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Year One: Semester Two > Perception > Flashcards

Perception Flashcards

1
Q

What three sections is the ear divided into?

A

The outer ear, the middle ear and the inner ear

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2
Q

What structures make up the outer ear?

A

The auricle (pinna), external acoustic meatus (ear canal) and the lateral surface of the tympanic membrane (ear drum).

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3
Q

What is the main function of the outer ear?

A

To conduct sound waves to the tympanic membrane

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4
Q

What are the main structures of the middle ear?

A

Main structures are three tiny bones:

  • Malleus (hammer)
  • Incus (anvil)
  • Stapes (stirrup)
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5
Q

How do the bones of the middle ear (ossicles) facilitate hearing?

A

They are arranged in a way to transmit sound vibrations from the tympanic membrane, one to the other and finally to the oval window and then into the fluid filled inner ear.

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6
Q

What is the Eustachian tube?

A

A tube that connects the middle ear with the nasopharynx. Normally closed but opens with yawning and swallowing.

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7
Q

What are the functions of the Eustachian tube?

A

Provides the means of equalizing the pressure in the middle ear with atmospheric pressure

Equal air pressure on both sides of the tympanic membrane ensures that sound transmission is not reduced.

Also avoids ruptured of the tympanic membrane during air travel.

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8
Q

Ear problems are common during infancy. Why is this?

A

Infant’s eustachian tube shorter, wider, positioned more horizontal

Easier pathway for pathogens from nasopharynx to migrate to middle ear.

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9
Q

What makes up the inner ear?

A

The inner ear contains a system of interconnecting membranous channels. Divided into:
-Cochlea
-Vestibule
-Semi-circular canals
Each is filled with a fluid called endolymph

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10
Q

What happens in the cochlea?

A

The cochlea is the receptor organ of hearing where transduction of sound stimuli occurs.

This occurs in the organ of Corti, a spiral organ located in the cochlea containing receptor cells.

Impulses are then transmitted through afferent fibres via the auditory nerve to the brain.

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11
Q

What types of deafness or hearing impairment are there?

A
  • Conductive Hearing Loss – mechanical dysfunction of the outer or middle ear. Partial loss of hearing, auditory nerve is normal.
  • Sensorineural Hearing loss – dysfunction with the inner ear and/or cranial nerve V111 or the auditory area of the cerebral cortex.
  • Mixed hearing loss is a combination of both.
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12
Q

What causes hearing loss in children?

A 
Causes:
-Genetic
-Intrauterine (infections, maternal drugs & alcohol)
-Birth asphysia
-Prematurity
-Severe jaundice
-Infections – meningitis, septicaemia
-Head injury
Conductive hearing loss due to glue ear is most common.
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13
Q

What is the role of the inner ear in balance?

A

Vestibules (static equilibrium), and semicircular canals (dynamic equilibrium) located in the inner ear are responsible for balance.

They sense head motion and acceleration. They also maintain and assist recovery of a stable body and head position.

Vertigo, nausea and vomiting can occur when impulses from vestibular structures “disagree” with what we see.

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14
Q

How does age affect hearing?

A
  • Cilia lines ear canal becomes coarse and stiff and impedes sound waves.
  • Impacted drier cerumen causes hearing loss.
  • Presbycusis – gradual sensorineural hearing loss in aging adult caused by nerve degeneration >50 years.
  • After >70 years auditory reaction takes a longer time to process sensory input and respond.
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15
Q

What is the definition of pain?

A

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

Pain is whatever the person experiencing the pain says it is, existing whenever he/she says it does

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16
Q

What are the categories of pain?

A
  • Acute
  • Nociceptive (No-sea-septive)
  • Chronic
  • Neuropathic
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17
Q

What is acute pain?

A
  • Sudden onset, eventually resolves & heals, treatment involves action followed by management
  • A protective mechanism
  • A response to internal or external stimuli
    i. e. Acute abdominal pain or hot frying pan handle
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18
Q

What is nociceptive pain? What is somatic and visceral?

A

The sensory response to noxious stimuli that implies damage or potential damage to somatic or visceral tissues

Somatic: Bone & soft tissue
Visceral: Organs found in GI tract & Pancreas: Can be caused by an obstruction

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19
Q

What are the phases of nociception?

A

Transduction, Conduction & Transmission

Begins when nerve endings (nociceptors) of C fibres and A-delta fibres in response to noxious stimuli
C fibre: dull, burning or aching (slow)
A-delta fibres: sharp, stinging (fast)

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20
Q

What is chronic pain?

