SENSORINEURAL FUNCTION

ANATOMY AND PHYSIOLOGY

EYES
Layers/ Tunics of the Eye 1. External layer (Fibrous tunic) Sclera - the opaque white tissue that helps maintain the shape of the eye Cornea - the dense transparent layer that permits light to enter the eye 2. Middle layer (Vascular tunic) Choroid between the sclera and the retina Ciliary body connects the choroid with the iris and secretes aqueous humor that helps give the eye its shape

EYES

Iris the colored part of the eye, located in front of the lens, and has a central circular opening called the pupil. 3. Internal layer Retina contains blood vessels and photoreceptors called rods and cones.

CATARACT
Definition: Opacity of the lens

Causes: Aging

Congenital Trauma

Retinopathy
Steroids

CATARACT
Signs and symptoms: Blurred vision Usually visual acuity is decreased Loss of vision Appearance of a milky eye Glare in bright lights NANDA: Sensory perceptual alteration RFI

CATARACT
Management: Photocoagulation Eye drop before: MYDRIATIC Cataract extraction Intracapsular - Extracapsular Eye patch After surgery: (unaffected side) No coughing No valsalva maneuver No lifting heavy objects No bending from the waist

CATARACT
No sneezing Never rearrange furnitures predictable environment

GLAUCOMA
Usual Cause: IOP Risk factors: Familial history Old age DM CVDs Myopia Signs and Symptoms: Painful Tunnel/halo/gun-barrel vision

GLAUCOMA

Management: IOP Cholinergics - Mitotics Surgery Trabeculoplasty Trabeculectomy - unaffected side

RETINAL DETACHMENT
Definition: Curtain or veil along the line of the patient's vision Cause: Trauma Signs and symptoms: Floating spots Flashes of light No pain

RETINAL DETACHMENT
Management: Scleral buckling Bed rest Eye patch

After surgery: (affected/dependent side) 6 N's Avoid reading

EAR
Functions: Hearing Maintenance of balance Anatomy and Physiology: External ear Mastoid process Middle ear Tympanic membrane - 3 bony ossicles (malleus, incus, stapes) Inner ear Semicircular canals - Cochlea - CNVIII

HEARING
WEBER'S TEST to check for bone conduction (lateralization of sound) Conductive hearing loss hear conduction/sound more on the affected ear - affected middle or outer ear Sensorineural hearing loss hear sound more on the unaffected ear - inner ear is affected

RINNE'S TEST to compare bone conduction with the air conduction if AC > BC normal - AC twice as long as BC if BC > AC conductive hearing loss if AC > BC and with impaired hearing sensorineural hearing loss

MENIERE'S DISEASE
Definition: Increase pressure in the labyrinth in the ear Etiology: Hypertension consumption of sodium Autoimmune and viral illness Triad Symptoms: Vertigo Tinnitus Loss of hearing

MENIERE'S DISEASE
Management: Avoid driving a car Lie supine and open your eyes and stare straight ahead. Low sodium diet Avoid high altitudes
Drug of choice: Antivert

MENIERE'S DISEASE

ACOUSTIC NERVE: Vestibulo Valance Vertigo Vomiting Viyahilo Vonamine Valium

Otosclerosis disease of the labyrinthine capsule of the middle ear that results in a bony overgrowth of the tissue surrounding the Ossicles Fenestration removal of the stapes with a small hole drilled in the footplate, and a prosthesis is connected between the incus and footplae.