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Hearing and Vision Disorders Flashcards

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1
Q

What are the primary functions of the ear?

A

Hearing and balance

The ear functions in hearing by converting mechanical energy to electrical impulses and maintains balance through the vestibular system.

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2
Q

What is the process of hearing?

A
  1. Sound enters the ear
  2. Sound vibrates the eardrum
  3. Bones in the ear vibrate
  4. Fluid in the cochlea moves
  5. Nerves carry the energy to your brain, these nerves correspond frequency, the brain interprets these signals as sound
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3
Q

How does the ear affect balance and equilibrium?

A

Vestibular system of the inner ear provides feedback regarding the movements and the position of the head and body in space

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4
Q

What is the function of the cochlea?

A

Stimulating hair cells to convert mechanical energy to electrical energy

This process is essential for the perception of sound.

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5
Q

What methods are used to assess hearing and balance disorders?

A
  • Inspection of external ear
  • Otoscopic examination
  • Weber test
  • Rinne test
  • Whisper test
  • Audiometry
  • Tympanogram
  • Auditory brainstem response
  • Electro/videonystagmography
  • Platform posturography
  • Sinusoidal harmonic acceleration

These assessments help determine the type and extent of hearing and balance issues.

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6
Q

How is the external ear assessed?

A
  • Inspection and direct palpation looking for deformities, lesions, discharge, symmetry
  • Assess for pain/tenderness (can indicate infection)
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7
Q

What should an otoscopic examination of the ear include?

A
  • Tympanic membrane should appear pearly gray
  • Note fluid, air bubbles, blood, or masses in the middle ear
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8
Q

What is the whisper test?

A

General estimate of hearing by covering one ear, whispers softly from a distance of 1 or 2 feet from the unoccluded ear, ask patient to repeat words

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9
Q

What is the Weber Test?

A
  • Uses bone conduction to test lateralization of sound
  • Useful for detecting unilateral hearing loss
  • Normal result:Sound is heard equally in both ears.
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10
Q

How is the Weber Test performed?

A

A tuning fork is struck and held at the patient’s forehead.
* Patient with conduction loss will hear the sound better in the affected ear (external sound is blocked).
* Patient with Sensorineural hearing loss will hear better in the unaffected ear (since the damaged ear can’t perceive the sound as well)

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11
Q

What is the Rinne test?

A
  • Useful for distinguishing between conductive and sensorineural hearing loss
  • Normal result:Air conduction > bone conduction
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12
Q

How is the Rinne test performed?

A

Using the tuning fork first at the mastoid process to assess for bone conduction, then moving it to just outside the ear canal to represent air conduction. The patient is then asked to state which sounds louder

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13
Q

What are common manifestations of hearing and balance disorders?

A
  • Tinnitus
  • Increased inability to hear in groups
  • Turning up the volume on the TV
  • Deterioration of speech
  • Fatigue and irritability
  • Social isolation

These symptoms can indicate various levels of hearing impairment.

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14
Q

What is the difference between Deaf culture and deafness?

A
  • Deaf culture: Individuals who identify with the Deaf community and prefer ASL
  • deafness: A medical condition where individuals may prefer to speak or lip-read and want to associate with the hearing world.

This distinction highlights the cultural identity versus the medical aspect of hearing loss.

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15
Q

What are the types of hearing loss?

A
  • Conductive (external or middle ear problem)
  • Sensorineural (damage to the cochlea or vestibulocochlear nerve)
  • Mixed
  • Functional (psychogenic i.e. emotional problems)

Each type has different causes and implications for treatment.

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16
Q

What are the risk factors for hearing loss?

A
  • Exposure to excessive noise levels
  • Congenital malformations
  • Family history
  • Low birth weight
  • Perforation of tympanic membrane
  • Recurrent ear infections
  • Ototoxic medications

Understanding these factors can help in prevention and early intervention.

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17
Q

How do hearing aids function?

A
  • Hearing aids amplify sound by converting and processing it electronically, then reconverting it to acoustic signals
  • They make sounds louderbutdo not improve speech discrimination
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18
Q

What are bone conduction devices used for?

A

Conductive/mixed hearing loss and is implanted in the mastoid bone when traditional hearing aids are ineffective

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19
Q

What are middle ear implants used for?