A

Prolonged, intensity varies, lasts >6mths, associated with depression, loss of work, fatigue, anger, frustration. Management is important

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21
Q

What is neuropathic pain?

A

Centrally generated from the central nervous system (phantom pain) or peripherally generated (neuropathies: diabetes, nerve entrapment)

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22
Q

What are the dimensions of pain?

A
  1. Sensory - the recognition of pain “sore, aching, headache”
  2. Affective - emotional responses eg, depression, laughter, anxiety.
  3. Cognitive - beliefs, attitudes, memories, age, gender and education (all impact pain and coping)
  4. Behavioural - facical expressions, posture, change in ADLs.
  5. Sociocultural - demograhics, support systems, social roles and culture.
23
Q

What functional health patterns are useful when assessing pain?

A

Health perceptions, activity and exercise, coping and stress tolerance.

24
Q

What does PQRSTU stand for?

A

P - provoking and palliative. What makes pain better or worse?
Q - Quality. What is the pain like in your own words?
R - Region and radiation. Where is it? Does it radiate? Does it occur anywhere else?
S - Severity. Client rates their pain on a scale.
T - Time. When did the pain begin? How long does it last?
U - Client’s understanding. What does the client think is causing the pain? What have they done to relieve it?

25
Q

What are some tools commonly used to assess pain?

A
  • The NRC (number rating scale) 0 = no pain, 10 = worst pain.
  • The faces pain scale.
  • FLACC (face, legs, activity, cry, consolability) scale. This is used for children.
  • PAINAD used for advanced dementia patients
26
Q

What are the structures that protect the anterior surface of the eye?

A
  • Eyebrows - hair projections located on the supraorbital ridges of the frontal bones
  • Eyelids. These meet at the medial & lateral corners of the eye, they are covered by skin & internally is a layer of tissue called the conjunctiva
  • Eyelashes. Theseare follicles of sensory nerves that protect against when anything moving towards the eye. This movement is a reflex action controlled by orbicularis oculi.
27
Q

Other than keeping things from entering the eye, what function does blinking serve?

A

Blinking cleans & lubricates the eye with tears & oil secretions coming from the glands.

28
Q

What structure is the eye located inside?

A

A bony structure or socket called the orbit. CT provides a cushioning effect within the orbit.

29
Q

What fluids fill the eye?

A

Aqueous humor and vitreous humor

30
Q

What is aqueous humor?

A
  • Aqueous humor is a clear, watery, fluid secreted by the ciliary body in the anterior cavity.
  • Flows behind the lens, through the pupil, into the space beneath the cornea
  • Provides O2 & nutrients to the lens & cornea
  • Fluid drains out of the eye into Schlemm’s canal (duct) & is absorbed into blood
31
Q

What is vitreous humor?

A

Vitreous humor (a gel) posterior to the lens transmits light, stabilises & keeps the eyeball inflated, supports the retina.

32
Q

What is intraoccular pressure?

A

Intraocular pressure is pressure created by the production & flow of aqueous humor & partly by vitreous humor. When this flow is obstructed or absorption is obstructed the pressure can increase & cause degeneration of the optic nerve & blindness: called glaucoma.

33
Q

What is the conjunctiva?

A

A layer of tissue covering over the exposed part of the eye & internal eyelids that irrigates the eye

34
Q

What is the nasolacrimal apparatus and what does the lacrimal fluid do?

A

Nasolacrimal apparatus consists of tear producing glands & drainage ducts. Lacrimal fluid contains antimicrobial agents protecting against virus’ & bacteria as well as constant irrigation. It drains into the nose.

35
Q

What are the extra-ocular muscles?

A

Extra-ocular muscles are six skeletal muscles that attached to the eyeball allowing it to move in all directions (superior/inferior/medial/lateral)

36
Q

Most of the eye’s structures form as part of 3 tissue layers. What are these?

A

Fibrous, vascular, neural tissue

37
Q

Describe the structure and function of the lens.

A
  • Composed of lots of elastic fibres & suspended by ligaments in the anterior portion of the eyeball
  • Function is to bends / refract light on to the retina
  • Avascular & no lymph vessels
38
Q

When light is unable to pass through it is most likely due to a clouding of the lens. What is this called?

A

Cataracts

39
Q

Describe the fibrous tissue layer of the eye.

