The document provides information about the eye and ear exam procedures performed by medical assistants in an ophthalmology or audiology office. It describes how to examine the eye by assessing visual acuity using a Snellen chart, checking the interior of the eye with a slit lamp, and testing for color blindness. It also outlines procedures for irrigating and instilling eye medications. For the ear exam, it discusses inspecting the outer, middle, and inner ear structures and performing the Weber and Rinne tests to evaluate hearing. Common ear conditions and treatment procedures like irrigation are also summarized.
This document summarizes microbial diseases of the nervous system. It discusses how microbes can enter the nervous system through fractures, medical procedures, or along nerves. It then describes common bacterial and viral infections like meningitis (inflammation of the meninges), encephalitis (inflammation of the brain), tetanus, botulism, leprosy, polio, and rabies. For each disease, it provides details on the causative agent, symptoms, transmission, treatment, and prevention. The document contains diagrams to illustrate anatomical structures and disease processes.
The document discusses the anatomy and physiology of the human ear. It is divided into four main parts: the outer, middle and inner ear, and the central auditory nervous system. Sound waves enter the outer ear and cause the tympanic membrane to vibrate, transmitting this motion through the ossicles to the cochlea. This fluid motion stimulates hair cells in the cochlea, generating nerve impulses that travel to the brain via the auditory nerve. The brain then interprets these signals as sound.
The respiratory system provides oxygen to cells and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs, and the blood vessels. The nose warms and humidifies inhaled air. The trachea divides into bronchi that enter the lungs and further divide into bronchioles and alveoli, where gas exchange occurs by diffusion between the air in alveoli and blood in capillaries. The lungs and chest wall muscles work together during breathing to inhale air and exhale carbon dioxide.
The document discusses several upper respiratory tract infections including tonsillitis, pharyngitis, pharyngotonsillitis, and laryngitis. It describes the causes, signs and symptoms, diagnostic procedures, treatment, and potential complications of each condition. The infections can be acute, sub-acute, or chronic and are generally caused by bacterial or viral infections entering through the nose and mouth and causing inflammation in the tonsils, pharynx, or larynx. Common treatments include saline gargles, analgesics, antibiotics, rest, and humidified air. Complications can include conditions like tuberculosis, rheumatic heart disease, or permanent voice loss.
The nose is responsible for smell and breathing. The cavity is lined with mucous membranes containing smell receptors connected to the olfactory nerve. Smells are detected by receptor cells in the nose interacting with odor molecules and transmitting sensations to the brain. The nose has a bony and cartilaginous framework supporting its structure and function. Olfactory receptors in the nose detect smells and transmit information through the olfactory bulb and tract to areas of the brain involved in perceiving odors. The nose also functions to warm, humidify, and filter air during breathing.
corona virus , a group of RNA viruses, covid 19 affects people in different ways. most infected people will develop mild to moderate illness and recover without hospitalization.
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
This document summarizes microbial diseases of the nervous system. It discusses how microbes can enter the nervous system through fractures, medical procedures, or along nerves. It then describes common bacterial and viral infections like meningitis (inflammation of the meninges), encephalitis (inflammation of the brain), tetanus, botulism, leprosy, polio, and rabies. For each disease, it provides details on the causative agent, symptoms, transmission, treatment, and prevention. The document contains diagrams to illustrate anatomical structures and disease processes.
The document discusses the anatomy and physiology of the human ear. It is divided into four main parts: the outer, middle and inner ear, and the central auditory nervous system. Sound waves enter the outer ear and cause the tympanic membrane to vibrate, transmitting this motion through the ossicles to the cochlea. This fluid motion stimulates hair cells in the cochlea, generating nerve impulses that travel to the brain via the auditory nerve. The brain then interprets these signals as sound.
The respiratory system provides oxygen to cells and removes carbon dioxide. It includes the nose, pharynx, larynx, trachea, bronchi, lungs, and the blood vessels. The nose warms and humidifies inhaled air. The trachea divides into bronchi that enter the lungs and further divide into bronchioles and alveoli, where gas exchange occurs by diffusion between the air in alveoli and blood in capillaries. The lungs and chest wall muscles work together during breathing to inhale air and exhale carbon dioxide.
The document discusses several upper respiratory tract infections including tonsillitis, pharyngitis, pharyngotonsillitis, and laryngitis. It describes the causes, signs and symptoms, diagnostic procedures, treatment, and potential complications of each condition. The infections can be acute, sub-acute, or chronic and are generally caused by bacterial or viral infections entering through the nose and mouth and causing inflammation in the tonsils, pharynx, or larynx. Common treatments include saline gargles, analgesics, antibiotics, rest, and humidified air. Complications can include conditions like tuberculosis, rheumatic heart disease, or permanent voice loss.
The nose is responsible for smell and breathing. The cavity is lined with mucous membranes containing smell receptors connected to the olfactory nerve. Smells are detected by receptor cells in the nose interacting with odor molecules and transmitting sensations to the brain. The nose has a bony and cartilaginous framework supporting its structure and function. Olfactory receptors in the nose detect smells and transmit information through the olfactory bulb and tract to areas of the brain involved in perceiving odors. The nose also functions to warm, humidify, and filter air during breathing.
corona virus , a group of RNA viruses, covid 19 affects people in different ways. most infected people will develop mild to moderate illness and recover without hospitalization.
Pathogenic microorganisms proliferate and invade bodily tissue, causing tissue harm and disease.
The invasion and multiplication of microorganisms such as bacteria, viruses, and parasites those are not normally present within the body.
An infection may cause no symptoms and be subclinical, or it may cause symptoms and be clinically apparent.
An infection may remain localized, or it may spread through the blood or lymphatic vessels to become systemic (body wide).
Microorganisms that live naturally in the body are not considered infections.
For example, bacteria that normally live within the mouth and intestine are not infections.
Infection prevention policies and practices are used in hospitals and other health care facilities to reduce the spread of infections.
The nose has several important functions including smelling, breathing, filtering air, and draining secretions. It is composed of an external nose made of cartilage and bone, and two internal nasal cavities separated by a nasal septum. The nasal cavities contain conchae which increase their surface area. They are lined with mucosa and well-vascularized. Common issues involving the nose include nosebleeds, nasal fractures, deviated septums, infections, and rhinitis.
