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Clinical Conditions > Exam 13: Adult Sensory Loss (Part 2) > Flashcards

Exam 13: Adult Sensory Loss (Part 2) Flashcards

1
Q

sensation

A

the processing of information about the external world by the sensory organs of the body

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2
Q

feedback systems:

A

both rely on intact sensation

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3
Q

feedback

A

action performed-sensory feedback on performance (catching toe while walking)

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4
Q

feed-forward

A

anticipatory adjustments prior to performance (muscle tone increase prior to standing)

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5
Q

sensory input: vision

A
  • acuity
  • oculomotor control
  • visual scanning
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6
Q

sensory input: touch

A
  • sharp/ dull/ pain
  • thermal sensation
  • localization of touch
  • light touch/ deep touch
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7
Q

sensory input: proprioception

A
  • joint receptors
  • position of body
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8
Q

sensory input: vestibular

A
  • position of semicircular canals in relation to gravity
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9
Q

additional sensory inputs

A
  • hearing
  • smell/ taste
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10
Q

problem spots within the eye

A
  • cornea
  • lens
  • retina
  • macula
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11
Q

areas of deficit in vision: eyeball

A
  • retina (retinopathy)
  • lens
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12
Q

areas of deficit in vision: eye muscles

A
  • will cause tracking or convergence problems
  • ciliary muscles control enlargement/ contraction of iris
  • diplopia = double vision
  • lazy eye
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13
Q

areas of deficit in vision: visual pathways including optic nerve

A
  • anywhere from eyes to occipital lobe
  • optic nerve strokes or damage
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14
Q

areas of deficit in vision: brain

A
  • occipital lobe
  • cortical blindness
  • untreated “lazy” eye
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15
Q

visual acuity

A
  • how clearly the eye discriminates detail and contrast
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16
Q

myopia

A

nearsightedness

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17
Q

hyperopia

A

farsightedness

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18
Q

presbyopia

A

age related farsightedness

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19
Q

astigmatism

A

spoon-shaped cornea

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20
Q

problems for people age 65+

A
  • presbyopia
  • cataracts
  • macular degeneration
  • visual field cuts
  • diabetic retinopathy
    • gradual vision loss starting at age 40 and continuing to worsen until around age 65
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21
Q

symptoms of presbyopia

A
  • blurred vision at a normal reading distance
  • headaches or eye strain after reading
  • holding objects farther away in order to see better
  • symptoms may worsen if tired or in a dimly lit area
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22
Q

etiology of presbyopia

A
  • the lens in your eye hardens as you age
  • the lens becomes less flexible which makes it harder to adjust to distances
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23
Q

cataracts

A
  • often develops as a person ages
  • most common type of REVERSIBLE vision loss
  • requires surgical prosthetic lens placed in the eye
  • clouded or discolored lens is removed
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24
Q

symptoms of cataracts

A
  • blurry or cloudy vision
  • poor night vision
  • decreased color perception
  • loss in contrast sensitivity
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25
Q

risk factors of cataracts

A
  • increasing age
  • smoking cigarettes
  • UV-B exposure
  • obesity
  • trauma
  • inflammation
  • high blood pressure
  • hormone replacement therapy
  • drinking excessive amounts of alcohol
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26
Q

general precautions post cataract surgery

A
  • avoid bending too far with head below the waist
  • do not lift more than 10 lbs
  • prevent straining on the toilet
  • keep out of swimming pools/ hot tubs
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27
Q

symptoms to watch out for post cataract surgery

A
  • sudden drop in vision
  • sudden or worsening pain
  • inflammation or blurry vision
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28
Q

macular degeneration

A
  • leading cause of vision loss
  • it is incurable
  • the center portion of the eye is damaged (cones: color & fine vision)
  • can occur in one or both eyes
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29
Q

dry MD symptoms

A
  • develops slowly
  • early, intermediate, advanced
  • increasing blurriness
  • low light difficulty
  • reduced central vision
  • peripheral vision is intact
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30
Q

wet MD symptoms

A
  • dry can develop into wet overtime
  • sudden, painless vision loss
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31
Q

risk factors of MD

A
  • age
  • genetics
  • caucasians more likely
  • smoking
  • cardiovascular issues
  • females > males
  • UV light exposure
  • diet and obesity
32
Q

precautions of MD

A
  • safety and injury risk
  • people with MD are at risk for social isolation and withdrawal, which can lead to or exacerbate depression
33
Q

hemianopia

A

visual field cuts

34
Q

causes of hemianopia

A
  • stroke (most common)
  • TBI
  • aneurysm
35
Q

brain areas affected in hemianopia

A
  • occipital lobe, parietal lobe, temporal lobe
36
Q

symptoms of hemianopia

A
  • bumping into things
  • missing objects on affected side
  • difficulty reading, double vision
  • depression & anxiety
  • impaired driving
37
Q

