ARCHETYPE Examination of External Auditory Canal and Tympanic Membrane (openEHR-EHR-CLUSTER.exam_tympanic_membrane.v1)

ARCHETYPE IDopenEHR-EHR-CLUSTER.exam_tympanic_membrane.v1
ConceptExamination of External Auditory Canal and Tympanic Membrane
DescriptionPhysical examination of the external auditory canal and tympanic membrane by a clinician.
UseUse to record the findings on physical examination of the external auditory canal and tympanic membrane by a clinician., including details of any perforation. Specifically designed to be used within the OBSERVATION.exam-ear archetype, but may be used within any clinically appropriate ENTRY or CLUSTER archetype. Please note: this archetype has been designed specifically to reflect current practice within the NT Hearing Health program. It is recognised that this is not currently reflecting a maximal dataset and may need to be extended in future revisions as more specific requirements are identified.
MisuseNot to be used to record findings of the physical examination of other parts of the ear, such as pinna and mastoid region - use other purpose-built archetypes for this purpose.
PurposeFor recording the findings on physical examination of the external auditory canal and tympanic membrane by a clinician.
ReferencesCommunication with clinical domain experts associated with Australia's Northern Territory Hearing Health Program.

Northern Territory Government, Department of Health: Hearing Health Program ENT Specialist Consultation Form 2011 12 07.

Northern Territory Government, Department of Health: Northern Territory Hearing Health Program Teleotology Nurse Consultation Form 2011 12 07.

Northern Territory Government, Department of Health: Northern Territory Hearing Health Program Audiologist Consultation Form 2011 12 07.

OATSIH: The Recommendations for Clinical Care Guidelines on the Management of Otitis Media in Aboriginal and Torres Strait Islander Populations (2010). Available at: http://www.health.gov.au/internet/publications/publishing.nsf/Content/CA2578620005D57ACA25792800821BE8?OpenDocument.
Copyright© openEHR Foundation
AuthorsIme avtorja: Heather Leslie
Organizacija: Ocean Informatics
e-Pošta: heather.leslie@oceaninformatics.com
Datum izvora: 2012-09-03
Other Details LanguageIme avtorja: Heather Leslie
Organizacija: Ocean Informatics
e-Pošta: heather.leslie@oceaninformatics.com
Datum izvora: 2012-09-03
OtherDetails Language Independent{references=Communication with clinical domain experts associated with Australia's Northern Territory Hearing Health Program. Northern Territory Government, Department of Health: Hearing Health Program ENT Specialist Consultation Form 2011 12 07. Northern Territory Government, Department of Health: Northern Territory Hearing Health Program Teleotology Nurse Consultation Form 2011 12 07. Northern Territory Government, Department of Health: Northern Territory Hearing Health Program Audiologist Consultation Form 2011 12 07. OATSIH: The Recommendations for Clinical Care Guidelines on the Management of Otitis Media in Aboriginal and Torres Strait Islander Populations (2010). Available at: http://www.health.gov.au/internet/publications/publishing.nsf/Content/CA2578620005D57ACA25792800821BE8?OpenDocument., MD5-CAM-1.0.1=8F6D4152A87D3B1BC1640C989B5CC83C}
Keywordsinspection, ear, tympanic, perforation, drum, canal, otoscopic, exam, examination, pneumatic, otoscopy, membrane
LifecycleCommitteeDraft
Language useden
Citeable Identifier1075.67.711
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Physical examination of the external auditory canal and tympanic membrane by a clinician., archetypeConceptComment=null, otherContributors=Anthony Leech, Hearing Health, Australia
Stephen Chu, NEHTA, Australia
Marissa Cookson, Dept of Health, Australia
Graeme Crossland, Northern Territory, Australia
Kathy Currie, Northern Territory Health, Australia
Jacques de Haan, Alice Springs Hospital, Australia
Jade Frederiksen, Hearing Health Program, DoH, Australia
Sam Heard, Ocean Informatics, Australia
Paul Hickey, Hearing Health Program, Australia
Oliver Hosking, Remote Health NT, Australia
Amanda Leach, Menzies School of Health Research, Australia
Kerrie Lee, Ngaanyatjarra Health Service, Australia (Editor)
Heather Leslie, Ocean Informatics, Australia (Editor)
Ian McNicoll, Ocean Informatics, United Kingdom
Hemi Patel, Royal Darwin Hospital, Australia
Fiona Wake, RAHC, Australia
Christine Wigger, Menzies School of Health Research, Australia, originalLanguage=en, translators=, subjectOfData=brez omejitev, archetypeTranslationTree=null, topLevelToAshis={source=[], state=[], description=[], content=[], provider=[], ism_transition=[], events=[], details=[], identities=[], contacts=[], activities=[], relationships=[], context=[], capabilities=[], other_participations=[], data=[], credentials=[], items=[ResourceSimplifiedHierarchyItem [path=/items[at0097], code=at0097, itemType=ELEMENT, level=1, text=Ear Examined, description=Identification of the ear under examination., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Left [The left external auditory canal and tympanic membrane.]