The document discusses the anatomy and physiology of the eye and ear. It describes the structures of the eye such as the coats, lacrimal apparatus, extraocular muscles, and refractive media. Common eye disorders like styes, conjunctivitis, glaucoma and strabismus are mentioned. The parts of the ear like the pinna, external auditory meatus, tympanic membrane, middle ear ossicles, inner ear bony and membranous labyrinths are outlined. Some ear diseases including otitis externa, media, Meniere's disease, and presbycusis are briefly discussed.
The document discusses diseases of the pharynx, including pharyngitis, tonsillitis, adenoids hypertrophy, and cancer. It describes the pharynx's anatomy and function. Pharyngitis is an inflammation of the pharynx often caused by viruses and bacteria. Tonsillitis is the inflammation of the tonsils, which can be caused by viruses or bacteria. Adenoids hypertrophy is the abnormal enlargement of the adenoids, usually due to infection. Cancers that can affect the pharynx include nasopharyngeal, oropharyngeal, and hypopharyngeal cancers. Risk factors, diagnosis, and treatment methods are outlined for each condition.
This document discusses surgical instruments. It begins with a brief history of surgical instruments from ancient Greece and Rome. It then defines surgical instruments as tools that perform functions like cutting, grasping, and suturing. The document goes on to classify different types of surgical instruments according to their functions, such as graspers, retractors, cutters, and powered devices. It also discusses sterilization of surgical instruments and common sterilization methods like steam, dry heat, and chemicals.
THIS POWER POINT PRESENTATION IS TO GIVE READERS AN OVERVIEW ON THE ANATOMY AND PHYSIOLOGY OF THE EYE: STRUCTURES, FUNCTIONS OF EACH PART OF THE EYE, AS WELL AS THE PHYSIOLOGY ON HOW THE IMAGE IS CAPTURED IN THE EYE AND TRANSLATED BY THE BRAIN IN ORDER TO HAVE THE MEANINGFUL VIEW OF THE IMAGE.
This document provides information about Neisseria meningitidis, the bacteria that causes meningococcal meningitis. It describes the morphological features and virulence factors of N. meningitidis, including its gram-negative diplococcal shape, polysaccharide capsule that allows it to evade the immune system, and pili that enable it to attach to cells in the nasopharynx. The document also outlines the pathogenesis of meningococcal meningitis, noting that the bacteria spread from the nasopharynx via the bloodstream to the meninges, where it can cause inflammation and potentially fatal infection.
This document provides instructions for examining the ear, including the external ear, tympanic membrane, and inner ear structures. It describes how to position the patient and manipulate the pinna to view the ear canal. It explains how to hold the otoscope and identify structures of the normal tympanic membrane. Finally, it includes diagrams of ear anatomy labeling the external, middle, and inner ear components.
The paranasal sinuses are air-filled spaces within the bones around the nasal cavity. They include the frontal, maxillary, ethmoid, and sphenoid sinuses. The maxillary sinus develops first, followed by the ethmoid and sphenoid sinuses. The frontal sinus develops last, beginning as a small sac within the frontal bone between ages 2-9 years. The paranasal sinuses provide functions like decreasing skull weight, insulating sensitive structures, humidifying air, and enhancing the sense of smell.
Monkeypox is a viral disease that occurs in humans and some animals. It is caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Monkeypox most commonly spreads through direct contact with infected animals or humans. Initial symptoms include fever, headache, muscle aches, and swollen lymph nodes. Within a few days, a rash develops on the face and spreads to other parts of the body. While monkeypox is generally mild, it can cause severe illness and has a fatality rate of around 1 in 10 people in parts of Africa. There are vaccines and treatments available to prevent and treat monkeypox infections.
Waheed Shouman was informed on December 31, 2019 of 44 cases of pneumonia in Wuhan, China with no known cause. Most patients reported a link to a seafood market. By January 1, 2020 person-to-person spread was occurring, including among healthcare workers. As of March 5, 2020 there were over 82 countries affected globally.
This document discusses the human respiratory system and the process of respiration. It describes the major organs of the respiratory system, including the nose, pharynx, larynx, trachea, bronchi, bronchioles and alveoli. It explains that the respiratory system allows for the intake of oxygen and removal of carbon dioxide. The document outlines the two phases of breathing - inspiration and expiration. It also discusses gas exchange that occurs between the blood and alveoli, and lists some common malfunctions and diseases of the respiratory system like asthma, bronchitis, emphysema and pneumonia.
This document discusses the anatomy and physiology of hearing and balance. It describes the parts of the hearing apparatus including the external, middle, and inner ear. Sound is conducted through the ear canal and vibrations are amplified by the ossicles in the middle ear before being transduced into nerve impulses in the cochlea. Hair cells in the organ of Corti detect sound vibrations and transmit signals to the brain. Several theories attempt to explain the mechanisms of hearing such as place theory and traveling wave theory. The vestibular system in the inner ear, along with visual and proprioceptive cues, helps maintain balance and orientation.
This document discusses several common tropical diseases seen in surgery, including filariasis, leprosy, tropical chronic pancreatitis, and poliomyelitis. Filariasis is caused by a parasitic worm and can lead to lymphedema and elephantiasis. Leprosy is caused by Mycobacterium leprae and can result in skin lesions and nerve damage leading to claw hand deformities. Tropical chronic pancreatitis has unknown causes but is linked to poor nutrition and affects young people in developing countries. Poliomyelitis is caused by an enterovirus and while most cases are mild, it can also lead to paralysis requiring rehabilitation and surgical intervention.
This document discusses various conditions affecting the ear, including:
1. Labyrinthitis, which causes sudden attacks of vertigo, tinnitus, vomiting and unilateral hearing loss.
2. Autoimmune inner ear disease (AIED), which results in bilateral fluctuating and progressive sensorineural hearing loss due to the immune system attacking the inner ear.
3. Age-related hearing loss, which produces alterations in the auditory system and is characterized by difficulty understanding speech.
