208 Concept: Sensory Perception: Eyes, Ears, Nose, Mouth and Throat Flashcards
Define sensation.
Sensation is the ability to perceive stimulation through one’s sensory organs, such as the nose, ears, and eyes.
This stimulation can be internal, from within the body, or external, from outside the body, and includes feelings of pain, temperature, and light.
External stimuli are commonly received and processed through the five senses: vision, hearing, taste, smell, and touch.
Define perception.
Perception is defined as the process by which we receive, organize, and interpret sensation.
Define sensory perception.
Sensory perception can then be defined as the ability to receive sensory input and, through various physiological processes in the body, translate the stimulus or data into meaningful information.
Define the scope of sensory perception.
Optimal functioning —————– Sensory impairment
What populations are at risk for disturbances in sensation and perception?
Primarily the elderly population
What individual risk factors exist for disturbances in sensation and perception?
- congenital conditions and genetics
- adverse reactions and side effects of medications (visual disturbances are the most common)
- acute injury
- chronic medical conditions
- lifestyle choices and occupation
What anatomical features protect the eye?
- bony orbital cavity, which is surrounded by a cushion of fat
- Eyelids
- Eyelashes
What are meibomian glands?
Modified subaceous glands that secrete an oily lubricating material onto the eyelid.
What is the consensual light reflex?
Constriction of both pupils when light is shined into one eye.
Define fixation.
Directing the eye to an object of attention.
What is presbyopia?
Decrease in accommodation abilities
What does accommodation refer to relative to vision?
Adaption for near vision.
What is the direct light reflex?
Constriction of the pupil when light is shined into the eye.
Of what use is the Snellen Eye Chart.
The most commonly used and accurate measure of visual acuity.
What additional health history questions would you as for infants and children for eye assessment?
- delivery: vaginal infection can cause ocular issues
- development
- vision testing
- safety
What additional health history questions would you as for older adults for eye assessment?
- movement
- glaucoma testing
- cataracts
- dryness
- activities
What does 20/20 vision mean?
You can read at 20 feet that the normal eye can read at 20 feet.
What type of vision does the Snellen chart assess?
Central vision
What does the Jaeger card assess?
Near vision
What does the Ishihara test assess?
Colour blindness
What does the confrontation test assess for vision?
peripheral vision
What does the Allen test assess?
It is a toddler vision screen
What is the Snellen E Chart used for?
For conducting preschool vision screen
What can a deficiency is vitamin A cause?
night blindness
What do you look at during inspection of external ocular structures?
- general
- eyebrows
- eyelids and eyelashes
- eyeballs
- conjunctiva and sclera
- eversion of the upper eyelid
- lacrimal apparatus
What characterizes glaucoma?
Increased intraocular pressure
Which tests assess central visual acuity?
- Snellen eye chart
- Near vision (for 40+)
Which test(s) assess visual fields?
- confrontation test (peripheral vision)
Which test(s) assess extraocular muscle function?
- Corneal light reflex (Hirschberg’s Test)
- Cover-uncover test
- Diagnostic positions test
What is nystagmus?
Fine oscillating movement best seen around the iris. Mild nystagmus at extreme lateral gaze is normal; at any other position is not.
Which external ocular structures should you inspect?
- general inspection
- eyebrows
- eyelids and lashes
- eyeballs
- conjunctiva and sclera
- lacrimal apparatus
What is ptosis?
drooping of upper eyelid
What anterior eyeball structures do you inspect?
- cornea and lens
- Iris and pupil
What is arcus senilis and is it a normal finding?
Grey-white arc around the limbus; normal in older adults.
What does PERRLA stand for?
pupils equal round react to light, and accommodation
What is the most common cause of hearing loss in young adults between 20 and 40?
otosclerosis
What kind of hearing loss involves a mechanical dysfunction of the external or middle ear?
conductive hearing loss
What can cause conductive hearing loss?
- impacted cerumen
- foreign bodies
- a perforated eardrum
- pus or serum in the middle ear
- otosclerosis
What does sensorineural hearing loss indicate?
- pathology of the inner ear, cranial nerve VIII, or the auditory area of the cerebral cortex
What are other names for the external ear?
auricle or pinna
What separates the external ear and the middle ear?
the eardrum (tympanic membrane)
What does the eardrum normally look like?
Translucent, pearly gray membrane, slightly oval, and concave, pulled in the middle by one of the inner ear ossicles (the malleus)
Which parts of the malleus show through the eardrum?
umbo, maubrium, and the short process
What is the outer, fibrous rim of the drum called?
annulus
What are the bones of the middle ear?
malleus, incus, and stapes
What parts does the eustachian tube connect?
Connects the middle ear with the nasopharynx and allows passage of air. Usually closed but opens with swallowing and yawning.
What are the three functions of the middle ear?
1) conducts sounds vibrations from the outer ear to the central hearing apparatus in the inner ear
2) It protects the inner ear by reducing the amplitude of loud sounds
3) the eustachian tube allows equalization of air pressure on each side of the eardrum so that the membrane does not rupture
True or false: The middle ear is embedded in bone.
True
What is the purpose of the bony labyrinth in the inner ear?
Holds the sensory organs for equilibrium and hearing (has cochlea and the vestibule and semicircular canals)
What are the two pathways of hearing?
1) air conduction (most efficient)
2) bone conduction (bones of the skull vibrate)
What is happening with sensorineural hearing loss?
Signifies pathology of the inner ear, cranial nerve VIII, or the auditory areas of the cerebral cortex.
What is presbycusis?
sensorineural hearing loss that is caused by a gradual nerve degeneration that occurs with aging. Can also be caused by ototoxic medications.
What are of the year helps determine position in space and when impaired can lead to vertigo?
