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Pathophysiology & Pharmacology > Ear & Eye Conditions > Flashcards

Ear & Eye Conditions Flashcards

1
Q

Eye Anatomy Overview: Sclera, Cornea, and Conjunctiva

A
  • Sclera - White outer layer of the eye.
  • Cornea - Clear outer layer of the eye covering the iris and pupil.
  • Conjunctiva - mucous membrane that lines the inner surfaces of the eyelids and folds back to cover the front surface of the eyeball, except for the cornea (protection)
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2
Q

Eye Anatomy Overview: Iris and Pupil

A
  • Iris - Colored contractile membrane between the lens and the cornea, separates the anterior and posterior chambers.
  • Pupil - Opening at the center of the iris.
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3
Q

Eye Anatomy Overview: Anterior Chamber, Posterior Chamber, Vitreous Chamber

A
  • Anterior Chamber - Compartment between the cornea and iris.
  • Posterior Chamber - Compartment between the iris and lens.
  • Vitreous Compartment - Large compartment behind the posterior compartment, contains vitreous humor.
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4
Q

Eye Anatomy Overview: Retina, Lens, and Optic Nerve

A
  • Retina
    ~ Innermost covering of the vitreous
    compartment.
    ~ Contains sensors for light.
  • Lens - Found behind the iris, focuses images on the retina.
  • Optic Nerve - Transmits sensory visual
    information to the brain.
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5
Q

Glaucoma

A
  • Condition that can damage the eye’s optic nerve and result in vision loss and blindness.
  • Aqueous Humor
    ~ Fills the eye chambers.
    ~ Produced in the posterior chamber.
    ~ Aqueous humor flows continuously in
    and out of the anterior chamber to
    nourishes lens and cornea and
    maintain eye shape
    ~ Humor leaves the anterior chamber
    at the open angle where the cornea
    and iris meet.
    ~ When the fluid reaches the angle, it
    flows through a spongy meshwork,
    like a drain, and leaves the eye via the
    venous system.
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6
Q

Glaucoma: Cause

A
  • When humor reaches the angle it passes too slowly through the meshwork drain and the humor builds-up.
  • Open Angle - Abnormalities in the meshwork
  • Closed Angle - Angle is obstructed by the iris
  • As the fluid builds up, the pressure inside the eye rises to a level that may damage the optic nerve
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7
Q

Glaucoma: S&S

A
  • At first no symptoms
    ~ It causes no pain
    ~ Vision stays the same
  • Lose their peripheral vision
  • Condition can be painful in later stages
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8
Q

Glaucoma: Management

A
  • Medicines - Cause the eye to make less humor or lower pressure by helping fluid drain from the eye
  • Laser Surgery - Evenly spaced burns that expand the drainage holes in the meshwork.
  • Conventional Surgery - Small piece of tissue is removed to create a new channel for the fluid to drain from the eye
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9
Q

Corneal Abrasion: Cause & Diagnosis

A
  • Cause
    ~ Trauma
    ~ Removal of foreign object
    > Pt thinks there’s something in eye
    so they try to dig it out causing
    abrasion
  • Diagnosis
    ~ Fluorescein dye introduced eye
    ~ Dye stains the abrasion a bright green
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10
Q

Corneal Abrasion: S&S and Management

A
  • S&S
    ~ Severe pain
    ~ Watering of the eye
    ~ Photophobia (light sensitivity)
  • Management
    ~ Patching/Contact Lens
    > “Bandaid” : protects abrasion from
    rubbing against the eyelid
    ~ Topical NSAIDs
    ~ Topical antibiotics
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11
Q

Globe Rupture/Laceration: Cause

A
  • Penetration of sharp objects
  • Direct blow
  • Results in the complete tear of sclera or cornea
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12
Q

Globe Rupture/Laceration: S&S and Management

A
  • S&S
    ~ Severe Pain
    ~ Impaired Vision
    ~ Irregular/Displaced Pupil
    ~ Orbital Leakage
  • Management
    ~ Activate EMS
    ~ Cover eye without pressure
    > Round/cupped covering that won’t
    press eye
    ~ Position supine or upright
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13
Q