The nervous system is divided into the central nervous system (CNS; brain and spinal cord) and peripheral nervous system (PNS). The CNS is organized into the forebrain, brainstem, and cerebellum. It contains neurons and glial cells. The PNS connects the CNS to the body and is divided into somatic and autonomic divisions. It transmits signals between the CNS and peripheral organs.
Anatomy 1-The anatomy and physiology of human earFatima Aftab
how human ear enables us to produce sound waves and how we actually interpret them.I got a grade hope students will be clarifying their basic concepts related to anatomy of the human ear.
This document provides an overview of research methodology in otology. It discusses what constitutes ideal research, factors that affect confidence intervals, different types of study designs including descriptive, analytical, and interventional designs. Descriptive designs include cross-sectional and longitudinal studies. Analytical designs include prospective and retrospective studies. The document also discusses variables, sample size calculation, data analysis techniques, and important considerations for research such as feasibility and timelines.
Anatomy and physiology of nervous systemShweta Sharma
The nervous system is made up of the central nervous system (brain and spinal cord) and the peripheral nervous system. The central nervous system contains approximately 10 million sensory neurons that send information to the brain and 500,000 motor neurons that control muscles and glands. The brain is protected by three layers of tissue called meninges and cerebrospinal fluid. The brain controls functions like sensation, memory, movement, vision, respiration, temperature regulation and more. The spinal cord transmits signals between the brain and body and contains sensory and motor neurons.
This document provides an outline for collecting history, performing a physical assessment, and conducting diagnostic evaluations for eye examinations. It describes examining the eyebrows, eyelids, eye lashes, conjunctiva, sclera, cornea, iris, pupils, ocular movements, visual acuity, tonometry, slit lamp examination, and other tests like color vision, tear duct function and production. The goal is to identify any abnormalities, diseases, or vision impairments through a thorough eye exam.
EYE ENT.pptx of pediatrics in third year bsc nursingAlanSudhan
This document provides information on various eye and ear conditions. It discusses congenital cataracts, types of cataracts, symptoms and treatment. It also covers conjunctivitis causes, symptoms and treatment. Additional topics include retinopathy of prematurity, styes, chalazions, refractive errors, treatments, and other eye conditions like glaucoma. Ear conditions discussed include otitis media, impacted cerumen, hearing impairment, tests to evaluate hearing, and management options. Rhinitis, epistaxis, pharyngitis, tonsillitis are also summarized.
The nose has several important functions including smelling, breathing, filtering air, and draining secretions. It is composed of an external nose made of cartilage and bone, and two internal nasal cavities separated by a nasal septum. The nasal cavities contain conchae which increase their surface area. They are lined with mucosa and well-vascularized. Common issues involving the nose include nosebleeds, nasal fractures, deviated septums, infections, and rhinitis.
The document discusses the anatomy and physiology of the eye and ear. It describes the structures of the eye such as the coats, lacrimal apparatus, extraocular muscles, and refractive media. Common eye disorders like styes, conjunctivitis, glaucoma and strabismus are mentioned. The parts of the ear like the pinna, external auditory meatus, tympanic membrane, middle ear ossicles, inner ear bony and membranous labyrinths are outlined. Some ear diseases including otitis externa, media, Meniere's disease, and presbycusis are briefly discussed.
The document discusses diseases of the pharynx, including pharyngitis, tonsillitis, adenoids hypertrophy, and cancer. It describes the pharynx's anatomy and function. Pharyngitis is an inflammation of the pharynx often caused by viruses and bacteria. Tonsillitis is the inflammation of the tonsils, which can be caused by viruses or bacteria. Adenoids hypertrophy is the abnormal enlargement of the adenoids, usually due to infection. Cancers that can affect the pharynx include nasopharyngeal, oropharyngeal, and hypopharyngeal cancers. Risk factors, diagnosis, and treatment methods are outlined for each condition.
This document discusses surgical instruments. It begins with a brief history of surgical instruments from ancient Greece and Rome. It then defines surgical instruments as tools that perform functions like cutting, grasping, and suturing. The document goes on to classify different types of surgical instruments according to their functions, such as graspers, retractors, cutters, and powered devices. It also discusses sterilization of surgical instruments and common sterilization methods like steam, dry heat, and chemicals.
THIS POWER POINT PRESENTATION IS TO GIVE READERS AN OVERVIEW ON THE ANATOMY AND PHYSIOLOGY OF THE EYE: STRUCTURES, FUNCTIONS OF EACH PART OF THE EYE, AS WELL AS THE PHYSIOLOGY ON HOW THE IMAGE IS CAPTURED IN THE EYE AND TRANSLATED BY THE BRAIN IN ORDER TO HAVE THE MEANINGFUL VIEW OF THE IMAGE.
This document provides information about Neisseria meningitidis, the bacteria that causes meningococcal meningitis. It describes the morphological features and virulence factors of N. meningitidis, including its gram-negative diplococcal shape, polysaccharide capsule that allows it to evade the immune system, and pili that enable it to attach to cells in the nasopharynx. The document also outlines the pathogenesis of meningococcal meningitis, noting that the bacteria spread from the nasopharynx via the bloodstream to the meninges, where it can cause inflammation and potentially fatal infection.
This document provides instructions for examining the ear, including the external ear, tympanic membrane, and inner ear structures. It describes how to position the patient and manipulate the pinna to view the ear canal. It explains how to hold the otoscope and identify structures of the normal tympanic membrane. Finally, it includes diagrams of ear anatomy labeling the external, middle, and inner ear components.
The paranasal sinuses are air-filled spaces within the bones around the nasal cavity. They include the frontal, maxillary, ethmoid, and sphenoid sinuses. The maxillary sinus develops first, followed by the ethmoid and sphenoid sinuses. The frontal sinus develops last, beginning as a small sac within the frontal bone between ages 2-9 years. The paranasal sinuses provide functions like decreasing skull weight, insulating sensitive structures, humidifying air, and enhancing the sense of smell.