A

Sensorineural loss and offer better sound quality and cosmetic outcomes but requires surgery and regular maintenance.

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20
Q

What are cochlear implants used for?

A

Profound bilateral sensorineural hearing loss and bypass damaged inner ear hair cells to directly stimulate the auditory nerve

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21
Q

What does presbycusis refer to?

A

Progressive hearing loss due to aging

It often results in difficulty hearing high-pitched sounds.

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22
Q

What nursing strategies can be implemented for patients with hearing loss?

A
  • Apply hearing aids
  • Provide emotional support
  • Environmental modifications
  • Use simple phrases
  • Educate about accessible emergency services

These strategies assist in improving communication and quality of life.

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23
Q

What is the purpose of tympanostomy tubes?

A

To allow fluid to drain from the middle ear and equalize pressure

They are often used in cases of recurrent acute otitis media.

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24
Q

What are the clinical manifestations of acute otitis media?

A
  • Otalgia (ear pain)
  • Fever
  • Hearing loss
  • Purulent exudate

These symptoms indicate an infection in the middle ear, commonly seen in children.

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25
What are risk factors for acute otitis media?
* Chronic respiratory infections * Chronic exposure to second hand smoke * Predisposition to ear infections
26
What is Menière's disease characterized by?
* Episodic vertigo * Tinnitus * Fluctuating sensorineural hearing loss * Feeling of fullness/pressure in the ear * Nausea and vomiting ## Footnote This chronic disorder involves an abnormal fluid balance in the inner ear.
27
What are common treatments for Menière's disease?
* Low-sodium diet * Antihistamines * Tranquilizers * Anti-emetics * Diuretics * Surgical management ## Footnote These treatments aim to manage symptoms and prevent attacks of vertigo.
28
What is the nursing management for a patient undergoing mastoid surgery?
* Reduction of anxiety * Pain relief * Preventing injury * Improving communication * Preventing infection ## Footnote These interventions are crucial for recovery and patient comfort.
29
What is the main cause of external otitis ("swimmer's ear")?
Bacterial or fungal infection of the external auditory canal ## Footnote Commonly known as 'Swimmer's ear', it can also be caused by trauma or other factors.
30
What are clinical manifestations of external otitis ("swimmer's ear")?
* pain and tenderness * discharge * edema * erythema * pruritus * hearing loss * feelings of fullness in the ear
31
What are the common causes of foreign body obstruction in the ear?
* Vegetables * Insects ## Footnote Objects that may swell should not be irrigated, and removal may require surgical intervention.
32
What are the clinical features of labyrinthitis?
Inflammation of the inner ear caused by bacteria or viruses ## Footnote This condition can lead to symptoms such as vertigo and hearing loss.
33
What is serous otitis media?
fluid in the middle ear without evidence of infection
34
What are the major internal and external structures of the eye?
Pupil, Iris, Conjunctiva, Retina, Sclera, Optic Nerve, Macular area ## Footnote Structures are essential for understanding eye anatomy and function.
35
What assessment findings are used in the evaluation of ocular disorders?
Visual acuity, patient ocular history, external examination, and ocular motor evaluation ## Footnote These findings inform the diagnosis and management of eye conditions.
36
What are the key components of managing patients with low vision and blindness?
Assessment strategies, use of low-vision aids, referrals to social services, and education on coping strategies ## Footnote Management aims to enhance quality of life and independence.
37
How is an ocular motor evaluation conducted?
Have the patient follow your finger or object without moving the head observing for nystagmus
38
What is myopia?
The image is focused in front of the retina. Patients are near sighted, with blurred distance
39
What is hyperopia?
Visual image is focused beyond the retina, patients are farsighted with excellent distant vision and poor near vision.
40
What is astigmatism?
The cornea or the lens may be egg shaped causing a mismatched image or blurred vision
41
List common pharmacologic actions of ophthalmic medications.
* Topical anesthetics * Mydriatics (dilate) * Cycloplegics (paralyze) * Anti-infectives * Corticosteroids ## Footnote Understanding these actions is crucial for safe medication administration.
