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Ears + Eyes Flashcards

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1
Q

The external ear borders are the _ to the _

A

The external ear borders are the auricle/pinna to the tympanic membrane (includes the tympanic membrane)
* Includes the external auditory canal

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2
Q

The middle ear contains: [structures]

A

The middle ear contains:
* Ossicles
* Eustachian tube
* Stapedial and tensor tympani muscles

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3
Q

From lateral to medial, the ossicles are _ , _ , _ (oval window)

A

From lateral to medial, the ossicles are malleus , incus , stapes (oval window)

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4
Q

The stapedial muscle is innervated by [CN]

A

The stapedial muscle is innervated by facial nerve (VII)

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5
Q

The tensor tympani muscle is innervated by _ nerve

A

The tensor tympani muscle is innervated by pterygoid nerve (branch of V3)

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6
Q

The eustachian tube is a connection between the ear and nasopharynx that allows for _

A

The eustachian tube is a connection between the ear and nasopharynx that allows for pressure equalization

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7
Q

The only part of the ear that is not mucosa lined is the _

A

The only part of the ear that is not mucosa lined is the external ear (skin-lined)

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8
Q

The _ labyrinth is filled with perilymph

A

The bony labyrinth is filled with perilymph

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9
Q

The _ labyrinth is filled with endolymph

A

The membranous labyrinth is filled with endolymph

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10
Q

(3) components of the bony labyrinth:

A

(3) components of the bony labyrinth:
1. Vestibule
2. Semicircular canals
3. Cochlea

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11
Q

Inside the vestibule, are two portions of membranous labyrinth that help detect head position, _ and _

A

Inside the vestibule, are two portions of membranous labyrinth that help detect head position, utricle and saccule

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12
Q

Inside the semicircular canals are the _ and inside the cochlea is the _

A

Inside the semicircular canals are the semicircular ducts and inside the cochlea is the cochlear duct

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13
Q

Vibration of the stapes –> _ –> movement of hair cells in the organ of corti –> _

A

Vibration of the stapes –> movement of perilymph in cochlea –> movement of hair cells in the organ of corti –> opening/closing of membrane channels and generation of nerve impulse

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14
Q

The base of the basilar membrane detects _ frequency sounds

A

The base of the basilar membrane detects high frequency sounds

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15
Q

The apex of the basilar membrane detects _ frequency sounds

A

The apex of the basilar membrane detects low frequency sounds

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16
Q

The _ branch of CN VIII receives signal from the inner and outer hair cells

A

The cochlear branch of CN VIII receives signal from the inner and outer hair cells
* It will then send information about pitch, volume, localization of sound

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17
Q

_ conduction is a way by which sound can vibrate through the skull and go directly to the coclea

A

Bone conduction is a way by which sound can vibrate through the skull and go directly to the coclea
* Skips the external and middle ear

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18
Q

In conductive hearing loss, the weber test will localize to the _

A

In conductive hearing loss, the weber test will localize to the affected ear

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19
Q

In sensorineural hearing loss, the weber test will localize to the _

A

In sensorineural hearing loss, the weber test will localize to the unaffected ear

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20
Q

In sensorineural hearing loss, the Rinne test will be better _

A

In sensorineural hearing loss, the Rinne test will be better in front of ear (air > bone)

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21
Q

In conductive hearing loss, the Rinne test will be better _

A

In conductive hearing loss, the Rinne test will be better behind the ear (bone > air)

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22
Q

Interpret this audiogram

A

Presbycusis: hearing loss at high frequencies

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23
Q

_ hearing loss means there is a problem in the external or middle ear; the problem is getting sound to the inner ear

A

Conductive hearing loss means there is a problem in the external or middle ear; the problem is getting sound to the inner ear
* Ex: cholesteatoma, otitis media, ossicular dysfunction, tympanic membrane perforation

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24
Q

Acquired cholesteatoma originates from _ dysfunction

A

Acquired cholesteatoma originates from eustachian tube dysfunction –> retraction of tympanic membrane –> build up of skin –> can degrade bone