Monkeypox is a viral disease that occurs in humans and some animals. It is caused by the monkeypox virus, which belongs to the same family of viruses as smallpox. Monkeypox most commonly spreads through direct contact with infected animals or humans. Initial symptoms include fever, headache, muscle aches, and swollen lymph nodes. Within a few days, a rash develops on the face and spreads to other parts of the body. While monkeypox is generally mild, it can cause severe illness and has a fatality rate of around 1 in 10 people in parts of Africa. There are vaccines and treatments available to prevent and treat monkeypox infections.
Waheed Shouman was informed on December 31, 2019 of 44 cases of pneumonia in Wuhan, China with no known cause. Most patients reported a link to a seafood market. By January 1, 2020 person-to-person spread was occurring, including among healthcare workers. As of March 5, 2020 there were over 82 countries affected globally.
This document discusses the human respiratory system and the process of respiration. It describes the major organs of the respiratory system, including the nose, pharynx, larynx, trachea, bronchi, bronchioles and alveoli. It explains that the respiratory system allows for the intake of oxygen and removal of carbon dioxide. The document outlines the two phases of breathing - inspiration and expiration. It also discusses gas exchange that occurs between the blood and alveoli, and lists some common malfunctions and diseases of the respiratory system like asthma, bronchitis, emphysema and pneumonia.
This document discusses the anatomy and physiology of hearing and balance. It describes the parts of the hearing apparatus including the external, middle, and inner ear. Sound is conducted through the ear canal and vibrations are amplified by the ossicles in the middle ear before being transduced into nerve impulses in the cochlea. Hair cells in the organ of Corti detect sound vibrations and transmit signals to the brain. Several theories attempt to explain the mechanisms of hearing such as place theory and traveling wave theory. The vestibular system in the inner ear, along with visual and proprioceptive cues, helps maintain balance and orientation.
This document discusses several common tropical diseases seen in surgery, including filariasis, leprosy, tropical chronic pancreatitis, and poliomyelitis. Filariasis is caused by a parasitic worm and can lead to lymphedema and elephantiasis. Leprosy is caused by Mycobacterium leprae and can result in skin lesions and nerve damage leading to claw hand deformities. Tropical chronic pancreatitis has unknown causes but is linked to poor nutrition and affects young people in developing countries. Poliomyelitis is caused by an enterovirus and while most cases are mild, it can also lead to paralysis requiring rehabilitation and surgical intervention.
This document discusses various conditions affecting the ear, including:
1. Labyrinthitis, which causes sudden attacks of vertigo, tinnitus, vomiting and unilateral hearing loss.
2. Autoimmune inner ear disease (AIED), which results in bilateral fluctuating and progressive sensorineural hearing loss due to the immune system attacking the inner ear.
3. Age-related hearing loss, which produces alterations in the auditory system and is characterized by difficulty understanding speech.
The nervous system is divided into the central nervous system (CNS; brain and spinal cord) and peripheral nervous system (PNS). The CNS is organized into the forebrain, brainstem, and cerebellum. It contains neurons and glial cells. The PNS connects the CNS to the body and is divided into somatic and autonomic divisions. It transmits signals between the CNS and peripheral organs.
Anatomy 1-The anatomy and physiology of human earFatima Aftab
how human ear enables us to produce sound waves and how we actually interpret them.I got a grade hope students will be clarifying their basic concepts related to anatomy of the human ear.
This document provides an overview of research methodology in otology. It discusses what constitutes ideal research, factors that affect confidence intervals, different types of study designs including descriptive, analytical, and interventional designs. Descriptive designs include cross-sectional and longitudinal studies. Analytical designs include prospective and retrospective studies. The document also discusses variables, sample size calculation, data analysis techniques, and important considerations for research such as feasibility and timelines.
Anatomy and physiology of nervous systemShweta Sharma
The nervous system is made up of the central nervous system (brain and spinal cord) and the peripheral nervous system. The central nervous system contains approximately 10 million sensory neurons that send information to the brain and 500,000 motor neurons that control muscles and glands. The brain is protected by three layers of tissue called meninges and cerebrospinal fluid. The brain controls functions like sensation, memory, movement, vision, respiration, temperature regulation and more. The spinal cord transmits signals between the brain and body and contains sensory and motor neurons.
This document provides an outline for collecting history, performing a physical assessment, and conducting diagnostic evaluations for eye examinations. It describes examining the eyebrows, eyelids, eye lashes, conjunctiva, sclera, cornea, iris, pupils, ocular movements, visual acuity, tonometry, slit lamp examination, and other tests like color vision, tear duct function and production. The goal is to identify any abnormalities, diseases, or vision impairments through a thorough eye exam.
EYE ENT.pptx of pediatrics in third year bsc nursingAlanSudhan
This document provides information on various eye and ear conditions. It discusses congenital cataracts, types of cataracts, symptoms and treatment. It also covers conjunctivitis causes, symptoms and treatment. Additional topics include retinopathy of prematurity, styes, chalazions, refractive errors, treatments, and other eye conditions like glaucoma. Ear conditions discussed include otitis media, impacted cerumen, hearing impairment, tests to evaluate hearing, and management options. Rhinitis, epistaxis, pharyngitis, tonsillitis are also summarized.
This document provides an overview of eye anatomy and common eye conditions for primary care practitioners. It begins with basic eye anatomy and optics, then covers topics like strabismus, amblyopia, external eye conditions including blepharitis, hordeolum, cellulitis, pterygium, corneal ulcers, and conjunctivitis. For each topic, it discusses signs, causes and treatment options to help primary care practitioners identify, explain, and facilitate referrals for various eye problems and conditions.
"Looking for Eye Specialist in Ahmedabad. Dr. Smita Dheer is Best Eye Doctor...jangidandsons
"Dr. Smita Dheer is the One Of The Best Eye Specialist in Ahmedabad. Dr. Smita Dheer is Top Eye Surgeon Doctors in Ahmedabad. Dr. Smita Dheer Provide Best Eye Care Solution in Ahmedabad at affordable Cost.
Born to doctor parents, state rank holder in HSC and SSC, Dr. Smita Dheer received scholarship for meritorious performance from the government, which she gave up to help the needy students.
