Domain 2 Module: Relevant Medical Information (10 test questions) Flashcards by Deleted Deleted

the globe
-	Collects and absorbs; light rays so they can form a clear image on the retina
-	Outer layer
o	Conjunctive
o	Sclera
o	Cornea
-	Inner layer
o	Anterior chamber
o	Posterior chamber
o	vitreous

Orbit

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thin, transparent membrane; lines the inside of the eyes/sclera; does not cover cornea

Protective barrier (alerts for foreign bodies)
Lubricates front of eye
Indicates ocular/physical health

Conjunctiva

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white part of the eye; dense; provides protection

Maintains shape of globe
Provides protection to inner structures
Provides attachment points for extraocular muscles

Sclera

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highly organized group of cells and proteins; contains no blood vessels; receives nourishment from tears
- Refract and transmit light
- Provides most of the eye’s optical power
- If cornea loses elasticity or is damaged, it won’t be able to function properly and blurred images will be transmitted to the
retina

Cornea

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Space in front of cornea, but behind the iris; contains iris, trabecular meshwork, canal of schlemm

Anterior Chamber

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Small space between back of iris and lens

Posterior Chamber

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Clear fluid inside anterior and posterior chamber; provides nourishment and support

Aqueous Humor

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Composed of ciliary muscle

Involved in controlling lens accommodation and IOP

Ciliary Body

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– colored part of the eye

- Regulates light entering the eye

Iris

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hole in the middle of the iris
Constricts in bright light
Dilates in dim light

Pupil

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extends where iris meets the cornea

- Drains/filters the eye

Trabecular Meshwork

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located between the retina and sclera
Nourishes retina
Removes waste
Contains many blood vessels and capillaries

Choroid

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Refracts and focuses light
Helps create a sharp image on retina
Can change shape

Lens

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Light sensitive nerve tissue
Breaks down images into brightness, position, color, and movement
Converts images into electrical signals and sends those signals to the brain

Retina

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Peripheral retina; active in low light
Responsible for night vision
Poor perception of color and detail

Rods

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Light receptor cells
Active in high light and color
Detects color and detail

Cones

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Central part of the retina
Responsible for detecting color and fine detail
Clear visual acuity

Macula

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visual pathway; no photoreceptor cells; cannot process light

Optic Nerve

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a. carries impulses for sight from the retina to the brain
b. each nerve fiber corresponds to specific parts of the retina
c. once information gets to the optic nerve, it gets sent to the brain via the Visual Pathway
d. damage in this area: loss of vision in affected eye

optic nerve/ optic pathway

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a. where nasal fibers of each optic nerve cross
b. separates information from the right visual field and the left visual field
c. right half of the visual field goes to the left side of the brain
d. left half of the visual field goes to the right side of the brain
e. images projected on the retina are inverted
f. damage in this area: hemianopia: loss of half the visual field (temporal loss)
g. damage AFTER chiasm: temporal loss in one eye, nasal loss in the other

optic chiasm

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a. contains visual cortex
b. info from each part of the retina is combined and interpreted
c. organized into layers and columns
d. responsible for vision and visual perceptions
e. damage in this area: temporal loss in one eye, nasal loss in the other
f. “macular sparring”: when the macula is left intact

occipital lobes

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a. the area at the side of each cerebral hemisphere
b. contains major portions of optic radiations
c. complex visual analysis
1. allows for categorization of objects; “memory library” of images

temporal lobes

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a. upper mid part of each cerebral hemisphere
b. responsible for body sensations
c. responsible for spatial information

Posterior Parietal Lobes

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What it is:

Progressive, degenerative damage to the central part of the retina
Affects the cones
Wet: abnormal blood vessel grow and leak under the macula
Dry: degeneration of retina

Causes:

Age
Genetics

Functional implications

Central acuity loss
Blind spot
Photophobia
Pool color vision
Normal peripheral vision

Adaptations:

Eccentric viewing
Magnification
Large print
Diffused less intense light
Direct light
Telescopes
Tinted lenses
CCVT
Adjustable lighting
Reduce/eliminate glare
High contrast

Treatments:
- Wet: shots in the eye to stop the bleeding

functional implications 
o	Central acuity loss
o	Blind spot
o	Photophobia
o	Pool color vision
o	Normal peripheral vision