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25
When bone > air there is _ hearing loss
When bone > air there is **conductive** hearing loss * On audiogram brackets = bone
26
Interpret the audiogram
**Sensorineural hearing loss** * There is a problem of VIII
27
Examples of sensorineural hearing loss:
Examples of sensorineural hearing loss: * Presbycusis * Exposure to loud noise * Congenital causes * Tumor * Ototoxic medications
28
Interpret the audiogram
Mixed hearing loss (combination)
29
The three main tissue layers of the eye are:
The three main tissue layers of the eye are: 1. **Sclera/cornea** from surface ectoderm 2. **Uveal tract** from mesoderm and neural crest 3. **Retina/ neural** from neuroectoderm
30
There are two segments of the eye; the _ which is the optical segment and the _ which is the sensory segment
There are two segments of the eye; the **anterior segment** which is the optical segment and the **posterior segment** which is the sensory segment
31
The anterior chamber is filled with _ and the posterior chamber is filled with _
The anterior chamber is filled with **aqueous fluid** and the posterior chamber is filled with **vitreous fluid**
32
The two chambers of the eye are in relation to the iris, the _ and _
The two chambers of the eye are in relation to the iris, the **anterior** and **posterior**
33
The _ are the output cells of the retina which send signal to the occipital cortex via the _
The **retinal ganglion cells** are the output cells of the retina which send signal to the occipital cortex via the **lateral geniculate nucleus (LGN)**
34
ID the major landmarks
35
There are two main refractive structures in the eye, the _ and _
There are two main refractive structures in the eye, the **cornea** and **lens**
36
The _ is the air- tear film interface and it has the greatest refractive power
The **cornea** is the air- tear film interface and it has the greatest refractive power
37
If light is refracted too heavily or the eye is too long, the result is _
If light is refracted too heavily or the eye is too long, the result is **myopia** (near-sightedness)
38
If light is not refracted enough or the eye is too short, the result is _
If light is not refracted enough or the eye is too short, the result is **hyperopia** (far sightedness)
39
_ is an irregular refraction due to ocular surface or lens aberration
**Astigmatism** is an irregular refraction due to ocular surface or lens aberration
40
_ occurs with age as the lens becomes stiff and loses accommodation
**Presbyopia** occurs with age as the lens becomes stiff and loses accommodation
41
The 1' neuron of the hypothalamospinal pathway begins at the _ and synapses at _
The 1' neuron of the hypothalamospinal pathway begins at the **hypothalamus** and synapses at **C8-T2**
42
The 2' neuron of the hypothalamospinal pathway extends from C8-T1, through the _ and synapses at the _
The 2' neuron of the hypothalamospinal pathway extends from C8-T1, through the **sympathetic chain** and synapses at the **superior cervical ganglion**
43
The 3' neuron of the hypothalamospinal tract is the _ nerve
The 3' neuron of the hypothalamospinal tract is the **long ciliary nerve** --> dilator pupillae
44
Parasympathetics to the eye originate at the _ nucleus and travel alongside CN III before synpasing in ciliary ganglion, where _ innervates the pupillary sphincter
Parasympathetics to the eye originate at the **edinger-westphal** nucleus and travel alongside CN III before synpasing in ciliary ganglion, where **short ciliary nerve** innervates the pupillary sphincter
45
The near reflex (which allows us to focus on close objects) requires (3) phenomenon:
The near reflex (which allows us to focus on close objects) requires (3) phenomenon: 1. **Lens accommodation** 2. **Miosis** 3. **Convergence**
46
In order for the lens to accomodate to close objects, _ must contract and _ must relax
In order for the lens to accomodate to close objects, **ciliary muscles** must contract and **suspensory ligaments** must relax * *This makes lens more spherical*
47
In order for the lens to focus distant objects, the ciliary muscles must _ and the suspensory muscles must _
In order for the lens to focus distant objects, the ciliary muscles must **relax** and the suspensory muscles must **stretch** * *This makes the lens flatten*
48
Optic neuropathy or severe midbrain dysfunction may result in loss of the _ reflex
Optic neuropathy or severe midbrain dysfunction may result in loss of the **light reflex**
49
Aqueous humor gets produced by _ on the ciliary body