  • Right [The right external auditory canal and tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001], code=at0001, itemType=ELEMENT, level=1, text=Clinical Description, description=Narrative description of findings observed by a clinician during a physical examination of the external auditory canal and tympanic membrane., comment=Use this data element to provide additional, narrative description of any data elements related to the external auditory canal and tympanic membrane examination as a whole, that are not represented by structured values. For example, the relative size and surface of the auditory canal; increased vascularity of the tympanic membrane; presence of abnormalities not captured in specific structured data elements, such as presence of canal stenosis, exostoses, mastoid bowl/cavity or tumours., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106], code=at0106, itemType=ELEMENT, level=1, text=Consistency of Wax, description=Description of the type of wax in the external auditory canal., comment=Presence of hard wax has implications on treatment decisions. Presence of soft wax may be a causative factor in visual occlusion., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Hard [The wax is hard.]
  • Soft [The wax is soft.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0109], code=at0109, itemType=ELEMENT, level=1, text=State of Wax, description=Description of the state of the wax observed in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Impacted [Ear wax is tightly packed in the external auditory canal, such that it may be hard to remove or cause difficulty with hearing.]
  • Not impacted [Ear wax is not tightly packed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002], code=at0002, itemType=ELEMENT, level=1, text=View of Tympanic Membrane, description=View of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Full view [All of the tympanic membrane was visualised.]
  • Partial occlusion [Part of the tympanic membrane was not clearly visualised, but sufficient to permit a clinical opinion to be formed.]
  • Total occlusion [None of the tympanic membrane visualised, such that a clinical opinion of the state of the tympanic membrane could not be formed.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006], code=at0006, itemType=ELEMENT, level=1, text=Reason for Occlusion of View, description=Description of the reason for occlusion to the view of the tympanic membrane., comment=For example, soft wax or foreign body., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0139], code=at0139, itemType=ELEMENT, level=1, text=Tenderness of Canal, description=Presence of tenderness in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Tenderness is noted in the external auditory canal wall.]
  • Absent [Tenderness is not noted in the external auditory canal wall.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0132], code=at0132, itemType=ELEMENT, level=1, text=Oedema of Canal, description=Presence of oedema in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Oedema is observed in the external auditory canal wall.]
  • Absent [Oedema is not observed in the external auditory canal wall.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0124], code=at0124, itemType=ELEMENT, level=1, text=Erythema of Canal, description=Presence of erythema or redness in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Erythema, or redness, is observed in the wall of the external auditory canal.]
  • Absent [There is no erythema or redness observed in the wall of the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0143], code=at0143, itemType=ELEMENT, level=1, text=Offensive Odour, description=Presence of any offensive odour originating from the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [An offensive odour is noted as originating from the external auditory canal.]
  • Absent [No odour is noted as originating from the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0157], code=at0157, itemType=ELEMENT, level=1, text=Discharge Type, description=Type of discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Serous [The discharge appears to consist mostly of clear, watery fluid.]
  • Bloody [The discharge appears to consist mostly of blood.]
