Sensory Study Guide Flashcards
Anatomy - EYE
EYE
- EXTERNAL
- SCLERA (“whites”)
- CORNEA (covers front of eyeball)
- MIDDLE
- CHOROID (nerves and blood vessels - nutrients to retina)
- CILIARY BODY (produces aqueous humor)
- IRIS (colored part of eye)
- CHOROID (nerves and blood vessels - nutrients to retina)
- INTERNAL
- RETINA (optic nerve receptors) - lightwaves changed into impulses.
- RODS (peripheral/darks)
- CONES (central/color)
- RETINA (optic nerve receptors) - lightwaves changed into impulses.
Anatomy - EAR
EAR
- EXTERNAL (pinna/auricle —> tympanic membrane)
- MASTOID -CERUMEN
- MIDDLE (medial side of TM)
- 3 BONES –> MALLEUS (hammer), INCUS (anvil), STAPES (saddle)
- INNER (Labyrinth)
- COCHLEA (snail-shaped)
- ORGAN OF CORTI -receptor/organ for hearing
- SEMICIRCULAR CANALS - 3 bony tubes w/ receptors
- VESTIBULE - 2 bony structures w/ receptors
- COCHLEA (snail-shaped)
** (SEMICIRC. & VESTIB. –> EQUILIBRIUM/BALANCE) **
Normal occurrences that take place with aging in the eyes and ears.
EYES
- DECR. lens accommodation (PRESBYOPIA/MYOPIA)
- DECR depth perception (FALL RISK)
- DECR PERIPHERAL VISION (driving risk!)
- DECR ability to react to light/dark
- DECR color perception (blues/greens/violets)
- DECR tear formation (DRY/itchy eyes)
- DECR. fluid circulation (INCR. RISK GLAUCOMA)
EARS
- PRESBYCUSIS
- HIGH-PITCHED sounds go first *
- VERTIGO/dizzoness/TINNITUS
- Equilibrium/BALANCE PROBLEMS
- INCR. CERUMEN
Normal adult vital signs and pulse ox
PULSE: 60-100bpm
RESP: 12-20rpm
PAIN: 0-10 scale (medicate @ 3 or above)
PULSE OX: 95%-100%
* (COPD 88%-92%)
TEMPERATURE
-ORAL: 96.8 - 100.4
-RECT: 97.7 - 101.3
-AXILL: 95.5 - 99.5GLAUCOMA
- cause
- s/s
- tx
GLAUCOMA: increase in IOP
- CAUSE: inability of the aqueous humor to drain
- RISK FACTORS: HTN, DM, Age, Infection
- S/S
- PROGRESSIVE (RAPID - acute glaucoma)
- PERIPHERAL VISION LOSS
- Mild eye pain (PAIN, NAUSEA - acute glaucoma)
- Halos
- TREATMENT
- PYLOCARPINE (MIOTIC drops) –> (vaso)CONSTRICT
- TINOLOL (beta blocker)
- SURGERY
What diagnostic testing would determine the persons risk at developing glaucoma?
VISUAL ASSESSMENT
TONOMETRY - mesures IOP
GONIOSCOPY - determines drainage angle
What normal findings would you expect to see and document during an eye assessment?
P:upils
E:qual - pupils of both eyes should be the same
R:ound
R:eactive to - both pupils should CONSTRICT w/ light
L:ight
A:ccomodation OK - pupils both change b/w near and far vision
C:oordination - reaction same in both eyes
What is peripheral vision?
“side-vision”
-Loss of peripheral vision is called “tunnel-vision”.
What is cerumen?
Earwax.
Produced in EXTERNAL ear.
PROTECT ear from foreign objects.
What types of medication can be used to treat middle and inner ear problems?
MIDDLE EAR PROBLEMS
-Infection -Injury -Dz
INNER EAR PROBLEMS
-Tinnitus -Vertigo
ANTIBIOTICS - for infection
ANTIHISTAMINES - effective in tx of vertigo/nausea
ANTIEMETICS - tx n/v associated with vertigo (Droperidol)
BENZOs - has antivertigo effects (Valium)
What is a cochlear implant?
Pt education imperative for success?
Can they have MRI’s?
COCHLEAR IMPLANT: surgically implanted coil beneath skin behind ear with electrode –> stimulates auditory nerve fibers.
For SENSORINEURAL hearing loss.
