Sense Organ Pathologies Flashcards
Which pathology is also known as ‘Swimmer’s Ear’?
Otitis Externa
Define otitis externa.
Inflammation of the outer ear.
90% of cases associated with a bacterial infection, but can be fungal or allergic.
In which populations / conditions is otitis externa more common?
- Swimmers
- People who live in humid climates
- Diabetes Mellitus
- HIV
What is cerumen?
Ear wax
Why is ear wax so important?
Because it contains lysozymes and oil that create an acidic, lubricating coat in the ear and inhibit bacterial/fungal infection.
Why are people with insufficient ear wax prone to ear infections?
Because ear wax is part of the body’s natural defences. It contains lysozymes and is acidic to inhibit bacterial and fungal infections.
Why is excess ear wax a bad thing?
It can cause an ear obstruction (especially if pushed further in with cotton buds)
List 3 things that can contribute to otitis externa.
- Frequent use of earplugs
- Hearing aids
- Fungal infections following antibiotic use
List 3 signs/symptoms of otitis externa.
- Pain (especially with movement of pinna)
- Discharge (purulent)
- Red, swollen auditory canal
Define otitis media.
Infection of the middle ear
Which pathology is the most common cause of earache in children?
Otitis media
List 2 causes of otitis media
- Bacteria & viruses, typically spread from nasopharynx.
2. Allergies (cows milk, wheat, egg)
List 3 signs/symptoms of otitis media
- Earache / pain
- Bulging of tympanic membrane
- Malaise
- Fever
- Mild hearing loss
What is the allopathic treatment for otitis media?
- Rupture of the tympanic membrane
- Antibiotics
What is secretory otitis media?
An effusion of the middle ear, due to incomplete resolution of otitis media.
Also known as glue ear.
What is ‘glue ear’ also known as?
Secretory otitis media
Explain the pathophysiology of secondary otitis media (glue ear).
Build up of a gluey fluid inside the middle ear, due to incomplete resolution of acute otitis media.
The gluey fluid dampens the tympanic membrane and resulting ossicle vibrations, leading to hearing impairment.
List 2 signs/symptoms of secretory otitis media.
- Hearing loss
2. Intermittent ear pain
What is the allopathic treatment for secretory otitis media (glue ear)?
Fitting a grommet into the eardrum
Sometimes tonsils are also removed to improve eustachian tube drainage.
For which pathology would allopathic medicine fit a grommet into the tympanic membrane?
Secretory otitis media
What is the medical name for Labyrinthitis?
Otitis interna
What is otitis interna also known as?
Labyrinthitis
Define labyrinthitis / otitis interna.
A balance disorder, associated with inflammation of the membranous labyrinth.
What is the name given to a balance disorder, associated with inflammation of the membranous labyrinth?
Labyrinthitis / otitis interna
List 3 causes of otitis interna.
- An upper respiratory infection
- Head injury
- Allergy
What are the signs / symptoms of otitis interna (Labyrinthitis)?
- Sudden and severe vertigo, NOT triggered by movement
- Sudden unilateral hearing loss
- Nausea and vomitting
- Tinnitus
What is the allopathic treatment for otitis interna (Labyrinthitis)?
Anti-emetic drugs (anti-sickness)
Describe Menieres Disease.
A disorder of the inner ear.
Caused by a change in fluid volume in the labyrinth.
Associated with progressive distension of the membranous labyrinth.
Which pathology is a disorder of the inner ear, caused by a change in fluid volume in the labyrinth?
Menieres Disease
Which pathology is characterised by vertigo, tinnitus and hearing loss, and has fluctuating patterns of symptoms (acute attacks for 2-3 hours, every 1-2 months)?
Menieres Disease
List 3 causes of Menieres Disease.
Largely unknown, by hypothesised as:
- Genetics
- Viral
- Autoimmune conditions (RA, SLE)
Name one autoimmune condition associated with Menieres Disease
- RA
- SLE
What is the allopathic treatment for Menieres Disease?
There is no cure. Allopathic medicine only seeks to minimise symptoms of attacks
List 3 natural approaches to treating Menieres Disease.
- Low salt intake (reduces fluid build up in the inner ear)
- Stop smoking
- Address fatigue
- Homeopathic - Conium Maculatum
What is tinnitus?
The perception of sound originating from within the head rather than outside.
List the 2 types of tinnitus.
