The document discusses the human sensory system and neurological functions. It describes how the sensory system processes sensory information through sensory receptors, transduction, and neural pathways in the central and peripheral nervous systems. It discusses the main sensory modalities of vision, hearing, taste, smell, and touch, and how stimuli are coded by sensory receptors in terms of type, intensity, location, and duration. The anatomy and physiology of neurons, neuroglia, and the central and peripheral nervous systems are also summarized.
3. SENSORY SYSTEM
3
¨ Responsible for processing sensory information
¤ Senses are physiological capacities of organisms that
provide data for perception.
n Physiology is the science of the function of living systems.
This includes how organisms, organ systems, organs, cells,
and bio-molecules carry out the chemical or physical
functions that exist in a living system.
n Perception (from the Latin perceptio, percipio) is the process
of attaining awareness or understanding of the environment
by organizing and interpreting sensory information.All
perception involves signals in the nervous system, which in
turn result from physical stimulation of the sense organs.
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¨ VISION involves light striking the retinas of the eyes,
smell is mediated by odor molecules and hearing
involves pressure waves.
¤ Perception is not the passive receipt of these signals,
but can be shaped by learning, memory and
expectation.
¤ Perception depends on complex functions of the nervous
system, but subjectively seems mostly effortless because
this processing happens outside conscious awareness.
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¨ The senses and their operation, classification, and
theory are overlapping topics studied by a variety of
fields, most notably neuroscience, cognitive
psychology (or cognitive science), and philosophy of
perception. The nervous system has a specific sensory
system or organ, dedicated to each sense.
¨ Senses are transducers from the physical world to
the realm of the mind
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¨ Human beings have a multitude of senses.
¤ Sight (ophthalmoception),
¤ hearing (audioception),
¤ taste (gustaoception),
¤ smell (olfacoception or olfacception), and
¤ touch (tactioception) are the five traditionally recognized
and the only senses proven to to be existent in humans.
¨ Some believe in other senses, including temperature
(thermoception), kinesthetic sense (proprioception), pain
(nociception), balance (equilibrioception) and
acceleration (kinesthesioception)
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7. Sensory system consists of
7
¨ Sensory receptors
¤ is a sensory nerve ending that responds to a
stimulus in the internal or external environment of
an organism. In response to stimuli the sensory
receptor initiates
n sensory transduction by creating graded potentials or
action potentials in the same cell or in an adjacent one.
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¨ Transduction is the conversion of a stimulus from
one form to another
¤ graded potential, is the transmembrane potential
difference of a sensory receptor
Transmembrane receptor:E=extracellular space;
I=intracellular space; P=plasma membrane
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11. Coding of sensory stimuli
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¨ Stimulus strength is coded as the frequency of AP
¨ Higher the stimulus more frequent are the APs
¨ Amplitude of AP is constant
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13. Sensory coding
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¨ A receptor must convey the type ¨ It must send information about
of information it is sending à the location and receptive field,
the kind of receptor activated characteristic of the receptor
determined the signal
recognition by the brain
¨ It must convey the intensity of the
stimulus à the stronger the
signals, the more frequent will
be the APs
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14. Transduction in different receptors
14
¨ Different receptors have different ion channels
¨ Their opening causes receptor potential
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16. NEURAL PATHWAYS and parts of the
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brain
¨ Involved in sensory perception.
¤ neural pathway, neural tract, or neural face,
connects one part of the nervous system with
another and usually consists of bundles of
elongated, myelin-insulated neurons, known
collectively as white matter. Neural pathways serve
to connect relatively distant areas of the brain or
nervous system, compared to the local
communication of grey matter.
