RLE: Eyes, Ears Flashcards
eyes diameter
1 in
what is on the anterior of the orbit
the eye
external layers of the eyes:
the white one?
the clear one?
sclera
cornea
brown, the nutrient supply of the eyes
choroid
connect choroids with iris, secretes aqueous humor;
Cilary Body
middle layer of the eye:
colored portion, opening [???] in the middle
Iris;
pupil
internal part of eyes:
distributed blood vessels and nerves, bordered internally by vitreous
Retina
gel-like, maintains shape of eye
Vitreous
peripheral vision, dim light
rods
color, bright light, central vision
Cones
depressed portion of retina where optic nerves exit
Optic Disk
optic disk is also called
“Blind Spot”
beside optic disc, contains Fovea Centralis where most acute vision occur
Macula Lutea
clear fluid produced by the Cilary Process draining out of the Canal of Schlemm to the Anterior Chamber (between cornea and iris) and Posterior Chamber (between iris and lens)
Aqueous Humor
extends around the eye to maintain IOP through drainage to systemic circulation
Canal of Schlemm
IOP means
intraocular pressure
bends ray of light to fall on the retina
Lens
controls amount of light that enters the eye
Pupils
clear mucous membrane covering posterior of eyelid and sclera
Conjunctivae
produces tears, drains out through punctum to lacrimal duct and sac
Lacrimal Gland
Eye Muscles:
???: turn temporally;
???: turn nasally
Rectus;
Oblique
cranial nerves on the eyes
CN II, III, IV, VI
blood supply in eyes (2)
Ophthalmic Artery, Ophthalmic Vein
??? Ear: embedded on the temporal bone, eye level
From Auricle, through Ear Canal, to the Tympanic Membrane (“Ear Drum”)
Includes Mastoid Process (bony ridge over temporal bone)
External
“Ear Drum”
Tympanic Membrane
bony ridge over temporal bone
Mastoid Process
??? Ear: tympanic membrane and ossicles (Malleus, Incus, Stapes)
Protected from the inner ear by oval and round window membrane
Eustachian canal to equalize ear pressure
Middle
??? canal to equalize ear pressure
Eustachian
??? Ear: Semicircular canals, cochlea, end of CN 8, maintains balance
Inner
drooping eyelid
Ptosis
oscillating movement of eyeball
Nystagmus
Visual Acuity: N: ???
20/20
Legal Blindness:
20/200
SNELLEN
If denominator>numerator?
Near Sighted (Myopia)
SNELLEN
If numerator>denominator
Far Sighted (Hyperopia)
Color Blindness
Ishihara Plates
measures IOP
Tonometry
IOP Normal
N: 10-21mmHg
visualizes anterior chamber angle; diagnoses congenital and 2O glaucoma
Gonioscopy
Otoscopic Examination
hearing assessment
single most impt test to detect hearing loss
Audiometry
2 audiometry
pure-tone
speech
audiometry: discrimination of sounds
Speech Audiometry
compares air conduction vs. bone conduction; conductive vs. sensorineural loss
Rinne test
Test: for unilateral hearing loss
Weber
WEBER
tone heard on poorer ear
Conductive Hearing Loss
WEBER
tone heard on better ear
Sensorineural Hearing Loss
Px repeats whispered words of examiner who 1 -2 ft and out of sight of him
Whispered Voice Test
(Caloric Ice Water Test): irrigate ear with cold water
Oculovestibular Test
Inflammation of eyelid margins
Blepharitis
Internal Sty, inflammation of the meibonian gland
Chalazion
External Sty, inflammation of eyelash follicle or sebaceous gland in the eyelid
Hordeolum
“crossed eyes” or “squint,” is a condition where the eyes do not align properly when looking at an object.
