045 | Sensory Innervation of the Ear

I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.

You can find more things on the FRCEM on this site here.

This one is special and has turned into an AFEM episode

This seems to be a favourite for examiners and not something i use commonly in real life

4 Nerves involved (the biggies in bold)

  • auricolotemporal [V3]
  • greater auricular [C2,3]
  • auricular branch of [X]
  • lesser occipital [C2]

Also note the names of the parts of the ear

The block (from the OHEM)

  • Greater Auricular
    • 1cm below ear lobe all the way from post border of SCM to angle of mandible
  • Lesser occipital
    • infiltrate just behind the ear
  • Auriculotemporal
    • just anterior to the EAM and tragus (watching out for the superficial temporal artery

Here’s a video from EMRAP with a further somewhat simplified method

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