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17. Sensory pathway
17
¨ Once a receptor is stimulated
¨ impulse travels through a particular pathway
¨ known as sensory pathway or ascending pathway
¨ up to the brain
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18. Sensory pathway Sensory area
in the brain
18
Ascending
Sensory pathway
Central Connections
Sensory nerve
Touch stimulus
Receptor
Sensory
modality
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19. Receptors
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¨ Receptor cells are specific cells that are sensitive to
different forms of energy from the environment
¨ These cells contain membrane receptors coupled to
ion channels
¨ They transform the stimulus into electrical signals
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20. HUMAN SENSORY RECEPTORS
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Classifications:
¨ Chemosensor – TRANSDUCES a chemical signal into
an action potential
¨ Nociceptor - responds to potentially damaging
stimuli by sending nerve signals to the spinal cord
and brain
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¨ Mechanoreceptor – RESPONDS to mechanical
pressure or distortion. Transform displacement or
mechanical force into action potentials.
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¨ Photoreceptor - specialized type of neuron found in
the retina that is capable of phototransduction.
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¨ Thermoreceptor - is a sensory receptor, or more
accurately the receptive portion of a sensory
neuron, that codes absolute and relative changes in
temperature
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24. Two ascending pathways
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¨ Dorsal column - medial lemniscus pathway
fast pathway
¨ Spinothalamic pathway
slow pathway
These two pathways come together at the level of thalamus
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27. Dorsal column pathway Spinothalamic pathway
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¨ touch: fine degree ¨ Pain
¨ highly localised touch ¨ Thermal sensations
sensations ¨ Crude touch & pressure
¨ crude localising sensations
¨ vibratory sensations
¨ tickle & itch
¨ sensations signalling ¨ sexual sensations
movement
¨ position sense
¨ pressure: fine degree
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28. 3rd
thalamocortical tracts order
neuron
internal capsule
thalamus
2nd
Medial lemniscus order
neuron
Dorsal column nuclei
(cuneate & gracile nucleus)
1st
Dorsal column order
neuron
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29. dorsal column - medial lemniscus pathway
29
¨ after entering the spinal cord
¤ lateral branch: participates in spinal cord reflexes
¤ medial branch: turns upwards
¨ forms the dorsal columns
¨ spatial orientation:
¤ medial: lower parts of the body
¤ lateral: upper part of the body
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30. dorsal column - medial lemniscus pathway
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¨ synapse in the dorsal column nuclei
¤ nucleus cuneatus & nucleus gracilus
¨ 2nd order neuron cross over to the opposite
side and ascends upwards as medial
lemniscus
¨ as this travels along the brain stem fibres
from head and neck are joined (trigeminal)
¨ ends in the thalamus (ventrobasal complex)
¤ ventral posterolateral nuclei
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31. dorsal column - medial lemniscus pathway
31
¨ spatial orientation in the thalamus
¤ medial: upper part of the body
¤ lateral: lower part of the body
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32. 3rd
thalamocortical tracts order
neuron
internal capsule
thalamus
2nd
Spinothalamic order
tracts neuron
1st
order
neuron
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33. spinothalamic pathway
33
¨ after entering the spinal cord
¤ synapse in the dorsal horn
¨ cross over to the opposite side
¨ divide in to two tracts
¤ lateral spinothalamic tract:
n pain and temperature
¤ anterior spinothalamic tract
n crude touch
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34. spinothalamic pathway
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¨ spatial orientation
¤ medial: upper part of the body
¤ lateral: lower part of the body
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36. STIMULUS
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¨ Sensory systems code for four aspects of a stimulus;
¤ type (modality)
n Receptors are sensitive to certain types of stimuli (for
example, different mechanoreceptors respond best to
different kinds of touch stimuli, like sharp or blunt objects).
¤ Intensity
n Receptorssend impulses in certain patterns to send
information about the intensity of a stimulus (for example,
how loud a sound is)
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¤ Location
n gives the brain information about the location of the stimulus
(for example, stimulating a mechanoreceptor in a finger will
send information to the brain about that finger)
¤ Duration
n The duration of the stimulus (how long it lasts) is conveyed by
firing patterns of receptors. These impulses are transmitted
to the brain through afferent neurons.
¤ Arrival time of a sound pulse and phase differences of
continuous sound are used for localization of sound
sources.
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39. MODALITY
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¨ A stimulus modality (sensory modality) is a
type of physical phenomenon that can be
sensed.
nExamples are temperature, taste, sound,
and pressure. The type of sensory receptor
activated by a stimulus plays the primary
role in coding the stimulus modality.