Hyphema: Cause and Major Complications

A
  • Collection of blood in the anterior chamber
  • Cause
    ~ Direct, contusive forces cause
    mechanical tearing of the fragile blood
    vessels of the iris.
  • Major Complications
    ~ Glaucoma
    > Increased pressure
    > Blood clogs draining system
    ~ Blood staining of the cornea
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14
Q

Hyphema: S&S and Management

A
  • S&S
    ~ Reddish tinge in the anterior chamber
    changing to blood settling inferiorly.
    ~ Partial or total vision block.
    ~ Painful
  • Management
    ~ Immediate Referral
    ~ Bed rest with head and shoulders
    elevated
    ~ Medication to reduce pressure in the
    anterior chamber.
    ~ Should resolve ≤ 5 Days
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15
Q

Subconjunctival Hemorrhage: Cause and S&S

A
  • Cause
    ~ Direct, contusive forces cause
    mechanical tearing of the blood
    vessels under the conjunctiva.
  • S&S
    ~ Red, bloody patch on the white of the
    eye
    ~ Painless
    ~ No change in vision
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16
Q

Retinal Detachment: S&S and Management

A
  • Any separation of the retina from the underlying tissue
  • S&S
    ~ Light Flashes
    ~ “Wavy,” or “Watery” Vision
    ~ Veil or Curtain Obstructing Vision
    ~ Shower of floaters that resemble
    spots, bugs, or spider webs
    ~ Sudden decrease of vision
    ~ Very abnormal and obvious
  • Management
    ~ Immediate Rest/Eye Patch
    ~ Immediate Referral
17
Q

Types of Retinal Detachment: Tear

A
  • Tear in the retina allows humor to seep underneath, causing retina to separate
  • Usually due to traumatic injury
    ~ Boxing, MMA, martial arts, etc
18
Q

Types of Retinal Detachment: Strands of…

A
  • Strands of scar tissue grow into retina and create traction, pulling it loose
  • Complication of disease
    ~ Diabetes
    ~ Sickle cell anemia
  • Complication of Trauma
19
Q

Types of Retinal Detachment: Exudate

A
  • Exudate collects underneath the layers of the retina, causing it to separate from the back of the wall of the eye
  • Tumor growth
  • Any eye disease that causes inflammation
20
Q

Conjunctivitis (Pink Eye): Causes and General Management

A
  • Inflammation of the conjunctiva
  • Causes
    ~ Viral infection
    ~ Bacterial infection
    > Staph
    > Strep
    ~ Allergic reaction
  • General Management
    ~ Disinfect surfaces such as doorknobs
    and counters with diluted bleach
    solution.
    ~ Don’t swim (some bacteria can be
    spread in the water).
    ~ Avoid touching the face.
    ~ Wash hands frequently.
    ~ Don’t share towels or washcloths.
    ~ Avoid shaking hands.
21
Q

Viral Conjunctivitis: S&S

A
  • Watery discharge (exudate)
  • Irritation
  • Red Eye
  • Infection usually begins with one eye,
    but may spread easily to the other eye.
  • Can be caused by herpes
22
Q

Viral Conjunctivitis: Management

A
  • Cool compresses and artificial tears to soothe eye.
  • Antivirals not typically used unless herpes infection is suspected
  • Non-steroidal topical steroid drops may be prescribed to reduce the discomfort from inflammation.
    ~ Steroidal drops in more extreme
    cases.
    ~ Sometimes combined with antibiotic
    because viral infection increases
    likelihood of secondary bacterial
    infection.
  • Viral conjunctivitis usually resolves within 3 weeks.
23
Q

Bacterial Conjunctivitis: S&S

A
  • Stringy discharge that may cause the lids to stick together, especially after sleeping
  • Swelling of the conjunctiva
  • Redness
  • Tearing
  • Irritation and/or a gritty feeling
  • Usually affects only one eye, but may spread easily to the fellow eye.
24
Q

Bacterial Conjunctivitis: Management

A
  • Cool compresses and artificial tears to soothe eye and clear debris.
  • Treated with antibiotic eye drops or ointments
25
Q

Allergic Conjunctivitis: S&S

A
  • Usually affects both eyes.
  • Itching
  • Tearing
  • Swollen Eyelids
26
Q

Allergic Conjunctivitis: Management

A
  • Cool compresses and artificial tears to soothe eye.
  • Non-steroidal anti-inflammatory medications and antihistamines
  • Chronic cases may require topical steroid drops.
27
Q

