Week 3 - sensory perception Flashcards
1
Q
What is the difference between sensory perception and impaired sensory perception?
A
sensory perception: the ability to receive sensory input through physiological processes in the body, and translating it into meaningful information.
things like vision, hearing, taste, smell and touch
impaired sensory perception: when the five senses are not at optimal function
2
Q
What does sensory input consist of?
A
pitch
- frequency of waves
-higher pitch = more frequent waves
loudness
- energy of wave
3
Q
what are the three parts of the peripheral auditory system?
A
external (outer), middle and inner
4
Q
what cranial nerve is associated with the central auditory system? what is it responsible for?
A
Cranial nerve VIII or 8, balance and hearing
5
Q
what does the eyes specifically perceive?
A
light waves!
6
Q
If ric the munch came into your clinic and mentioned that he recently visited a doctor and was said that he’s conjunctiva was inflamed. He asked you want part of the eye is this located?
A
the external eye ya munch
7
Q
what does the internal eye consist of?
A
the outer sclera (white part) and cornea
the middle layer
inner layer
8
Q
What does the external eye consist of?
A
eye lid
conjunctiva (thin clear layer that protects the eye)
lacrimal duct (takes tears to nasal cavity)
eye muscles
9
Q
A
10
Q
Dr. pepper comes in the office and mentions that he was having eye problems. he went to his colleagues office to see what’s up and he was told his results were 20/200 in his left eye (best eye). what kind of vision is this?
A
mfer is BLINDDDDD babyyyyyy
11
Q
what disease fall under primary vision impairment?
A
glaucoma, cataracts, retinal detachment and macular degeneration
12
Q
what disease falls under secondary vision impairment?
A
diabetes and diabetic retinopathy
13
Q
what are some age related changes in smell, taste and tactile threshold?
A
smell - reduced smell and ability to distinguish smell. starts at age of 60
taste - decrease
tactile threshold - increases, starts at age of 20
14
Q
true of false: age related changes do not affect all the structures involved in retinal-neural pathways in the absesne of disease
A
false; it does affect
15
Q
true of false: age related changes are gradual and do not have a major effect on everyday activites
A
trueeeeeee
16
Q
a patient walk in and the first thing you notice is their upper lid of their eye is drooping. what is the medical term so that you can chart it?
A
senile ptosis
17
Q
Whats another word for external eye?
A
extraocular
18
Q
what is the difference between ectropion and entropion?
A
ectro(out) - turning outward of the lower lid
entro(in) - prolonged turning inward of the lower lid
19
Q
true of false: within the older client, narrowing of the tear duct and reduced production of tear occurs, as well as decrease goblet cells the produce mucin(mucus)
A
true
20
Q
what changes occur in the internal eye?
A
cornea - opaque and interferes with the passage of light
lens - becomes stiffer and more opaque - decrease response of lens
iris- less flexible
pupil is less responsive
less function of the atrophy of ciliary muscle
21
Q
Which are some age related changes in the internal eye:
a) artheroschlerosis
b) degeneration of neutrons in the visual cortex
c) thinning and sclerosis of retinal blood vessels
d) number of rods diminsh
e)reduced contrast sensibility
A
all
22
Q
what are some age related changes on visual function?
A
reduced visual field, finished depth perception, altered colour vision, finished critical flicker fusion, longer processing time for visual info, increase sensitivity to glare and reduced contrast sensitivity
23
Q
what is presbyopia?
A
near sightedness, loss of elasticity, leads to decrease in the eyes ability to change the shape of the lens to focus on near objects and decrease ability to adapt to light.
within the ciliary body
lens becomes stiffer, denser and more opaque.
leads to seeing darker blues and white light appears more yellowy
24
Q
What is glaucoma?
A
age related disease,
risk factors: age, genetic predisposition, h bp and diabetes
structure: build up of aqueous fluid (increase intro ocular pressure) enters pressure and damages the optic nerve.
how to assess: loss of peripheral vision and progresses to blindness.
Primary open angle - most common
Normal tension glaucoma - intra ocular pressure isn’t high
Acute closed-angle. - medical emergency, sever eye pressure
tonometry - to measure intraocular pressure, IOP
25
what is cataract?
risk factor: advanced age, smoking, prolonged exposure to sunlight, diabetes, corticosteroids
structure: oxidative damage to lens protein, fatty deposits in ocular lens
clouding of ocular lens, "halos" around objects, blurring usually bilateral
intervention: surgery when visual acuity decreases to 20/50. risk of surgery: detached retina post surgery
26
what are some risk factors of cataracts?
too much sunlight, diet, diabetes, hypertension, history of alcohol or tobacco, kidney disease
27
what can reduce the risk of cataracts?
intake of high dietary lutein and zeaxanthin, vitamin C, E copper and zinc
28
What is macular degeneration?
