neuro (class 9) hearing & vision loss Flashcards
hearing loss
50% of those over age 75.
develops due to lesions of outer ear, middle ear, or central auditory pathways.
conductive hearing loss
transmission of sound is disrupted ( cerumen, edema, stenosis, tumors, perforated tympanic scarring) hearing loss across all frequencies.
sensorineural hearing loss
sound waves get to the inner ear but reception/interception is decreased or distorted (commonly caused by impulse or continuous noise damage to hair and cells and organ of corti = high frequency hearing loss_
presbycusis
aging related degeneration of cochlear hair cells, gradual hearing loss progressing across adulthood.
cues to hearing loss
increased voice volume. head position with good ear toward speaker. ask for repetition. respond inapppropriately to conversation can appear confused decreased socialization difficulty in groups.
audiometry
diagnose conductive & sensorineural hearing loss.
pt sits in soundproof room & responds to sounds when heard.
identifies type and pattern of hearing loss.
hearing aidsy
amplify sounds, doesnt correct or treat problem.
challenges: denial, vision problems, manual dexterity, cost.
types: in-canal, in the ear, and behind the ear.
conductive surgery
reconstruction
sensorineural surgery
cochlear imlants.
vertigo
sensation of movement when there is none.
symptom caused by various problems-often RT inner ear.
vertigo assessment:
is the world spinning or are you light-headed?
is it related to movement?
are you having problems with your balance?
are you experiencing nausea and vomiting?
how long does the sensation last?
ringing in your ers?
autonomic symptoms(sweating, hypotension, salivation, pallor)?
vertigo interventions
gradual position changes
turn whole body
sit down immediately
medication.
Menieres disease
cause: unknown, but accumulation of excessive fluid in the membranous labyrinth occurs.
symptoms: vertigo, tinnitus, progressive hearing loss.
diagnosis: hx & PE, audiometry, vestibular testing, glycerol test (osmotic effects pulls some of excess fluid)
Menieres disease treatment
symptomatic management & diet: no ETOH, caffeine, low sodium.
meds: diuretics, motion sickness meds (meclizine), nausea meds.
macular degeneration
damage to the retina (macula provides focus/central vision)
dry (nonexudative), accumulation of drusen deposits, nutrition slows progress-vitamins, lutein, betacarotene.
wet: develops from progression of dry, leakage from waek blood vessels, scarring.
treatment: injections that prevent new vessel growth, laser.
risk: age, caucasion, smoking.
cataracts
opacifacion of the lens due to clumping of protein that blocks light and blurs vision.
common > 50% of those over 80.
risk: age, sunlight, smoking, trauma, DM, steroids.
surgery: surgical removal of lens & replacement intraocular lens implanted. outpatient surgery. eye drops per&post op.
glaucoma
damage to optic nerve from increased intraocular pressure
loss of peripheral vision
open angle glaucoma-most common, gradual impaired drainage thru trabecular meshwork, painless; both eyes.
closed angle- rapid or gradual onset, systemic s/s with exac: HA, N/V, pain, blurred vision, halos, one eye, pupil may be fixed.
meds: beta blockers, prostaglandins, carbonic anhydrase inhibitors.
surgery laser holes into trabecular network, fistula or tubes for drainage.
retinal tears and detachment
separation of the retina or sensory portion of the eye from the choroid, the pigmented vascular layer.
usually spontaneous, but can be caused by trauma.
medical emergency.
s/s: floaters, flashes of light, blurred/curtained vision, painless.
positioning so gravity pulls retina into contact with choroid.
surgery for tears: cryotherapy or laser to weld layers back together.
surgery for detachment: pneumatic retinopexy (use air/gas bubble) to pressure area back against the wall, scleral buckle or vitrectomy.