PT EDUCATION
- DO NOT GET IT WET
- MRI’s CONTRAINDICATED
- Teach infection prevention
- Device is not turned on immediately after surgery
What is an ear wick used for?
Used to KEEP MEDICATION IN EAR.
- common w/ abx and swimmers ear.
- PREVENTS MED LOSS
- Remove before administering more medication
How does a corticosteroid work in a pt who just had a lens transplant?
ANTIINFLAMMAROTY.
- Keeps inflammation down
(LONG TERM use corticosteroid can lead to INCR. IOP)
Why is it important to assess visual acuity before and after one eye having surgery?
Establishes a BASELINE.
-You’ll be able to see effectiveness/ineffectiveness of surgery.
What does a “consensual pupil response” mean?
When you shine a light in one eye and both eyes do the same thing.
Ex: light shined in (L) eye —> (L) eye AND (R) eye constrict.
Describe HORDEOLUM
- CAUSE
- S/S
- TX
- PT TEACHING
HORDEOLUM: (“STYE”)
CAUSE: inflammation of SEBACEOUS gland
S/S:
- RED
- inflamed/RAISED
- PAIN (w/PUS)
TX:
- WARM COMPRESS to promote drainage
- Topical ABX
TEACHING
- WASH HANDS
- Do NOT share make-up
- Do NOT pop it!
Describe PRESBYOPIA
- CAUSE
- S/S
- TX
- PT TEACHING
PRESBYOPIA: gradual loss of accommodation
CAUSE: AGE-related (lens becomes less elastic)
S/S
-FARSIGHTED
TX
- GLASSES (bifocals if myopia and presbyopia)
TEACHING
-Caution DRIVING AT NIGHT
Describe PRESBYCUSIS
- CAUSE
- S/S
- TX
- PT TEACHING
PRESBYCUSIS: gradual/degeneration of hearing loss
CAUSE: AGE-related (deterioration of cochlear structures)
S/S
-Decreased ability to hear HI-PITCHED sounds
TX
- HEARING AID
TEACHING
- Wash ear piece DAILY with MILD SOAP
- Check batteries regularly.
- Have patience - takes time to get used to.
Describe MYOPIA
- CAUSE
- S/S
- TX
- PT TEACHING
MYOPIA: (NEARSIGHTED) - light rays focus in FRONT of retina
CAUSE: AGE, elongation of eyeball
S/S
- blurred far vision
- DECR accommodation
TX
-GLASSES
TEACHING
-caution DRIVING AT NIGHT
Describe CATARACTS
- CAUSE
- S/S
- TX
- PT TEACHING
CATARACTS: opacity of the lens that impairs vision.
CAUSE
- AGE
- FAMILY HX
- DM
- SMOKING
- injury
S/S
- WHITE PUPIL (cloudiness)
- ABSENT RED REFLEX
- Halos
- DECR. VISUAL ACUITY
TX
-CATARACT SURGERY to remove lens and replace with prosthesis
TEACHING
-REPORT N/V
-AVOID activities that INCREASE IOP
(DON’T WANT IMPLANT COMING OUT!)
Describe EXTERNAL OTITIS
- CAUSE
- S/S
- TX
- PT TEACHING
EXTERNAL OTITIS: (“swimmer’s ear”) - inflammation of the external ear.
CAUSE: chronic external ear inflammation, exposure to water.
S/S
- PAIN
- FLUID in ear
- PURULENT DRAINAGE (sometimes)
TX
- wear EARPLUGS while doing water activities
- prescribed ear drops can be used in prevention
Describe MENIERE’S DISEASE
- CAUSE
- S/S
- TX
- PT TEACHING
MENIERE’S DISEASE: chronic INNER EAR disease (VERTIGO)
CAUSE: increase in endolymph fluid
S/S
- RECURRENT VERTIGO
- N/V
- TINNITUS
- Progressive unilateral hearing loss
TX
- DRAMAMINE
- DIURETICS between attacks
- LOW-SODIUM Diet
TEACHING (when vertigo is present)
- Lie down, dim lights
- NO fast head movements
Describe ACUTE OTITIS MEDIA
- CAUSE
- S/S
- TX
- PT TEACHING
ACUTE OTITIS MEDIA: inflammation/infection of the MIDDLE EAR.
CAUSE: URI’s, *(Eustachian tube —> throat)
S/S
- PAIN behind eardrum
- FEVER
TX
- NARCOTIC analgesics
- ANTIBIOTICS
TEACHING
- Application of local heat is helpful
- Finish abx