  • Purulent [The discharge appears to consist mostly of pus.]
  • Mucous [The discharge appears to consist mostly of a thick, mucoid substance.]
  • Mucopurulent [The discharge appears to consist of both mucous and pus.]
  • Haemoserous [The discharge appears to consist of both blood and clear, watery fluid.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0151], code=at0151, itemType=ELEMENT, level=1, text=Discharge Amount, description=Amount of discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No discharge is observed in the external auditory canal.]
  • Scant [A small amount of discharge is observed in the external auditory canal.]
  • Moderate [A moderate amount of discharge is observed in the external auditory canal.]
  • Profuse [A profuse amount of discharge is observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0156], code=at0156, itemType=ELEMENT, level=1, text=Discharge Description, description=Narrative description of the discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0166], code=at0166, itemType=ELEMENT, level=1, text=Ventilation Tube Position, description=Observed position of the ventilation tube (or grommet) in the tympanic membrane or the auditory canal., comment=There is value in identifying the presence of ventilation tubes in all examinations. There is no value in recording the absence of ventilation tubes if they have never been inserted. Note, however, that it is useful to record the extrusion of ventilation tubes if there is a known history of previous ventilation tube insertion., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • In situ [The ventilation tube is located in situ in the tympanic membrane.]
  • Partially extruded [The ventilation tube is partially extruded from it's original position in the tympanic membrane.]
  • Extruded - remains in canal [The ventilation tube has been extruded from the tympanic membrane but is visualised within the external auditory canal.]
  • Extruded - missing [The ventilation tube has been extruded from the tympanic membrane and is not visualised anywhere within the external auditory canal.]
  • Unknown [The position of the ventilation tube cannot be determined because the tympanic membrane is obscured and the ventilation tube is not observed within the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064], code=at0064, itemType=CLUSTER, level=1, text=Abnormal Features, description=Details about abnormal features noted during the examination of the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0112], code=at0112, itemType=ELEMENT, level=2, text=Polyps, description=Presence of polyp/polyps in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Polyps are observed in the external auditory canal.]
  • Absent [No polyps are observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0147], code=at0147, itemType=ELEMENT, level=2, text=Fungal Spores, description=Presence of fungal spores in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Fungal spores are observed in the external auditory canal.]
  • Absent [No fungal spores are observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0159], code=at0159, itemType=ELEMENT, level=2, text=Foreign Body, description=Presence of a foreign body in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [A foreign body is present in the external auditory canal.]
  • Absent [A foreign body is present in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0163], code=at0163, itemType=ELEMENT, level=2, text=Location of Foreign Body, description=Location of the foreign body within the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Outer canal [The foreign body is located in the outer part of the external auditory canal.]
  • Deep canal [The foreign body is located in the deep, inner part of the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104], code=at0104, itemType=CLUSTER, level=1, text=Tympanic Membrane Details, description=Details about findings on examination of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Membrane Intact?, description=Is the tympanic membrane intact?, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Intact [The tympanic membrane appears intact.]
  • Perforated [The tympanic membrane appears perforated.]
  • Indeterminate [It is not possible to tell if the tympanic membrane is intact or perforated.]


Možni razlogi za odsotnost vrednosti (''null''):
  • unknown
  • no information
  • not applicable
  • masked
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0018], code=at0018, itemType=ELEMENT, level=2, text=Appearance, description=Category describing the appearance of the tympanic membrane., comment=In most situations, this data element would only be recorded if the tympanic membrane is intact., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Translucent [The tympanic membrane appears healthy.]
  • Opaque [The tympanic membrane appears dull and opaque.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Normal Light Reflex, description=Presence of a normal light reflex noted., comment=In most situations, this data element would only be recorded if the tympanic membrane is intact. A 'normal' light reflex may be described as : a complete, bright triangular area of reflected light seen in the anteroinferior portion of the tympanic membrane., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [A normal light reflex is visible.]
