Ears + Eyes Flashcards

1
Q

The external ear borders are the _ to the _

A

The external ear borders are the auricle/pinna to the tympanic membrane (includes the tympanic membrane)
* Includes the external auditory canal

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2
Q

The middle ear contains: [structures]

A

The middle ear contains:
* Ossicles
* Eustachian tube
* Stapedial and tensor tympani muscles

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3
Q

From lateral to medial, the ossicles are _ , _ , _ (oval window)

A

From lateral to medial, the ossicles are malleus , incus , stapes (oval window)

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4
Q

The stapedial muscle is innervated by [CN]

A

The stapedial muscle is innervated by facial nerve (VII)

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5
Q

The tensor tympani muscle is innervated by _ nerve

A

The tensor tympani muscle is innervated by pterygoid nerve (branch of V3)

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6
Q

The eustachian tube is a connection between the ear and nasopharynx that allows for _

A

The eustachian tube is a connection between the ear and nasopharynx that allows for pressure equalization

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7
Q

The only part of the ear that is not mucosa lined is the _

A

The only part of the ear that is not mucosa lined is the external ear (skin-lined)

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8
Q

The _ labyrinth is filled with perilymph

A

The bony labyrinth is filled with perilymph

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9
Q

The _ labyrinth is filled with endolymph

A

The membranous labyrinth is filled with endolymph

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10
Q

(3) components of the bony labyrinth:

A

(3) components of the bony labyrinth:
1. Vestibule
2. Semicircular canals
3. Cochlea

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11
Q

Inside the vestibule, are two portions of membranous labyrinth that help detect head position, _ and _

A

Inside the vestibule, are two portions of membranous labyrinth that help detect head position, utricle and saccule

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12
Q

Inside the semicircular canals are the _ and inside the cochlea is the _

A

Inside the semicircular canals are the semicircular ducts and inside the cochlea is the cochlear duct

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13
Q

Vibration of the stapes –> _ –> movement of hair cells in the organ of corti –> _

A

Vibration of the stapes –> movement of perilymph in cochlea –> movement of hair cells in the organ of corti –> opening/closing of membrane channels and generation of nerve impulse

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14
Q

The base of the basilar membrane detects _ frequency sounds

A

The base of the basilar membrane detects high frequency sounds

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15
Q

The apex of the basilar membrane detects _ frequency sounds

A

The apex of the basilar membrane detects low frequency sounds

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16
Q

The _ branch of CN VIII receives signal from the inner and outer hair cells

A

The cochlear branch of CN VIII receives signal from the inner and outer hair cells
* It will then send information about pitch, volume, localization of sound

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17
Q

_ conduction is a way by which sound can vibrate through the skull and go directly to the coclea

A

Bone conduction is a way by which sound can vibrate through the skull and go directly to the coclea
* Skips the external and middle ear

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18
Q

In conductive hearing loss, the weber test will localize to the _

A

In conductive hearing loss, the weber test will localize to the affected ear

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19
Q

In sensorineural hearing loss, the weber test will localize to the _

A

In sensorineural hearing loss, the weber test will localize to the unaffected ear

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20
Q

In sensorineural hearing loss, the Rinne test will be better _

A

In sensorineural hearing loss, the Rinne test will be better in front of ear (air > bone)

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21
Q

In conductive hearing loss, the Rinne test will be better _

A

In conductive hearing loss, the Rinne test will be better behind the ear (bone > air)

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22
Q

Interpret this audiogram

A

Presbycusis: hearing loss at high frequencies

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23
Q

_ hearing loss means there is a problem in the external or middle ear; the problem is getting sound to the inner ear

A

Conductive hearing loss means there is a problem in the external or middle ear; the problem is getting sound to the inner ear
* Ex: cholesteatoma, otitis media, ossicular dysfunction, tympanic membrane perforation

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24
Q

Acquired cholesteatoma originates from _ dysfunction

A

Acquired cholesteatoma originates from eustachian tube dysfunction –> retraction of tympanic membrane –> build up of skin –> can degrade bone

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25
Q

When bone > air there is _ hearing loss

A

When bone > air there is conductive hearing loss
* On audiogram brackets = bone

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26
Q

Interpret the audiogram

A

Sensorineural hearing loss
* There is a problem of VIII

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27
Q

Examples of sensorineural hearing loss:

