Jr special senses with patho

JUNIORJUNIORA&P SPECIAL SENSES WITHA&P SPECIAL SENSES WITH

PATHOPHYSIOLOGYPATHOPHYSIOLOGY

J.J.NelsonRN,CMAJ.J.NelsonRN,CMA

EYE ORBITEYE ORBIT

• FrontalFrontal• LacrimalLacrimal• EthmoidEthmoid• MaxillaMaxilla• ZygomaticZygomatic• SphenoidSphenoid• PalatinePalatine

EXTRINSIC EYE MUSCLESEXTRINSIC EYE MUSCLES

MEIBOMIAN GLANDSMEIBOMIAN GLANDS

Pathology:•Stye•Chalzion

STYESTYE A stye (Hordeolum) is an inflammatory infection of thehair follicle or mebomian gland, usually a result of a Staphylococcal infection.

CHALAZIONCHALAZION A chalazion is a cyst caused by obstruction of A chalazion is a cyst caused by obstruction of

an oil producing or meibomian gland.  an oil producing or meibomian gland.  Chalazia may occur in the upper or lower lids, Chalazia may occur in the upper or lower lids, causing redness, swelling and soreness in causing redness, swelling and soreness in some cases.  some cases. 

CONJUNCTIVACONJUNCTIVA

CONJUNCTIVITISCONJUNCTIVITIS

Conjunctivitis, commonly known as pink eye, is an infection of the conjunctivia The three most common types of conjunctivitis are: viral, bacterial or allergy. Each requires different treatments. With the exception of the allergic type, conjunctivitis is typically contagious.  

LACRIMAL APPARATUSLACRIMAL APPARATUS

EYE LAYERSEYE LAYERS

• SCLERA SCLERA (Cornea)(Cornea)

• CHOROID CHOROID COATCOAT

• RETINARETINA

CORNEAL ABRASIONCORNEAL ABRASION

CATARACTCATARACT                                        

A cataract is a cloudy opaque area in a normally clear lens of the eye.

http://www.allaboutvision.com/conditions/cataracts.htm

GLAUCOMAGLAUCOMAGlaucoma is a group of diseases that can damage the eye's optic nerve and result in vision loss and blindness. Glaucoma occurs when the normal fluid pressure inside the eyes slowly rises. However, with early treatment, you can often protect your eyes against serious vision loss.

NIHSeniorHealth: Glaucoma - Glaucoma Defined

PUPIL DILATION AND PUPIL DILATION AND CONSTRICTIONCONSTRICTION

TEAM REVIEWTEAM REVIEW

• Use models to identify Use models to identify (large model and Pat’s (large model and Pat’s eye):eye):

• Scelera, choroid coat, retina, corneaScelera, choroid coat, retina, cornea• Iris, radial muscles, extrinsic musclesIris, radial muscles, extrinsic muscles• Pupil, lensPupil, lens

• Use Rapid Review and identify (on Use Rapid Review and identify (on paper to be handed in with WS)paper to be handed in with WS)• 2,3,4,8,10,11,12,29-32 (one name for all)2,3,4,8,10,11,12,29-32 (one name for all)• 33,35,38-4533,35,38-45

OPTIC DISC &OPTIC DISC &MACULEA LUTEAMACULEA LUTEA

PHOTORECEPTOR CELLSPHOTORECEPTOR CELLS

• Rods=gray tones; Rods=gray tones; scattered around scattered around retinal edge retinal edge (increasing in (increasing in number as distance number as distance from fovea centralis)from fovea centralis)

• Cones=color; fovea Cones=color; fovea centralis is all conescentralis is all cones

VISION ANIMATIONVISION ANIMATION

http://www.pennmedicine.org/encyclopedia/em_DisplayAnimation.aspx?gcid=000109&ptid=17

VISION TERMINOLOGYVISION TERMINOLOGY

• RefractedRefracted• AccomodationAccomodation• EmmetropiaEmmetropia• MyopiaMyopia• HyperopiaHyperopia• AstigmatismAstigmatism• PresbyopiaPresbyopia• Strabismus Strabismus

View Retina with View Retina with OphthmaloscopeOphthmaloscope

• Webvision: Facts and Figures Webvision: Facts and Figures concerning the human retinaconcerning the human retina

MYOPIAMYOPIA

Myopia, AKA Nearsightedness: Objects from a Distance are blurry. The light rays entering the eye focus in front of the retina.

HyperopiaHyperopia• Hyperopia AKA Farsightedness Hyperopia AKA Farsightedness

results in difficulty focusing up results in difficulty focusing up close. Light rays that enter the eye close. Light rays that enter the eye focus focus behind the retina.behind the retina.

ASTIGMATISMASTIGMATISM• With astigmatism, With astigmatism,

light entering the light entering the eye from different eye from different directions is directions is focused different focused different amounts. For amounts. For example, light example, light entering vertically entering vertically (from 12 o'clock (from 12 o'clock to 6 o'clock) may to 6 o'clock) may be focused more be focused more than light than light entering entering horizontally (from horizontally (from 9 o'clock to 3 9 o'clock to 3 o'clock). o'clock).

