A patient reports a feeling of fullness in the ears and forcefully blows through pinched nostrils, resulting in a diagnosis of a ruptured tympanic membrane. What would indicate this?

In the scenario provided, a ruptured tympanic membrane commonly presents with specific signs and symptoms. The presence of bright red blood in the ear canal indicates a failure of the tympanic membrane’s integrity, often resulting from trauma or pressure changes, as seen in this case where the patient forcefully blew their nose.

When the tympanic membrane ruptures, blood may collect in the external ear canal due to bleeding from the surrounding structures, including the vessels near the tympanic membrane. This is a clear indication of rupture, highlighting the process by which pressure from actions such as nasal blowing can lead to ear trauma.

While drainage of clear fluid can also occur with a ruptured tympanic membrane, it may suggest otitis media or a different underlying issue rather than direct trauma. Decreased hearing is a common symptom associated with a ruptured tympanic membrane, but it is more of a functional outcome rather than a direct observation of the rupture itself. Severe ear pain may be present but is not universally experienced; some individuals report minimal pain or discomfort with a rupture. Thus, the presence of bright red blood provides a directly observable sign that confirms the diagnosis.