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42. I. Anatomy/Physiology
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A. Neuron- highly specialized for the processing and
transmission of cellular signals
1. Basic component of the nervous sy.
2. Composed of cell body, axon & dendrites
a. Cell body = center of metabolism
b. Axon =long fibers > conduct impulses away from the cell
body; usually 1 axon for each cell body
c. Dendrites = short, unsheathed fibers> receive nerve
impulses> transmit to cell body
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3. Myelin sheath – covering that protects nerve fiber>
facilitates> speed of impulse conductor
a. Axon & dendrite – may/may not have myelin
sheath
b. Most axons leaving the CNS – heavily myelinated
w/ schwann cells
c. Gaps in myelin sheath – termed Nodes of Ranvier
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4. Primary fxn – transmission of nerve impulses
a. Afferent (sensory) n. – transmit impulses from
peripheral receptors } CNS
b. Efferent (motor) n. – conduct impulses from CNS
c. Action potentials travel along axons} end of
nerve fiber }impulse is transmitted across
junction bet. nerve cells (synapse) }chemical
interaction
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5. Neuroglia – glial cells
a. Provide support,
b. Nourishment and
c. Protection for neurons
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C. CNS contains:
1. Cerebrum – divided into: left right hemisphere}
longitudinal fissure
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a. Frontal lobes
n Precentral gyrus – contralateral movement; face, arm, leg,
trunk
n Broca’s area – dominant hemisphere } respon.> formation of
words
n Supplementary motor area – contralateral head & eye
turning
n Prefrontal area- personality, initiative
n Paracentral lobule- contralateral inhibition of bladder &
bowel
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b. Parietal lobes
¤ Postcentralgyrus – body sensations; temp, touch,
pressure, pain }from opposite side of the body
¤ Dominant parietal lobe- wernickes’ speech area,
auditory & visual aspects> comprehensions are
integrated
n Responsible for skills { handle numbers & calculations
¤ Nondominant parietal lobe- concept of body image &
awareness of external envi{ ability to construct shapes
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c. Occipital lobes – visual center; comprehension of
written word
d. Temporal lobes
¤ Dominant hearing of language; taste, smell
¤ Memory
¤ Wernicke’s speech area – recognition of language
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2. Basal ganglia – reg & integr skeletal voluntary &
autonomic motor activity originating in cerebral cortex
3. Diencephalon – connects the cerebrum & brain stem;
contains several small structures, the most important of
w/c are the thalamus & hypothalamus
a. Thalamus – relay station for discrimination of sensation
}received from periphery>several nuclei in the thalamus,
each w/ specific fxns} such as: integration of sensory stimuli
necessary for abstract thinking & reasoning, vision, hearing;
relay station for fibers going to limbic system
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¤ Hypothalamus- responsible for maintaining
momeostasis} thru the secretion of hormones & central
control of ANS
n Controls vital fxn: water balance, BP, sleep, appetite, temp
n Affects some emotional responses ] pleasure/fear
n Control center for pituitary fxn
n Affects both divisions of the ANS
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c. Limbic system –responsible for controlling various
functions in the body. Structures of this system
include the hippocampus, hypothalamus, and
thalamus
¤ Fig.
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4. Brain stem- contains; midbrain, pons & medulla
oblangata, extending from the cerebral
hemispheres to the foramen magnum @ the base of
the skull
a. Contains nuclei- 5,6,7,8th Cnerves & ascending
sensory & descending motor tracts
b. Contains vital center- respiratory, vasomotor &
cardiac fxn
c. Reticular formation – relays sensory of info; controls
vasomotor/respiratory activity
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5. Ventricular system & CSF – supports & cushions
CNS
¤ Removes metabolic wastes
¤ Compensatory mechanisms for ICVolume/pressure
¤ Produces 55 cc/d of CSF; 130-150cc amt ave in sy
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6. Cranial meninges
¤ Dura mater – dense, fibrous, outermost layer serves as
periosteum for Cnerves
¤ Arachnoid mater
n Delicate, avascular membrane lying under dura
n Surrounds brain loosely
n Subarachnoid space contains; CSF, arteries & veins
n Contains arachnoid granulations that enable CSF } pass from
subarachnoid space>venous system
¤ Pia mater
n Most delicate inner meningeal layer
n Barrier system
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7. Cerebellum – control of: muscle motion, balance,
coordination; trunk mobility & equilibrium
¤ Spinal cord – communications link bet CNS & PNS
n Ascending pathways ] transmit
n Sensory information
n Descending pathways] relay
n Motor instrtuctions
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58. HUMAN SENSORY SYSTEM
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¨ The Human sensory system consists of the following
sub-systems:
¤ Visual system consists of the photoreceptor cells, optic nerve, and
V1.
