Inspect the External Ear Structures

A small dimple in front of the tragus is usually a remnant of the first branchial arch.

Inspect the external ear for deformities, nodules, inflammation, or lesions. The presence of tophi is a highly specific but nonsensitive sign of gout. Tophi are deposits of uric acid crystals. They appear as hard nodules in the helix or antihelix. In rare cases, a white discharge may be seen in association with them. A ''cauliflower ear'' is a pinna that is gnarled as a result of repeated trauma. Figure 11-11 shows a squamous cell carcinoma and a malignant melanoma of one lobule.

Inspect for discharge. If discharge is present, note its characteristics, such as color, consistency, and clarity.

Baby Sleeping

Baby Sleeping

Everything You Need To Know About Baby Sleeping. Your baby is going to be sleeping a lot. During the first few months, your baby will sleep for most of theday. You may not get any real interaction, or reactions other than sleep and crying.

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