PRESBYOPIAPRESBYOPIA

• Presbyopia is the inability to focus with Presbyopia is the inability to focus with the internal lens owing to loss of its the internal lens owing to loss of its elasticity. Normal process of aging.elasticity. Normal process of aging.

MACULAR DEGENERATIONMACULAR DEGENERATION

Macular Degeneration occurs with Macular Degeneration occurs with degeneration of the macular, degeneration of the macular, which is the part of the retina which is the part of the retina responsible for the sharp, central responsible for the sharp, central vision needed to read or drive. vision needed to read or drive.

Left: How an Amsler grid should look to a person with normal vision.Right: With macular degeneration, a person might see some of the lines as wavy or blurred, with some dark areas at the center.

COLOR BLINDNESSCOLOR BLINDNESS

• http://colorvisiontesting.com/ http://colorvisiontesting.com/

OPTICAL ILLUSIONSOPTICAL ILLUSIONS

Old woman or Old woman or young woman?young woman?

VASES OR FACES?

EAREAREXTERNAL EAR MIDDLE EAR INNER EAR

MIDDLE EARMIDDLE EAR

INNER EARINNER EAR

HEARINGHEARING

• http://www.pennmedicine.org/http://www.pennmedicine.org/encyclopedia/encyclopedia/em_DisplayAnimation.aspx?em_DisplayAnimation.aspx?gcid=000062&ptid=17gcid=000062&ptid=17

PATHWAY OF HEARING

OTITISOTITIS

• Otitis Externa-AKA “Swimmers Ear”Otitis Externa-AKA “Swimmers Ear”

• Otitis Media: bacterial or viralOtitis Media: bacterial or viral

• Otitis Interna-AKA LabyrinthitisOtitis Interna-AKA Labyrinthitis

OTITISOTITIS• Etiology: Bacteria or viralEtiology: Bacteria or viral• S&S: Depends on location. Pain, S&S: Depends on location. Pain,

feeling of fullness, vertigo is typical feeling of fullness, vertigo is typical with labryinthitis, fever.with labryinthitis, fever.

• TX: antibiotics if bacteria. Otitis TX: antibiotics if bacteria. Otitis Externa usually treated with antibiotic Externa usually treated with antibiotic ear drops.ear drops.

• PX: good with treatment. If untreated PX: good with treatment. If untreated can progress to mastoiditis,possible can progress to mastoiditis,possible meningitis.meningitis.

OTITIS MEDIAOTITIS MEDIA

http://faculty.ksu.edu.sa/7115/ Pictures%20Library/Photographs%20of%20Ear%20Tubes,%20Eardrums,%20Infections,%20Cholesteatomas,%20and%20Acute%20Otitis%20Media.htm

MENIERE’S DISEASEMENIERE’S DISEASE

• Meniere's disease is a disorder of the inner Meniere's disease is a disorder of the inner ear affecting balance and hearing, ear affecting balance and hearing, characterized by vertigo, loss of hearing in characterized by vertigo, loss of hearing in one or both ears, and tinnitus in the ear.one or both ears, and tinnitus in the ear.

• The fluid-filled semicircular canals The fluid-filled semicircular canals (labyrinths) of the inner ear, in conjunction (labyrinths) of the inner ear, in conjunction with the cranial nerve VIII, control balance with the cranial nerve VIII, control balance and sense of body position. Meniere's and sense of body position. Meniere's disease involves a swelling of part of the disease involves a swelling of part of the canal. canal.

Meniere’s Disease cont.Meniere’s Disease cont.

• Etiology is unknownEtiology is unknown• DX: R/O other pathologiesDX: R/O other pathologies• TX: There is no known cure for TX: There is no known cure for Meniere's disease. Treatment is Meniere's disease. Treatment is focused on lowering the pressurefocused on lowering the pressurewithin the inner ear and treatingwithin the inner ear and treating symptoms. symptoms.

CHEMICAL SENSES:CHEMICAL SENSES:

• OLFACTORYOLFACTORY

• GUSTATORYGUSTATORY

• CHEMORECEPTOCHEMORECEPTORSRS

Physiology of tastePhysiology of taste

• http://http://www.vivo.colostate.edu/www.vivo.colostate.edu/hbooks/pathphys/hbooks/pathphys/digestion/pregastric/digestion/pregastric/taste.html taste.html

ORAL CANDIDASISORAL CANDIDASIS Thrush is a fungal infection of the mouth

caused by an overgrowth of the yeast organismCandida albicans. Thrush usually begins on the tongue and inside of the cheeks and may spread to the palate, gums, tonsils, and throat.

GEOGRAPHIC TONGUEGEOGRAPHIC TONGUE

Geographic tongue is a bothersome Geographic tongue is a bothersome condition with possible viral condition with possible viral etiology. etiology.

BLACK HAIRY TONGUEBLACK HAIRY TONGUE

Hairy tongue is an uncommon, Hairy tongue is an uncommon, benign condition that is also known benign condition that is also known as black hairy tongue or lingua as black hairy tongue or lingua nigra. nigra.

QUESTIONS??QUESTIONS??