After finishing her MBBS from Gandhi medical college BHOPAL, she perused her Master of surgery (M.S) from REGIONAL INSTITUTE OF OPHTHALMOLOGY BHOPAL in 2000. She did her fellowship in SMALL INSCISION CATARACT SURGERY from B.A.B.T EYE HOSPITAL Mumbai. She gathered working experience under renowned surgeonSPITAL run by Lions Club Sight Savers in AHEMDABAD. She served in the organisation for a decade as CHIEF SURGEON from 2007 TO 2016. During her tenure, she handled complicated cases and polished her administrative and surgical skills. She did her post graduate diploma in hospital and health care management (PGDHHM) from SYMBIOSIS PUNE in 2005, and did a certificate course in clinical research (CCCR) in 2008. Now she is associated with CIMS HOSPITAL as CONSULTANT OPHTHALMOLOGIST."
This document discusses the relationship between teeth and eye diseases. It begins by outlining typical visual development milestones in infants and children. It then describes tests for visual acuity like optokinetic nystagmus and using visual acuity charts. Common refractive errors like myopia and hyperopia are explained. Causes of reduced vision and eye problems are covered such as cataracts, glaucoma, diabetic retinopathy, and retinal detachment. Conditions involving the eyes and teeth are also reviewed like Marcus Gunn jaw-winking phenomenon and risks of dental procedures. The document emphasizes collaboration between eye doctors and dentists to detect vision issues early.
1. An eye examination assesses vision and eye health using tests like visual acuity, eye movement, pupil response, and ophthalmoscopy.
2. Examiners take a patient's ocular history and examine the eyes externally for issues like eyelid positioning and extraocular muscle function.
3. Diagnostic tests evaluate intraocular pressure, depth perception, color vision, and screen for retinal diseases using tools like tonometry, Amsler grids, fundus photography, and angiography to visualize the eye's internal structures.
1. An eye examination assesses vision and eye health using tests like visual acuity, eye movement, pupil response, and ophthalmoscopy.
2. Examiners take a patient's ocular history and examine the eyes externally for issues like eyelid positioning and extraocular muscle function.
3. Diagnostic tests evaluate intraocular pressure, depth perception, color vision, and scan the retina, optic nerve and choroid using techniques like tonometry, Amsler grid, fundus photography, and angiography to detect disorders.
An ophthalmoscope is a medical device used to examine the inside of the eye. It allows viewing of the retina, optic nerve, arteries and veins. Observation of these structures can reveal diseases of the eye or indicate systemic conditions like diabetes or hypertension. An exam with an ophthalmoscope can detect dangerous eye conditions like glaucoma or retinal detachment and prompt referral for treatment to prevent vision loss. Proper use of the ophthalmoscope involves dimming the lights, positioning the instrument close to the patient's eye to view the optic disc and following blood vessels to examine the retina and macula.
The document provides an overview of the pupillary pathway, including its anatomy, physiology, and clinical aspects. It describes:
- The afferent and efferent pathways that control the pupillary light reflex and near response.
- Clinical tests to evaluate the pupillary light reflex, including for anisocoria, RAPD, and other defects.
- Causes and features of different types of pupillary defects affecting the afferent pathway (e.g. optic nerve lesions) or efferent pathway (e.g. Horner's syndrome, Adie's tonic pupil).
Ophthalmoscopy allows examination of the inside of the eye. It is done using an ophthalmoscope to view the retina and optic disc. It was invented in 1851 and has since improved. During the exam, the pupil is dilated and the ophthalmologist views the retina through different aperture settings and filters on the ophthalmoscope. They examine the optic disc, retina, blood vessels and look for any abnormalities. Common findings include signs of diabetes, hypertension, glaucoma, or other eye conditions. The ophthalmoscopy exam is important for evaluating eye health and detecting underlying diseases.
The document provides an overview of eye anatomy and examination procedures. It describes the external structures of the eye including the eyelids, muscles, and lacrimal apparatus. Internally, it outlines the three layers of the eye - sclera, choroid, and retina. Examination steps are detailed including visual acuity tests, pupil examination, eye muscle function, ophthalmoscopy, and visual field testing. Common eye signs and conditions like strabismus, cataracts, and hemorrhages are also summarized.
This document provides information on pupillary anatomy, physiology, and examination. It discusses the normal anatomy and functions of the pupil. It describes how to perform a systematic pupillary examination, including testing the light reflex and near reflex. It covers common and uncommon disorders that can be diagnosed based on pupillary examination findings, such as Horner's syndrome and Adie's tonic pupil. The document emphasizes that the pupillary examination can provide useful clues about underlying ocular and neurological conditions.
This document discusses the relation between teeth and eye diseases. It summarizes common eye examination techniques used to assess visual acuity at different ages. It then outlines some common causes of vision loss like cataracts, glaucoma, diabetic retinopathy, and macular degeneration. The document concludes by noting that dental professionals and eye doctors should work together to catch vision-threatening conditions earlier through appropriate medical referrals.
1. A physical examination of the eyes provides information about various body systems as the eyes contain structures that are sensitive to nutritional, endocrine, cardiovascular, gastrointestinal, and neurological factors.
2. The eyes have three layers - an outer fibrous layer, a middle vascular layer, and an inner retinal layer. Within these layers are structures like the iris, pupil, cornea, lens, vitreous humor, and retina.
3. A standard eye exam assesses visual acuity, visual fields, and the external, internal and neurological components of the eye through tests of the eyelids, eye movements, anterior and posterior chambers, and associated cranial nerves. Abnormalities provide clues to underlying conditions.
This document discusses pupillary examination and various aspects of pupillary reflexes. It begins by describing the pathway of the pupillary light reflex from the retina through the brain. It then discusses the efferent pathway from the Edinger-Westphal nucleus to the iris sphincter muscle. The document also covers the near reflex pathway and differences between the light and near reflexes. It provides tips for examining pupillary reflexes, potential causes of anisocoria, and tests such as color vision testing and confrontation visual field testing.
This document reviews ocular emergencies including red eye, glaucoma, retinal detachment, corneal injuries, chemical burns, ruptured globe, and central retinal artery occlusion. Key points discussed are differential diagnosis and management of these conditions, with emphasis on timely referral to ophthalmology as needed to prevent vision loss or further injury. Examination techniques like fluorescein staining and tonometry are also outlined.