  • Absent [A normal light reflex is not visible.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Surface Features, description=Features observed on the surface of the tympanic membrane., comment=Data element has multiple occurrences to enable multiple selections, if required. In most situations, this data element would only be recorded if the tympanic membrane is intact., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Blistering present [Blistering is observed on the surface of the tympanic membrane.]
  • Scarring present [Scarring is observed on the surface of the tympanic membrane.]
  • Granulation present [Granulation is observed on the surface of the tympanic membrane.]
  • Thickening present [Thickening is observed on the surface of the tympanic membrane.]
  • Tympanosclerosis present [White patches, consistent with tympanosclerosis, are observed on surface of the tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0028], code=at0028, itemType=ELEMENT, level=2, text=Colour, description=Description of the overall colour of the tympanic membrane., comment=For example: red, bluish, or yellow. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010], code=at0010, itemType=CLUSTER, level=2, text=Landmark Anatomy, description=Details about visibility of anatomical landmarks of the middle ear at the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Annulus, description=Narrative description of the Annulus., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0015], code=at0015, itemType=ELEMENT, level=3, text=Malleus Handle, description=Narrative description of the Malleus Handle., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0016], code=at0016, itemType=ELEMENT, level=3, text=Malleus Head, description=Narrative description of the Malleus Head., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0017], code=at0017, itemType=ELEMENT, level=3, text=Umbo, description=Narrative description of the Umbo., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0061], code=at0061, itemType=ELEMENT, level=3, text=Incus, description=Narrative description of the Incus., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0060], code=at0060, itemType=ELEMENT, level=3, text=Stapes, description=Narrative description of the Stapes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0034], code=at0034, itemType=ELEMENT, level=2, text=Location of Tympanosclerosis, description=Description of the location of any tympanosclerosis observed on the tympanic membrane., comment=May be coded with an external terminology, if desired, and be expressed as multiple occurrences for multiple sites., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0035], code=at0035, itemType=ELEMENT, level=2, text=Position of Tympanic Membrane, description=Description of the position of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Bulging [The tympanic membrane appears to be bulging.]
  • Neutral [The tympanic membrane is in a normal, neutral position - neither bulging or retracted.]
  • Retracted [The tympanic membrane appears to be retracted.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0040], code=at0040, itemType=ELEMENT, level=2, text=Description of Retraction, description=Description of retraction of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0044], code=at0044, itemType=SLOT, level=2, text=Retraction Grade, description=Description of retraction using formal classification/grading., comment=For example: Sade Classification or Tos Classification, typically used by ENT specialists., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Vključi:
openEHR-EHR-CLUSTER.sade_classification.v1 in specializacije ali
openEHR-EHR-CLUSTER.tos_classification.v1 in specializacije, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0048], code=at0048, itemType=ELEMENT, level=2, text=Fluid Level Presence, description=Presence of a fluid level behind the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [A fluid level is observed behind the tympanic membrane.]
  • Absent [A fluid level is not observed behind the tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0051], code=at0051, itemType=ELEMENT, level=2, text=Fluid Level Description, description=Narrative description of the fluid level and other related features observed behind the tympanic membrane., comment=For example, presence of bubbles., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0052], code=at0052, itemType=ELEMENT, level=2, text=Mobility, description=Description of mobility of the tympanic membrane, usually as determined by pneumatic otoscopy., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Immobile [There is minimal or no movement of the tympanic membrane when positive pressure is applied.]
  • Hypomobile [The tympanic membrane moves with less excursion and in a more sluggish fashion when positive pressure is applied.]
  • Mobile [The tympanic membrane shows a crisp inward (medial) movement (approx 1mm) with positive pressure.]
  • Hypermobile [There is exaggerated movement of the tympanic membrane when positive pressure is applied.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062], code=at0062, itemType=CLUSTER, level=2, text=Perforation Details, description=Details about the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0065], code=at0065, itemType=ELEMENT, level=3, text=Estimation of Size, description=Estimation of the size of the tympanic membrane perforation, based on anatomical landmarks., comment=Many clinicians record perforations between the well defined 'pinhole' and 'subtotal' perforations using a variety of terms with inconsistent usage and definitions, such as small, medium and large. 'Intermediate' has been proposed as a means to minimise inter-clinician variability for documenting the size of all perforations falling between the 'pinhole' and 'subtotal' definitions. If more detail is required, then measurement of the perforation should be recorded., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Pinhole [A pinhole perforation is present in the tympanic membrane.]
