Week 5 Sensory Flashcards

1
Q

White part of the eye that protects the eyeball

A

Sclera

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2
Q

Black dot in which light can enter is the

A

Pupil

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3
Q

Color part of the eyes that surrounds the pupil

A

Iris

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4
Q

Cranial nerve II is the

A

Optic Nerve

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5
Q

what cranial nerves control EOMs of the eye

A

3, 4, and 6

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6
Q

Transparent anterior part of the eye ball

A

Cornea

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7
Q

Fluid filled space betweent cornea and iris

A

Anterior Chamber

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8
Q

Aqueous Humor

A

Watery liquid, fills anterior and posterior chambers of the eye, provides nourishment to the eye

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9
Q

Conjunctiva

A

Mucous Membrane that lines the eye lid and outer surfaces of the eye

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10
Q

Tubes that carry tears to the lacrimal sac

A

Lacrimal Ducts

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11
Q

Glands of Zeis

A

Oil glands around the eyelashes - sebaceous glands

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12
Q

Moil gland

A

Sweat gland - apocrine gland

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13
Q

Meibomian Gland

A

Secretes oily portion of tears to help keep the eye lubricated from tears evaporating

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14
Q

Fundus

A

Interior surface of the eye, which includes the retina, optic disk, macula lutea, and posterior pole

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15
Q

Central region of the retina responsible for central vision yellow pigment provides its color

A

Macula or Macula Lutea

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16
Q

Fovea or Focal Point

A

Pinpoint depression in the center of the back of the eye- sharpest area vision- near center of macula- where most cones are located

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17
Q

Optic Disc

A

Exit site of retinal nerve fibers as well as entrance point for retinal arteries and exit point for retinal veins

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18
Q

Perceives and transmits light to the optic nerve

A

Retina

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19
Q

Contracts and dilates to regulate light from passing through the pupil

A

Iris

  • colored part of the eye
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20
Q

Lens

A

Transparent structure behind the pupil that bends and focuses light ray to the retina

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21
Q

Area between the iris and lens

Lens is behind the iris and normally clear

Light passes through the pupil to the lens

Lens held in place by small tissue strands or fibers extending from inner wall of the eye

A

Posterior Chamber

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22
Q

Nerve carrying sense of sight from retina to the brain

A

Cranial Nerve II

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23
Q

Black circular opening in the center of the iris through which light passes as it enters the eye

A

Pupil

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24
Q

Vitreous

A

Jelly like mass filling the inner chamber between the lens and retina that gives bulk to the eye

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25
Q

Eyes are the organ of sight that provide what view?

A

3D view

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26
Q

Light enters the eye through the pupil and the lens focuses light rays on the retina on what nerve tissue?

A

Nerve Tissue in the inner posterior of the eye

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27
Q

Distorted Vision

A

Astigmatism

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28
Q

Hyperopia

A

Beyond sight - can only see far away

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29
Q

Myopia

A

Can only see things that are closer to the eye.

Light that is being bent in front of the retina and not exactly at the retina

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30
Q

Hyperopia

A

Light rays are bent behind the retina

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31
Q

Black and white color

A

Rods

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32
Q

Different colored tones

A

Cones

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33
Q

Nerve fibers from the __________and _____________ join into the __________

A

rods and cones optic disk where the optic nerve carries transmissions to the brain

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34
Q

Where the optic nerves converge and exit the eye

A

Optic disc

  • no light cells to detect light
  • Results in a break in the visual field, known as the blind spot
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35
Q

Retinal Detachment

A

Separation of the retina from the underlying epithelium

Will lead to blindness if not surgically repaired

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36
Q

Anisocoria

A

Unequal pupils

Need to assess as soon as possible to determine if acute damage or congenital

acute can mean brain bleed

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37
Q

Coloboma

A

Congenital malformation of the eye causing defects in the lens, iris, or retina

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38
Q

The hole is present from birth and can be caused when a gap called the

A

Chronic Fissure

Present during early stages prenatal development

Fails to close up completely before a child is born

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39
Q

Eye Strain

A

Asthenopia

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40
Q

Bleparospasm

A

Involuntarily contraction of the muscle surrounding the eye causing uncontrolled blinking and lid squeezing

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41
Q

Double Vision

A

Diplopia

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42
Q

Involuntary, rapid bouncing of the eye

A

Nystagmus

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43
Q

Extreme sensitivity and discomfort from light

A

Photophobia

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44
Q

Blind spot in vision

A

Scotoma

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45
Q

Cataracts can be both what?