A
  • The outer layer which gives the eye its shape whilst protecting structures
  • Consists mostly of the sclera (the white of the eye)
  • At the front of the eye it forms the cornea
  • The cornea is avascular, no lymph vessels, & bends light (refraction) to focus it on the retina
40
Q

What three parts make up the vascular layer of the eye?

A

The choroid, the ciliary and the iris

41
Q

What is the function of the choroid?

A

The choroid is highly vascular, provides nutrients & O2 to the retina & sclera. The choroid contains melanin to absorb light & reduce glare & reflection back to the retina.

42
Q

What are the structure and function of the ciliary?

A

The ciliary encircles the lens, consists of fibrous tissue & smooth muscle. The ciliary produces some fluids & adjusts the shape of the lens to focus images on the retina.

43
Q

What are the structure and function of the iris?

A
  • The iris is a disc of tissue & muscle, circles the pupil, adjusts the pupil size to allow light to enter the eyeball.
  • Pupil is in the centre of the iris that dilates (enlarges) or constricts (shrinks) controlled predominantly by receptors depending upon the amount of light entering the eye
  • Pupil dilation/constriction occurs in response to flight / fight response in accordance with the parasympathetic / sympathetic nerves
44
Q

What are some eye assessments that can be performed?

A
  • Distant vision can be assessed by asking the person to identify objects from 30 cm away.
  • Near vision can be assessed by asking someone to read something from 5-6 cm away.
  • Reaction to light is assessed by using a pen light.
  • A Snellen Eye Chart is used to test distant vision, placed on the wall 6 m (20 feet) away.
45
Q

What are some common eye problems?

A
  • Myopia (short sightedness)
  • Hyperopia (long sightedness)
  • Astigmatism
  • Colour blindness
  • Amblyopia (lazy eye)
  • Strabismus (cross eye/squint)
46
Q

What are common eye problems that occur in the aging adult?

A
  • Presbyopia - difficulty in seeing objects up close
  • Cataracts - involves a clouding of the lens, can begin at age 35 years
  • Macular degeneration - caused by a degeneration of the retina
  • Glaucoma - causing increased intraocular pressure in the eyes resulting from obstruction of the aqueous humor
  • Diabetic retinopathy - hardens the blood vessels in the eye
47
Q

How does age affest the eyes of older people?

A
  • Decreased pupil size & less responsive to light, including difficulty adjusting to light changes
  • Increased problems with glare/bright sunlight when leaving a dimly lit building
  • Fewer tears produced resulting in dry eyes
  • Loss of peripheral vision
  • Decreased colour vision
  • Spots &floaters increase as a result of vitreous detachment
  • Diagnosis rates of macular degeneration, glaucoma, cataracts increase
48
Q

How can you take care of eyes?

A
  • Washing with a clean cloth/mitt moistened in water
  • No direct pressure over the eye
  • Don’t use soap/gels as they may irritate the eye
  • Administer medications as directed (p.854)
  • Consider the risk of transferring infections from one eye to the other
  • Don’t touch the cornea
  • Avoid touching the eye/lids with droppers/tubes for ointments
  • Never touch another persons applications (p. 995)
49
Q

What are some examples of subjective noticing in a physical assessment of the eye?

A
  • Squinting
  • Frequent blinking
  • Swelling
  • Weeping
  • Pain
  • Redness
50
Q

What evidence of vision can be observed in an infant between newborn and 6 weeks?

A
  • They focus on and follow people and objects, smile, stare at faces close to them
  • They turn toward light or close eyes in response to a bright light
51
Q

What evidence of vision can be observed in an infant at 6 months?

A
  • They follow a slow moving, brightly coloured toy
  • They reach for toys/objects
  • Hold a toy, look closely at them
52
Q

What evidence of vision can be observed in one year old baby?

A
  • Watch people with interest
  • Look for dropped toys
  • Pick up small objects the size of a pea
  • Follow movement in all directions
53
Q

How developed is vision in a child from age two onward?

A

Eyesight is well developed, can see small things on the floor & objects clearly at a distance.

54
Q

How are eye problems identified in children?

A
  • Children with a vision problem may have problems with communication, development, behaviour, health education & future learning.
  • Children have an eye check before school at 4 years
  • If they miss this check, they will be assessed at school between 5-7 years
  • However, not all vision problems can be detected at this early age, screening is repeated at 11 years

Year One: Semester Two (8 decks)

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