¤ Auditory system
¤ Somatosensory system consists of the receptors, transmitters
(pathways) leading to S1, and S1 that experiences the sensations
labelled as touch or pressure, temperature (warm or cold), pain
(including itch and tickle), and the sensations of muscle movement
and joint position including posture, movement, and facial
expression (collectively also called proprioception).
¤ Gustatory system
¤ Olfactory system
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59. I. ANATOMY OF THE EYE
59
¨ A. three layers
¤ Sclera –fibrous outer coat
¤ Choroid – middle vascular coat
¤ Retina – inner nerve coat
¨ B. Lens
¤ Lies behind pupil & iris
¤ Held in position by suspensory ligament attached to the
ciliary body
¤ Elastic qualities allow accommodation to focus image on
the retina
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¨ C. Iris
¤ Colored portion of eye
¤ Attached around circumference by ciliary body
¤ Opening at center – pupil
¤ Controls the amt of light entering eye
¨ D. retina
1. Innermost lining
2. Contains rods & cons
a. Rods fxns w/ colorless, twilight vision
b. Cones fxns w/ perception of color & bright, daylight vision
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c. Optic disk
1) Point of entrance of nerve & bld vessels
2) Blind spot
3) Most prominent structure visible on the fundus (retina
lining of the back of the eye)
a) Excessive pallor signals optic atrophy, a partial
or complete destruction of the optic nerve
b) Excessive redness- papilledema inflamation
c) Papilledema – choked disks: severe form
i. Inflammation
ii. Passive congestion from ICP
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62. II. VISUAL FUNCTION
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¨ A. Assessment (fig)
¤ Test
n Tonometry –measures IOP
n Visual fields – measurement of range of vision
(perimetry)
n Snellen test – visual acuity
n Client preparation: recumbent/sitting position,
remove contact lenses, not to
squint/cough/hold breath during procedure
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¨ B. S/S of eye problem
1. Redness, pain & burning
2. Edema
3. #lacrimation & exudate
4. Headache
5. Nausea & vomiting
6. Squinting
7. Visual disturbances
8. Disorders of accommodation
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DISORDERS OF ACCOMMODATION
Types Nsg Considerations
Myopia (nearsightedness) – Corrective lenses
light rays refract at a point in
front of the retina
Hyperopia (farsightedness) – Corrective lenses
light rays refract behind the
retina
Presbyopia with aging Commonly occurs after age 35
Astigmatism – uneven curvature Corrective lenses
of cornea causing blurring of
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¨ C. Treatments
1. Eye irrigation method
a. Tilt head back toward the side of affected area
b. Allow irrigating fluid to flow from the inner to outer
canthus
c. Use a small bulb syringe/eye dropper to dispense fluid
d. Place a small basin close to head to collect excess
fluid/drainage
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¤ 2. Eyedrop instillation
a. Tilt head back toward the side of affected area
b. Allow irrigating fluid to flow from the inner to outer
canthus
c. Use a small bulb syringe/eye dropper to dispense fluid
d. Place a small basin close to head to collect excess
fluid/drainage
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¨ D. Nsg Mgt
1. Prevent eye injuries
a. Provide safe toys
b. Use of eye protectors when working w/ chemicals
c. Use of eye protectors during sports
d. Protect eyes from ultraviolet rays
e. Instruction for first aid
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¤ 2. Emergency Treatment
n A. Burns
Types Nsg Considerations
Chemical – acids, cleanser, Eye irrigation w/ copious
insecticides amts of H2O for 15-20min
Radiation – sun, lightning, Prevention- use of
eclipses eyeshields
Thermal – hot metals, Use of goggles to protect
liquids, occupational the cornea, patching,
hazards analgesics