A

Congenital at birth or develop over time or be caused by eye trauma

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46
Q

Blepharitis

A

Inflammation of the eye lid

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47
Q

Blepharoptosis

A

Drooping of the eye lid

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48
Q

Cataract

A

Opaque clouding of the lens

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49
Q

Amblyopia

A

Decreased vision early life because of a functional defect that can occur as a result of strabismus, ( condition of eye misalignment caused by intraocular muscle imbalance) refractory errors ( one eye being in focused and the other is either near or far sighted) or trauma; it is also lazy eye

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50
Q

3 types of Amblyopia

A

Hypertropia - Upward

Entropion/ Esotropia - Middle inward

Ectropion/ Exotropia- Top outward

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51
Q

How can lazy eye be corrected?

A

Can be done through brain training by wearing a patch over the good eye to strengthen the lazy eye muscles to force the brain to recognize the weaker eye

May need to wear glasses

If not corrected; then surgery can be done to tighten the loose eye

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52
Q

Drooping of the eyelid usually caused by paralysis

A

Blepharoptosis

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53
Q

Chronic nodular inflammation of the meibomian gland, usually the result of the blocked duct

A

Chalazion; also known as a Stye

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54
Q

Pink eye inflammation of the conjunctiva

A

Conjunctivitis

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55
Q

Inflammation of the lacrimal duct

A

Dacryoadenitis

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56
Q

Inflammation of the iris

A

Iritis

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57
Q

Inflammation of the cornea

A

Keratitis

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58
Q

Snellen Eye Chart

A

Used for distance acuity

Measure to see details and shape from 20ft, normal is 20/20U

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59
Q

Use of ophthalmoscope to view the interior of the eye

A

Ophthalmoscopy

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60
Q

Slit Lamp

A

Tabletop microscope used to examine the eye, especially the cornea, lens, fluids, and membranes

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61
Q

Used to measure intraocular pressures, the eye pressure is elevated in glaucoma

A

Tonometry

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62
Q

Fluorescein Angiography

A

Visualization and photography of retinal and choroidal vessels made as fluorescein dye circulates through the eye, the dye is injected into patients vein

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63
Q

Wet Type

A

Macular Degeneration

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64
Q

AMD

A

Age related Macular Degeneration

Most common cause of vision loss in persons older than age 60 years

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65
Q

Wet Type

A

Neovascular or Exudative
May have abrupt onset

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66
Q

Dry or Nonexudative Type

A

Most common 85-95
Slow breakdown of the layers of the retinal with the appearance of drusen(yellow discolorations under the retina)

67
Q

Proliferation of abnormal blood vessels growing under the retina

A

Choroidal Revascularization

68
Q

AMD Pathways to Vision Loss

A

Risk Factors
Age
Smoking History
HTN
Obesity
Hyperopia
Wet AMD
Use of thyroid
Arthritis

69
Q

Drusen

A

Yellow spots associated with aging and appear in retina

No visual symptoms if not located in macula. Mary vary in size.

70
Q

Macula is the area of the retina where _____________ focuses

A

Light
Fovea centralis is the center point of the macula

71
Q

Drusen

A

Deposits of fatty proteins of lipids

Presence of drusen does NOT indicate AMD, but increases chance of AMD

As drusen hardens over time, bleeding and scarring may occur on the macula

72
Q

What is used to determine macular degeneration?

A

Amsler Grid

73
Q

Amsler Grid

A

Test eyes under normal lighting for reading

14-16 in away Test each separately cover one eye

Keep eye focused on the dot in center and answer questions
- Lines wavy or blurred?
- Do all boxes look the same?
- Are there any holes?
- Can you see all corners and sides?

74
Q

Photodynamic Therapy for Slowing Progression of AMD

A

Light sensitive verteporfin dye injected to vessels
A laser then activates the dye, shutting down the vessels without damaging the vessels

Result is slow or stabilize vision loss

Patient must avoid exposure to sunlight or bright light for 5 days to avoid activation of dye in vessels near the surface of the skin

75
Q

Blurred vision is key symptom

A

AMD

76
Q

A special combination of vitamins and minerals may reduce disease progression. Surgery may also be an option

A

AREDS Formula for AMD

77
Q

VEGF occurs in eyes with

A

Wet AMD

These elevated levels of VEGF promote the growth of abnormal new blood vessels

78
Q

Several anti- VGEF drugs are available to do what?

