnitus. Marked loss of hearing, transient dizziness.  Blood or fluid may be viewed escaping from the ear or viewed through otoscope.  Any fluid noted in the ear canal be should be a red flag indicating rupture. Mgt:   Potential for associated basilar skull fx depending on MOI.  Cover with sterile gauze, and immediate referal.

Traumatic perforation Subtotal perforation of the tympanic membrane insect (ant) in external auditory meatus, www.rcsullivan.com/ www/forum/zlinsky/glueear1.jpg

 MOI: direct blow  S/s:  May or may not have deformity but bleeding usually present. Signs of direct trauma. Ecchymosis, and swelling often present.  C/c is pain on and around the nose  MGT: ice, stop bleeding and refer Cuppett, 2012

 MOI: direct blow  S/s:  Same as those associated with nasal fracture. May have difficulties breathing through involved side.  MGT:  Same as with nasal fracture Cuppett, 2012

Caused by:  Previous surgery  Trauma  Cocaine Use  Excessive nose picking  Cancer & other diseases  Complications:  Pain, bleeding, &  whistling sound Treatment:  Small: Saline solution & lubricating gels Large: Surgery http://www.webmd.com/allergies/tc/repair- of-nasal-septal-perforation-surgery-overview

Soft painless, non  cancerous growths within nasal lining. Caused by:  Inflammation, Asthma, reoccurring infections, immune disorder May lead to breathing  problems, Chronic infections Treated with Meds and  or surgery http://www.mayoclinic.com/health/nasal-polyps/DS00498

 Fungal infection involving mucous membranes in mouth.  Caused by fungus Candida alicans which is caused from antibiotics use and immunosuppression.  Signs and symptoms include creamy white plague on tongue, cheeks and palate which later develop into lesions.  Treat with topical or systemic antifungal medications Cuppett, 2012

 Gingivitis-swollen, red, or bleeding gums  Sensitivity to Hot or Cold Beverages caused from teeth demineralization http://www.blogaholics.ca/wp/uploads/illu_mouth.jpg  Halitosis (Bad breath)-poor dental hygiene and periodental disease  Plaque-fungal infections such as candidiasis http://www.acm.uiuc.edu/sigbio/project/digestive/early/mouth.jpg

Pharyngitis and Tonsillitis produce  throat pain, pain swallowing, and pain in the ears when swallowing Pharyngitis (Strep Throat)  Inspection: Erythematous in the throat with mucoid covering the pharynx. Tonsillitis Inspection: Inflamed  tonsils Laryngitis: causes changes in voice ,  hoarseness or complete inability to speak. Fever or dyspnea may occur. Upon inspection may notice purulent exudate on larynx. O’Conner, 2008

 Position patient in seated position with head turned downward and away.  Select the largest speculum that can be comfortably inserted in ear  Hold Otoscope in the same hand as the ear you examine. “Right to Right , Left to Left”  Rest ring & Little finger on patient’s cheek.  Pull the Pinna up & backwards to straighten canal  Watch your way into ear canal, never insert blindly.  Inspect the Tympanic Membrane Cuppett, 2012

 Rotate speculum to view all corners of the membrane and ear canal.  Inspect the membrane for  Color  Clarity  Position  Use of Otoscope http://www.youtube.com/watch?v=FqSCfqoCNiI Cuppett, 2012 https://www.google.com/search?q=Use+of+Otoscope&client

Allergies are typically  bilateral, infection is unilateral Infectious conjunctivitis  will spread quickly Treatment: Referral for  antihistamine (allergy) or antibiotics (infection) Eye infections with severe  px or photophobia may be more severe (Corneal http://www.healthanswersboard.com/blog/wp-content/uploads/2008/05/pink- injury or a herpes viral eye.jpg infection) O’Conner, 2008

 Blood in the anterior chamber of eye.  Caused by blunt trauma.  Signs & Symptoms:  Pain, Bleeding  Blurred Vision  Treatment: http://www.kellogg.umich.edu/theeyeshaveit/trauma/images/hyphema.jpg  Keep Head Elevated  Immediate referral to specialist Cuppett, 2012

 Bleeding under the conjunctiva  Caused by trauma, forceful cough, high BP, bleeding disorders  Treatment: Resolve in 1-3 weeks  Lack of trauma = normally benign O’Conner, 2008 http://www.tedmontgomery.com/the_eye/eyephotos/pics/SubconjunctivalHe morrhage.jpg

 Most common sports eye injury  Direct trauma from outside object  Object caught and rubbed  What are the signs and symptoms http://www.eyedoctom.com/eyedoctom/EyeI nfo/Images/CornealAbrasion.jpg associated with this pathology? O’Conner, 2008

 MOI:Forceful jarring, strong sneeze, no known cause.  Sx: Floaters, halos, blind spots, curtain falling over vision http://graphics8.nytimes.com/images /2007/08/01/health/adam/9931.jpg  Treatment: Referral to ophthalmologist O’Conner, 2008

 Chronic eye disease causing central field of vision loss.  Dry Degeneration  More common  Age related  Wet Degeneration  Blood vessels under the retina begin leaking blood and fluid. Refer to Ophthalmologist https://www.google.com/search?q=macular+degeneration http://www.mayoclinic.com/health/macular- degeneration/DS00284

https://www.google.com/search?q=macular+degeneration&clien http://www.hollows.org.au/eye-health/macular-degeneration

http://www.youtube.com/watch?v=wPzCA9k8GRQ

Cuppett, M., Walsh, K.M. (2012) General Medical Conditions in the Athlete (Second Edition) Elsevier-Mosby O'Connor, D. P., Fincher, A. L. (2008). Clinical Pathology for Athletic Trainers: Recognizing Systemic Disease (Second ed.). Thorofare, NJ: SLACK Incorporated.

 Extra and or Unusual Sounds during a heart beat  Range fro very faint to load  May hear a swishing or whooshing sounds  Classified as innocent(harmless) or Abnormal http://www.nhlbi.nih.gov/health/health-topics/topics/heartmurmur/ 

INNOCENT ABNORMAL  Children’s murmurs  Common in healthy typically caused by children heart defects at birth  Are not due to heart  Adult murmurs are problems caused by an acquired  May have been heard heart valve disease by child’s pediatrician  Typically will display as some point signs and symptoms of heart disease 

 Auscultation of Heart Sounds and Murmurs

 Cuppett, M., Walsh, K.M. (2012) General Medical Conditions in the Athlete (Second Edition) Elsevier-Mosby  http://www.youtube.com/watch?v=39n4XWv 7flQ  http://www.nhlbi.nih.gov/health/health- topics/topics/heartmurmur/  http://www.youtube.com/watch?v=ax9B6g6g EOc