A

Examples of sensorineural hearing loss:
* Presbycusis
* Exposure to loud noise
* Congenital causes
* Tumor
* Ototoxic medications

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28
Q

Interpret the audiogram

A

Mixed hearing loss (combination)

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29
Q

The three main tissue layers of the eye are:

A

The three main tissue layers of the eye are:
1. Sclera/cornea from surface ectoderm
2. Uveal tract from mesoderm and neural crest
3. Retina/ neural from neuroectoderm

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30
Q

There are two segments of the eye; the _ which is the optical segment and the _ which is the sensory segment

A

There are two segments of the eye; the anterior segment which is the optical segment and the posterior segment which is the sensory segment

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31
Q

The anterior chamber is filled with _ and the posterior chamber is filled with _

A

The anterior chamber is filled with aqueous fluid and the posterior chamber is filled with vitreous fluid

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32
Q

The two chambers of the eye are in relation to the iris, the _ and _

A

The two chambers of the eye are in relation to the iris, the anterior and posterior

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33
Q

The _ are the output cells of the retina which send signal to the occipital cortex via the _

A

The retinal ganglion cells are the output cells of the retina which send signal to the occipital cortex via the lateral geniculate nucleus (LGN)

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34
Q

ID the major landmarks

A
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35
Q

There are two main refractive structures in the eye, the _ and _

A

There are two main refractive structures in the eye, the cornea and lens

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36
Q

The _ is the air- tear film interface and it has the greatest refractive power

A

The cornea is the air- tear film interface and it has the greatest refractive power

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37
Q

If light is refracted too heavily or the eye is too long, the result is _

A

If light is refracted too heavily or the eye is too long, the result is myopia (near-sightedness)

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38
Q

If light is not refracted enough or the eye is too short, the result is _

A

If light is not refracted enough or the eye is too short, the result is hyperopia (far sightedness)

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39
Q

_ is an irregular refraction due to ocular surface or lens aberration

A

Astigmatism is an irregular refraction due to ocular surface or lens aberration

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40
Q

_ occurs with age as the lens becomes stiff and loses accommodation

A

Presbyopia occurs with age as the lens becomes stiff and loses accommodation

41
Q

The 1’ neuron of the hypothalamospinal pathway begins at the _ and synapses at _

A

The 1’ neuron of the hypothalamospinal pathway begins at the hypothalamus and synapses at C8-T2

42
Q

The 2’ neuron of the hypothalamospinal pathway extends from C8-T1, through the _ and synapses at the _

A

The 2’ neuron of the hypothalamospinal pathway extends from C8-T1, through the sympathetic chain and synapses at the superior cervical ganglion

43
Q

The 3’ neuron of the hypothalamospinal tract is the _ nerve

A

The 3’ neuron of the hypothalamospinal tract is the long ciliary nerve –> dilator pupillae

44
Q

Parasympathetics to the eye originate at the _ nucleus and travel alongside CN III before synpasing in ciliary ganglion, where _ innervates the pupillary sphincter

A

Parasympathetics to the eye originate at the edinger-westphal nucleus and travel alongside CN III before synpasing in ciliary ganglion, where short ciliary nerve innervates the pupillary sphincter

45
Q

The near reflex (which allows us to focus on close objects) requires (3) phenomenon:

A

The near reflex (which allows us to focus on close objects) requires (3) phenomenon:
1. Lens accommodation
2. Miosis
3. Convergence

46
Q

In order for the lens to accomodate to close objects, _ must contract and _ must relax

A

In order for the lens to accomodate to close objects, ciliary muscles must contract and suspensory ligaments must relax
* This makes lens more spherical

47
Q

In order for the lens to focus distant objects, the ciliary muscles must _ and the suspensory muscles must _

A

In order for the lens to focus distant objects, the ciliary muscles must relax and the suspensory muscles must stretch
* This makes the lens flatten

48
Q

Optic neuropathy or severe midbrain dysfunction may result in loss of the _ reflex

A

Optic neuropathy or severe midbrain dysfunction may result in loss of the light reflex

49
Q

Aqueous humor gets produced by _ on the ciliary body

A

Aqueous humor gets produced by non-pigmented epithelium on the ciliary body
* This ciliary body is in the posterior chamber

50
Q

The dilator muscle on the iris has [receptors]

A

The dilator muscle on the iris has a1 receptors

51
Q

The sphincter muscle of the iris has [receptors]