risk factors: advanced age, family history, smoking, obesity and exposure to sunlight
literally it is the degeneration of the macula - the central part of the eye responsible for central vision. photoreceptor cells in early stages, in later stages hemorrhage of blood vessels in the choroid can lead to total blindness
assessment: use of amsler grid- wavy lines + development of AMD
NO CURE
29
zeaxanthina and no beta carotene can reduce the risk of advanced AMD and later on cure it
False; it can reduce but not cure
30
when you assess for eye comfort, what are you looking for?
mild dry eyes (scratching feeling)
moderate dry eyes (discomfort or pain, decreased mucus production)
usually too sensitive to tolerate artificial tears, eye pain associated with pathological conditions
31
what are some risk factors for impaired vision?
population - genetic component
lifestyle - such as smoking, nutrient deficiencies
medications - adverse effects
environment - eye damage from UV, warmer temperatures, prysbyopia
environment conditions that cause dry eyes
32
what are some interventions to prevent vision loss?
prevent vision impairment:
attend no smoking programs, good nutrition and exercise, nutritional considerations such as vitamin C, carotene, zinc and copper
prevention to minimize impact of vision changes:
fall prevention, eye exams regularly
33
this is the ability to receives stimulation through one's sensory organs
sensation
34
what does sensation mean?
this is the ability to receives stimulation through one's sensory organs
35
What does perception mean
how one perceives, organizes and interprets
36
what does sensation + perception
refers to the ability to receive sensory input and, through various physiologic in the body, translate the stimulus or data into meaningful information.
37
refers to the ability to receive sensory input and, through various physiologic in the body, translate and stimulus or data into meaningful information.
sensation + perception
38
Complex physiologic process that allows humans to interact efficiently within the environment provide what ?
provide the basis for social interactions, communication, and learning
39
sensory perception also provides.....
a level of protection through detection and reaction to dangers within the environment
40
true or false. Sensory Perception. A level of protection through detection and reaction to dangers within the environment.
true
41
true or false.impairment of any of the five senses can lead to significant challenges that can negatively impact development, health and well being
true
42
this is the ability to perceive through one's sensory organs. Can be internal fro within the body or external from outside the body. Includes feelings pain, temperature, light.
sensation
43
Can eyes, ears, nose, touch receptors can be apart of sensation ?
yes they are apart of that
44
what is the external stimuli of sensation?
received and processed through five senses : vision, hearing, taste, smell, and touch
45
what is this describing : bottom-up process by which our senses receive and relay outside of stimuli
sensation
46
how does one receives, organizes and interprets sensation
perception
47
the top-down way our brains organize and interpret that information and put it into context
perception
48
What is the population at greatest risk ?
older adults
49
What is the physiological changes that occur with aging :
age- related changes
50
true or false. Population at greatest risk : older adults decline occurs in in all five senses
true
51
Risk Factors : Impaired Visual Perception
congenital conditions and genetics
adverse reactions and side effects of medications
acute injury
chronic medical conditions
lifestyle choices and occupation
52
in the following below match the descriptions it the category of the risk factors for impaired visual perception :
congenital cataracts
common side effects of medications
acute brain injury that affects a part of the brain in relation
diabetes & stroke related to the area of the brain related to sensory perception
smoking- a risk factor for cataracts and macular degeneration
occupations that place eyes at risk ( use of glasses)
congenital conditions and genetics
adverse reactions and side effects of medications
acute injury
chronic medical conditions
lifestyle choices and occupation
53
Name some consequences of impaired visual perception
delirium ( cognition )
dementia ( cognition )
depression ( cognition/mood & affect)
anxiety ( mood & affect)
loss of slef worth ( congition/mod & affect)
54
true or false. Consequences of impaired visual perception can be seen as instuiting and maintaining meaningful interpersonal relationships ( personhood)
true
55
Functional decline can ( functional ability) can be seen as consequences of impaired visual perception
true
56
Age-related changes : Impaired Visual Perception
true or false.
Age related loss of elasticity in the lens of the eye leading to an increase in the eyes ability to change the shape of the lens to focus on near objects such as fine prints and decreased ability to adapt to light
false, it decreases.