  • Intermediate [A perforation is present in the tympanic membrane, that is larger than a pinhole but smaller than a subtotal perforation.]
  • Subtotal [A subtotal perforation is present in the tympanic membrane: the pars tensa is absent but the perforation does not include the annulus.]
  • Total [A total perforation is present in the tympanic membrane; the tympanic membrane is essentially absent.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0070], code=at0070, itemType=SLOT, level=3, text=Measurement, description=Direct measurement of the size of the tympanic membrane perforation, usually using a photograph as the source for direct measurement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Vključi:
openEHR-EHR-CLUSTER.dimensions.v1 in specializacije, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0074], code=at0074, itemType=ELEMENT, level=3, text=Region, description=Description of the region of the tympanic membrane perforation., comment=To document if the perforation is in the Pars flaccida and may be potentially unsafe. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant. Coding with a terminology is preferred, if possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Pars flaccida [The tympanic membrane perforation is located in the pars flaccida.]
  • Pars tensa [The tympanic membrane perforation is located in the pars tensa.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0071], code=at0071, itemType=ELEMENT, level=3, text=Marginal?, description=Location of the tympanic membrane perforation., comment=To document explicitly whether the perforation is located marginally, and therefore might be clinically unsafe. If 'Total' is selected in 'Estimation of Size' data element then this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Central [The perforation is not involving the annulus and is bounded on all sides by the remnant of the tympanic membrane.]
  • Marginal [The perforation involves the annulus of the tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0076], code=at0076, itemType=ELEMENT, level=3, text=Anterior?, description=Is an anterior perforation present?, comment=To document the presence of perf in the anterior portions of the pars tensa can be more difficult to manage. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [An anterior perforation is present in the pars tensa.]
  • Absent [An anterior perforation is not present in the pars tensa.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0079], code=at0079, itemType=ELEMENT, level=3, text=Edge, description=Narrative description of the edge of the perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0172], code=at0172, itemType=ELEMENT, level=1, text=Image, description=Multimedia image taken during the physical examination of the external auditory canal and tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=image/cgm, image/gif, image/png, image/tiff, image/jpeg, video/BT656, video/CelB, video/H261, video/H263, video/H263-1998, video/H263-2000, video/quicktime, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0105], code=at0105, itemType=ELEMENT, level=1, text=Clinical Interpretation, description=Single word, phrase or brief description representing a summary of the examination findings., comment=Coding with a terminology is preferred, if possible. For example, normal examination or chronic otitis media., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0173], code=at0173, itemType=ELEMENT, level=1, text=Comments, description=Additional narrative about the physical examination findings of the external auditory canal and tympanic membrane, not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], protocol=[], target=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Obvezno, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0097], code=at0097, itemType=ELEMENT, level=1, text=Ear Examined, description=Identification of the ear under examination., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Left [The left external auditory canal and tympanic membrane.]
  • Right [The right external auditory canal and tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001], code=at0001, itemType=ELEMENT, level=1, text=Clinical Description, description=Narrative description of findings observed by a clinician during a physical examination of the external auditory canal and tympanic membrane., comment=Use this data element to provide additional, narrative description of any data elements related to the external auditory canal and tympanic membrane examination as a whole, that are not represented by structured values. For example, the relative size and surface of the auditory canal; increased vascularity of the tympanic membrane; presence of abnormalities not captured in specific structured data elements, such as presence of canal stenosis, exostoses, mastoid bowl/cavity or tumours., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0106], code=at0106, itemType=ELEMENT, level=1, text=Consistency of Wax, description=Description of the type of wax in the external auditory canal., comment=Presence of hard wax has implications on treatment decisions. Presence of soft wax may be a causative factor in visual occlusion., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Hard [The wax is hard.]
