module 6 chapter 46; ear, eye, taste, smell Flashcards

Question

sensorineural hearing loss

Answer 1

mechanism in inner ear disturbed, in cochlea or vestibulocochlear nerve to brain

Answer 2

age related hearing loss sensory metabolic mechanical

Answer 3

atrophy and degeneration of sensory and supporting cells

Answer 4

loss of neurons in cochlea and CNS

Answer 5

middle ear changes in properties -> conductive hearing loss

Answer 6

inflammation of middle ear almost always related to disfunction of eustatian tube, dx with presence of effusion - more common in winter: URI - children more susceptible: short, flexible, and horizontal eustachian tube

Answer 7

``` pacifiers secondhand smoke reflux poor socioeconomic living daycare males natives eskimo craniofacial abnormalities ```

Answer 8

sudden onset of ear pain associated with URI

Answer 9

``` pain children; - irritable - difficulty eating and sleeping - tugging - fever ```

Answer 10

abx pain relief manage fever surgical tubes with recurrent

Answer 11

``` inflammation of middle ear > 12 weeks irreversible damage - atrophy - perforation of tympanic membrane - adhesions - calcification of ossicles ```

Answer 12

surgical removal of debris from middle ear tubes adenoidectomy: help with eustachian tube function

Answer 13

formation of image on retina stimulation of rods and cones conduction of nerve impulses to brain

Answer 14

sclera choroid retina

Answer 15

white, opaque, made up of dense connective tissue protects inner structure maintains shape clear portion: cornea

Answer 16

has greater curvature than rest of sclera, causing it to protrude.

Answer 17

deep in sclera, at conjunction with cornea | drains aqueous humor

Answer 18

highly vascularized, darkly pigmented | attached to iris; pigments responsible for eye color

Answer 19

controls size of pupil

Answer 20

behind pupil, is clear and avascular | elastic membrane, elasticity helps focus light stimuli on retina

Answer 21

filled with aqueous humor | drained by canal of schlemm

Answer 22

anterior chamber of eye provides O2 and nutrients to lens and cornea continually formed and resorbed - balance is total volume and pressure of intraoccular fluid.

Answer 23

portion behind lens | contains thicker fluid: vitreous humor

Answer 24

retinal layer: light waves turn into nerve impulses several layers 2 types of photoreceptors: rod and curves 4 types of neurons: bipolar, ganglion, horizontal, amacrine

Answer 25

photoreceptors synapses with bipolar cells then goes to ganglion cells ganglion axons converge and leave eye in optic nerve

Answer 26

nighttime and peripheral vision | outnumber cones 20:1

Answer 27

stimulated by relatively high intensity light responsible for color and visual acuity - greater concentration in macula: responsible for detailed vision

Answer 28

modify transmission from photoreceptors to ganglion cells | sharpen and enhance responses of ganglion

Answer 29

one cell thick: epithelium removes metabolic cellular debris from photoreceptor cells prevents new vessel growth into retina absorbs light to diminish scattering -> enhanced vision

Answer 30

upside down and reversed left to right | - at optic chiasm nerve fibers cross over to other side

Answer 31

eye elongated, image focuses in front of retina rather than on it: fuzzy image nearsightedness: corrected with concave lenses unable to see distant objects clearly

Answer 32

eye shorter than normal, image focuses behind retina: fuzzy image farsightedness: corrected with convex lenses

Answer 33

loss of accommodative capacity inability to see near objects in middle age corrected with reading glasses

Answer 34

irregular curve of cornea or lens -> distorted image | corrected with lens formed with opposite curvature

Answer 35

cross-eyedness, condition of ocular misalignment | - abnormal neuromuscluar control of eyes

Answer 36

``` squinting frowning with reading closing one eye to see trouble picking up objects dizzy headache ```

Answer 37

``` occlusion therapy: patching of good eye corrective lens surgery on eye muscles prisms exercises for eye ```

Answer 38

poor vision even with corrective lens in one or both eyes most common cause of dec. vision in peds results from: altered visual development despite normal appearing retinal and optic pathways

Answer 39

dx at earlier age is better atropine to blur vision patching of stronger eye

Answer 40

clouding or opacity of lens gradual painless, blurring of vision and eventual loss of sight. by 80, 50- 70% of americans have cataracts

Answer 41

``` aging trauma: lens rupture and swlling congenital: downs, intrauterine rubella metabolic: DM, hypoparathyroidism systemic/inhaled corticosteriods cigarette smoking heavy ETOH ```

Answer 42

increased glare at night one or both eyes blurred vision altered color perception