treatment for hemianopia

A
  • patient is aware of field cut and can compensate for it
  • prism glasses are used to expand visual field
  • homonymous hemianopia is more common after CVA
38
Q

oculomotor control visual scanning

A
  • motor function of the muscles in the eye is impaired
    • intrinsic & extrinsic
  • damage either at muscle level, cranial nerve level, brain motor centers for that area
  • tests: convergence/ divergence
  • following an object: test in all 4 quadrants, assess tracking as the person crosses midline
39
Q

diabetic retinopathy

A
  • umbrella term for ALL retina disorders caused by diabetes
  • 2 major types:
    • nonproliferative retinopathy (early, most common)
    • proliferative retinopathy (advanced, more serious)
40
Q

nonproliferative retinopathy (most common) (NRDR)

A
  • blood vessels in back of eye balloon/ form pouches
  • typically no vision loss
  • often no symptoms
  • some leakage of fluid which may cause swelling of the macula and blurred vision
41
Q

proliferative retinopathy (more serious) (PDR)

A
  • blood vessels are damaged, close off, and new vessels start growing
  • new blood vessels are weak and can lead to vitreous hemorrhage, causing vision loss
  • scar tissue can grow and then shrink which can lead to retina detachment
  • new blood vessels interfere with flow of fluid and pressure may build up, damaging the optic nerve and leading to glaucoma
42
Q

diabetic retinopathy symptoms

A
  • spots or dark strings floating in your vision (floaters)
  • blurred vision
  • fluctuating vision
  • impaired color vision
  • dark or empty areas in your vision
  • vision loss
  • usually affects both eyes
43
Q

glaucoma

A
  • a group of diseases that cause damage to the optic nerve
  • the most common cause is an increase in pressure to the eye
  • fluid in anterior chamber of eye doesn’t drain
  • 2 major types:
    • open-angle glaucoma
    • closed-angle glaucoma
  • if untreated, can lead to vision loss and blindness
44
Q

open-angle glaucoma symptoms

A
  • at first there are no symptoms
  • leads to loss in peripheral vision
  • if untreated, can lead to blindness
45
Q

closed-angle glaucoma symptoms

A
  • suddenly blurry vision
  • severe eye pain
  • nausea
  • headache
  • see halos around lights
46
Q

glaucoma risk factors

A
  • age 40+
  • diabetic
  • family history
  • high eye pressure
  • african, hispanic, or asian heritage
  • long-term use of steroid meds
  • nearsighted
  • farsighted
47
Q

occupational impacts of low vision

A
  • ADLs
  • IADLs
  • Work
48
Q

role of OT in low vision

A
  • preventing accidents and injury
  • teaching new skills
  • modifying the task or environment
  • promoting a healthy lifestyle
    • obtain specialty certification for low vision
49
Q

preventing accidents & injury

A
  • managing clutter
  • keeping walkways clear
  • ensuring adequate lighting
  • manage layout of furniture
  • keep doors completely open or shut
  • preventing falls with contrast and placement of items in home
  • kitchen modifications
  • AE/ assistance devices
50
Q

hearing loss stats

A
  • hearing impairments are more prevalent than vision loss
  • hearing loss can be associated with balance problems, ambulation difficulties, and an increased incidence in falls
  • 1/3 people between 65-74
  • 85-90% in nursing homes
51
Q

presbycusis

A
  • age related hearing loss
  • can be related to sound exposure, genetic predisposition, and normal aging
52
Q

otosclerosis

A
  • hardening of the small bones of the ear, which fixates them and they can’t vibrate
  • can have surgery to reverse this or implant prosthetics
53
Q

sensorineural hearing loss

A
  • hair cell damage or loss of sensory hair cells in cochlea
  • loss is gradual; people lose the ability to hear high-frequency sounds
  • sounds may be distorted, making language difficult to hear
    • speak in a low voice directly to the person
54
Q

sensorineural: sensory

A
  • loss of hair cells in the basilar membrane
    • high-frequency hearing loss
    • may not hear ringing phone, doorbell, dripping water
55
Q

sensorineural: neural

A
  • loss of the auditory nerve fibers
    • inability to distinguish speech sounds
56
Q

sensorineural: mechanical

A
  • degeneration of the vibrating membrane in the cochlea
    • several sounds in various frequencies are present at the same time, making discrimination difficult
57
Q

conductive hearing loss

A
  • inability of the external ear to conduct waves to the inner ear
    • causes: ear wax (cerumen) buildup, fluid accumulation in middle ear
    • treatments: cleaning ears, meds, surgery, hearing aids, cochlear implants
58
Q