  • Soft [The wax is soft.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0109], code=at0109, itemType=ELEMENT, level=1, text=State of Wax, description=Description of the state of the wax observed in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Impacted [Ear wax is tightly packed in the external auditory canal, such that it may be hard to remove or cause difficulty with hearing.]
  • Not impacted [Ear wax is not tightly packed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0002], code=at0002, itemType=ELEMENT, level=1, text=View of Tympanic Membrane, description=View of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Full view [All of the tympanic membrane was visualised.]
  • Partial occlusion [Part of the tympanic membrane was not clearly visualised, but sufficient to permit a clinical opinion to be formed.]
  • Total occlusion [None of the tympanic membrane visualised, such that a clinical opinion of the state of the tympanic membrane could not be formed.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0006], code=at0006, itemType=ELEMENT, level=1, text=Reason for Occlusion of View, description=Description of the reason for occlusion to the view of the tympanic membrane., comment=For example, soft wax or foreign body., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0139], code=at0139, itemType=ELEMENT, level=1, text=Tenderness of Canal, description=Presence of tenderness in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Tenderness is noted in the external auditory canal wall.]
  • Absent [Tenderness is not noted in the external auditory canal wall.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0132], code=at0132, itemType=ELEMENT, level=1, text=Oedema of Canal, description=Presence of oedema in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Oedema is observed in the external auditory canal wall.]
  • Absent [Oedema is not observed in the external auditory canal wall.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0124], code=at0124, itemType=ELEMENT, level=1, text=Erythema of Canal, description=Presence of erythema or redness in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Erythema, or redness, is observed in the wall of the external auditory canal.]
  • Absent [There is no erythema or redness observed in the wall of the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0143], code=at0143, itemType=ELEMENT, level=1, text=Offensive Odour, description=Presence of any offensive odour originating from the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [An offensive odour is noted as originating from the external auditory canal.]
  • Absent [No odour is noted as originating from the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0157], code=at0157, itemType=ELEMENT, level=1, text=Discharge Type, description=Type of discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Serous [The discharge appears to consist mostly of clear, watery fluid.]
  • Bloody [The discharge appears to consist mostly of blood.]
  • Purulent [The discharge appears to consist mostly of pus.]
  • Mucous [The discharge appears to consist mostly of a thick, mucoid substance.]
  • Mucopurulent [The discharge appears to consist of both mucous and pus.]
  • Haemoserous [The discharge appears to consist of both blood and clear, watery fluid.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0151], code=at0151, itemType=ELEMENT, level=1, text=Discharge Amount, description=Amount of discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • None [No discharge is observed in the external auditory canal.]
  • Scant [A small amount of discharge is observed in the external auditory canal.]
  • Moderate [A moderate amount of discharge is observed in the external auditory canal.]
  • Profuse [A profuse amount of discharge is observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0156], code=at0156, itemType=ELEMENT, level=1, text=Discharge Description, description=Narrative description of the discharge observed in the external auditory canal or at the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0166], code=at0166, itemType=ELEMENT, level=1, text=Ventilation Tube Position, description=Observed position of the ventilation tube (or grommet) in the tympanic membrane or the auditory canal., comment=There is value in identifying the presence of ventilation tubes in all examinations. There is no value in recording the absence of ventilation tubes if they have never been inserted. Note, however, that it is useful to record the extrusion of ventilation tubes if there is a known history of previous ventilation tube insertion., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • In situ [The ventilation tube is located in situ in the tympanic membrane.]
  • Partially extruded [The ventilation tube is partially extruded from it's original position in the tympanic membrane.]
  • Extruded - remains in canal [The ventilation tube has been extruded from the tympanic membrane but is visualised within the external auditory canal.]
  • Extruded - missing [The ventilation tube has been extruded from the tympanic membrane and is not visualised anywhere within the external auditory canal.]
  • Unknown [The position of the ventilation tube cannot be determined because the tympanic membrane is obscured and the ventilation tube is not observed within the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064], code=at0064, itemType=CLUSTER, level=1, text=Abnormal Features, description=Details about abnormal features noted during the examination of the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0112], code=at0112, itemType=ELEMENT, level=2, text=Polyps, description=Presence of polyp/polyps in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Polyps are observed in the external auditory canal.]