The inner ear: the labyrinth
What kinds of maternal infection during fetus development can impair hearing?
rubella infection
True or false. An infant’s eustachian tube is shorter, wider, and more horizontal than an adult’s, making it easier for pathogens to get in and cause ear infections
True,
What % of Canadians older than 65 have hearing loss?
More than 50%
What happens to the cilia in the ears of olders persons and what does it affect?
Cilia lining the ear canal become coarse and stiff. May cause decrease in hearing. `
How often should hearing generally be tested?
Every 3 years
What is one of the most common illnesses in children?
otitis media (inflammation in the middle ear)
What are the two major types of cerumen?
a) dry cerumen, which is grey, flaky, and frequently forms a thin mass in the ear canal (common in people of Asian or Indigenous descent)
b) wet cerumen, which is honey brown to dark brown and moist (common in African or Euro-Canadian descent)
What is otalgia?
ear pain
True or false. Repeated ear infections in childhood can result in hearing loss.
True.
What does otorrhea suggest?
Otorrhea (discharge from the ear) suggests infection of the ear canal or a perforated eardrum.
What is recruitment as it relates to hearing?
A condition in which loss is marked when sounds is initially at low intensity but actually becomes painful when repeated loudly.
What is tinnitus?
Ringing, crackling or buzzing in ears. Originate within the person. Seems louder when there is no competition from environmental sounds.
What is microtia?
ears smaller than 4 cm vertically
What is macrotia?
ears larger than 10 cm vertically
What is atresia?
Absence or closure of the ear canal.
What does the whisper test assess?
high-frequency sounds and detects high-tone loss
What test can be used to assess the vestibular apparatus?
The Romberg test
When is it best to perform the ear assessment in infants and young children?
towards the end of the assessment
Until what age should you pull the pinna straight down?
Until 3 years of age
The ________ vibrates in response to the sound waves in the air.
tympanic membrane
The ear structure that carries the vibrations to the oval window from the tympanic membrane is called the ________.
ossicle
The ________ of the ear responds to specific frequencies in specific locations.
basilar membrane
The ________ translates vibrations into electrical impulses.
organ of Corti
The ________ executes binaural interaction.
brainstem
The ear’s ________ senses the angle of the head in relation to gravity.
labyrinth
What are the purposes of the nose?
- sensory organ for smell
- warms, moistens, and filters inhaled air
What does the columella do?
Divides the two nares and is continuous inside the nasal septum.
What are the names of the bones that are contained in the lateral walls of each nasal cavity?
superior, middle, and inferior turbinates
What do the paranasal sinuses do?
- lighten the weight of the skull
- serve as resonators for sound production
- provide mucus
Which two sinuses can be accessed for examination and which ones cannot?
- frontal and maxillary can
- ethmoid and sphenoid cannot (deeper and smaller)
Which sinuses are present at birth?
maxillary and ethmoid (though sphenoid are there but minute)
Frontal sinuses are absent at birth and develop between 7 and 8 years of age
What borders the oral cavity?
lips, palate, cheeks, and tongue
What are the two parts of the palate?
1) hard palate: anterior, bone, whitish in colour
2) soft palate: pinker, mobile arch, muscle
What connects the tongue to the mouth floor?
frenulum
List the salivary glands and their location.
1) Parotid gland; largest, i cheek in front of ear and extends down the angle of the jaw (its duct is called the Stensen’s duct; opens the buccal mucosa opposite the 2nd molar)
2) Submandibular gland; beneath the mandible (its duct is called Wharton’s duct)
3) Sublingual gland; smallest; flood of the mouth
What roles does saliva play?
- moistens and lubricates the bolus
- starts digestion
- cleanses and protects the mucosa
How many teeth do adults have?
32 permanent teeth
What are the three parts of the tooth?
crown, neck, and root
What separates the mouth from the oropharynx?
anterior tonsillar pillars
True or false. Tonsillar tissue enlarges during childhood until puberty, then decreases in size and function.
True
How many deciduous teeth do children have?
20
When do teeth first start to erupt?
6 - 24 months of age
When are the deciduous teeth lost?
6 - 12 years old
What effects in the nose and mouth might someone experience when pregnant?
- nasal stuffiness and nosebleeds (epitaxis)
- gums bleeding
What causes taste loss in older adults?
- soft tissue atrophy and thinning epithelium
- decreased salivary secretions
- presence of upper dentures
Tooth loss that results in upper and lower incisors to protrude
malocclusion
True or false. Aging is the major cause of decreased saliva flow.
False. It is the use of medications that have an anticholinergic effect.
Greyish-white benign lesions occurring on the buccal mucosa.
Leukoedema
What can cause changes in sense of smell?
- cigarette smoking
- chronic allergies
- certain illnesses (COID-19)
- aging
What can untreated streptococcal infections lead to?
rheumatic fever
What is the main cause of tooth decay and periodontal disease in Canada?
sugar
What causes hoarseness of the larynx?
- overuse of voice
- upper respiratory infections
- chronic inflammation
- lesions
- neoplasm
Pain upon swallowing.
odynophagia
What can cause occlusion in children?
Prolonged thumb sucking
What is xerostomia?
dry mouth
What are cherry red lips a sign of?
Carbon monoxide poisoning.
What is cheilitis (perleche)?
cracking at the corners of the mouth
When does enlargement of the tongue (macroglossia) occur?
- allergic and anaphylactic reactions
- hypothyroidism
- acromegaly
What do you expect to happen to the uvula and soft palate when the patient says ‘ahhhh’.
rise in the midlne (tests the vagus nerve)
How are tonsils graded?
1+ = visible
2+ = halfway between tonsillar pillars and uvula
3+ = touching the uvula
4+ touching each other
