Unit 4

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Unit 4
2012-04-27 16:50:17
Sensory Neuro

Unit 4
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  1. What conditions predispose a person to glaucoma
    • Hypertension
    • cardiovascular disease
    • diabetes
    • obesity
  2. What conditions predispose a person to retinal detachment
    • Eye trauma
    • head injury
    • severe myopia
  3. what is the single most important risk factor in cataract development
    Exposure to UV light
  4. what are manifestations of glaucoma
    • halos around lights
    • blurred vision
    • visual field loss
  5. What do clients with cataracts experience
    • blurred vision
    • photophobia
    • glare
  6. What is the glaucoma disease process
    intraocular pressure, causes optic nerve atrophy and visual field loss
  7. What is primary open-angle glaucoma
    most common type of glaucoma. Often genetically determined. Insidious and comes on slowly and bilateral. the cause is that the aqueous humor cna't leve the eye, its blocked. Aqueous humor flow is slowed or stopped b/c of obstruction by the trabecular meshwork
  8. What is angle-closure glaucoma
    • sudden blockage of aqueous humor usually in one eye
    • anterior chamber angle is automatically narrow. the attack occurs b/c of a sudden blockage of the anterior angle by the bases of the iris
  9. What is normal-tension glaucoma
    optic nerve damage, optic nerve is damaged even though IOP is not high
  10. What is secondary glaucoma
    always has to do with something else (trauma, surgery, injury, DM). May occur as a result of trauma that can disrupt the flow pattern of aqueous humor
  11. What are the diagnostic tests for glaucoma
    • ophthalmoscopic exam - shows atrophy (pale color) and cupping (indentation) of the optic nerve head
    • visual field exam - used to determine the extent of peripheral vision loss
    • slit-lamp exam - may deomnstrate an erythematous conjunctiva and corneal cloudiness. aqueous humor may appear turbid (hazy) and the pupil may be nonreactive.
  12. How do you try to manage glaucoma
    try to facilitate the outflow of aqueous humor through remaining channels and to maintain IOP w/in a range that prevents futher damage to the optic nerve. If the IOP is high it must be reduced to retain vision. If the vision is lost the goals are to restore independence
  13. What is the pathophysiology of cataracts
    decreased O2 level in lens, and become dehydrated. Na and Ca become increased in lens. After a period of time they will appear more yellowish. Blurred vision that is not cleared by glasses. Photophoia, see better in low lit environments. No pain in cataracts
  14. what is retinal detachment
    separation of retina from choroid. Detaches and deprived of blood supply which can result in blindness
  15. what is age-related macular degeneration
    degenerative process that affects macula and surrounding tissue. Affects central visual deficits. Usually in older people
  16. What is hyperopia
    farsighted. Eye focuses light rays behind eye and image in retina is blurred. Eye shorter than the other
  17. What is myopia
    nearsightedness. Light rays come into foucs in front of retina. refractive power of eye is too strong and a concave or minus lens is used to focus light rays on the eye. Eyeball longer than the other
  18. What is the nation's primary disability
    hearing loss
  19. What is conductive hearing loss
    • results from the interference of sound transmission through the external ear and middle ear
    • Sound transimssion from inner ear to brain is normal
    • sound is perceived as faint or distant but remains clear
    • correctable by surgery
  20. What can conductive hearing loss be caused by
    • anything that blocks the ear, like ear wax, infection, foreign body
    • thickening, retraction, scarring, or perforation of the tympanic membrane
    • any pathophysiologic changes in the middle ear that affect or freeze one or more of the ossicles
  21. What is sensorineural hearing loss
    • caused by the impairment of the function of the inner ear, the eighth crainial nerve, or the brain
    • results from disease or trauma to the organ of Corti or auditory nerve pathways of the inner ear leading to the brain stem. Normal reception and transmission of sound waves are disrupted. sound is distorted and faint. usually permanent and not correctable by surgery
  22. What are the causes of sensorineural hearing loss
    congenital and hereditary, noise injury, aging and degenerative process, meiere's disease, and ototoxicity
  23. What is tinnitus
    • ringing, roaring, chirping
    • Subjective tinnitus - most common, ear noise that can't be heard by observer
    • Objective tinnitus - ear noise that can be heard by someone other than the client
  24. What is an otalgia
    ear infection. Defined as pain in the ear or earache. Can be the result of infection in the external or middle ear or trauma to the ear and head. Most common problem found in the external ear are infections, called external otitis
  25. What is vertigo
    perception that either oneself or one's surroundings are moving. Often described as dizziness. Vertigo is different than dizziness, results from the imbalance of neural signals from the vestibular system in the ears the imbalance is interpreted by the brain as constant motion in space
  26. What is pilocarpine hydrochloride (isopto carpine)
    facilitates the rate that aqueous humor leaves the eye to decrease intraocular pressure. Used to treat glaucoma
  27. What is timolol maleate (timoptic)
    eye drops to reduce production of aqueous humor (for glaucoma)