  • Absent [No polyps are observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0147], code=at0147, itemType=ELEMENT, level=2, text=Fungal Spores, description=Presence of fungal spores in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [Fungal spores are observed in the external auditory canal.]
  • Absent [No fungal spores are observed in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0159], code=at0159, itemType=ELEMENT, level=2, text=Foreign Body, description=Presence of a foreign body in the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [A foreign body is present in the external auditory canal.]
  • Absent [A foreign body is present in the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0064]/items[at0163], code=at0163, itemType=ELEMENT, level=2, text=Location of Foreign Body, description=Location of the foreign body within the external auditory canal., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Outer canal [The foreign body is located in the outer part of the external auditory canal.]
  • Deep canal [The foreign body is located in the deep, inner part of the external auditory canal.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104], code=at0104, itemType=CLUSTER, level=1, text=Tympanic Membrane Details, description=Details about findings on examination of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Membrane Intact?, description=Is the tympanic membrane intact?, comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Intact [The tympanic membrane appears intact.]
  • Perforated [The tympanic membrane appears perforated.]
  • Indeterminate [It is not possible to tell if the tympanic membrane is intact or perforated.]


Možni razlogi za odsotnost vrednosti (''null''):
  • unknown
  • no information
  • not applicable
  • masked
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0018], code=at0018, itemType=ELEMENT, level=2, text=Appearance, description=Category describing the appearance of the tympanic membrane., comment=In most situations, this data element would only be recorded if the tympanic membrane is intact., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Translucent [The tympanic membrane appears healthy.]
  • Opaque [The tympanic membrane appears dull and opaque.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Normal Light Reflex, description=Presence of a normal light reflex noted., comment=In most situations, this data element would only be recorded if the tympanic membrane is intact. A 'normal' light reflex may be described as : a complete, bright triangular area of reflected light seen in the anteroinferior portion of the tympanic membrane., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [A normal light reflex is visible.]
  • Absent [A normal light reflex is not visible.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Surface Features, description=Features observed on the surface of the tympanic membrane., comment=Data element has multiple occurrences to enable multiple selections, if required. In most situations, this data element would only be recorded if the tympanic membrane is intact., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Blistering present [Blistering is observed on the surface of the tympanic membrane.]
  • Scarring present [Scarring is observed on the surface of the tympanic membrane.]
  • Granulation present [Granulation is observed on the surface of the tympanic membrane.]
  • Thickening present [Thickening is observed on the surface of the tympanic membrane.]
  • Tympanosclerosis present [White patches, consistent with tympanosclerosis, are observed on surface of the tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0028], code=at0028, itemType=ELEMENT, level=2, text=Colour, description=Description of the overall colour of the tympanic membrane., comment=For example: red, bluish, or yellow. , uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010], code=at0010, itemType=CLUSTER, level=2, text=Landmark Anatomy, description=Details about visibility of anatomical landmarks of the middle ear at the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Annulus, description=Narrative description of the Annulus., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0015], code=at0015, itemType=ELEMENT, level=3, text=Malleus Handle, description=Narrative description of the Malleus Handle., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0016], code=at0016, itemType=ELEMENT, level=3, text=Malleus Head, description=Narrative description of the Malleus Head., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0017], code=at0017, itemType=ELEMENT, level=3, text=Umbo, description=Narrative description of the Umbo., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0061], code=at0061, itemType=ELEMENT, level=3, text=Incus, description=Narrative description of the Incus., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0010]/items[at0060], code=at0060, itemType=ELEMENT, level=3, text=Stapes, description=Narrative description of the Stapes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0034], code=at0034, itemType=ELEMENT, level=2, text=Location of Tympanosclerosis, description=Description of the location of any tympanosclerosis observed on the tympanic membrane., comment=May be coded with an external terminology, if desired, and be expressed as multiple occurrences for multiple sites., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0035], code=at0035, itemType=ELEMENT, level=2, text=Position of Tympanic Membrane, description=Description of the position of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Bulging [The tympanic membrane appears to be bulging.]