tinnitus

A
  • ringing in the ear
    • associated with many hearing loss conditions (Meniere’s)
    • assess individual for cardiovascular disease, anemia, and hypothyroidism
    • most noticeable at night
59
Q

psychosocial aspects of hearing immpairments

A
  • isolation/ loneliness
  • elders reluctant to ask for clarification
  • experience embarrassment and vulnerability
  • communication can become exhausting
  • paranoia, suspicion, accusations of lying
60
Q

observable behaviors that may indicate hearing loss

A
  • speaking loudly
  • high volume
  • asking for you to repeat
  • not responding
  • confused look and inappropriate responses
  • withdrawing from social situations
61
Q

recommendations for improving elder communication

A
  • inform/ educate
  • increase self-confidence in adaptations
  • improve work/ living environment (reduce background noise)
    • add carpets to floors, drapes on windows, and upholstered furniture
  • improve environmental safety
    • add fire/ smoke alarms, add flashing lights for phones/ doorbell
  • reduce risk for falls
    • avoid startling - always approach from front
  • enhance conversation
    • speak in a low, slow tone, stand in front of and show your lips
62
Q

recommendations for improving elder communication cont.

A
  • closed-captioned TVs
  • telephones that can be typed into
  • reduce glare by improving lighting
  • use a “pocket talker” in therapy
63
Q

assistive hearing devices

A
  • hearing aids
    • determined by an audiologist
    • modern devices are smaller and fit in the ear
    • more cosmetically appealing
    • battery cost is a factor
  • assisted listening device (ALD)
    • mic and amplifier and headset (pocket talker)
    • reduces background noise & amplifies sound
64
Q

proprioception

A
  • sensory receptors for this sensation are in the joint
  • provide information to the brain regarding the position of the body part in space, including joint position
65
Q

stereognosis

A
  • PERCEPTUAL; requires cognition
  • have person say what they call it (schema)
  • best practice is to show them the item and have them identify it/ you tell them what it is
  • testing a person to see what they are holding in their hand using only tactile input/ previous knowledge
66
Q

cause of loss of taste & smell

A
  • chronic sinusitis or sinus polyps
  • dementia can dampen sensory receptors and processing
  • age related changes: decreased sensitivity to flavors and decreased appetite, decreased safety awareness due to loss of smell
  • older adults prone to malnutrition and dehydration (failure to thrive)
67
Q

interventions for loss of taste & smell

A

primarily compensatory for decreased food intake
- use non salt spices, onions, etc.
- utilize feeding routine, don’t rely on hunger
- use visual cues (smoke alarm) since they won’t smell it
- print large dates on food items to make sure that food hasn’t spoiled

68
Q

developing a vestibular deficit

A

injury
- damage to area the controls balance, eye movement, and hearing
- meds can cause injury
genetics
- hereditary deafness - can lead to vest. disorders
environmental conditions
- Meniere’s Disease - inner ear disorder causes vertigo
- atmospheric pressure
- allergies (flare ups)

69
Q

vertigo (what is the most common type??)

A
  • most common type of vertigo is benign paroxysmal positional vertigo
  • increases risk of falls
  • decreases occupational performance
  • can be caused by vestibular or cerebellar dysfunction
70
Q

signs & symptoms for vestibular deficits

A
  • chronic dizziness
  • imbalance (& ataxia)
  • vision disturbance
  • hearing changes
  • cognitive
    -psychological changes
  • other symptoms (nausea, ear pain, slurred speech)
71
Q

vestibular rehabilitation therapy (VRT)

A
  • used to treat vestibular disorders (BPPV)
  • brain learns to use other senses to compensate for the issues through movement retraining & exercises)
  • advanced training is required as an OT
  • alternative to meds or surgeries
  • may be used in addition to OT interventions
72
Q

fall risk factors

A
  • history or falls (& near falls)
  • fear of falling
  • multiple meds
  • decreased eyesight, hearing, or mobility
  • urinary incontinence/ urgency
  • weakness
  • bp changes
  • environmental hazards
73
Q

causes of falls in elderly

A
  • environmental (yard/ walkway issues)
  • lighting deficits
  • lack of handrails
  • uneven surfaces
  • unstable or poorly placed furniture
  • throw rugs & pets
  • inaccessible items
74
Q

biological causes of falls

A
  • vision
  • cardiovascular
  • neurologic
  • cognitive changes
  • urinary/ bowel issues
  • poor sensation in feet
  • weakness
  • sensory
    • depth perception, acuity
  • vision
    • spatial organization & misinterpreting visual info; vision conditions
75
Q

sensory processing & integration in adults

A
  • can carryover from childhood
  • can develop with a TBI
  • can be seen in mental illness
  • SI has been successfully used with adults in many capacities

Clinical Conditions (16 decks)

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