ARMD

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``` What it is: - Progressive: night blindness peripheral loss tunnel vision complete blindness - Degeneration of rods (light sensitive cells in retinal periphery) - Can be found in: Ushers and Lebers Causes: - Genetics Risk Factors: - Age (teens/young adults) - Gender (more common in males) ``` Functional implications - Loss of peripheral vision - Night blindness - Tunnel vision - Decreased acuity and depth perception - Retinal scarring (causes spotty vision) - Cataracts possible - May be accompanied with myopia, cataracts, keratoconus Adaptations: - High illumination - Reduce glare - Absorptive lenses - Prism glasses - CCVT - High contrast - Teach organized search patterns Treatments: - None – take precautions to prevent retinal detachment ``` functional implications o Loss of peripheral vision o Night blindness o Tunnel vision o Decreased acuity and depth perception o Retinal scarring (causes spotty vision) o Cataracts possible o May be accompanied with myopia, cataracts, keratoconus ```

What it is: - Decrease in retinal blood vessel development in preemie babies - Leads to bleeding, scarring, and detachment - Can range from minimal damage to complete blindness Causes: - Low birthweight - Born before 31 weeks - High duration and administration of oxygen Risk Factors: - Low birthweight - Born before 31 weeks - Overall health of infant Functional implications - Decreased visual acuity - Severe myopia - Possible retinal detachment - Spotty vision - Strabismus - Retinal scarring - Field loss - Possible glaucoma Adaptations - high illumination - magnification - telescopes - CCTV Treatments: - Vitamin E therapy - Cryotherapy - Vitrectomy - Some cases resolve themselves ``` functional implications o Decreased visual acuity o Severe myopia o Possible retinal detachment o Spotty vision o Strabismus o Retinal scarring o Field loss o Possible glaucoma ```

ROP

What it is: • Collection of Eye disease that causes increased pressure in the eye because of blockage in the normal flow of fluid in the aqueous humor • Damages optic nerve ``` Caused by: • Changes in the uveal tract • Trauma • Medication reaction • Surgery • Genetics ``` ``` Risk factors: • 55+ • family history • diabetes • Race (higher prevalence in African American or native American) ``` ``` Functional Implications: • Fluctuating vision – can lead to stress and fatigue • Tunnel vision • Peripheral field loss • Poor night vision • Photophobia • Difficulty seeing large objects in close range • Decreased sensitivity to contrast • Pain/headaches • Eye redness • Hazy cornea • Wide open pupil • Degeneration of optic disc • Poor spatial awareness ``` ``` Adaptations: • Sunglasses, eye shades • Lamps with adjustable lighting • Reduce glare • Increase contrast • Magnifiers • CCVT ``` ``` Treatment: • Eye drops • Surgery o Trabeculectomy – removing portion of trabecular meshwork to improve drainage o Iridotomy – laser creates hole in iris ``` ``` functional implications o Fluctuating vision – can lead to stress and fatigue o Tunnel vision o Peripheral field loss o Poor night vision o Photophobia o Difficulty seeing large objects in close range o Decreased sensitivity to contrast o Pain/headaches o Eye redness o Hazy cornea o Wide open pupil o Degeneration of optic disc o Poor spatial awareness ```

Glaucoma

What it is: - Diabetes can cause changes in blood vessels of the retina - Causes hemorrhaging in the retina and vitreous - Neuropathy in feet and hands - Retinal detachment and full blindness possible - Proliferative: formation of new blood vessels - Non-proliferative: beginning stages, blood vessels become weak Caused by: - Diabetes - Genetics - Retinal hemorrhage - Glaucoma - Cataracts - Optic neuropathy Functional Implications: - Sensitive to glare - Double vision - Lack of accommodation - Fluctuating acuity - Diminished color vision - Defective visual fields - Floaters - Retinal detachment - Neuropathy – unable to tactilely discriminate Adaptations: - Good lighting - Good contrast - Magnification - Reduce glare - Pay attention to diet - Tinted lenses - Take care of feet to prevent infections - Wear comfortable well-fitting shoes at all times - Avoid bending, lifting, straining, rapid movement – can affect DR Treatment: - Diet - Insulin - Surgery o Vascular photocoagulation – abnormal/leaky blood vessels sealed/destroyed by light o Retinal photocoagulation – laser used to destroy oxygen starved area of retina creating regressing of abnormal/weak blood vessel growth ``` functional implications o Sensitive to glare o Double vision o Lack of accommodation o Fluctuating acuity o Diminished color vision o Defective visual fields o Floaters o Retinal detachment o Neuropathy – unable to tactilely discriminate ```