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¨ B. EyeTrauma
Types Nsg considertions
Nonpenetrating- abrasions Eye patch for
24hrs
Nonpenetrating- contusions Cold compresses,
analgesics
Penetrating – pointed or Cover w/ patch
sharp objects
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70. III. Visual Function
70
¨ A. Assessment
1. Adjustment to vision loss depends upon:
a. Age of onset
b. Degree of suddenness
2. Principles of working w/ blind persons
a. Facilitate normal lifestyle patterns
a. Adapted household eqpt
b. Books/newspaper w/ large print for partially sighted
c. Information > aids for the blind
d. Braile, canes, guide dogs
e. Facilitate dev patterns
f. Enc social devt
g. Provide for educ & employment
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¨ 3. Nsg Mgt for the blind px
a. Enhance communication
a. Address px by name
b. Always introduce self
c. State reason for being there
d. Inform px when leaving the room
b. Provide sense of safety/security
a. Explain procedures in detail
b. Keep furniture arrangement consistent, provide hand rail
c. Door should never be half open
d. Lightweight walking stick if walking alone
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72. IV. SELECTED DISORDERS OF THE EYE
72
¨ A. DETACHED RETINA
¤ 1. History
n Flashes of light
n Blurred or sooty vision
n Sensation of particles moving in line of vision
n Delineated of vision areas blank
n Feeling of coating coming u & down
n Loss of vision
n Confusion/apprehension
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¨ 2. Characteristics
¤ Separation of the retina from choroid
¤ Cause
n Trauma
n Aging process
n Diabetes
n Tumors
¤ Medical mgt
n Sedatives & tranquilizers
n Surgery- retina to adhere to choroid
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¨ 3. Nsg Mgt
¤ Bedrest
¤ Affected eye maybe patch- to decrease movement of
eyes
¤ Specific positioning
¤ Hairwashing delayed for 1 wk
¤ Avoid strenuous activity for 3 mos
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¨ B. CATARACTS
¤ 1. Hx
n Objects appear distorted and blurred
n Annoying glare
n Pupil changes from black to gray to milky white
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¨ 2. Assessment
¤ Partial/total opacity of the normally transparent
crystalline lens
¤ Cause
n Congenital
n Trauma
n Aging process
n Assoc w/ diabetes mellitus, intraocular surgery
n Drugs- steroid therapy
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¤ Surgical Mgt – laser surgery
n Extracapsular extraction – cut thru the anteriorcapsule to express
the opaque lens material
n Intracapsular extraction (method of choice) –entire removal of
lens & capsule
n Lens implantation
¤ Nsg Mgt
n Observe for post-operative complications
n Hemorrhage
n #IOP
n Slipped suture
n If lens implant, pupil should remain constricted; if aphakic, pupil
remains dilated
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n Avoid straining /no heavy lifting
n Bend from the knees only to pick up things
n Instruct in instillation of eye drops/use of night shields
n Protect from bright light
n Adjustments needed if aphakic
n Diversional activities
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¨ GLAUCOMA
¤ 1. Assessment
n Cloudy, blurry vision
n Artificial lights appear to have rainbows
n Loss of vision
n #decreased peripheral vision
n Pain, headache
n Nausea, vomiting
n Tonometer readings exceed normal IOP (10-21mmhg)
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¨ 2. Characteristics
¤ A. Abnormal #IOP leading to visual disability/blindness
– obstruction of outflow of aqueous humor
¤ B. Types
n Acute/close(narrow) – angle glaucoma; sudden onset
n Chronic or open (wide) – angle glaucoma; most common
¤ C. Causes
n Close-angle glaucoma – assoc w/ ocular d’s, trauma
n Open-angle glaucoma – assoc w/ aging, heredity, retinal
vein occlusion
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¤ D. Tx
n Meds – miotics, carbonic anhydrase inhibitors, oral glycerin