A

Help slow down vision loss from AMD, and in some cases, improve sight

79
Q

AREDS 2 is composed of?

A

Zeaxanthin
Vitamin C
Vitamin E
Copper

80
Q

Bevacizumab

A

Blood vessel growth inhibitor (chemotherapy)

Treat wet AMD
Just as effective and safe as Lucentis

81
Q

Ranibizumab

A

Lucentis
Blood Vessel Growth Inhibitor (chemotherapy)

Treats wet AMD

Slows the rate of vision loss from wet AMD

1/3rd significant improvement of vision

82
Q

Alibercept

A

Eylea
Blood vessel growth inhibitor (chemotherapy)

Tx for wet AMD

Can be given less frequent than Lucestin and Avastin

83
Q

Pegaptanib Sodium

A

Macugen
Anti angiogenic

Tx of wet AMD

Used for patients with allergies with other drugs and/ or long term Tx

84
Q

Nursing Management of AMD

A

Pt education
Supportive care
Promote safety

Recommendations to improve lighting, magnification devices, and referral to vision center to improve or promote function

Ensure Pt must manage symptoms for entire life

85
Q

Opacity or cloudiness of the lens

A

Cataracts

Due to protein aggregation or destabilization

Increased incidence with aging

Leading cause of disability

86
Q

Cataract lens does what to light?

A

It scatters light causing hazy and out of focus vision with colors hazy too

87
Q

Clinical Manifestations of Cataracts

A

Painless, Blurry Vision
Sensitivity to glare
Reduced visual acuity

88
Q

Other effects of cataracts include

A

Myopic shift
Astigmatism, diplopia, and color shifts, including brunecens

89
Q

Dx Findings of Cataracts

A

Decreased Visual Acuity and opacity of the lens by ophthalmoscope, slit lamp, or inspection

90
Q

Surgical Management of Cataracts

A

If reduced vision does NOT interfere with normal activities than surgery is not needed

Surgery performed on outpatient basis with local anesthesia

Surgery usually takes less than a hour and patients are soon discharged after

Complications are rare but may be significant

91
Q

ICCE

A

Type of Cataract Surgery
Intracapsular Cataract Extraction

Removes entire lens; rarely done today

92
Q

ECCE

A

Cataract Surgery

Extracapsular Cataract Extraction

Maintains the posterior capsule of the lens, reducing potential post op complications

93
Q

Phacoemulsification

A

Cataract Surgery

An ECCE that uses an ultrasonic device to suction the lens out through a tube, incision is smaller than with standard ECCE

94
Q

Lens Replacement

A

After removal of the lens by ICCE or ECCE, the surgeon inserts an intraocular lens implant

This eliminates the need for aphakic lenses

Pt may still require glasses

95
Q

Intraocular Lens Implant

A

Implantation of an artificial lens to replace defective natural lens

96
Q

Phacoemulsification

A

Use of ultrasound to shatter and break up cataract, with aspiration and removal

97
Q

Surgical Tx of Cataracts

A

Telescopic lens
- In one ye

Plastic tube magnifies field of vision

IOL= Intraocular Lens

98
Q

Nursing Management for Cataracts

A

Preoperative Care

Usual preoperative care for ambulatory surgery

Dilating eye drops or other medications as ordered

Post op care

Pt education normal for eye to shine or flicker after cataract removal

Provide written and verbal instructions

99
Q

Nursing management for Cataracts

A

Instruct pt. to call physician immediately if vision changes
Continuous flashing lights, redness, swelling, or pain increase

Type and amount of drainage increases

Or significant pain is not relieved by acetaminophen

100
Q

AMD is leading cause of

A

Disability

101
Q

Glaucoma is leading cause of

A

Blindness

102
Q

Group of ocular conditions in which damage to the optic nerve is related to increased IOP caused by congestion of aqueous humor

A

Glaucoma

103
Q

Risk Factors of Glaucoma

A

Increases incidence with age

104
Q

Aqueous production and drainage are not in balance

A

Glaucoma

When aqueous outflow is blocked, pressure builds in the eye

105
Q

IOP causes what type of damage ?

