The tympanic membrane, often known as the eardrum, is an important element of the human ear. It is made by a thin layer of soft tissues situated between the outer and middle ear. The tympanic membrane is 0.1mm thick and 9mm wide, with a weight of roughly 14 mg (Kitazawa 441). The human ear's tympanic membrane is resistant to injury and adaptable to a variety of circumstances. The tympanic membrane regulates the flow of fluids into and out of the ear. The breakage of the tympanic membrane may lead to the hearing loss, a situation that may interfere with the normal operation of the entire ear organ. The tympanic membrane consists of three major layers formed by numerous soft tissues; the layers include the external cutaneous layer, the middle layer of the ear usually consists of fibers that help in trapping dust and other foreign particles, as well as the mucous layer that found in the lining of the deepest surface. The tympanic membrane is supported by the thick threads of ligaments that are extremely adaptable to the changes in the body condition. The perforation of the tympanic membrane is as a result of injuries or the dusts that accumulate in the eardrum, a situation that can lead to the growth of the microorganisms that may corrode the soft tissues that support the tympanic membrane. The injuries may be brought about by explosive physical instances that may interfere with the entire head, cracks on the skull and when the ear is subjected to severe physical forces. In many cases, the perforation is brought about by the foreign materials in the ear e.g. cotton, bobby pins, and dust inserted in the outer auditory canal (Kitazawa 437).
There are several medical assessments history associated with the tympanic membrane that has been carried out in different hospitals. In Massachusetts General Hospital, a 40-year-old man was diagnosed with the tympanic membrane disorder on 22nd October 2016. The patient complained of right ear pain, the nurse carried out the assessment on the patient's ear. The result of the assessment revealed a bulging and red tympanic membrane on the right ear. During the examination, the nurse also observed that the auditory canal consisted of a small hole on the tympanic membrane using and otoscope. The above symptoms clearly indicate that the patient had a tympanic membrane disorder. Tympanic perforations can be considered secondary to otitis trauma. The examination of the ear also showed the loss of cone of light, the light reflected off the tympanic membrane. The damage in the ear can sometimes be partial or total depending with the nature of infection, the partial damages are usually easier to be identified than the total perforations that are characterized by the large holes. The patients associated with otitis condition and the copious discharge of pus should be treated with antibiotics. The traumatic perforations do not need initial treatment. The patients that show the symptoms of perforations should be advised not to insert objects into their ears.
On 14th February 2016, a nurse in Massachusetts General Hospital assessed a 49-year old patient who was feeling pain on the right ear. The assessment revealed that the patient had a new onset of acute otitis media (Kitazawa 441). According to the above information, the patient’s tympanic membrane appeared red. During the same assessment, the nurse carried out Rinne test to further determine the nature of the disorder. During the Rinne test, a nurse found out that the patient was able to hear the tuning fork placed on the mastoid process for about fifteen seconds. The same result could also be observed on the other ear. The above results were the result of the tympanic membrane disorder. The health assessment is a schedule that normally identifies the needs of a patient and how all the needs can be addressed to ensure patient safety. The skilled medical personnel is usually required in the mitigation of disorders that may cause health hazards. Medical or health assessment is usually done after the health history have been done in order to assess the health condition which can be done by carrying out a physical examination. The objective of the health examination is to identify and detect disorders and several diseases at their early stages of development. Many health professionals have separated physical assessment from health assessment in order to include the fundamental medical practices. Health history can enable the nurses to collect data and past medical information about the patients. The health assessment is, therefore, an essential procedure that can resolve some of the sensitive medical problems. Assessment of medical disorders relating to tympanic membrane is an essential process that can enable doctors to take early steps in mitigating the acute conditions that may lead to the loss of hearing.
Examining Thyroid Glands
Thyroid glands are located on the anterior side of the neck between the suprasternal notch and the cricoids cartilage found on the upper side of the glands. It consists of left lobe and right lobes that are connected by the isthmus. The isthmus provides coverage to the second, third, and fourth tracheal rings and the posterior curves that form the lobes in the tracheal glands. The normal glands of the thyroid normally weigh ten to twenty-five kilograms. These glands are usually invincible on the normal inspection and are usually difficult to palpate. The condition of goiter is usually an enlarged thyroid caused by different disorders in the thyroid glands. It is necessary to assess the size of thyroid glands in order to palpate the thyroid for its shape consistency, mobility, and tenderness. The normal thyroid is usually soft, symmetrical, smooth, and non-tender; the thyroid gland usually slides upwards when swallowing. The thyroid glands usually undergo symmetrical enlargements within the tracheal lining. The above situation occurs due to the deficiency of iodine. The thyroid disorders are normally characterized by Graves’ disease and Hashimoto’s thyroiditis. In the thyroid glands, thyroid nodules are usually common but occur incidentally. On the other hand, 10% of the thyroid nodules usually turn out to be malignant. The thyroid glands are usually multiple or single, they are usually firm and exhibit symmetrical goiter, typically resembles thyroiditis.
When examining the thyroid glands from the posterior position, it is necessary for the nurse or any other medical practitioner to ask the patients to slightly flex their necks, a situation that slightly relaxed sternomastoid muscles (Hegerova 349). From the rear part, patients usually reach for tracheal muscles by the use of both hands and they usually use their fingers to spot the thyroid marks from the upper part of the gland to the lower parts. Following the above procedure, they can also reach for hyoid bone found just beneath the thyroid cartilage and mandibles with the superior cricoids cartilage and suprasternal notch. When examining the thyroid glands from the anterior position, it is necessary to advise the patient to place their index fingers just under the cricoids cartilage. It is also necessary to ask the patients to swallow the saliva as before and feel for the thyroid isthmus moving up under the figure pads. The thyroid glands are not always palpable. The nurse should be able to feel for the size, consistency, and shape of the tenderness of any nodules. Using the fingers, the nurse should be able gently to move the trachea towards the left and reach for the right lobe near the space found in between the sternomastoid muscle and the trachea. The left lobe of the thyroid gland can also be observed using the left figure.
Patients suffering from the thyroid disorders and the tympanic membrane disorder can be subjected to subjective, objective, assessment and plans when managing the disorder. For the 49-year-old man described above, it is necessary to consider the conventional method of treatment and early treatment procedures through carrying out an assessment in order to mitigate the conditions at the earliest stages. For the 40-year-old man, the medical practitioner should record the historical disorder that may lead to the tympanic membrane disorder. The above patient encountered the ear problems through the dust and foreign materials.
There are several laboratory tests that can be used to identify the tympanic membrane disorder. The laboratory test disorders involve the measures of the movement of the tympanic membrane relative to the changes in the pressure. The pressure can be obtained from the gas pressure cylinder found in the laboratory. The normal levels for the test involve the normal operation of the ear system; this would mean lack of holes or foreign materials in the eardrum. Thyroid function is measured in the laboratory by the thyroid panel. The panel usually includes test for the free thyroxine and the Thyroid stimulating hormone.
References
Hegerova, Livia. "Metastasis to the thyroid gland: report of a large series from the Mayo Clinic." American journal of clinical oncology 38.4 (2015): 338-342.
Kitazawa, Taro. "Developmental genetic bases behind the independent origin of the tympanic membrane in mammals and diapsids." Nature communications 6 (2015).