& mannitol
n Surgery – laser trabeculoplasty, standard glaucoma surgery
¤ Common nsg diagnosis – sensory/ perceptual/visual
alteration
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¨ Nsg Mgt
¤ Compliance w/ medical therapy
¤ Avoid tight clothing
¤ Reduce external stimuli
¤ Avoid heavy lifting, straining at stool
¤ Avoid use of mydriatics
¤ Educate public to 5 danger signs of glaucoma:
n Brow arching
n Blurry vision
n Diminished peripheral vision
n Headache or eye pain
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83. I. Anatomy & Physiology of EAR
83
¨ A. External Ear
¤ Pinna/auricle
¤ External acoustic meatus
¤ External auditory canal
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¨ B. Middle ear
¤ Located in temporal lobe
¤ Contains ossicles
n Malleus
n Incus
n Stapes
¤ Eustachian tube – connects middle ear to the throat &
assist in equalizing pressure
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¤ Physiology of sound
n Sound waves enter external auditory canal >tympanic
membrane >vibrates, triggering ossicles(m,i,s) } transmitted
to oval window to acoustic nerve and brain
¨ C. Inner ear
¤ Contains: vestibule, semicircular canals,
cochlea(labyrinth) } movment of the sensory hair signals
changes in position; aids in maintaining stable posture
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86. II. Alterations in Fxn
86
¨ A. Assessment
¤ S/S } pain, fever, headache, discharge, altered growth
& dev, personality changes (irritability, depression,
suspiciousness, w/drawal
¤ Dx } Audiogram – quantitative(degree of loss), Tuning
fork – qualitative (type of loss)
¤ Types:
n Conductive loss
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¤ Types:
n 1. Conductive loss – disorder in auditorycanal, eardrum/ossicles
n Causes: infection, inflammation, foreign body, trauma
n Complications : meningitis resulting from initial infection
n Nsg Mgt: heat, antibiotics, ear drops/ointments/irrigation, surgery,
hearing aid
n 2. perceptive(sensorineural loss) – due to disorder of organ of
corti/auditory nerve
n Causes: congenital-maternal exposure to com’cable d’s, infection,
drug toxicity, trauma, labyrinth dsfxn(Meniere’s d’s
n Complications: vertigo, tinnitus, vomiting
n Mgt: meds, surgery, combined loss- conductive & sensorineural,
psychogenic loss-functional
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¨ C. Nsg Mgt
¤ Ear irrigation
¤ Ear drop instillation
¤ Px undergoing surgery
¤ Discharge teaching – avoid getting water in ear, flying,
drafts, crowds, exercise caution around people w/
respiratory infections
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¨ III. Selected disorders
¤ A. Acute otitis media – infection of middle ear, cause:
pathogenic organisms(bacteria/virus)
¤ B. Mastoiditis –inflammation
¤ C. meniere’s syndrome(endolymphatic hydrops) –
dilation of the labyrinth, causes: trauma,
intoxication,syphilis, otitis media, otosclerosis
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¨ Medical & Nsg Mgt
¤ Saltfree/neutral ash diet(furstenberg diet) – restrict
h2o & salt intake
¤ Symptomatic treatment: antiemetics, histamines,
vasodilators
¤ Px education: need to slow down body motion, self
protection, occupational counseling
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91. SOMATIC SENSATION (TOUCH)
91
¨ somatosensory system
¤ isa diverse sensory system composed of the
receptors and processing centres to produce the
sensory modalities such as touch, temperature,
proprioception (body position), and nociception
(pain). The sensory receptors cover the skin and
epithelia, skeletal muscles, bones and joints, internal
organs, and the cardiovascular system.
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93. Taste/GUSTATION
93
¨ Taste (also called smatch)
¤is one of the traditional five senses. It
refers to the ability to detect the flavor
of substances such as food, certain
minerals, poisons
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