| Course | PA 516 Comprehensive Clinical Module HEENT (Head, Ears, Eyes, Nose, Throat) |
|---|---|
| Week | 2 |
| Paper type | Tympanic membrane documentation |
| Length | About 790 words, 6 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 516 Week 2
Tympanic Membrane Documentation After Irrigation: An Amber, Retracted Right Drum With a Fluid Line, a Normal Left Drum and Each Landmark Recorded Ear by Ear for T.M.
Student Name
Chamberlain University
PA 516: Comprehensive Clinical Module HEENT (Head, Ears, Eyes, Nose, Throat)
Instructor Name
Month Day, Year
Tympanic Membrane Documentation After Irrigation: An Amber, Retracted Right Drum With a Fluid Line, a Normal Left Drum and Each Landmark Recorded Ear by Ear for T.M.
Conditions of the Examination
Date: one week after the first visit. T.M. used carbamide peroxide drops twice daily for six days. The right canal was irrigated with body-temperature water until clear, the step the cerumen guideline lists among first-line removal methods (Schwartz et al., 2017); the left canal needed nothing. Instrument: wall-mounted otoscope with a 4 mm speculum and a pneumatic bulb. T.M. was seated, head tilted away from each examined ear. Lighting and seal were adequate on both sides after irrigation.
Right Ear
Canal: mildly erythematous along the floor after irrigation, no laceration, no residual cerumen, no discharge.
Membrane, whole: intact, no perforation seen in any quadrant.
Color and translucency: amber and less translucent than the left, with a thin curved line in the lower half that moved slightly when T.M. swallowed, read as an air-fluid level.
Cone of light: absent; only a faint scattered reflex anteroinferiorly.
Malleus: the handle appeared shortened and more horizontal than on the left, and the short process stood out prominently.
Pars flaccida: visible, no pocket or crust, no keratin debris.
Mobility: reduced on gentle pneumatic pressure, with no outward movement on release.
Left Ear
Canal: clean, skin intact.
Membrane: intact, gray and translucent.
Cone of light: sharp, pointing anteroinferiorly.
Malleus: handle and short process seen in normal position.
Pars flaccida: no retraction.
Mobility: brisk inward and outward movement with the bulb.
Position Is Not a Verdict
The right membrane is retracted. That is a statement about position: the drum sits closer to the middle ear than normal, which is why the malleus handle looks foreshortened and the short process prominent. Retraction is consistent with negative middle ear pressure from a eustachian tube that is not opening, but the note does not say why the tube is failing. The diagnosis is a separate step, and the documentation should not slip it into the description of the drum.
Reading the Two Sides Together
The fluid line, the amber color and the reduced mobility together describe a middle ear effusion on the right only. In children, effusion after a cold is common and often clears without treatment; the guideline on effusion was written for children and gives little direction for adults (Rosenfeld et al., 2016). In an adult, a persistent effusion in one ear alone is less common and is the finding that will need to be explained, which is why the record must be precise about which side it is on.
The Parts No Light Reached
The posterosuperior part of the right drum was partly hidden by a bony overhang of the canal wall, and the attic was seen only through the pars flaccida. The ossicles beyond the malleus were not visible, which is normal through an intact drum. The middle ear space, the eustachian tube opening and the nasopharynx behind it were not examined, because an otoscope cannot reach them. Those limits are written here so the next examiner does not assume they were checked.
Comparison With the First Visit
At the first visit the right drum could not be seen at all, so there is no earlier right-sided finding to compare with, and the record says that rather than implying a change. The left drum looks the same as it did a week ago. The hearing complaint is unchanged: T.M. still reports that voices on the right sound as if they come through a wall, and that the CB radio is easier to hear with the left ear turned toward it. Clearing the wax did not improve the muffling, which matters, because it means the wax was hiding the problem rather than causing it.
What the Record Leaves for Next Time
Three things are left open for later visits and are written here so they are not lost. First, the hearing loss has not been characterized: a tuning fork test is planned for the next visit, and formal audiometry may follow. Second, the effusion has an onset date only from T.M.'s memory, about five weeks before this visit, so its duration should be tracked from today's documented finding. Third, the reason for a one-sided effusion in an adult has not been addressed. A follow-up visit was booked in two weeks, and T.M. was asked to return sooner for ear pain, discharge or dizziness.
