Ear Basins
Arnold Douch
Hosmer ear funnel
Kidney tray
Ear spouts / basins are of historical interest. They are convenient tools during clinical examination of ear. They can be used as a receptacle to collect fluids escaping from the ear.
Examination mirror And Bulls Eye Lamp
Head Mirror
The head mirror is a concave mirror . Diameter 89 mm and diameter of inner hole 19 mm . It has a hole in the centre. The approximate focal length of the mirror is about 25 cm or 10 inches . It has a plastic head band with a lever with 2 ball and socket joints. the joints are at right angles to each other.
BULLS EYE LAMP
The source of light is from a Bulls lamp. It is a semimobile source of illumination. It has a 100 watts milk white bulb which acts as the source of illumination. The light is focused with a plano convex lens placed in front of the bulb. Ideally the Bull’s lamp should be placed 6 inches above and behind the left shoulder of the patient, at the level of left ear of the patient.
Bulls eye Lamp
Otoscope
Modern otoscope design owes itself to the German otologist Wilhelm Kramer who developed a steel aural speculum with a distinct funnel shape that expanded when the two handles are separated. This was known as the Kramer’s speculum.
A standard Welch Allyn otoscope in use today owes much of its shape and design to Hartmann.
Otoscopy tips:
•It is held in the hand at the same side of the ear that is being examined
•Two grips used – pencil & hammer grips
•Good ear is examined first to prevent infection from infected ear spreading to good ear
•Speculum chosen should fit snugly into the ear canal
Pencil grip
The pencil grip allows the side of your hand to rest on the patient’s temple, reducing the risk of trauma if the patient suddenly moves his or her head (this is common when examining young children or patients with tender canals).
Hammer grip:
It is less satisfactory, however, because you have less control, which increases the risk of inflicting pain by pressing the speculum tip on to the skin of the canal wall.
Examine the good ear first. This has several advantages: it prevents the spread of infection into an unaffected ear, it usually allows you to see some normal anatomy with which to compare the other side, and also helps stop you relaxing once you have identified one abnormality, failing to see less obvious but often more important findings - a common problem of students. With the light source turned up full, use the otoscope as a torch to examine the pinna briefly for meatal abnormalities and previous surgical wounds.
Otoscope insufflator bulb which can be attached to the otoscope. Pressure can be increased at the level of ear drum by just compressing the bulb. Increased pressure would push the ear drum inwards. On releasing the pressure the drum would move outwards. This set up is used to test the mobility of ear drum.