57
Does the lens become stiffer, denser, and opaquer when age related changes are impaired?
true
58
true or false. When older and becoming impaired visual perception ,colour vision may be affected by lens opaqueness leading to seeking darker blues and whit light appear more yellowly
true
59
Age-related changes : Impaired Visual perception
How does the lower eye change ? and eyelashes ?
lower eyelid changes drooping down ( decreased lubrication) and inversion of eyelashes into the eye ( causing irritation and inflammation)
60
Age - related changes : Impaired Visual Perception
narrowing of the tear duct and reduced production of tears lead to
dry eye syndrome ( irritation and inflammation )
61
what is Presyobia?
is a result of an age related changes ( loss accommodation or ability to focus on object at various distances )
62
this si caused by degenerative changes in the lens and the ciliary body
Presbyopia
63
Major disease causes of visual impairment and blindness among older adults :
cataracts
macular degeneration
glaucoma
diabetic retinopathy
64
name some risk factors for cataracts :
advanced age, smoking, prolonged exposure to sunlight, diabetes, malnutrition, corticosteroids
65
name the pathology of cataract
oxidative damage to the lens protein, fatty deposits in the ocular lens
66
what is the assessment for a patient with cataract
" clouding " of the ocular lens, appearance of halos around objects, blurring, decreased perception to light and color, sensitivity to glare
67
what is the intervention for patient who suffers with catarct?
surgery when there is safety risks of quality of life. Risk of surgery: detached retina post- surgery ( curtain coming down over line of vision, this is an emergency!)
68
this is when central vision lost
AMD ( macular degeneration)
69
what is the risk factors for age related macular degeneration
advanced age, family history, smoking, obesity, exposure to sunlight
70
what is the pathology for age-related macular degenration
results from systemic changes in circulation, disruption of photoreceptor cells
71
what is the assessment for age- related macular degeneration
central vision loss, use of armsler grid ( perception of wavy lines mean beginning of macular degenration)
72
what is the intervention for AMD ( macular degeneration )
No cure for amd, managed by medications, laser based treatments
73
is there any cure for AMD ?
no there arent any cure
74
Is glaucoma common for older people, and can be connected with blood pressure?
this is true
75
what is the risk factor for glaucoma ?
age, older women twice as affected as older men, african, asian, or latin american descent
76
what is Pathology for Glaucoma ?
Build- up of aqueous fluid in the eye which exerts pressure on and damages the optic nerve , leading to blindness
77
what is the assessment for glaucoma ?
regular screening by eye speciliast, dilated- eye examination ( check status of optic nerve and retina) , tonotmetry ( to measure intraocular pressure, IOP)
78
what is the intervention for glaucoma :
chronic : gradual onset - medical theraphy with eye drops ( beta-blockers)
Acute : sudden onset- medications and immediate surgery
79
this has something to do with glucose regulation, and inflammation. Manage as early as you can by maintaining eye check ups
diabetic neuropathy
80
What is the risk factors for diabetic neuropathy ?
most diabetic patients develop diabetic neuropathy within 20 years of diagnosis
81
what is the pathology of diabetic neuropathy?
changes in retinal microvasculature, increased vessel permeability (leakage)
82
what is the assessment for diabetic neuropathy
done via funduscopy ( part of the eye exam to visualize fundus )
83
what is the intervention for diabetic neuropathy
blood sugar/blood pressure movement, laser-based treatment
84
name some consequences of impaired visual perception:
impact on safety
inability to read medication labels
difficulty navigating ( stairs, curbs)
difficulty/inability to drive
higher risk of falls
85
true or false. one of the major consequences of impaired visual perception is the impact of quality of life. It reduces independence, ability to read, etc.
true
86
Clinical connection : applying your knowledge into practice
Ms. Simons, a 78 year old woman who has presented to the emergency department after falling when she was walking in her home in the middle of the night. In the E.R, when assisting Ms. Simons to the bathroom, she bumped into the medication cart and moved very hesitantly. When interviewing Ms. Simons, the nurse identifies that she has glasses, but says she has no longer wears them as " they don't help, everything's still blurry."
What signs do Ms. Simons have potential visual impairment ? What potential consequences of visual impiarment is she at risk for? why?
What are the possible nursing interventions which can be implemented ?
What is the impact of the impaired sensory perception ( visual) to Ms. Simons' functional ability?
1. Falling
Bumped into the medication cart
moved very hesistanly
she has glasses but says she no longer wear them as they dont help, everything is still blurry
functional decline
safety
impact on quality of life
cognitive decline, delirium, anxiety, depression
2.interventions to prevent delirium
needs an eye examination
needs to be assessed by occupational therapist to address safety issues
possible referral to GPAT ( geriatric program assessment team)
3.as stated earlier, with impaired sensory perception ( visual) , she will likely have decreased functional ability, higher risk of functional ability, higher risk of functional decline, reduced quality of life, higher safety risk
87
impaired auditor perception is another word for
hearing loss
88
impaired auditory perception ( hearing loss) causes can be :
conductive
sensorineural
89
what does conductive and sensorineural mean?
conductive : infection, eardrum perforation, fluid, or cerumen (earwax) accumulation
sensorineural : changes in the inner ear or never
pathway
- prebycusis (eldery hearing)
90
true or false. cerumen impaction is done by a doctor or nurse practitioner
true
91
Explain briefly what cerumen impaction is
interfered with the conduction of sound through the air in the eardrum
easily said: earwax blockage
92
Cerumen impaction : Individuals at particular risk of impact are
individuals who wear hearing aids
older men with large amounts of ear canal tragi ( hairs in the ear)
93
True or false. Cerumen Impaction is most common and not easily corrected.