Ear Anatomy Overview: External Ear, Middle Ear, and Internal Ear

A
  • External Ear
    ~ Auricle
    ~ Ear Canal
    ~ Outer Layer of Tympanic Membrane
  • Middle Ear
    ~ Tympanic Membrane
    ~ Ossicles
    ~ Tympanic Cavity
  • Internal Ear
    ~ Cochlea
    ~ Semicircular Ducts
28
Q

Auricular Hematoma: Cause and Management

A
  • Formation of a hematoma between the cartilage of the ear and the Connective Tissue covering the cartilage
  • Cause
    ~ Repeated shearing forces
  • Management
    ~ Ear Guard Use
    ~ Application of friction reducing agent.
    (Skin lube or Vaseline)
    ~ Donut Pad
    ~ Prevention of scar tissue formation.
    > Aspiration
    > Pressure dressing
29
Q

Otitis Externa (Swimmer’s Ear): Cause

A
  • Inflammation of the ear canal between the ear drum and the outside of the ear
  • Cause
    ~ Bacterial or fungal infection.
    ~ Often occurs when water removes the
    protective ear wax.
    > Excessive ear wax can trap
    organisms in the ear canal and
    cause OE, as well
    ~ Can also develop in the ear canal if
    injured by putting finger or some
    other object in ear (causes abrasion)
30
Q

Otitis Externa (Swimmer’s Ear): S&S and Management

A
  • S&S
    ~ Itching
    ~ Pain/pain with Movement
    ~ Ear Feels Plugged
    ~ Diminished Hearing
    ~ Discharge
  • Management
    ~ Referral to rule out more serious
    problem.
    ~ Ear drops to make ear environment
    more acidic to kill bacteria.
    ~ Antibiotics - if bacterial
31
Q

Otitis Externa (Swimmer’s Ear): Prevention

A
  • Dry ears thoroughly.
  • Avoid excess cleaning of ears.
  • Avoid putting obiects in ears
  • Use drops of solution containing boric acid and alcohol to kill bacteria and dry the ear
32
Q

Otitis Media (Middle Ear Infection): Cause

A
  • Inflammation of the area behind the tympanic membrane in the middle ear, results in fluid accumulation
  • Cause
    ~ Bacterial or viral infection
    ~ Organisms enter through the
    eustachian tube
    > Tube runs to the nasopharynx.
    > Evens pressure behind tympanic
    membrane.
    > Tube becomes blocked and
    pathogen is trapped
    • Blockage many times associated
    with URI
  • More serious than Swimmer’s Ear because it affects balance/proprioception and won’t be able to hear
33
Q

Otitis Media (Middle Ear Infection): S&S and Management

A
  • S&S
    ~ Intense pain in the ear/no pain with
    movement
    ~ Discharge due to possible membrane
    rupture
    ~ Diminished hearing
    ~ Fever
    ~ Fatigue
  • Management
    ~ Treat symptoms
    ~ Anti-biotic if bacterial
    ~ Orally so it can reach it
34
Q

Rupture of Tympanic Membrane: Cause

A
  • Otitis Media
    ~ When the infection causes a build up
    of pus or fluid in middle ear
    > Can cause eardrum to burst
    ~ Pathology or inflammatory response
    can damage membrane
  • Injury and Sudden Pressure Changes
    ~ Cleaning Ears
    ~ Blow to the Ear
    ~ Severe Pressure or Suction
    > Sudden Altitude or Air Pressure
    Changes
    > Swimming or Diving
    > Nearby Explosion
35
Q

Rupture of Tympanic Membrane: S&S and Management

A
  • S&S
    ~ Loud “Pop”
    ~ Hearing Loss
    ~ Pain
  • Management
    ~ Protection
    ~ Referral
    ~ Surgical Repair
  • If small enough can heal itself
36
Q

Otoscope Exam

A
  • Best way to see/diagnose is to stick a camera in ear
  • Normal
    ~ Canal clear, although some wax
    normal. Wax should not occlude more
    than 50% of membrane
    ~ Color of membrane should be pearly
    grey and translucent
  • Abnormal
    ~ Otitis Media (air bubbles = fluid build
    up)
    ~ Excessive Wax
    ~ Exostosis (abnormal bone growth)
    ~ Perforation (hole)

Pathophysiology & Pharmacology (20 decks)

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