Eye n Ear Flashcards
1
Q
Cornea – outer most layer of eye, clear dome shaped covers
front of eye, helps focus vision
A
2
Q
- Iris – thin membrane responsible for controlling diameter and
size of pupil
A
3
Q
- Ciliary body – connects iris in the eye
A
4
Q
- Pupil – hole in center of iris, control amt of light that gets into
eye
A
5
Q
Lens – transparent, refracts light on the retina
A
6
Q
- Retina – lines the back of the eye near the optic nerve, sends
signals to brain for visual recognition
A
7
Q
- Optic nerve – back of eye, transfers visual information from the
retina to vision centers to brain via electrical impulses
A
8
Q
Hearing less acute, (age 40)
A
presbycusis-higher frequencies & consonants
more difficult to distinguish-NI- talk in lower tones
9
Q
Xanthelasma
A
yellow discoloration cholesterol buildup
under skin; hyperlipidemia
don’t cause issues just look at cholesterol
10
Q
Ptosis
A
(Lid lag), droppy
11
Q
Exophthalmos
A
is the protrusion of one or both eyes anteriorly out of the orbit due to an increase in orbital contents within the rigid bony orbit
12
Q
Arcus Senilis
A
13
Q
Miosis –
A
constrict pupils
14
Q
- Anisocoria –
A
unequal pupils (seen in CNS disorders)
15
Q
sclera
A
Protective outer layer
16
Q
Conjunctiva:
Yellow
Red
PaleBlueCast
A
inner surface of
eyelid
juadince
conjustvtis
17
Q
red and green meaning on line of ear chart
A
color blinding
18
Q
Accommodation
A
both pupils should constrict at the same time
when objects come towards face eyes accommodate
19
Q
PERRLA
A
Pupils Equal Round and Reactive to Light, Accommodation =
20
Q
Congenital cataracts
A
fetus exposed to rubella
21
Q
Strabism
A
cross eye
22
Q
Amblyopia
A
lazy eye
23
Q
Central Vision-
A
with loss of
peripheral vision
24
Q
Hordeolum
A
Inflammatory:
Stye infection of sebaceous gland by staph ( keep hands clean and off area)
25
Blepharitis
inflammation of the eyelids. demeatix
26
Conjunctivitis
pink eye
27
Myopia (me what can i see)
nearsightness; ppl can see near but not far away...
28
Hyperopia ( farsightedness)
can see far but cant see close objects
29
Astigmatism
30
Presbyopia-
Progressive loss of near
focusing ability of the eye due to ageing
31
Retinal detachment
s/s
define
tx
Fluid accumulation between retina and epithelium
* S/S: Photopsia (light flashes), floaters, “cobwebs” in
eye, once detachment has occurred > painless loss of
peripheral or central vision, feels “like a curtain”
comes across the field of vision
Cover eye, no activity; keep pt in bed, quiet. Position the head so hole lowest part of the body
32
Vitrectomy-
Your ophthalmologist removes the vitreous pulling on the
retina. The vitreous will be replaced with an air, gas, or oil bubble. The
bubble pushes the retina into place so it can heal properly.
33
Diathermy
* Photo coagulation-
* Cryopexy
* Buckled-
produces focal areas of heat injury at selected sites in the eye.
The surgeon hopes that the proliferation which occurs in the reparative
phase of reaction to the injury will lead to the development of
chorioretinal adhesions.
laser photocoagulation is used to destroy leaking
blood vessels in the retina
is a procedure to seal retinal tears or holes. A nitrogen-cooled
probe is applied to the outside of the eye to freeze the area near the
break.
A buckle or sponge is stitched around the sclera.The buckle helps
repair retinal detachment by pushing the sclera toward the retinal break
or tear
34
Gas bubbles
* Laser RX-
* Post Op
push the detached retina into place-injected in vitreous
cavity (pneumatic retinoplexy)
Seals the retina
– Bed rest
– Specific Head position (depending on surg and HCP)
– No doing anything that will increase the IOP (bending, lifting,
straining, coughing, sneezing, vomiting, Valsalva)
35
Scleral Buckling
36
Occular Trauma
37
2 types: Macular dengernation
Dry (nonexudative)
Wet (exudative)
s/s
define
Wet macular degeneration more severe – blindness,
rapid onset of vision loss, development of abnormal
blood vessels in or near macula. Have hx of dry AMD
first.
* S/S: blurred and darkened vision, scotomas
(blind spots), metamorphopsia (visual distortion)
38
Scotomas
= blind
spots
39
Amsler grid -
helps to define
the involved
area, provides
baseline
40
Treatment of AMD
-Dietary supplements of vit C, vit E, Zinc, beta-carotene
*Nutritional intake of dark green leafy vegetables (contain
lutein) and fatty fish
*No smoking
*New tx for severe AMD-GA- Pegcetacoplan (SYFOVRE)
Wet AMD
*Ranibizumab (Lucentis) injected directly into eye. Slows/stops
new vessels from forming.
*Photodynamic therapy – IV + cold laser to damage abnormal
blood vessels.
41
Diabetic Retinopathy
define:
s/s:
Long-standing uncontrolled DM, characterized by capillary
microaneurysms, retinal swelling, hard exudates.