Aqueous humor gets produced by **non-pigmented epithelium** on the ciliary body * *This ciliary body is in the posterior chamber*
50
The dilator muscle on the iris has [receptors]
The dilator muscle on the iris has **a1** receptors
51
The sphincter muscle of the iris has [receptors]
The sphincter muscle of the iris has **M3** receptors
52
90% of aqueous humor gets drained through the _
90% of aqueous humor gets drained through the **trabecular meshwork** --> canal of schlemm --> episcleral vasculature
53
10% of aqueous humor gets drained into the _
10% of aqueous humor gets drained into the **uvea** and **sclera** (uveoscleral outflow)
54
Glaucoma is a neurodegenerative disease that results in vision loss starting in the _
Glaucoma is a neurodegenerative disease that results in vision loss starting in the **periphery** * *Type of optic neuropathy that causes progressive vision loss* * *Intraocular pressure plays a significant role*
55
Glaucoma is associated with [phenomenon] of the optic nerve/disc
Glaucoma is associated with **cupping** of the optic nerve/disc
56
Acute angle _ glaucoma is a vision threatening emergency; treat by _
Acute **angle-closure** glaucoma is a vision threatening emergency; treat by **reducing intraocular pressure** (laser peripheral iridotomy)
57
_ involves degeneration and opacification of the crystalline lens
**Cataracts** involves degeneration and opacification of the crystalline lens
58
Cataracts are most commonly due to increased _ and _
Cataracts are most commonly due to increased **age** and **UV exposure** * *Can be congenital or related to metabolic disorders*
59
How does cataract present?
**Cataracts** present with gradual vision loss, glare, color dulling, myopic shift * *Myopic shift happens because of increase in AP diameter and increased optic power of the lens*
60
Macular degeneration begins with [region] vision loss
Macular degeneration begins with **central** vision loss
61
Dry macular degeneration is associated with _ deposits, leading to atrophy and slow vision loss
Dry macular degeneration is associated with **drusen** deposits, leading to atrophy and slow vision loss
62
Wet macular degeneration involves _ and can be a more rapid loss of central vision
Wet macular degeneration involves **neovascularization** and can be a more rapid loss of central vision
63
Macular degeneration begins in the center due to the highest density of _ here
Macular degeneration begins in the center due to the highest density of **photoreceptors** here * *Photoreceptors are particularly vulnerable to oxidative stress*
64
We treat dry macular degeneration with _
We treat dry macular degeneration with **multivitamins**
65
We treat wet macular degeneration with _
We treat wet macular degeneration with **anti-VEGF**
66
The _ layer supports the neurosensory retina by regulating oxidative stress
The **retinal pigment epithelium (RPE)** layer supports the neurosensory retina by regulating oxidative stress
67
Retinal detachment occurs when fluid separates the neurosensory retina from the _
Retinal detachment occurs when fluid separates the neurosensory retina from the **retinal pigment epithelium** * *May involve detachment or preservation of macula*
68
Retinal detachment is preceded by [signs]
Retinal detachment is preceded by **flashes, floaters, progressive dark curtain over vision**
69
Pathogenesis of diabetic retinopathy:
Pathogenesis of diabetic retinopathy: **glycosylation of proteins** in capillary walls --> poor vascular integrity --> leakage and ischemia
70
Clinical signs of diabetic retinopathy:
Clinical signs of diabetic retinopathy: * Microaneurysms * Dot-blot hemorrhage * Cotton wool spots (infarts) * Neovascularization *Can be nonproliferative or proliferative (NV)* *Treat with glycemic control or anti-VEGF*
71
Chronic increased blood pressure and IOP can cause _
Chronic increased blood pressure and IOP can cause **hypertensive retinopathy**
72
Clinical signs of hypertensive retinopathy:
Clinical signs of hypertensive retinopathy: * **Copper or silver wiring**: arterioles are thickened so more reflective on exam * **AV nicking**: arteriole crosses vein * Later stage: **retinal venous obstruction** *Treat with BP control*
73
Retinitis pigmentosa is [aquired/inherited] retinal disease with progressive loss of photoreceptors
Retinitis pigmentosa is an**inherited** retinal disease with progressive loss of photoreceptors
74
Retinitis pigmentosa vision loss begins in [region]
Retinitis pigmentosa vision loss begins in **periphery** * Peripheral --> central