- Objective tinnitus
2. Subjective tinnitus
What is the difference between objective and subjective tinnitus?
Objective tinnitus involves an internal acoustic stimuli that is either pulsatile or muscular.
Subjective tinnitus involves no internal acoustic stimuli and instead can be caused by a number of pathologies, including head injuries, meningitis, TMJ dysfunction and ear infections.
List 3 possible causes of subjective tinnitus.
- Head injury
- Ear infection
- Menieres Disease
- Meningitis
- TMJ dysfunction
Long term exposure to noises about ____ Db can cause hearing impairment.
90 dbs
List the 2 main categories of hearing impairment.
Conductive & Sensory
What is the difference between a conductive and a sensory hearing impairment?
Conductive = caused by an ear canal obstruction, ossicle abnormalities or ruptured tympanic membrane.
Sensory = Poor hair cell function (caused by infection, noise trauma or congenital)
List 3 pathologies that can cause hearing impairment.
Measles
Meningitis
Mumps
List 3 causes of hearing impairment
- Disease
- Head injuries
- Shaken baby syndrome
Name 2 treatments for a hearing impairment.
- Hearing aid
2. Cochlear implant
What structure does the stapes connect to?
Oval window
Which 2 bones in the inner ear send nerve impulses for balance?
Vestibule and semi-circular canals
What is blepharitis?
Inflammation of the eyelid margin. Can be acute or chronic.
Which pathogen is often associated with blepharitis?
Staphylococcus aureus
List 4 signs/symptoms of blepharitis.
- Red eyelid margins
- Sore, gritty eyes
- Scales and flakes around the eyes
- Itching and burning
- Loss of eyelashes
Why does blepharitis sometimes lead to recurrent styes?
Because the inflammation involved in blepharitis blocks the sebaceous glands.
What is the allopathic treatment for blepharitis?
- Eyelid hygiene
- Warm compress on eyes for 5-10 minutes
- Topical antibiotics
What is a stye?
Inflammation / blocking of the sebaceous glands of the eyelid.
What is the most common cause of a stye?
Bacterial infection - staphylococcus
List 2 risk factors for styes
- Diabetes Mellitus
- Chronic blepharitis
Describe the symptoms of a stye
Red, swollen and/or painful infection of the sebaceous glands in the eyelid.
Usually affects the upper lid.
List one complication of a stye.
The formation of the stye cyst can damage the cornea.
What is the allopathic treatment for a stye?
Usually none necessary - the stye will usually burst on its own and the pus will drain.
Hot compresses used 3-4x per day can ease pain and aid pus removal.
How infectious is conjunctivitis?
Very
What is conjunctivitis?
Inflammation of the conjunctiva (very infectious)
List 3 potential causes of conjunctivitis.
- Bacterial
- Viral
- Allergies
What would suggest deeper (corneal) involvement in conjunctivitis?
Photophobia
What is the allopathic treatment for conjunctivitis?
- Eye baths with salt water
- Antibiotic eye drops
- Oral antibiotics (rarely)
List 3 signs/symptoms of conjunctivitis.
- Red eye
- Irritation / discomfort
- Purulent discharge (if bacterial)
- Water eye (if viral / allergic)
What is uveitis?
Inflammation of any part of the uvea (iris, ciliary body, choroid)
List 3 causes of uveitis.
- Autoimmune disease
- Trauma to the eye
- Viral infection (i.e, herpes)
Name one autoimmune disease commonly associated with uveitis.
Ankylosing Spondylitis (AS)
Why is there an association between uveitis and Ankylosing Spondylitis (AS)?
They both share an increased risk as a result of the HLA-B27 gene.
Which gene is linked with a predisposition to both uveitis and AS?
HLA-B27
List the 3 main symptoms of uveitis.
- Progressive unilateral red eye with pain
- Blurred vision
- Photophobia
Which eye pathology is associated with progressive, unilateral red eye with pain?
Uveitis
What is the allopathic treatment for uveitis?
Antibiotics
Sometimes cortisone
What is a corneal ulcer?
An ulcer (open sore) that develops in the cornea.
Why is a corneal ulcer a medical emergency?
Because loss of sight is possible
Name one eye pathology that is a medical emergency.
Corneal ulcer
List 3 causes of a corneal ulcer.