false, though it is common, it is easily corrected
94
what is the intervention for cerumen imapaction
remove cerumen ( lavage ) and prevent build up ( oil drops)
95
Older adult who suffers from presbycusis diminished ability to hear high pitched sounds ( frequency), and how do they hear high pitched sounds?
this is a true statement, older adults who suffers from presbycusis are people who hears high pitched as distorted. In other word its filtered out
96
______ hearing loss interferes with ability to identify the spatial location of source of speech or noise
sensorineural
97
what is presbycusis?
a sensorineural hearing loss related to age-related degeneration of the auditory structures
98
True or false. Background nosies further aggravates hearing deficit i.e in health care settings in older adult who suffers from presbycusis.
true
99
consequences of hearing loss
impact on quality of life
- impairs ability to communicate with others
-social isolation
-leads to depression or ow- self esteem
safety issues
unable to hear
instructions, warnings ( danger)
a car coming when crossing the roads
a phone or a doorbell ringing or knocking
100
True or false: age related changes affect all of the structures involved in retinal-neural pathway but in the absence of disease they are gradual and do not have a major effect on everyday activities
true
101
True of false: age related changes to the external ear include: auricle (external ear) gains flexibility, auditory glands narrows, cerumen(earwax) glands decrease (atrophy), in men: tendency to have long thick hair at periphery of the auricle
false; auricle loses flexibility
102
true or false: in terms of age related changes of external ear - age related changes prevent the natural expelling of the cerumen
true
103
what are some age related changes of the middle ear?
tympanic membrane thinner and stiffer ear drum
muscles and ligaments become weaker and stiffer - reduces the effect of the acoustic reflex (an involuntary reflex in response to loud sounds and sounds from ones voice)
104
true or false: some age related changes fo the inner ear: cochlea: reduce blood supply, lose of neutrons in cochlear nuclei, increase in hair cells, fibrous changes in the small blood vessels that supply the cochlea, Prysbycusis- sensorineural hearing loss
true except decrease in hair cells
105
true of false: age related changes to inner, middle and external ear influence the sound being sent to the brain, also account for hearing loss experienced in older adults
true
106
what cranial nerve is responsible for the auditory nervous system?
cranial nerve VIII
107
what are the most common hearing problems in older adults?
sensorineural loss - age related changes in middle ear (presbycusis) usually both ears
conductive hearing loss: disruption in the external or middle ear that interferes with the transmission of sound
108
what is otosclerosis?
calcification of the middle ear bones
109
what are some difference between sensorineural and conductive hearing impairment?
sensorineural hearing loss - decreased ability to hear high pitch sound
- older adult can hear vowels better then consonants
-messes with the ability to identify the spatial location of the source of speech or noise
-diminished speech discrimination
conductive - reduce ability to hear votes and low pitch sound
-loudness can improve hearing in all frequencies
-background noise, not as big of a problem as sensorineural
110
is it true that: you should never assume hearing loss is because of age until other causes are ruled out
true
111
it is true that you can prevent hearing loss by treating/impacting cerumen?
yes it is true
112
why should you treat cerumen to prevent hearing loss ?
underdiagnosed, can interfere with hearing aide, affects 19-65% of adults over 65 y/o
113
what are some symptoms of excess cerumen?
hearing loss, diminished cognitive function and possibly pain, itching, tinnitus, dizziness
114
true or false: Nurses can visualize the tympanic membrane and detect cerumen impaction with a opthamascope
false: use otoscope
115
What are some assessment options for the extent of hearing impairment
whisper test
finger-rubbing
audiometer - test tone
tuning fork - weber test or rinne test
116
interventions to treat hearing loss: hearing aids - what are they
hearing aide: battery operated, amplifier, a microphone and a receiver
Types: Behind the ear, mini behind the ear, in the ear, completely in canal
117
true or false: assistive listening devices enhance face to face communication
true
118
what are some ways that you should consider when communicating with the older adult with hearing impairment
avoid shouting, position, clear articulation, lower your tone, slow to moderate rate of speech, position according to ear that has best hearing, eliminate environmental noise and distractions, avoid background noise echoing
119
what is population health?
- this is educating everybody about risk of being in a loud environment for extended periods of time
- Reduces the extent of hearing loss experienced in aging
- reduces the occurrence of tinnitus
120
what are some risk factors for impaired hearing?
male
men with hair in ear
increased age
genetic predisposition
lifestyle such as smoking occupation - exposed to noise
diabetes, hypertension, hypothyroidism, head injury, high fevers, renal failure, cardiovascular disease, brain tumour,
121
what are some meds that can be a risk for impaired hearing?
ototoxic medications: common Furoseminide, Ciprofloxacin