Diabetic Retinopathy

What it is: - Damage to the visual cortex (in the brain) o Problem with how information is transmitted from the eye to the brain and how the brain interprets that information - Ocular structures remain in tact - Disorders associated with CP, epilepsy, hydrocephalus, learning disabilities, deafness - Common with : optic nerve atrophy, optic nerve hypoplasia, retinal abnormalities Causes: - Lack of oxygen (anoxia) at birth - Head injury - Infections that affect nervous system Functional implications - Fluctuation in visual functioning - Loss of ability to understand information the eye is giving you - Visual neglect - Eye may look normal - Inattention to visual stimuli - Preference of touch over vision - Difficult with visual clutter or when things are too close together - Difficult discriminating figure-ground - May have more central vision, peripheral vision - Light gazing - Photophobia - Slower processing/response time - May easily become overwhelmed - Inability to coordinate visual information with other senses - Visual Midline Shift Syndrome- shift in concept of midline following stroke or TBI Adaptations: - High illumination – spotlighting/indirect lighting sources are beneficial for clarity - Eliminate visual clutter - Eliminate glare - Routines - Repetition - Bright contrast - Consistent visual cues - Combination of reading media - Determine which sensory system works best - Prevent visual overload - Provide simple images and tasks - Encourage tactile exploration - Demonstrate via hand-over-hand - Eliminate distractions - Yoked Prisms Treatments: - None functional implications o Fluctuation in visual functioning o Loss of ability to understand information the eye is giving you o Visual neglect o Eye may look normal o Inattention to visual stimuli o Preference of touch over vision o Difficult with visual clutter or when things are too close together o Difficult discriminating figure-ground o May have more central vision, peripheral vision o Light gazing o Photophobia o Slower processing/response time o May easily become overwhelmed o Inability to coordinate visual information with other senses o Visual Midline Shift Syndrome- shift in concept of midline following stroke or TBI

CVI

congenital abnormality; optic disc is small, sometimes surrounded with a halo; vision may or may not be reduced Small optic cup. Usually results in low visual acuity. Additional cognitive disabilities often present. Frequent in children. functional implications: o Decreased visual acuity o Additional cognitive disabilities often present

Optic Nerve Hypoplasia

progressive retinal degeneration in both eyes; night blindness in childhood followed by loss of peripheral vision to finally blindness; hereditary functional implications o Progressive decreased night vision o Followed by central loss, color, and detail vision

Rod/Cone

degeneration of retinal receptors results in loss of color and central vision, followed by loss of night vision functional implications o Loss of central, color and detail vision first o Followed by loss of night vision

Cone/Rod

malignant Intraocular tumor that develops from retinal & visual cells; hereditary; vision loss can be total or scotomic functional implications o If one eye – lack of depth perception and Field loss o If both eyes – total blindness

Retinoblastoma

Farsightedness functional implications refractive ability too weak, eye is too sort, power must be increased to form a point on retina o Inability to see close o Blurred image on retina when viewing close objects o May need to move objects farther from the eye for clear image o If uncorrected  Brain receives poor, blurred image  Impacts development of the visual system  Reduced attention to objects at near

Hyperopia

Nearsightedness functional implications refractive ability too strong, eye too long; power must be taken away to form a point on retina o Can’t see distance o Blurred image on retina when viewing objects at a distance o May need to bring object closer to eye for clear image o If uncorrected:  Brain receives poor, blurred image  Impacts development of visual system  Visual world “collapses” – reduced/inattention to distant objects/activities o May not be able to be fixed

Myopia

uneven focus of light between both eyes functional implications o Light rays entering the eye are bent unequally o Prevents formation of a sharp image on the retina o Inability of the eye to focus sharply at any distance