- Viral, bacterial or fungal pathogen
- Trauma (i.e, from contact lens)
- Spread from blepharitis
List 3 symptoms of a corneal ulcer
- Pain
- Reduced vision
- Photophobia
- Discharge
What is the allopathic treatment for a corneal ulcer?
Antibiotics, anti fungal or antiviral drugs.
Corneal transplant
What is the medical term for a squint?
Strabismus
What is strabismus?
A misalignment of the eyes, which means that the retinal image is not in corresponding areas of both eyes.
The terms ‘exotropia’ and ‘esotropia’ are associated with which eye pathology?
Strabismus (squint)
In the eye pathology strabismus (squint), ________ describes an inward squint, whilst _______ describes an outward squint.
Esotropia = inward squint Exotropia = outward squint
In which eye pathology might an eye patch be used as part of treatment?
Strabismus (squint)
Eye patch is used on the normal eye, to force the brain to use the affected eye.
List 2 causes of strabismus (squint).
- Genetic / family history
2. Damage to nerves (ie. stroke, brain tumour)
In which eye pathology would you see an opaque lens?
Cataracts
Which eye pathology is the leading cause of blindness in the world?
Cataracts
What is the allopathic treatment for cataracts?
Lens replacement
Describe the pathophysiology of cataracts.
A healthy lens is transparent, due to regular arrangement of lens fibres.
In cataracts, new lens fibres are produced and become disorganised within cytoplasm, which leads to clouding.
List 4 causes of cataracts
- Age related degeneration
- Diabetes Mellitus
- Smoking
- Steroids
In which eye pathology would you see gradual, painless loss of vision?
Cataracts
What is age-related macular degeneration (AMD)?
The ageing changes that occur in the central area of the retina (the macula).
List 3 risk factors for age-related macular degeneration (AMD).
- Smoking
- Cardiovascular disease
- Family history
List 2 tools you might use to diagnose age-related macular degeneration (AMD).
- Amsler Grid
2. Opthalmoscope
In which eye pathology might you use an Amsler Grid to help with diagnosis?
Age-related Macular Degeneration (AMD)
Which age group are most at risk from age-related macular degeneration (AMD)?
Over 55’s
What is the medical term for eye ‘floaters’?
Muscae Volitantes
What are muscae volitantes (‘floaters’)?
Opacities floating in the field of vision
Why are eye floaters visible to the patient?
Because of the shadows they cast on the retina.
List 2 causes of eye floaters.
- Collagen fibrils presenting as floaters
2. Vitreous haemorrhage in diabetic retinopathy
What is retinal detachment?
Detachment of the neurosensory layer of the retina
Which age group are more at risk of retinal detachment?
Middle-aged and elderly
Which eye pathology presents as floaters in vision, flashing lights and curtains descending over vision?
Retinal detachment
Name an ocular emergency that usually requires surgery.
Retinal detachment
Describe the pathophysiology of glaucoma.
Increased intraocular pressure, caused by inadequate drainage.
Which eye pathology causes compression of the retina and optic nerve?
Glaucoma
What is the main complication of glaucoma?
Permanent blindness, caused by damage to the optic nerve and retina.
There are 2 types of glaucoma, ______ and _______
Mild and severe
Which eye pathology is associated with increased intraocular pressure?
Glaucoma
List 3 causes of glaucoma.
- Congenital
- Uveitis
- Smoking (can increase pressure)
Why is glaucoma a serious condition?
Because it can lead to permanent blindness.
Which eye pathology is often associated with loss of night vision when in chronic stages?
Glaucoma
List 3 signs/symptoms of acute glaucoma.
- Pain in the eyes
- Haloes around lights (relieved by sleep)
- Deteriation of vision
- Sensitivity to bright light
What is the allopathic treatment for glaucoma?
Eye drops / tablets to reduce fluid protection
Laser or surgical treatment
What is diabetic retinopathy?
A progressive disease of the retinal microvasculature, which is potentially sight-threatening.
Diabetic retinopathy occurs as a result of chronic _______.
Hyperglycaemia
What is neovascularisation and in which eye pathology would you expect to see it?
Neovascularisation = new vessel formation in an attempt to re-vascularise.
Seen in diabetic retinopathy.
In which eye pathology do retinal vessel walls become weak and leaky, leading to micro-aneurysms, oedema and haemorrhaging?
Diabetic retinopathy
Patients with diabetic retinopathy may retain normal sight, or experience a decline in vision and floaters. True or false?
True