A

The sphincter muscle of the iris has M3 receptors

52
Q

90% of aqueous humor gets drained through the _

A

90% of aqueous humor gets drained through the trabecular meshwork –> canal of schlemm –> episcleral vasculature

53
Q

10% of aqueous humor gets drained into the _

A

10% of aqueous humor gets drained into the uvea and sclera (uveoscleral outflow)

54
Q

Glaucoma is a neurodegenerative disease that results in vision loss starting in the _

A

Glaucoma is a neurodegenerative disease that results in vision loss starting in the periphery
* Type of optic neuropathy that causes progressive vision loss
* Intraocular pressure plays a significant role

55
Q

Glaucoma is associated with [phenomenon] of the optic nerve/disc

A

Glaucoma is associated with cupping of the optic nerve/disc

56
Q

Acute angle _ glaucoma is a vision threatening emergency; treat by _

A

Acute angle-closure glaucoma is a vision threatening emergency; treat by reducing intraocular pressure (laser peripheral iridotomy)

57
Q

_ involves degeneration and opacification of the crystalline lens

A

Cataracts involves degeneration and opacification of the crystalline lens

58
Q

Cataracts are most commonly due to increased _ and _

A

Cataracts are most commonly due to increased age and UV exposure
* Can be congenital or related to metabolic disorders

59
Q

How does cataract present?

A

Cataracts present with gradual vision loss, glare, color dulling, myopic shift
* Myopic shift happens because of increase in AP diameter and increased optic power of the lens

60
Q

Macular degeneration begins with [region] vision loss

A

Macular degeneration begins with central vision loss

61
Q

Dry macular degeneration is associated with _ deposits, leading to atrophy and slow vision loss

A

Dry macular degeneration is associated with drusen deposits, leading to atrophy and slow vision loss

62
Q

Wet macular degeneration involves _ and can be a more rapid loss of central vision

A

Wet macular degeneration involves neovascularization and can be a more rapid loss of central vision

63
Q

Macular degeneration begins in the center due to the highest density of _ here

A

Macular degeneration begins in the center due to the highest density of photoreceptors here
* Photoreceptors are particularly vulnerable to oxidative stress

64
Q

We treat dry macular degeneration with _

A

We treat dry macular degeneration with multivitamins

65
Q

We treat wet macular degeneration with _

A

We treat wet macular degeneration with anti-VEGF

66
Q

The _ layer supports the neurosensory retina by regulating oxidative stress

A

The retinal pigment epithelium (RPE) layer supports the neurosensory retina by regulating oxidative stress

67
Q

Retinal detachment occurs when fluid separates the neurosensory retina from the _

A

Retinal detachment occurs when fluid separates the neurosensory retina from the retinal pigment epithelium
* May involve detachment or preservation of macula

68
Q

Retinal detachment is preceded by [signs]

A

Retinal detachment is preceded by flashes, floaters, progressive dark curtain over vision

69
Q

Pathogenesis of diabetic retinopathy:

A

Pathogenesis of diabetic retinopathy:
glycosylation of proteins in capillary walls –> poor vascular integrity –> leakage and ischemia

70
Q

Clinical signs of diabetic retinopathy:

A

Clinical signs of diabetic retinopathy:
* Microaneurysms
* Dot-blot hemorrhage
* Cotton wool spots (infarts)
* Neovascularization

Can be nonproliferative or proliferative (NV)
Treat with glycemic control or anti-VEGF

71
Q

Chronic increased blood pressure and IOP can cause _

A

Chronic increased blood pressure and IOP can cause hypertensive retinopathy

72
Q

Clinical signs of hypertensive retinopathy:

A

Clinical signs of hypertensive retinopathy:
* Copper or silver wiring: arterioles are thickened so more reflective on exam
* AV nicking: arteriole crosses vein
* Later stage: retinal venous obstruction

Treat with BP control

73
Q

Retinitis pigmentosa is [aquired/inherited] retinal disease with progressive loss of photoreceptors

A

Retinitis pigmentosa is aninherited retinal disease with progressive loss of photoreceptors

74
Q

Retinitis pigmentosa vision loss begins in [region]

A

Retinitis pigmentosa vision loss begins in periphery
* Peripheral –> central

75
Q

Retinitis pigmentosa will begin with [vision deficit]

A

Retinitis pigmentosa will begin with night blindness –> peripheral vision loss –> central

76
Q

“Bone spicule pigmentation” =

A

“Bone spicule pigmentation” = retinitis pigmentosa

77
Q

Babies born prematurely will have _ retinas due to incomplete vascularization; this triggers an increase in _ release

A

Babies born prematurely will have ischemic retinas due to incomplete vascularization; this triggers an increase in VEGF release –> retinal neovascularization
* Can treat with anti-VEGF or laser

78
Q

_ commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness.