strabismus
STRABISMUS
inward/convergent deviation
Esotropia
STRABISMUS
outward / divergent deviation
Exotropia
STRABISMUS
upward deviation
Hypertropia
STRABISMUS
downward deviation
Hypotropia
chronic infection of conjuctiva and cornea caused by Chlamydia
Very contagious and may cause blindness
Trachoma
very red eye and painful to move
Scleritis and Iritis
S/Sx: Pain, Photophobia, blepharospasms, lacrfimation
C. Ulceration: emergency: may cause perforation, infection
Corneal Ulceration, Keratitis (Inflamed Cornea)
Inflammation of Iris
Iritis
Inflammation of Iris and Cilary Body
Iridocyclitis
Inflammation of the Choroid
Choroiditis
Inflammation of the Choroid and Retina
Causes: Trauma, Local and Systemic Disease
Choroidretinitis
rare, severe, bilateral, granulomatous
Occurs after penetrating injury near the cilary body
Sympathetic Opthalmis (Uveitis)
Separation of 2 retinal primitive layer (outer pigment epithelium, inner rods and cones) or Elevation from the choroid of both retinal layers due to a tumor
Retinal Detachment
Increased Intraocular Pressure
Permanent Vision Loss due to compression of retina and optic nerve
Glaucoma
Clouding or opacity of the lens due to changes in its CHON’s
cataracts
Refraction Errors
AMMETROPIA
Normal refractive state
Emmetropia
“Farsighted”, Light focuses behind retina,
Hyperopia
Hyperopia lens
Use Convex lens
“Nearsighted”, Light focuses before retina,
Myopia
Myopia lens
Use Concave lens, radial keratotomy
“Old sight”, hardening of lens causing ⬇️ accommodating powers of the lens
Presbyopia
“Distorted vision” due to irregular colrneal curvature
Astigmatism
removal of the eyeball
Enucleation
removal of eyeball contents, leaving sclera intact
Evisceration
Enucleation with blepharectomy
Exenteration
CARE FOR PATIENTS UNDERGOING EYE SURGERY
Avoid activities that may ???:
e.g. coughing, bending, carrying heavy objects, straining, sneezing, vomiting (open eyes!!!)
⬆️ IOP
hearing loss
disease or trauma to inner ear or acoustic nerve
Sensorineural
hearing loss
impedes impulses to external auditory canal, tympanic membrane, and middle ear
Conductive
Stapes can no longer vibrate due to over growth of bones at oval window
Leads to conductive hearing loss
otosclerosis
Chronic accumulation of endolymph in the inner ear
With remission and exacerbation triggered by viruses or emotional stress
MENIER’S DISEASE (Endolymphic Hydrops)
simple incision of tympanic membrane
Myringotomy
closure of perforated tympanic membrane
Myringoplasty
inadequate blood, insufficient blood flow, low hemoglobin levels
a finding seen in conjunctiva
pallor
fluid retention
edema
PERRLA
pupils are equal, round, reactive to light and accommodation
conducted if patient is legally blind
functional tests
unequal size of pupils
anisocoria
dilation of pupil
midriasys
constriction of pupil
miosis
tympanic membrane cone of light
left= 7:00
right= 5:00
patient complaint: blurry vision & halos around rights
Most likely condition
Glaucoma
ptosis in a patient indicates
drooping of the eyelid
patient presents with redness, itching, watery discharge from both eyes
conjunctivitis
hearing loss, tinnitus, vertigo
suspected condition
Meniere’s Disease
observed retracted tympanic membrane during otoscopic examination
suggests ?
otitis media w/ effusion
complain: ear pain, itching, drainage
likely diagnosis
otitis externa
patient report: seeing floaters & flashes of light
serious possibility
retinal tear/detachment
patient has difficulty focusing on near objects (presbyopia)
typical cause
age-related change in lens
complaint: hearing loss in noisy environment
suggest
sensorineural hearing loss
Rinne test: patient hears sound better in bone conduction than air conduction
indicates conductive hearing loss
excessive earwax (cerumen) buildup
most appropriate initial management
cerumenolystic agents
sudden, painless loss of vision in one eye
most likely cause
retinal detachment
test that compares air conduction to bone conduction
Rinne Test
test that assesses lateralization of sound.
vibrating fork is placed on the midline of forehead or top of the head
Weber test
red, swelling, tenderness of the hair follicle & glands that empty at the edge of the eyelids
Sty