This document provides an introduction to examining the eyes from Dr. Zia-Ul-Mazhry. It outlines the intended learning outcomes which include performing various eye exams and communicating effectively with patients. It also discusses taking a history, which includes questions about vision complaints, medical history, medications and more. The physical exam section explains how to test visual acuity, examine the eyelids, conjunctiva, cornea, anterior chamber, pupil and extraocular muscles. Images are included to demonstrate examination techniques.
The document provides instructions and assessments for various eye exams and tests, including visual acuity, visual fields, tonometry, fundoscopy, and tests for color blindness, pupil response, and extraocular muscle function. It also describes common eye conditions like cataracts, glaucoma, retinal detachment, and macular degeneration. Finally, the document outlines procedures for ear exams including otoscopic inspection, tests for hearing like Weber's and Rinne's, and conditions such as otitis externa, media, chronic otitis, and Meniere's disease.
This document provides information on performing a physical assessment of the eyes and ears. It discusses important landmarks to inspect in the eyes including the eyelids, eyebrows, lacrimal apparatus and positioning. Common eye conditions like blepharitis, chalazion, styes, ptosis, and nystagmus are described. Assessment techniques for the eyes include checking visual acuity, extraocular muscle function, visual fields, pupillary response, and ophthalmoscopy. For the ears, inspection, otoscopy and tests of auditory function like the Weber test and Rinne test are outlined. Common causes and presentations of conductive and sensorineural hearing loss are also summarized.
Similar to MA119 Chapter 31 ophthalmology and otolaryngology (20)
The document discusses the drivers and pressures for organizational change. It identifies that change comes from both external environmental pressures such as competition, regulations and technological changes as well as internal pressures like growth, leadership changes, and politics. Some of the key external pressures mentioned are globalization, hypercompetition, and reputation concerns. The document also examines why organizations may not change in response to environmental pressures or after crises, citing factors such as organizational learning difficulties and defensive priorities over innovation.
This document discusses evolutionary developmental biology and how changes in development can lead to evolutionary changes. It provides examples of modularity and molecular parsimony which help explain this. Modularity means parts of the body and DNA can develop differently. Molecular parsimony means organisms share developmental toolkit genes. The document then discusses specific examples like stickleback fish pelvic spines being due to different Pitx1 expression, and Darwin's finches having beak shape variations due to differing Bmp4 and Calmodulin expression levels. Mechanisms of evolutionary change include changes in location, timing, amount, or kind of gene expression.
Developmental plasticity allows an organism's phenotype to change in response to environmental conditions during development. There are two main types of phenotypic plasticity: reaction norms, where the environment determines the phenotype from a continuum of genetic possibilities, and polyphenisms, where discrete alternative phenotypes are produced. Examples include caterpillars changing appearance to match plant growth stages, frogs hatching early in response to vibrations, and temperature determining sex in crocodiles. Stressors like water levels can also influence development, as seen in spadefoot toads. Symbiotic relationships between organisms, like nitrogen-fixing bacteria in plant roots, are important to development and often involve vertical transmission from parents. Gut bacteria are also necessary for
This document discusses several genetic and environmental factors that can influence human development. Genetic factors like pleiotropy and mosaicism can result in syndromes with multiple abnormalities. The same genetic mutation can also produce different phenotypes depending on gene interactions. Environmental teratogens during critical periods of embryonic development can irreversibly damage organ formation, with alcohol, retinoic acid, and endocrine disruptors like bisphenol A and atrazine posing particular risks like fetal alcohol syndrome, cleft palate, lower sperm counts, and cancer. Both genetic and environmental heterogeneity contribute to the complexity of human development.
The endoderm forms the epithelial lining of the digestive and respiratory systems. It gives rise to tissues like the notochord, heart, blood vessels, and parts of the mesoderm. The endoderm comes from two sources - the definitive endoderm and the visceral endoderm. The transcription factor Sox17 marks and regulates the formation of the endoderm. The endoderm lines tubes in the body and gives rise to organs like the liver, pancreas, lungs and digestive system through the formation of buds and pouches along the foregut.
The document summarizes the development of the intermediate mesoderm and lateral plate mesoderm. The intermediate mesoderm forms the urogenital system including the kidneys, ureters, ovaries, fallopian tubes, testes and vas deferens. Kidney development occurs through the pronephros, mesonephros and metanephros stages. The lateral plate mesoderm splits into somatic and splanchnic layers and forms the heart through the merging of cardiac progenitor cells from both sides of the embryo. The heart tube loops to the right to begin resembling the four-chambered adult heart.
The paraxial mesoderm lies just lateral to the notochord and gives rise to vertebrae, skeletal muscles, and skin connective tissue. It is divided into somites which then form dermomyotomes and sclerotomes. Dermomyotomes develop into dermatomes that make dermis and myotomes that form back, rib, and body wall muscles. Sclerotomes form the vertebrae and rib cage. Somitogenesis occurs through a clock-wavefront model where somites sequentially segment from cranial to caudal regions under the influence of signaling molecules like retinoic acid and FGF.
The document summarizes ectodermal placodes and the epidermis. It discusses how placodes give rise to sensory structures like the eye lens, inner ear, and nose. It describes the different cranial placodes that form sensory tissues and nerves, including the anterior placodes that form the pituitary gland and eye lens. The intermediate placodes form nerves involved in sensation of the face and hearing/balance. The epidermis derives from surface ectoderm under the influence of BMPs and forms the protective outer layer of skin and its appendages like hair, sweat glands, and teeth.
- The neural plate transforms into a neural tube through a process called neurulation regulated by proteins like BMP and transcription factors like Sox1, 2, and 3.
- Primary neurulation involves the elongation, bending, and convergence of the neural folds before their closure at the midline to form the neural tube. Key regulation events involve hinge points at the midline and dorsolateral edges.
- Neural tube defects can occur if closure fails, as in spina bifida where the posterior neuropore remains open, preventing proper spinal cord development.