Answer 43

``` usually spontataneous could be secondary to - trauma - eye tumors - myopia - cataract extraction ```

Answer 44

exudative (serous) tractional spontaneous/ rhegmatogenous

Answer 45

results from accumulation of serous or hemorrhagic fluid in subretinal space - sudden severe HTN - inflammation - neoplastic effusion

Answer 46

mechanical forces on retina caused by fibrosis or scarring pull it away - injury or surgery to eye - diabetic retinopathy

Answer 47

as people age vitreous humor decreases -> traction, causing separation

Answer 48

fluid flows behind retina leading to traction and progressive detachment

Answer 49

sudden appearance of floating spots odd flashes of light blurry vision in single eye "curtain pulled down"

Answer 50

disease of vasculature in retina - capillaries lose ability to transport RBC -> hypoxia and decreased nourishment of retina - vascular and neuronal degeneration, vascular leakage, macular edema, retinal neovascularization

Answer 51

nonproliferative | proliferative

Answer 52

retinal veins become dilated and microaneurysms develop - result of damaged vascular epilthelium - small retinal hemorrhages and cotton-wool spots early: visual changes minimun or resolves in few days. progresses: retinal edema -> affected visual acuity

Answer 53

developments of new abnormal vessels caused by decreased retinal blood flow and ischemia affects vision in 2 ways - abnormal and prone to leak in the vitreous cavity -> vitreous hemmorhage - firmly attach to retina and grow out into vitreous humor -> traction on retina -> detachment

Answer 54

blurred, darkened, and distorted vision changes in vision may fluctuate some unable to read

Answer 55

leading cause of blindness among older adults bilateral progressive degeneration with central vision loss - decreased ability for O2 to diffuse to retinal pigment epithelium and photoreceptors -> release of growth factors and cytokines - > growth of vessels into subretinal space -- new vessels leak -> distortion and reduction in clarity of central vision may also result from cell death and atrophy of retinal pigment epithelium

Answer 56

``` age female smoing family hx increased cholesterol cardiovascular disease HTN obesity hx cataract surgery linked with oxidative stress and inflammatory chemicals ```

Answer 57

dry (nonneovascular atrophic degeneration) | wet (neovascular or exudative)

Answer 58

most common subretinal accumulation of cellular debris: drusen metabolic dysfunction of retina initially affects one eye, will spread to other

Answer 59

appear as discrete yellow deposits on retina on exam

Answer 60

visual loss more rapid onset more severe visual disruption impairment of barrier function -> subretinal collections of fluid -> retinal detachment or neovascularizations

Answer 61

``` painless atrophic (dry): - slightly blurry vision - decreased fine detail - need more light exudative (wet): - progressive blurring - hallmark: wavy appearance of straight lines - vision may be lost rapidly or occur suddenly ```

Answer 62

decreased smell: - smokers - conditions involving congestion and swelling of nasal mucosa - head trauma: loss of smell r/t shearing of the neuronal fibers - tumors and large cerebral aneurysms of anterior cerebral and anterior communicating arteries Olfactory hallucinations - epilepsy and psych disorders

Answer 63

decreased taste (gustatory) - smoking; dryness of tongue and mucous membranes - meds: antidepressant, antithyroid, antirheumatic, anticancer - flu like illness - lesions on thalamus and parietal lobe

Answer 64

``` dec. smell often complains of dec. taste decreased appetite increased sugar, salt, and seasonings no reaction to strong smells do not notice body odor increased risk accident d/t not smelling gas/smoke increased ingestion of spoiled food ```

Answer 65

disease often bilateral genetic component noted no s/s in early stages intraocular pressure consistently elevated gradual loss of peripheral vision (tunnel vision) retinal ganglion cell apoptosis -> axonal loss in optic nerve optic disc atrophy vague persistent dull eye pain, inability to distinguish colors halos around lights

Answer 66

- abnormal angle between the pupil and lateral cornea - angle is narrow and blocks the outflow of aqueous humor when pupil is dilated - rapid onset: can lead to medical emergency - forward displacement of iris toward cornea with dilation harrows or closes changer angle - rapid increase in pressure ->ischemia - s/s: - - severe eye pain - - N/V - - blurred vision with halos - - redness of eye - - steamy cornea - - dilated pupil that is non-reactive to light

Answer 67

intraocular pressure measurements central visual field test exam of optic disk

Answer 68

at birth: 20/400 by 6 month: 20/30 blink reflex, corneal reflex, and pupillary reaction to light unable to coordinate head and eyes: dolls eyes reflex shape of eyeballs, cornea, and lens changes with growth stereopsis (depth perception) by 7 months of age binocularity (perceived vision from both eyes simultaneously) begins at 6 weeks and established at 4 months.

Answer 69

- decreased skin elasticity, changes in lacrimal gland function, and shrinking of vitreous body. - changes to retina and lens -> decreased color vision and discrimination, reduced contrast sensitivity, and diminished accommodation - retinal changes: loss of luteal pigment in macular areas - > reduced light sensing of rods and cones - development of presbyopia r/t decreased elasticity of lens and decrease in the effectiveness of the ciliary muscle. (inability to focus on near objects)

Answer 70

obstruction mass loading stiffness discontinuity

Answer 71

cerumen impaction most common

Answer 72

middle ear effusion

Answer 73

otosclerosis

Answer 74

ossicular disruption

Answer 75

idiopathic impairment of inner ear to regulate normal homeostatic systems - production, maintenance, recycling of endolymph and perilymph

Answer 76

``` autoimmunity allergies viral and bacterial infections head trauma chronic stress -men and women equally - usually in 50's ```

Answer 77

episodic tinnitus vertigo sensations of ear fullness fluctuating hearing loss

Answer 78

``` symptomatic relief - antiemetic, anticholinergics, low sodium diet smoking cessation management of stress dec. caffeine surgical interventions anti-migraine meds ```