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hearing,balance,visi
patho exam 3
| Question | Answer |
|---|---|
| What do the structures within the ear do? | Hear and interpret sounds, Provide information about position and movement of head in space |
| What do the structures within the eye do? | Shapes and colors conveyed in light energy |
| disorders of hearing, balance, and vision have a negative effect on? | overall quality of life |
| children born with hearing or vision deficits have... | developmental, communication, mobility delays |
| adults with vision or hearing loss have problems with... | mobility, nutrition, stress, coping, mood, affect |
| adults with vision or hearing loss have increased susceptibility to... | environmental issues |
| hearing process | Sound waves transformed into neural impulses |
| pitch, loudness, timing in the hearing process are... | preserved at each step allowing brain to perceive sound accurately |
| auditory system pathologies | disrupt normal sound transmission process |
| types of hearing loss | sensorineural, conductive, mixed |
| sensorineural hearing loss | damage to the area that makes sense of sound |
| auricle (pinna) of the ear | collects sound pressure waves; directs them into the external auditory canal. Generates cues about timing and intensity of sounds to localize them |
| ossicles parts | malleus (largest, incus, stapes |
| what is the stapes attached to? | oval window |
| what does the stapes do? | transmits vibrations into the fluid filled cochlea |
| 3 areas of ear | external ear, middle ear, internal ear (labyrinth) |
| what does the external acoustic meatus end at? | tympanic membrane, or eardrum |
| what is the external acoustic meatus lined with? | lined with hairs and glands that secrete cerumen to protect the rest of hearing system from dust/debris |
| tympanic membrane | sound receptor and transmitter, vibrations transmitted to ossicles |
| neural signal pathway | along the auditory portion of the vestibulocochlear nerve. Exits cochlea via internal auditory canal. Travels through multiple nuclei in the brainstem. Proceeds to thalamus. Reaches primary auditory cortex. Located in the temporal lobe. |
| Bony labyrinth components | Cochlea (hearing), Vestibule (acceleration), Three semicircular canals (balance) |
| Bony labyrinth | System of canals in temporal bone, Fluid-filled membranous labyrinth |
| cochlea canals | scala vestibuli, scala media, scala tympani; pressure windows |
| cochlea canals are filled with | perilymph (similar to CSF) |
| kinetic labyrinth inner ear | semicircular ducts in semicircular canals (anterior, posterior, lateral) |
| static labyrinth inner ear | utricle in vestibule, saccule in vestibule |
| possible effects of loss of peripheral balance function | Vertigo, Feelings of unsteadiness, Visual blurring, Hearing sensitivity |
| causes of balance disruption | Certain diseases and conditions, Central vestibular disorders, Some medications |
| conductive hearing loss | Some unable to travel normally to inner ear, Reflects audibility problem |
| types of conductive hearing loss | Outer ear disorders, Otitis media, Otosclerosis |
| most common disorder of middle ear | otitis media |
| outer ear disorders | Highly treatable (most), Typically do not involve hearing loss |
| outer ear disorders typically do not involve hearing loss except... | congenital outer ear malformations |
| some common disorders of outer ear disorders | Cerumen impaction, Collapsed ear canal, External otitis, Stenosis of ear canal, Microtia or anotia |
| otitis media | inflammation of middle ear space |
| otitis media is associated with? | eustachian tube dysfunction |
| otitis media is commonly diagnosed in... | children |
| clinical manifestations of otitis media | coldlike symptoms and/or upper respiratory problems |
| acute otitis media | inflammation of middle ear with acute onset, moderate to severe bulging of TM and middle ear effusion |
| acute otitis media complications | rupture of TM, conductive hearing loss (temporary) |
| acute otitis media treatment | antibiotics |
| recurrent acute otitis media | three or more episodes of AOM in 6 months, or four or more episodes in 12 months |
| factors that increase risk of recurrent acute otitis media | male gender, passive exposure to smoking, winter season |
| chronic otitis media | infection longer than 6 weeks with persistent effusion in middle ear space, mild to moderate conductive hearing loss |
| chronic otitis media treatment | Topical antibiotics and/or steroids, Frequent cleaning of ear canal |
| chronic otitis media severe cases | Surgical intervention and/or systemic antibiotics, ventilation/pressure equalization (PE) tubes |
| otosclerosis | abnormal bone growth in middle ear space (usually in ossicles) |