Mammalian development begins with fertilization and cleavage of the egg. The egg develops membranes that allow development outside of water. In mammals, the placenta exchanges gases and nutrients between the embryo and mother. Cleavage is rotational, with zygotic genes activating later than other animals. Cells compact and the morula forms an inner cell mass and trophoblast cells. The trophoblast secretes fluid to form a blastocyst cavity. The inner cell mass forms the epiblast and hypoblast, which generate the embryo and extraembryonic tissues through gastrulation. Axis formation is guided by gradients of genes like HOX and left/right asymmetries are regulated by proteins including Nodal.
- Drosophila melanogaster is a useful model organism for studying development due to its short life cycle, fully sequenced genome, and ease of breeding.
- Early Drosophila development involves syncytial cleavage where nuclei divide without cell division, specifying the dorsal/ventral and anterior/posterior axes.
- Fertilization occurs when sperm enters an egg that has already begun specifying axes; maternal and paternal chromosomes remain separate during early divisions.
This document summarizes key patterns in animal development. It describes that animals undergo gastrulation where cells migrate to form germ layers and axes. Animals are categorized into 35 phyla based on features like germ layers, organ formation, and cleavage patterns. It describes that diploblastic animals have two germ layers while most are triploblastic with three germ layers. Triploblastic animals are further divided into protostomes and deuterostomes based on mouth formation. The document also provides examples of cleavage patterns in snails which are spirally arranged in either a dextral or sinistral pattern determined by maternal factors.
1) Sex determination in mammals is primarily determined by the XY sex determination system, with females having XX and males having XY. The SRY gene on the Y chromosome causes the development of testes.
2) The gonads are initially bipotential but develop into either ovaries or testes based on the sex chromosomes. Testes secrete AMH and testosterone to direct male development while ovaries secrete estrogens for female development.
3) Gametogenesis includes the process of meiosis which produces haploid gametes from diploid germ cells in the gonads. In females, oogenesis begins in the embryo but arrests until puberty while spermatogenesis only occurs at puberty in males.
Stem cells are unspecialized cells that can divide and differentiate into specialized cell types. There are several types of stem cells defined by their potency, including totipotent stem cells found in early embryos, pluripotent stem cells in the embryo, and multipotent adult stem cells. Stem cell regulation is controlled through extracellular signals from the stem cell niche and intracellular factors that influence gene expression and cell fate. Researchers have also induced pluripotency in adult cells by introducing genes that code for key transcription factors.
This document discusses cell-to-cell communication and how it allows for the development of specialized tissues and organs through three main mechanisms: cell adhering, cell shape changing, and cell signaling. It describes how cells interact at the cell membrane through various receptor and ligand proteins. These interactions can be homophilic or heterophilic, and occur through direct contact between neighboring cells (juxtacrine signaling) or over short distances (paracrine signaling). Differential adhesion and cadherins allow cells to sort themselves into tissues based on adhesion strengths. The extracellular matrix and integrins also influence cell communication and development.
Differential gene expression refers to the process where different genes are activated in different cell types, leading to cellular specialization. While all cells contain the full genome, only a small percentage of genes are expressed in each cell. Gene expression is regulated at multiple levels, including differential transcription, selective pre-mRNA processing, selective mRNA translation, and posttranslational protein modification. The most common mechanisms involve regulating transcription through epigenetic modifications of chromatin and the use of transcription factors.
The document summarizes key stages in animal development from fertilization through organogenesis. It begins with fertilization and cleavage, followed by gastrulation where the three germ layers (endoderm, mesoderm, ectoderm) are formed. During organogenesis, organs develop from the germ layers. Metamorphosis may also occur to transition organisms like frogs from immature to sexually mature forms. Examples are provided of developmental processes in frogs and other model organisms like fruit flies and plants. Cell behavior and patterning during these stages are also discussed.
The document discusses considerations for small businesses when hiring employees. It covers deciding when to hire an employee, defining job roles, writing job descriptions, attracting and evaluating candidates, selecting the right hire, training employees, rewarding and compensating employees, and managing ownership and dividends when there are family business partners involved. The key aspects of setting up an employee program for a small business are planning job roles, writing thorough job descriptions, developing fair hiring and review processes, providing training, and establishing clear compensation and ownership structures.
This document discusses various legal issues that small business owners should be aware of, including:
- Understanding the different types of laws (federal, state, local) that may apply to a small business.
- Hiring an experienced small business attorney to provide legal advice and represent the business as needed.
- Choosing an appropriate legal structure for the business, such as a sole proprietorship, partnership, corporation, or LLC.
- Protecting the business name as intellectual property and complying with regulations regarding contracts, liability, taxation and other legal matters.
This document discusses risk management and insurance for small businesses. It begins by defining risk for business owners and identifying common sources of risk such as financial investments, theft, nonpayment of debts, and natural disasters. It then examines risks related to a business's property, personnel, customers, and intangible property. The document provides strategies for managing these risks, such as developing policies and procedures, securing valuable assets, and obtaining different types of insurance. It concludes by discussing ways for businesses to share risk through joint ventures, industry groups, and government funding programs.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
2. Ophthalmology: the science of the eye and its disorders
and diseases
Opthalmologist: physician who specializes in the
diagnosis and treatment of disorders and diseases of the
eye
Optometrist: is not a medical doctor, but can perform eye
examinations, diagnose vision problems and eye
diseases, and treat visual defects through corrective
lenses and eye exercises
Opticians: trained to fill prescriptions written by
ophthalmologists and optometrists for corrective lenses
by grinding the lenses and dispensing eyewear
2
4. 4
Modified from Damjanov I: Pathology for the health-related professions, Philadelphia, 1996, Saunders.