  28. How do you treat cateracts?
    With surgery, regional or local anesthetic used, moderate conciousness, removed by making incision in cornea put intraocular lens in eye and actually replace lens. Complications include secondary glaucoma infections. highest in first 12 months
  29. How do you care for post op cateract
    • leave eye patch in place
    • for 24 hrs limit activity to sitting in chair
    • do not rub eye
    • do not lift more than 5 pounds
    • do not strain or bear down (BM)
    • do not sleep on operative side of body
    • take eyedrops
    • take tylenol
    • do not take aspirin
    • report any pain
  30. How do you care for post op glaucoma
    • take eye drops
    • know manifestations of infections
    • know manifestations of IOP
    • do not rub
    • clarefully clean around eye with warm washcloth
  31. What are the types of peripheral vestibular disorders
    • benign paroxysmal positional vertigo - common cause of vertigo tends to follow head injury and viral infections of the inner ear. Due to presence of Ca crystals in semicircular canals. When head is placed in certain positions
    • labyrinthitis - infection or inflammation of cochlear or vestibular portion of the inner ear. tends to occur in spring and summer and to be preceded by an upper respiratory tract infection. Vertigo is sudden in onset and peaks in 24-48 hrs then gradually subsides
    • Meniere's Disease
  32. What are central disorders
    dizziness may be a manifestation of a TIA, loss of blood to brain. Numbness, tingling, momentary LOC, weakness
  33. What are 3 types of systemic disorders
    • physiologic vertigo - involved in common disorders such as motion sickness, vertigo is minimal or absent, but autonomic manifestations are present. N/V, increased salvation, yawning
    • presbyastasis - disequilibruim of aging. generalized degenerative changes that occur in aging, balance and stability are affected
    • orthostatic hypotension
  34. What is meniere's disease
    • caused by excess endolymph in the vestibular and semicircular canals. Causes hearing changes and vertigo. is an episodic illness that waxes and wanes, often remain quiescent for many years than reappearing.
    • problems with balance, dizziness, tennitus, fluctuating hearing loss,
  35. What type of diet is suggested for people with menieres disease
    low salt, and diuretic may reduce frequency of attacks. Avoid caffeine, smoking and alcohol
  36. What are cluster headaches
    a precursor to a migraine, more common in men, in spring and fall and can last 4-8 weeks for 15 min to 3 hrs. triggered by ETOH
  37. what are tension headaches
    result from muscle contraction. described as a tight band-like discomfort that is unrelenting. pain builds slowly, fluctuates in severity and may persist more or less for many days. occur more often than 15 days a month
  38. what are migraine headaches
    often considered to be a vascular headache with vasospasm and ischemia of intracrainal vessels being the cause of the pain. begin in puberty and are more common in women. last b/t 4-72 hrs. pain is thrbbing and pulsatile. Photophobia, anorexia, N/V
  39. A person with otitis media is at risk for what
    meningitis and a brain abscess
  40. What is the best method to reduce vertigo
    lie down or remain stationary