42
What is glaucoma?
Damage to the optic nerve related to increased intraocular pressure (IOP) ## Footnote It is often termed the 'silent thief of sight' due to its asymptomatic nature.
43
What are common clinical features of glaucoma?
* Peripheral vision loss * Blurring * Halos * Difficulty focusing * Headaches ## Footnote Early detection is critical to prevent irreversible damage.
44
What are the types of glaucoma?
* Wide Angle / Open-angle * Narrow Angle / Angle-closure * Congenital * Primary or Secondary ## Footnote Each type has different characteristics and management approaches.
45
What is a cataract?
An opacity or cloudiness of the lens ## Footnote Cataracts are a leading cause of visual impairment, especially in older adults.
46
What are risk factors to cataracts?
Aging (most common) Herpes zoster Retinal detachment/retinal surgery Cigarette smoking Long-term use of corticosteroids Obesity, DM UV radiation Blunt trauma
47
List the clinical manifestations of cataracts.
* Painless blurry vision * Sensitivity to glare * Reduced visual acuity * Myopic shift * Color shifts ## Footnote These symptoms can significantly affect daily activities.
48
What is the primary goal of cataract surgery?
To improve visual acuity that negatively affects activities of daily living (ADLs) ## Footnote Surgery is typically performed on an outpatient basis.
49
What is phacoemulsification cataract surgery?
Liquefies (US) the cataract and extracts the material from the eye
50
What is lens replacement cataract surgery?
Intraocular lens (IOL) is inserted to replace natural lens. The pt. may or may not require corrective lenses after surgery
51
What is retinal detachment?
Separation of the retinal pigment epithelium from the neurosensory layer ## Footnote This condition is considered an ocular emergency requiring immediate intervention.
52
What are clinical manifestations of retinal detachment?
Sensation of a shade or curtain coming across the vision of one eye, bright flashing lights, sudden onset of many floaters, painless
53
What are the types of macular degeneration?
* Dry Macular Degeneration * Wet Macular Degeneration ## Footnote Dry is more common and progresses slowly, while wet is rapid and severe.
54
What is dry macular degeneration?
* Slow to come on * See drusen deposit build up
55
What is wet macular degeneration?
* rapid and more devastating * leaky blood vessels
56
What is enucleation?
A surgical procedure that removes the entire eye including the optic nerve ## Footnote This procedure is indicated for conditions like intraocular malignancy or severe trauma.
57
What are indications for enucleation?
* Intraocular malignancy or high suspicion * Trauma
58
What is color blindness?
Altered ability to perceive color due to genetic mutation or retinal injury ## Footnote It is more common in males due to X-linked inheritance.
59
What causes color blindness?
* genetic mutation in cone cells or injury to retina * X-linked recessive inheritance more common in males
60
Types of colorblindness
* Red-Green * Blue- Yellow * Complete
61
What are common causes of conjunctivitis?
* Viruses * Bacteria * Allergies * Chemical irritation ## Footnote Treatment often includes antimicrobial eye drops and corticosteroids.
62
What are clinical manifestations of conjunctivitis?
* Eye redness/swelling * watery eye * gritty feeling * itchiness * irritation * burning * discharge from the eye * Crusting of the eye lids or lashes
63
What are treatments for conjunctivitis?
* Antimicrobial eye drops * corticosteroids * NSAIDs * OTC lubricating eye drops
64
What are types of ocular traumas?
* Splash injuries * Corneal abrasion * Contusion of the eyeball * Intraocular foreign bodies * Ocular burns
65
What is a blow out fracture involving the eye?
often involve the orbital floor and can trap eye muscles or nerves, leading to enophthalmos (sunken eye/inward displacement of the eye)
66
What is an orbital roof fracture?
Serious due to the risk of brain complications and require combined surgical care from neurosurgeons and ophthalmologists
67
What are strategies for interacting with patients with low vision?
* Identify yourself upon approach * Face the person and speak directly * Offer assistance while allowing them to hold your arm * Ensure a clear environment ## Footnote These strategies promote safety and independence.
68
Fill in the blank: The ability of the eye to absorb medication is _______.
limited ## Footnote This necessitates careful administration of ocular medications.
69
What is the recommended time interval between administering different eye drops?
3-5 minutes ## Footnote This allows for proper absorption of the medication.

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