A

Irreversible mechanical or ischemic damage

106
Q

Ophthalmic Medications

A

Ability of eye to absorb medication is limited

107
Q

What are barriers of absorption for ophthalmic medications?

A

Size of conjunct. sac, corneal membrane barriers, blood-ocular barriers, tearing, and blinking, and drainage

108
Q

Intraocular or systemic medication may be needed to treat some eye structures or to provide high concentrations of medication

A

TRUE

109
Q

Topical medications are used the most for the eye. Why?

A

Least invasive, fewer side effects, and permit self administration

Tx goal is to manage or decrease IOP

110
Q

How do prostaglandins work?

A

Relaxing muscles in the eye interior structure to allow better outflow of fluids, thus reducing buildup of eye pressure

111
Q

Eye Medications

A

Xalatan
Lumigan
Travatan Z
Rescula

112
Q

Side Effects of Eye Medications

A

Eye color change
Darkening of eyelid
Eyelash growth
Droopy eyelids
sunken eyes
stinging
eye redness
itching

113
Q

What drugs were once the first choice in treating glaucoma?

A

Beta Blockers

Work by decreasing fluids production in the eye and are now often prescribed as adjunct or in combination with prostaglandins

114
Q

Betablocker eye Medications

A

Timolol
Timoptic
Isatol
Betoptic

Side Effects include: Low BP, reduced pulse rate, fatigue, SOB, reduced libido, depression

115
Q

Alpha Agonists

A

Decrease production of fluid and increase drainage

Brimonidine- preservative breaks down into natural tear components and has better client tolerance

Side Effects: burning or stinging, fatigue, headache, drowsiness, dry mouth and nose, higher likelihood of allergic reaction

116
Q

Carbonic Anhydrase Inhibitors

A

CAIs
- Decrease rate of aqueous humor production

Eye drops include: Trusopt, Azopt

117
Q

Pill form of carbonic anhydrase inhibitors

A

Diamox
Neptazane
Daranide

Side Effects include: stinging, burbing, eye discomfort

Pill form SE: tingling hands and feet, fatigue, stomach upset, memory problems, frequent urination

118
Q

Rho Kinase Inhibitors

A

Increase drainage of intraocular fluid

Netarsudil
SE: eye redness, corneal deposits, stinging, and small bleeds on the white of the eye

119
Q

Medications used for glaucoma

A

Increase aqueous outflow or decrease production
May constrict the pupil and may affect ability to focus the lens of the eye; main side effect of blurred vision
-May also produce systemic effects

120
Q

Anti-inflammatory Drugs, corticoid suspensions

A

Side Effects
Long term use include: glaucoma, cataracts, and increased risk of infection

Avoid these effects use NSAID therapy as alternate use than steroids

121
Q

Guidelines for ophthalmic therapy

A

Topical most common

Correct Administration required

Systemic absorption decreased by occluding the lacrimal duct

Multiple drops need 5-10 min intervals

Absorption decreased with eye inflammation

122
Q

Example of topical anesthetic is

A

Proparacaine

123
Q

Drugs to avoid IOP

A

Topical Anesthetics
Mydriatics and cycloplegics

Contraindicated with narrow angles or shallow anterior chambers and inpatients on monoamine oxidase inhibitors or TCAs
- May increase IOP can cause CNS symptoms and high BP

Topical anticholinergic or sympathomimetic,TCAs, MAOIs, antihistamines, antiparkinsonian, antipsychotic, and antispasmolytic

124
Q

Nursing Dx for Ophthalmic

A

Disturbed Sensory Perception
Risk for injury
Risk for falls
Self- Care deficit
Deficient Knowledge

125
Q

Eustachian Tube

A

Auditory tube
Provides passageway to the throat allowing air to pass to and from outside the body
important to maintaining equal air pressure

126
Q

Tympanic Membrane

A

Eardrum; receives sound collected in the external auditory canal and amplifies in through the middle of the ear

127
Q

Assessment of the Ears

A

Inspection of external ear
Otoscopic examination
Gross auditory acuity
Whisper Test
Weber Test
Rinne Test