75
Retinitis pigmentosa will begin with [vision deficit]
Retinitis pigmentosa will begin with **night blindness** --> **peripheral vision loss** --> **central**
76
"Bone spicule pigmentation" =
"Bone spicule pigmentation" = **retinitis pigmentosa**
77
Babies born prematurely will have _ retinas due to incomplete vascularization; this triggers an increase in _ release
Babies born prematurely will have **ischemic retinas** due to incomplete vascularization; this triggers an increase in **VEGF** release --> retinal neovascularization * Can treat with anti-VEGF or laser
78
_ commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness.
**Blepharitis** commonly occurs when tiny oil glands near the base of the eyelashes become clogged, causing irritation and redness * *These glands are called Meibomian glands* * Dysfunction of gland --> dryness, itching
79
Blepharitis is most commonly caused by [pathogen] or [pathogen]
Blepharitis is most commonly caused by **staph** or **demodex**
80
Treatment for blepharitis includes _
Treatment for blepharitis includes **lid hygiene, warm compress**
81
Styes are defined simply by _
Styes are defined simply by **glandular obstruction +/- inflammation**
82
_ is a style usually caused by bacteria with significant inflammation
**Hordeolum** is a style usually caused by bacteria with significant inflammation
83
_ is a stye caused by a blocked oil gland without much inflammation
**Chalazion** is a stye caused by a blocked oil gland without much inflammation
84
Bacterial conjunctivitis is usually treated with _
Bacterial conjunctivitis is usually treated with **topical antibiotics** * Chlamydial or gonococcal infection treated with systemic abx
85
_ is infection of the conjunctiva, while _ is infection of the cornea
**Conjunctivitis** is infection of the conjunctiva, while **keratitis** is infection of the cornea
86
Diagnosis?
Keratitis
87
Diagnosis?
**Herpes simplex keratitis** featuring **dendritic ulcer**
88
Anterior inflammation of the uveal tract is called _
Anterior inflammation of the uveal tract is called **iridocyclitis** * *Can be caused by disruption of blood aqueous barrier or sometimes primary (autoimmune)*
89
Posterior inflammation of the uveal tract is either _ or _
Posterior inflammation of the uveal tract is either **choroiditis** or **retinitis** * *Can be caused by disruption of blood retinal barrier or sometimes primary (autoimmune)*
90
Name (3) major categories of glaucoma drugs that *decrease aqueous humor production*
Name (3) major categories of glaucoma drugs that *decrease aqueous humor production* 1. **Beta blockers** 2. **Carbonic anhydrase inhibitors** 3. **a2 agonists**
91
Name (4) major categories of glaucoma drugs that increase aqueous humor outflow
Name (4) major categories of glaucoma drugs that *increase aqueous humor outflow* 1. **a2 agonists** (fall into both categories) 2. **Prostaglandin analogs** 3. **M3 agonists** 4. **RHO kinase inhibitor**
92
Brimonidine works by [mechanism] and [mechanism]
Brimonidine works by **inhibiting aqueous humor production** and **increasing outflow** * *Indirect mechanism by inhibiting ciliary blood flow*
93
Both beta bockers and a2 agonists block sympathetic signaling to the _ , resulting in reduced aqueous humor
Both beta bockers and a2 agonists block sympathetic signaling to the **ciliary body** , resulting in reduced aqueous humor
94
Acetazolamide helps treat glaucoma via [mechanism]
Acetazolamide helps treat glaucoma via **inhibiting aqueous production at the nonpigemented epithelium on ciliary body**
95
Prostaglandin analogs like latanoprost increase _ outflow of aqueous humor
Prostaglandin analogs like latanoprost increase **uveoscleral** outflow of aqueous humor
96
Prostaglandin analogs have toxicities of _ and _
Prostaglandin analogs have toxicities of **iris discoloration** and **increased eyelash length**
97
M3 agonists, carbachol and pilocarpine increase AH outflow via [mechanism]
M3 agonists, carbachol and pilocarpine increase AH outflow via **ciliary muscle contraction --> opens the canal of schlemm** * Direct M3
98
Indirect M3 agonists, _ and _ also help to contract the ciliary muscle, open the canal of schlemm, and increase AH outflow
Indirect M3 agonists, **echothiophate** and **physostigmine** also help to contract the ciliary muscle, open the canal of schlemm, and increase AH outflow
99
Toxicities of M3 agonists include _ and _
Toxicities of M3 agonists include **miosis** and **loss of night vision**

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