| otosclerosis associated hearing loss | bilateral, slowly progressive, conductive (can be mixed if otic capsule involved) |
| otosclerosis etiology and pathogenesis | Alternating bone resorption and formation, Genetic component as autosomal dominant, Viral factors, Autoimmune system disorders |
| otosclerosis diagnosis | Patient history, Otoscopy, Audiologic results, Radiologic studies |
| otosclerosis treatment | Annual hearing tests to monitor hearing loss, Surgical procedures- to diminish size of ossicles, Hearing aids, Fluoride, calcium, vitamin D |
| presbycusis | hearing loss due to aging |
| most common form of hearing loss | presbycusis |
| four types of presbycusis | Sensory presbycusis; Neural presbycusis; Metabolic, or strial, presbycusis; Mechanical, or cochlear conductive, presbycusis |
| sensory presbycusis | problem on cochlea |
| neural presbycusis | problem with cranial nerves |
| mechanical, or cochlear conductive, presbycusis | probelm of movement inside cochlea |
| etiology of presbycusis | no widely accepted etiology, various contributing factors |
| presbycusis clinical manifestations | progressive decrease in hearing thresholds, decreased ability to understand speech |
| presbycusis diagnosis | history and complete audiologic assessment |
| presbycusis treatment | hearing aids, assistive listening devices, cochlear implants |
| meniere disease | inner ear disorder with both auditory and vestibular symptoms- excess endolymph within membranous labyrinth of inner ear |
| meniere disease clinical manifestations | Intense vertigo with accompanying nausea and vomiting, Tinnitus, Pressure or fullness in the ear, Fluctuating hearing loss |
| ototoxicity | side effect of some medications- damage sensory cells of inner ear |
| cochleotoxic medications | damage sensory cells of cochlea, cause sensorineural hearing loss (typically bilateral) |
| vestibulotoxic medications | damage sensory cells of peripheral balance system, effects typically bilateral |
| factors affecting extent of ototoxic effects | age, coexisting medical conditions, genetic predisposition, drug in use, drug dosage, schedule |
| genetic hearing loss | one of the most common birth defects, caused by genetic mutation |
| genetic hearing loss clinical manifestations | nonsyndromic hearing loss, syndromic hearing loss |
| nonsyndromic hearing loss | hearing loss only |
| syndromic hearing loss | accompanied by pattern of other clinical abnormalities |
| genetic hearing loss diagnosis | physical attributes related to syndrome, genetic testing for definitive diagnosis |
| genetic hearing loss treatment | regular audiologic monitoring, sensorineural hearing loss- hearing aid or cochlear implant, conductive hearing loss- hearing aid or osseointegrated hearing implant |
| how does light enter the eye? | through cornea, crosses anterior, through pupil, through lens, image is inverted in lens, inverted light lands on retina. Optic nerve exits back of eye at optic disc |
| anterior portion of the eye that protects iris | cornea |
| liquid that fills area between cornea and iris | aqueous humor |
| vitreous humor | gives form of eye |
| lens | allows focus of vision: stretches and relaxes |
| iris | located in front of lens |
| optic disc (blind spot) | where arteries and veins supplying retina pass through |
| macula | area of retina where more rods and cones, vision to optic nerves |
| retina | in contact with vitreous humor, photoreceptors (rods and cones), lots of capillaries that provide nutrients |
| rods | black and white |
| cones | color |
| choroid | vascular- brings blood supply to retina |
| sclera | white portion of eye |
| myopia | nearsightedness, image focused in front of the lens |
| myopia correction | by biconcave lens |
| hyperopia | far sightedness, eyeball is too small, image focuses behind the retina |
| hyperopia correction | by biconvex lens |
| presbyopia | farsightedness associated with aging, loss of elasticity reduces accommodation. ciliary muscles weakening and the eye's lens becoming less flexible with age |
| accomodation | ability of lens to expand and relax and focus on objects closer and farther |
| what happens to the lens when looking at an object far away? | lens is in its native shape which enables far vision; relaxed ciliary muscle, thin lens |
| what happens to the lens when looking at an object close? | the lens changes shape, known as accommodation to allow focus on close objects; contracted ciliary muscle, thick lens |
| astigmatism | irregular curvature in the cornea or lens |
| strabismus | result from deviation of one eye, double vision (diplopia) |
| what may strabismus be caused by? | weak or hypertonic muscle, short muscle or neurological defect |
| strabismus in children | must be treated immediately to prevent development of amblyopia |