References
Rosenfeld, R. M., Shin, J. J., Schwartz, S. R., Coggins, R., Gagnon, L., Hackell, J. M., Hoelting, D., Hunter, L. L., Kummer, A. W., Payne, S. C., Poe, D. S., Veling, M., Vila, P. M., Walsh, S. A., & Corrigan, M. D. (2016). Clinical practice guideline: Otitis media with effusion (update). Otolaryngology-Head and Neck Surgery, 154(1 Suppl.), S1-S41. https://doi.org/10.1177/0194599815623467
Schwartz, S. R., Magit, A. E., Rosenfeld, R. M., Ballachanda, B. B., Hackell, J. M., Krouse, H. J., Lawlor, C. M., Lin, K., Parham, K., Stutz, D. R., Walsh, S., Woodson, E. A., Yanagisawa, K., & Cunningham, E. R. (2017). Clinical practice guideline (update): Earwax (cerumen impaction). Otolaryngology-Head and Neck Surgery, 156(1 Suppl.), S1-S29. https://doi.org/10.1177/0194599816671491
What the PA 516 Week 2 assignment asks for
Week two asks for a written otoscopic record of both ears. Begin with the conditions: any wax removal, the instrument and speculum, patient position and whether pneumatic testing was done. Then document each ear in its own block, never merging them. Report the canal before the membrane, since a narrowed or inflamed canal changes what follows. Describe the membrane in named parts, including the light reflex, the handle and short process of the malleus, the pars flaccida, color, translucency and mobility. Keep descriptions of position, such as bulging or retraction, separate from any diagnosis. Compare the two sides only after both are recorded. Finish with the parts of the ear the light did not reach and what remains for later visits. Cite the guideline that frames your findings.
How the PA 516 Week 2 example is put together
The record opens with six days of carbamide peroxide, irrigation of the right canal with body-temperature water as the cerumen guideline allows, and an otoscope with a 4 mm speculum and bulb. The right block lists an irritated canal floor, an intact amber drum, a curved fluid line that shifts on swallowing, no light reflex, a foreshortened malleus with a prominent short process and reduced pneumatic movement. The left block repeats each landmark as normal. A section on position explains retraction as negative pressure without naming its cause. A reading of both sides together cites the effusion guideline and observes that it covers children. Separate sections compare the visit with the first, list the posterior canal overhang and unseen nasopharynx, and set a follow-up in two weeks with return advice for pain or dizziness.
Where the points sit in the PA 516 Week 2 rubric
Points for this documentation track organization and precision. A record that blends both ears into one paragraph, or reports the membrane before the canal, loses heavily because a grader cannot check each landmark against its side. Strong marks come from naming the parts of the drum individually and describing color, translucency and mobility rather than writing a single word like normal or abnormal. Faculty deduct for diagnosis slipped into description, such as calling a retracted drum infected. Conditions at the top earn credit when they explain how good the view was. The section on unreached areas is weighted more than students expect, since it shows the examiner knows the otoscope's limits. Citations should be current clinical guidelines and must match the reference list.
Common PA 516 Week 2 mistakes, and how to avoid them
Marks slip away on this record when a draft becomes a narrative paragraph that mixes the two ears or skips mobility. If you send your case findings and the documentation template your instructor uses, the custom sample will lay out each ear in its own block, landmark by landmark, in the order the template expects. Conditions such as wax removal or a crying child are written at the top so the reader can judge the view. Positions are described plainly and kept apart from the impression. A section listing what was not seen is added, matched to your case. If your course requires a particular guideline or atlas, the sample cites it. The record you submit should rest on your own examination notes, with the model used only to check order and wording.
Get a PA-516 Week 2 example written to your instructions
Send the Week 2 instructions and any documentation template your classroom posted, and a custom tympanic membrane record is written to those headings and returned inside 24 to 48 hours, first one free. If the week has you examine a live patient, that examination and any image of it stay outside this; the sample covers the written form around them.
More PA 516 papers and MPAS samples
- PA 516 Week 1: Hidden Eardrum Discussion Post
- PA 516 Week 3: Tuning Fork Interpretation
- PA 516 Week 4: Fundoscopic Exam Limits
- PA 516 Week 5: Visual Acuity Documentation
- PA 516 Week 6: Referred Pain Mapping
- PA 516 Week 7: Sinus Imaging Rationale
- PA 516 Week 8: ENT Referral Letter
- PA 514 Week 2: Exposure History Timeline
- PA 512 Week 2: CBC Interpretation Write-Up
- PA 510 Week 2: Lesion Morphology Description
- PA 505 Week 2: MSE Narrative
PA 516 Week 2 questions, answered
What if the canal was completely blocked?
Then the record says so and stops there, which is a complete answer rather than a failed one. Finished examples state the obstruction, name what it prevented, and say what would have to change before the membrane could be described at all. What loses points is a set of landmark statements written as though the drum had been seen straight through the blockage.
Does mobility have to be included?
Only where your section's template carries a row for it, since not every classroom includes pneumatic insufflation. Where it is included, the finished record pairs the finding with the method, because mobility is a claim about something that was done rather than about something that was looked at. Send the template and the example follows whichever version applies.
Should the record end with a diagnosis?
Many templates ask for a brief impression and mark it lightly. In the finished examples it stays one sentence and stays consistent with the described findings, naming what the appearance is compatible with rather than declaring a condition outright. An impression reaching past the landmarks recorded above it is the mismatch faculty look for first.
Where can I find a free PA 516 Week 2 sample paper?
The complete PA 516 Week 2 eardrum record is on this page, an amber, retracted right drum with a fluid line and a normal left drum, each ear in its own block.
Does the PA 516 Week 2 sample give a diagnosis?
No. It describes retraction and fluid as positions and findings, and leaves the reason for the one-sided effusion to later weeks.