128
Q

Inner Ear

A

Receives sound vibrations passed from oval window to the cochlea

129
Q

Cochlea

A

Coiled tubular structure that contains the organ of Corti

130
Q

Perilymph

A

Fluid that fills the bony labyrinth of the ear

131
Q

Endolymp

A

Fluid within the cochlear duct of inner ear

132
Q

Organ of Corti

A

Contains receptors that receive vibrations and generate nerve impulses for hearing

133
Q

Vestibule

A

Middle part of the inner ear that contains the utricle and the saccule

134
Q

Larger of the two sacs in the inner ear

A

Utricle

135
Q

Smaller of the two sacs

A

Saccule

136
Q

Semicircular Canals

A

3 canals within the inner ear that contain specialized receptors that generate nerve impulses with body movements

137
Q

Altered sense of orientation in space
- client has sensation of spinning

A

Dizziness

138
Q

The illusion of motion or spinning motion

A

Illusion

139
Q

Ringing of the ear

A

Tinnitus

140
Q

Involuntarily movement rhythmically associated with vestibicular dysfunction

A

Nystagmus

141
Q

Labrythititis

A

Inflammation of the inner ear

142
Q

Imbalance of inner ear fluids

A

Ménière’s disease

143
Q

Imbalance of inner ear fluids

A

Ménière’s disease

144
Q

Benign Positional Vertigo

A

Dizziness occurs with change of head position

145
Q

Hearing or balance issues related to meds

A

Ototoxicity

NSAIDS, alcohol, caffeine

146
Q

Acoustic Neuroma

A

Tumor of the cranial nerve 8

Vestibulocochlear

147
Q

Abnormal inner ear fluid balance caused by malabsorption of the endolymphatic sac or blockage of the endolymphatic duct

A

Meniere’s Disease

148
Q

What are the various causes of Meniere’s Disease?

A

Head Injury
Infections
Seasonal Allergies
Alcohol Use
Stress or anxiety
Certain Medications
Smoking
Fatigue
Migraines
Abnormal Immune Response

149
Q

One of the first signs of Meniere’s Disease

A

Tinnitus or muffled hearing

150
Q

Manifestations of Meniere’s Disease

A

Tinnitus
Feeling of pressure in one ear
Hearing loss that comes and goes ( early stage)
Recurring episodes of vertigo that start and stop ( late stage )
Unstable balance in dark conditions

151
Q

Tx of Meniere’s Disease

A

Low sodium diet
Decrease caffeine, alcohol
Smaller more frequent meals
Smoking cessation
Stress and anxiety management

152
Q

Tx of Meniere’s Disease

A

Meclizine
Benzo- ending in -lam, -pam
Barbiturates
Antiemetics’
Diuretics may be used

153
Q

Surgical Management to eliminate attacks of vertigo

A

Also includes

  • Endolymphatic sac decompression, middle and inner ear perfusion, and vestibular sectioning
154
Q

Two types of Labyrinthitis include

A

Viral and Bacterial

Inflammation of the inner part of the ear

Usually affects only one ear

155
Q

The labyrinth is made up of

A

Fluid filled channels that control balance and hearing

156
Q

Hearing is controlled by the

A

Cochlea

157
Q

Organs of ear are inflamed , then what happens

A

Information sent to the brain will be different from the unaffected ear

Varied information can make a person feel dizzy

Hearing is also affected

158
Q

Viral Labyrinthitis

A

Most cases

Often follows common illnesses such as cold or flu

159
Q

Sudden incapacitating onset of vertigo, nausea and vomiting as well as sudden unilateral hearing loss

A

Viral Labyrinthitis

160
Q

Tx of Viral Labyrinthitis

A

Symptomatic

Antivertiginous medications
Antihistamines
Antiemetics
Bed rest
Hydration

161
Q

Bacterial Labyrinthitis

A

Occur after chronic middle ear infection

Bacteria enters the inner ear through the oval or round windows, through the bone or as a result of injury to the head or ear

162
Q

Sudden unilateral hearing loss along with nystagmus, vertigo, and sickness

A

Bacterial Labyrinthitis

Tx is antibiotics

Care should be taken with driving, ladders or operating machinery for at least a week after symptoms have gone as they may return

163
Q

Dizziness with quick head movements may last for…

A

Years

Bacterial Labyrinthitis more likely to cause residual affects of hearing loss, tinnitus, or imbalance