  • Neutral [The tympanic membrane is in a normal, neutral position - neither bulging or retracted.]
  • Retracted [The tympanic membrane appears to be retracted.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0040], code=at0040, itemType=ELEMENT, level=2, text=Description of Retraction, description=Description of retraction of the tympanic membrane., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0044], code=at0044, itemType=SLOT, level=2, text=Retraction Grade, description=Description of retraction using formal classification/grading., comment=For example: Sade Classification or Tos Classification, typically used by ENT specialists., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Vključi:
openEHR-EHR-CLUSTER.sade_classification.v1 in specializacije ali
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  • Present [A fluid level is observed behind the tympanic membrane.]
  • Absent [A fluid level is not observed behind the tympanic membrane.]
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  • Immobile [There is minimal or no movement of the tympanic membrane when positive pressure is applied.]
  • Hypomobile [The tympanic membrane moves with less excursion and in a more sluggish fashion when positive pressure is applied.]
  • Mobile [The tympanic membrane shows a crisp inward (medial) movement (approx 1mm) with positive pressure.]
  • Hypermobile [There is exaggerated movement of the tympanic membrane when positive pressure is applied.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062], code=at0062, itemType=CLUSTER, level=2, text=Perforation Details, description=Details about the tympanic membrane perforation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0065], code=at0065, itemType=ELEMENT, level=3, text=Estimation of Size, description=Estimation of the size of the tympanic membrane perforation, based on anatomical landmarks., comment=Many clinicians record perforations between the well defined 'pinhole' and 'subtotal' perforations using a variety of terms with inconsistent usage and definitions, such as small, medium and large. 'Intermediate' has been proposed as a means to minimise inter-clinician variability for documenting the size of all perforations falling between the 'pinhole' and 'subtotal' definitions. If more detail is required, then measurement of the perforation should be recorded., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Pinhole [A pinhole perforation is present in the tympanic membrane.]
  • Intermediate [A perforation is present in the tympanic membrane, that is larger than a pinhole but smaller than a subtotal perforation.]
  • Subtotal [A subtotal perforation is present in the tympanic membrane: the pars tensa is absent but the perforation does not include the annulus.]
  • Total [A total perforation is present in the tympanic membrane; the tympanic membrane is essentially absent.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0070], code=at0070, itemType=SLOT, level=3, text=Measurement, description=Direct measurement of the size of the tympanic membrane perforation, usually using a photograph as the source for direct measurement., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Neobvezen, ponavljam, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Vključi:
openEHR-EHR-CLUSTER.dimensions.v1 in specializacije, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0074], code=at0074, itemType=ELEMENT, level=3, text=Region, description=Description of the region of the tympanic membrane perforation., comment=To document if the perforation is in the Pars flaccida and may be potentially unsafe. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant. Coding with a terminology is preferred, if possible., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Pars flaccida [The tympanic membrane perforation is located in the pars flaccida.]
  • Pars tensa [The tympanic membrane perforation is located in the pars tensa.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0071], code=at0071, itemType=ELEMENT, level=3, text=Marginal?, description=Location of the tympanic membrane perforation., comment=To document explicitly whether the perforation is located marginally, and therefore might be clinically unsafe. If 'Total' is selected in 'Estimation of Size' data element then this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Central [The perforation is not involving the annulus and is bounded on all sides by the remnant of the tympanic membrane.]
  • Marginal [The perforation involves the annulus of the tympanic membrane.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0104]/items[at0062]/items[at0076], code=at0076, itemType=ELEMENT, level=3, text=Anterior?, description=Is an anterior perforation present?, comment=To document the presence of perf in the anterior portions of the pars tensa can be more difficult to manage. If 'Total' or 'Subtotal' is selected in 'Estimation of Size' data element then this data element becomes redundant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Neobvezen, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Present [An anterior perforation is present in the pars tensa.]
  • Absent [An anterior perforation is not present in the pars tensa.]
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