Astigmatism

``` What it is: - Gradual hardening of the lens elasticity Causes: - Age Functional implications - Reduced ability to accommodate Adaptations - Good lighting - High contrast Treatments: - none ``` functional implications o Reduced ability to accommodate o Affects the elderly

Presbyopia

Both Eyes together

Right eye

Left eye

shows the quietest sounds you can just hear

Audiogram

a. strength of sound b. amplitude c. measured in decibels d. measure of sound pressure level e. relative strength of sound waves (transmitted vibrations), which we perceive as loudness or volume

Intensity

a. pitch b. the rate of particle vibration measured in cycles per second c. measured in Hertz d. For sound, this means the number of pressure waves per second that would move past a fixed point. It is also the same as the number of vibrations per second the particles are making as they transmit the sound.

Frequency

portion of a particle in its vibrating cycle

Phase

a. sensation of frequency b. high pitch = high frequency c. relates to the frequency, or how many times a second the particles vibrate. The distance between one wave and the next gives the wavelength. For sounds all travelling at the same speed, high-frequency sounds have waves very close together. Low-frequency sounds have a greater distance between each wave.

Pitch

a. unit used to measure the intensity of a sound or power level of electrical signal by comparing it with a given level on a logarithmic scale b. not linear

Decibel

air conduction test unmasked left ear

air conduction test unmasked Right ear

bone conduction test right ear

bone conduction test Left ear

affecting both sides

bilateral

o dysfunction of the outer/middle ear o usually treated with medication/surgery o loudness deficit o functional implications  soft speaking voice (they hear their voice louder than normal)  excellent speech discrimination when speech is loud enough  lower frequencies tend to be affected  temporary

conductive hearing loss

o dysfunction of the inner ear/auditory nerve o usually permanent o untreatable o loudness deficit o distorted hearing – nerve endings in the cochlea/nerve pathways damaged; messages do not effectively reach the brain o middle ear structures in tact o functional implications  inappropriately loud voice  tinnitus  frequency loss – high frequency (most common)  speech sounds distorted  background noise makes listening more difficult  hearing aids may help • Hearing aids, cochlear implants, and other listening devices are notorious for distorting, changing, and generally making sounds unusable for orientation and mobility tasks. Many assistive devices are designed and set to enhance the human voice for communication, not to retrieve environmental sounds. In fact, they may be intentionally blocking distal environmental input. Also, no assistive listening device can reach far into the environment (such as hearing a car 300 feet away).  vertigo  gradual deterioration  difficulty distinguishing near vs. far (location acuity loss)  specific sounds seem unnaturally loud  difficulty understanding speech patterns

sensorineural hearing loss

combo of conductive and sensorineural hearing loss treatment may be available for the conductive loss both high and low frequency losses

Mixed hearing loss

help people with communication disorders to express themselves. These devices can range from a simple picture board to a computer program that synthesizes speech from text.

augmented communication (def.)

If the bone conduction hearing thresholds are normal, but there is a loss of hearing for air conduction sounds, this is called a

conductive hearing loss

When there is no difference between the air conduction and the bone conduction thresholds it indicates that the hearing loss is due to a problem in the cochlea.

sensorineural hearing loss

gap between the air conduction and the bone conduction thresholds, however the bone conduction thresholds still indicate a hearing loss as they are not within normal limits. This would suggest that there is a problem in both the cochlear and the middle ear

mixed hearing loss

-10 to 15 dB HL → normal hearing 16 to 25 dB HL→ slight hearing loss 26 to 40 dB HL→ mild hearing loss 41 to 55 dB HL→ moderate hearing loss 56 to 70 dB HL→ moderately severe hearing loss 71 to 90 dB HL→ severe hearing loss >90 → profound hearing loss

Classification of Hearing Impairment

What eye diseases are associated with diabetes?

a. Diabetic Retinopathy b. Glaucoma c. Cataracts

a. Monitor blood sugar and note instances of low/high b. Lethargy c. Neuropathy i. Hands- make it difficult to get feedback from cane ii. Feet – make it difficult to detect drop offs d. Rapid changes in vision likely i. Bad vision days make indicate low blood sugar e. Pressure sores common i. Wear comfortable sneakers ii. Monitor for pain, swelling, bruising, blistering, tenderness, discoloration of the skin f. Keep a diabetic information sheet i. Student name, address, phone number ii. School/agency name, address phone number iii. Doctor name and phone number iv. Emergency contact v. Type of insulin, amount taken, time of day given vi. Typical symptoms of student and how student wants to handle them vii. Time of day likely to have reaction

the considerations when developing an O&M instruction program for persons with diabetes?

a. CMV (cytomegalovirus): b. Kaposi’s sarcoma c. Toxoplasmosis d. Cryptococcal meningitis e. Central nervous system infections f. HIV retinopathy

eye diseases that are associated with AIDS

a. Decreased functioning of immune system can lead to neurological complications b. Prevent yourself from becoming infected c. Practice good hygiene d. Reschedule if you are sick e. Practice “universal health precautions” f. Students willingness and ability to participate may vary from day to day or even hour to hour g. Confirm all meetings several hours before appointment h. Goals may need to be reassessed and modified as students physical condition changes i. Because of privacy las, you may not know if a student has HIV/AIDS and it might be difficult to accurately plan lessons and goals j. Vision impairment comes in the later stages

implications of AIDS for O&M instruction?

What should an O&M specialist do if a client has a hypoglycemic reaction or a hyperglycemic reaction during an O&M lesson?

Hypoglycemic: give fruit drink/sugar Hyperglycemic: insulin