| nystagmus | rapid, involuntary eye movement |
| who does nystagmus develop in? | some individuals with amblyopia and strabismus |
| what may nystagmus result from? | neurological causes, inner ear or cerebral disturbance, drug toxicity |
| what does inhered diplopia result from? | neurological causes (stroke), paralysis of extra ocular muscle, |
| inhered diplopia | loss depth perception |
| types of color blindness | red/green color blindness, blue/yellow color blindness, Achromotopsia |
| most common type of color blindness | red/green color blindness |
| most severe type of color blindness | achromotopsia |
| how is color blindness developed? | congenital or acquired |
| hordeolum (stye) | Tender, red, often pus-filled bump along edge of eyelid, Bacterial infection in oil glands at base of eyelash |
| how does a hordeolum (stye resolve) | in a week without treatment (can apply antibiotics to eye) |
| conjunctivitis (pinkeye) symptoms | Redness, discharge, itching, burning of eyes, Increased tearing; blurred vision, light sensitivity |
| types of conjunctivitis | viral, bacterial, allergic |
| viral conjunctivitis | most common, adenoviruses (herpes simplex virus), resolves in 7-21 days, contagious |
| bacterial conjunctivitis | chlamydia, resolves within 1 week, symptoms persist up to 3 weeks, topical antibiotics (eye drops), contagious |
| allergic conjunctivitis | not contagious, treated with saline and/or oral and topical medications |
| pterygium | benign growth on conjunctiva; may extend to cornea |
| pterygium risk factors | High levels of exposure to UV light, wind, and/or airborne irritants |
| pterygium causes for removal | unsightly, interferes with vision, causes discomfort |
| keratitis | severe pain and photophobia, scar formation damages the cornea |
| how does keratitis develop? | when cornea is infected or irritated |
| how does keratitis transfer? | from herpes lesion around mouth |
| keratitis increases the risk of... | ulceration eroding the cornea |
| keratitis cause | damage from chemicals, splashes and fume |
| corneal abrasion | scratch or cut on cornea |
| corneal abrasion causes | foreign body or chemical irritant, rubbing eye too forcefully or being poked in eye |
| corneal abrasion symptoms | eye redness, tearing, eye pain, blurred vision, light sensitvity |
| corneal abrasion treatment | Flushing with water or a sterile saline solution, Topical antibiotics and anti-inflammatories |
| cataracts | cloudy or opaque discoloration of lens |
| cataracts causes | Most common: age related changes; Trauma, congenital anomalies, systemic disease, pharmacologic triggers |
| cataracts diagnosis | ophthalmologic exam |
| cataracts treatment | Limit exposure to ultraviolet light; Surgery; ultrasonic vibrations; artificial lens; Capsulotomy- cut part of lens |
| glaucoma | increase in intraocular pressure; leads to slow, painless, progressive loss of vision |
| risk factors of glaucoma | numerous |
| cause of blindness | glaucoma |
| signs and symptoms of glaucoma | Halos around the eye at night; Loss of peripheral vision; Pain may occur if IOP is greatly increased- most advanced stages |
| what secretes aqueous humor? | ciliary body |
| acute glaucoma (narrow angle) | angle between cornea and iris is decreased- decreases ability of aqueous humor to be drained |
| acute glaucoma cause | aging developmental abnormalities, trauma, or infection |
| acute glaucoma treatment | surgery |
| who is chronic glaucoma (open-angle) higher in? | older than 50 |
| chronic glaucoma (open-angle) | thickness of trabecular network which allows for resorption of fluid; pressure increase over time |
| chronic glaucoma (open-angle): what happens when pressure increases over time? | may cause damage to the retina or optical nerve |
| what may chronic glaucoma cause? | may cause blindness; irreversible |
| second leading cause of blindness | chronic glaucoma |
| retinopathy | any disorder of, or damage to, retina |
| diabetic retinopathy | leading cause of blindness in US |
| non proliferative diabetic retinopathy | no-angiogenesis |
| proliferative diabetic retinopathy (PDR) | angiogenesis |
| retinopathy: retinal detachment | retina separates from underlying structures, usually does not cause any pain |
| retinopathy: retinal detachment risk factors | significant myopia; cataract surgery; PDR; trauma |
| macular degeneration (age-related macular degeneration) | Macula degenerates; distortion or loss of central vision |
| Dry macular degeneration (most common) | Blurry or “wavy” central vision with normal peripheral vision |
| Wet macular degeneration (more severe) | New blood vessels grow around macula; Causes bleeding, scarring, and photoreceptor atrophy |
Created by:
camrynfoster