A

Blepharitis commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness
* These glands are called Meibomian glands
* Dysfunction of gland –> dryness, itching

79
Q

Blepharitis is most commonly caused by [pathogen] or [pathogen]

A

Blepharitis is most commonly caused by staph or demodex

80
Q

Treatment for blepharitis includes _

A

Treatment for blepharitis includes lid hygiene, warm compress

81
Q

Styes are defined simply by _

A

Styes are defined simply by glandular obstruction +/- inflammation

82
Q

_ is a style usually caused by bacteria with significant inflammation

A

Hordeolum is a style usually caused by bacteria with significant inflammation

83
Q

_ is a stye caused by a blocked oil gland without much inflammation

A

Chalazion is a stye caused by a blocked oil gland without much inflammation

84
Q

Bacterial conjunctivitis is usually treated with _

A

Bacterial conjunctivitis is usually treated with topical antibiotics
* Chlamydial or gonococcal infection treated with systemic abx

85
Q

_ is infection of the conjunctiva, while _ is infection of the cornea

A

Conjunctivitis is infection of the conjunctiva, while keratitis is infection of the cornea

86
Q

Diagnosis?

A

Keratitis

87
Q

Diagnosis?

A

Herpes simplex keratitis featuring dendritic ulcer

88
Q

Anterior inflammation of the uveal tract is called _

A

Anterior inflammation of the uveal tract is called iridocyclitis
* Can be caused by disruption of blood aqueous barrier or sometimes primary (autoimmune)

89
Q

Posterior inflammation of the uveal tract is either _ or _

A

Posterior inflammation of the uveal tract is either choroiditis or retinitis
* Can be caused by disruption of blood retinal barrier or sometimes primary (autoimmune)

90
Q

Name (3) major categories of glaucoma drugs that decrease aqueous humor production

A

Name (3) major categories of glaucoma drugs that decrease aqueous humor production
1. Beta blockers
2. Carbonic anhydrase inhibitors
3. a2 agonists

91
Q

Name (4) major categories of glaucoma drugs that increase aqueous humor outflow

A

Name (4) major categories of glaucoma drugs that increase aqueous humor outflow
1. a2 agonists (fall into both categories)
2. Prostaglandin analogs
3. M3 agonists
4. RHO kinase inhibitor

92
Q

Brimonidine works by [mechanism] and [mechanism]

A

Brimonidine works by inhibiting aqueous humor production and increasing outflow
* Indirect mechanism by inhibiting ciliary blood flow

93
Q

Both beta bockers and a2 agonists block sympathetic signaling to the _ , resulting in reduced aqueous humor

A

Both beta bockers and a2 agonists block sympathetic signaling to the ciliary body , resulting in reduced aqueous humor

94
Q

Acetazolamide helps treat glaucoma via [mechanism]

A

Acetazolamide helps treat glaucoma via inhibiting aqueous production at the nonpigemented epithelium on ciliary body

95
Q

Prostaglandin analogs like latanoprost increase _ outflow of aqueous humor

A

Prostaglandin analogs like latanoprost increase uveoscleral outflow of aqueous humor

96
Q

Prostaglandin analogs have toxicities of _ and _

A

Prostaglandin analogs have toxicities of iris discoloration and increased eyelash length

97
Q

M3 agonists, carbachol and pilocarpine increase AH outflow via [mechanism]

A

M3 agonists, carbachol and pilocarpine increase AH outflow via ciliary muscle contraction –> opens the canal of schlemm
* Direct M3

98
Q

Indirect M3 agonists, _ and _ also help to contract the ciliary muscle, open the canal of schlemm, and increase AH outflow

A

Indirect M3 agonists, echothiophate and physostigmine also help to contract the ciliary muscle, open the canal of schlemm, and increase AH outflow

99
Q

Toxicities of M3 agonists include _ and _

A

Toxicities of M3 agonists include miosis and loss of night vision