S/S: poor night
vision, floaters, blurred vision, loss of central vision, blindness
42
Tx Diabetic Retinopathy
Vitrectomy = define this
* Control BS, BP and cholesterol
* Tx does not reverse existing damage, slows
progression of disease
* Laser surgery- get rid of weaken/abnormal fragile
eye vessels
* Vitrectomy – aspiration of blood, membrane and
fiber from inside eye
43
Cataracts
Cloudy opacity of lens-Blurry vision
Senile- age related cataracts; uncomplicated age 50 +
Excision of lens and replacement of new lens or
special contacts
May occur in one or both eyes
44
Secondary (catartacts) DM, renal disease, steroids
45
* UV light exposure
* S & S:
– Hazy, blurry or fuzzy vision
– Change in eyeglass RX
– Feeling of thin film over eyes
– Change in pupil color black to gray, yellow or white
– Poor night vision
– Light that appears esp. bright
46
Cataract treatment
Non-surgical – change eye glass prescription, strong reading
glasses or magnifying lens, increase light, lifestyle changes –
avoiding driving at night
* Surgical
* Extracapsular- lens removed, posterior chamber intact
* Phacoemulsification-An ultrasonic probe is inserted through
the incision to break up the cataract into tiny fragments using
high-frequency sound waves. The fragments are then
suctioned out of the eye.
* New lens implanted with both procedures, correct near and
far vision
47
Darwin’s Tubercle
painless nod ; congenital
48
Tympanic membrane
Shiny, translucent, pearl gray, white or pink in color, concave, light reflective
49
otoscope to examine inner ear canal and tympanic membrane
Pull pinna up and back for adults, down and back for children under three
Need to stabilize hand holding scope against head so if patient jumps or jerks, speculum does not injure ear canal or tympanic membrane
50
2 pathways for sound conduction
Air conduction-external & middle ear most efficient
Sound ear drum ossicles cochlea CN 8 brain
Sound conduction
Bone conduction-sound passes through bone directly to inner ear
51
Two types of hearing loss :
Conductive
Sensorineural
Conductive
Problem in external or middle ear
Decrease ability to hear normal sounds
Most conductive losses are correctable
Sensorineural
Disorders affect inner ear (cochlea) or the brain
Affects high frequency sounds more than low frequency sounds
Sensorineural losses are not as correctable. Depends on impairment to nerves of inner ear.
52
Hearing Tests
whisper
audiometry
Whisper test-stand 1-2 ft away & whisper at side (cover opposite ear). Inc. Wisper to spoken then test on opposite ear
Audiometry_ most accurate- one part of full audiological assessment done by audiologist. Uses audiometer with headphones on- different frequencies tested in each ear
53
Normal =
Conductive Hearing Loss =
air conduction (longer than bone) > bone conduction
bone> air
54
Sound lateralized to one ear =
conductive loss in that ear or
sensorineural loss in other ear
55
Causes of Hearing Loss
Age
Noise exposure
Frequent otitis media
Ototoxicity (Gentamycin)
Trauma
Congenital
56
External Otitis
Swimmer’s Ear VERY painful
Tx: Ear gtts, depends on if bacterial or fungal
Maintain asepsis of dropper and position on unaffected side for at least 2 mins after instillation to allow medication to absorb
57
Cerumen (ear wax)
May need gtts to soften and then irrigate to flush out.
Foreign bodies to be removed by otolaryngologist
58
Otitis media-
Acute Otitis Media- Usually in
s/s
Infection of middle ear. Acute otitis media: swelling of auditory tube, trapping bacteria
Childhood along with URI, Allergies
No fluid drainage
s/s pain/earache, fever, malaise, H/A Decreased hearing
Can be viral or bacterial
ATB if bacterial
59
Serous otitis media:
fluid collection d/t eustacian tube dysfunction, pain, c/o fullness, popping, or plugged
60
Chronic otitis media + mastoiditis:
nausea, dizziness, purulent exudate, pain, hearing loss, perforation of TM
61
Mastoiditis:
Otosclerosis:
Mastoiditis: inflamed mastoid process
Otosclerosis: hereditary, stapes fixation to oval window > stapedectomy
62
otosclerosis:
NI:
spongy bone
develops preventing movement
of footplate of the staples in oval
window, dec. of transmission,
Conductive hearing loss.
NI: cotton ball in ear with dsg
covering it, avoid sudden move-
ments, coughing, sneezing, lifting,
bending, straining = inc. ear
pressure. May c/o slight
dizziness,
nausea, vomiting
63
Reddened Eardrum
Abnormal, (otitis media), swelling, possible perforation of eardrum d/t increase pressure
64
Motion sickness=
a common and complex syndrome that occurs in response to the real or perceived motion. There is often a mismatch between what the eyes, the muscles, joints, and the vestibular organs in the inner ear sense.
65
Meniere’s Disease-Involves all three:
Accumulation of
Sx:
Usually starts at ages _____
Attacks may last ____-
Involves all three: sensory hearing loss, Vertigo, and/or tinnitus, sweating, pallor
Accumulation of endolymph in membranous labyrinth
Sx: Sudden attacks of vertigo, w/ N & V-Cause unknown
Usually starts at ages 30-60
Attacks may last hours or days and occur several times/year
66
Tx during acute attack:
Antihistamines (diphenhydramine)
Anticholinergics
Benzodiazepines
Decreases abnormal sensations and alleviate symptoms
Vertigo-bedrest, sedation and antiemetics
Tx between attacks: Diuretics, antihistamines, low sodium diet, Anti vertigo meds (Meclizine)
67
Acoustic Neuroma
Benign tumor where acoustic nerve enters the temporal bone from brain
Need early dx to prevent growth and compression on facial and acoustic nerves. This can lead to hearing loss and facial nerve paralysis
68