5. Visual impulse begins with light passing through the
cornea
Cornea refracts the light and passes it through the
aqueous humor and pupil into the lens
Ciliary muscle adjusts the curvature of lens to again
refract light rays
Rays pass into the retina, trigger photo-receptor cells of
rods and cones
Light energy converts into an electrical impulse and is
sent through the optic nerve to the brain
5
7. Presbyopia
o Changing the point of focus from distance to near becomes
difficult, due to age
o Difficulty seeing at reading level
Astigmatism
o Occurs when light rays entering the eye are focused irregularly
o Occurs because the cornea or the lens is not a smooth sphere,
but has an irregular shape
o Corrected with glasses, contacts, or surgery
7
12. Strabismus
o Eyes do not track together (do not look in same direction)
o In children, caused by weakness in eye muscles
Nystagmus
o Constant, involuntary movement of one/both eyes
o Accompanied by blurred vision
o Caused by an abnormal function in part of the brain that controls
eye movements
12
13. Strabismus
Eyes do not track together, do not look in the same
direction at the same time.
14.
15.
16. Hordeolum (stye): localized purulent infection of
sebaceous gland of eyelid
Chalazion: small cyst from blockage of meibomian gland
Keratitis: inflammation of cornea, results in superficial
ulcerations
Conjunctivitis: inflammation of conjunctiva caused by
irritation, allergy, or bacterial infection
Blepharitis: inflammation of glands and lash follicles
along eyelids
16
21. Corneal abrasion: caused by foreign body or direct
trauma
o Diagnosis is confirmed by fluorescein stain, highlighted by cobalt
blue light
o Foreign bodies are removed first, then treated with antibiotic
ointment and nonsteroidal antiinflammatory ophthalmic
ointments
Cataract: cloudy area blocks passage of light into retina
o Condition may result from eye injury, exposure to extreme heat
or radiation, or inherited factors, but is usually due to aging
o Blurred, dimmed vision
o Effective treatment is surgical removal of the lens
21
23. Glaucoma: common and serious, increased intraocular
pressure (IOP)
o Damages the optic nerve and causes blindness if untreated
o Tonometer and gonioscopy used to diagnose
o Miotic and beta-blocker eye drops or surgery for treatment
Macular degeneration: progressive deterioration of the
macula lutea
o Causes severe vision loss and blindness
o No cure, but antioxidants may prevent or slow progression
o Two forms: dry (90% of cases) and wet
23
30. Diabetic retinopathy is a complication of diabetes that
results from damage to the blood vessels of the light-
sensitive tissue at the back of the eye (retina). At first,
diabetic retinopathy may cause no symptoms or only
mild vision problems. Eventually, however, diabetic
retinopathy can result in blindness.
Diabetic retinopathy can develop in anyone who has
type 1 diabetes or type 2 diabetes. The longer you have
diabetes, and the less controlled your blood sugar is, the
more likely you are to develop diabetic retinopathy.
31.
32. Ophthalmoscope projects light to view interior parts of
eye and retina
Eyelids examined for edema
Pupils examined for shape, symmetry, reactivity to light,
and movement coordination
Slit lamp biomicroscope to view details of eye, requires
mydriatic eye drops
Exophthalmometer measures how far eye protrudes
beyond edge of socket
PERRLA: Pupils, Equal, Round, Reactive to Light and
Accommodation
32
33. Best single test for vision screening, used with the
Snellen alphabetical chart
Patients must be able to view the chart at eye level, from
a distance and well-lit
Gross screening of visual acuity, patients usually allowed
to use glasses or contacts
Document use of corrective lenses, result of each eye
separately and as fractions, outcomes of each test with
appropriate abbreviations
33
35. Distance Visual Acuity
Distance visual acuity is typically assessed using a
Snellen chart.
– May use E chart, pediatric picture chart, or alphabet chart
– Patient stands 20 feet from chart at eye level
– Eyes tested with corrective lenses worn
36. – Distance Visual Acuity
– Record results as fraction with 20 feet on top
– Visual acuity is expressed as a fraction. The top number
refers to the distance you stand from the chart. This is
usually 20 feet. The bottom number indicates the
distance at which a person with normal eyesight could
read the same line you correctly read. For example,
20/20 is considered normal. 20/40 indicates that the line
you correctly read at 20 feet can be read by a person
with normal vision from 40 feet away.
– Both eyes remain open during examination; no squinting or
straining
37. Abbreviations
OD-Oculus Dexter- EYE RIGHT
OS-Oculus Sinister- EYE LEFT
OU-Oculus Uterque- EYE BOTH
PERRLA: Pupils Equal, Round, Reactive to Light and
Accommodation
38. Patient holds card 14 to 16 inches from face, with
varying size font
Test each eye, other eye covered, but open
Document number at which the patient stopped reading
for each eye, whether corrective lenses were worn, and
any signs of eye strain, like squinting
38
40. Tests for defects in color vision (congenital or acquired)
Assess perception of primary colors and shades of
colors
Polychromatic plates with numbers of one color, and
background dots are different color
If the score is 10 or higher, the patient is within average
range
40
42. Eye irrigation
o Use sterile technique and equipment to avoid contamination
o Used to relieve inflammation, remove drainage, dilute chemicals,
or wash away foreign bodies
o Never attempt to remove foreign body with an applicator
Instillation of medication to treat infection, soothe
irritation, anesthetize eye, dilate pupils
o Eye drops or ointments are common
Aseptic procedures in ophthalmology
o Avoid contamination of eye medication applicators
o Sterility of medications is critical
42
44. Outer ear
o Auricle, auditory canal
Middle ear
o Tympanic cavity
Inner ear
o Called the labyrinth
o Organ of Corti
44
45. From Jarvis C: Physical examination and health assessment, ed 7, Philadelphia, 2016, Saunders.
45
46. From Applegate EJ: The anatomy and physiology learning system, ed 4, Philadelphia, 2011, Saunders.
46
47. Conductive hearing loss
o Caused by a problem that originates in the external or middle ear
Sensorineural hearing loss
o Results from an abnormality of the organ of Corti or of the
auditory nerve
47
50. Otitis externa (swimmer's ear)
o Causes: dermatologic conditions, trauma, continuous use of
earplugs/earphones, swimming
Otitis media
o Serous or suppurative
o Often associated with upper respiratory tract infection or allergic
reaction
o More common in children
50
52. 52
(From Frazier MS, Drzymkowski JW: Essentials of Human
Diseases and Conditions , ed 5, St Louis, 2013, Saunders.)
53. Cerumen: soft, yellowish, waxy substance that lubricates
the external auditory canal
o Excessive secretion can cause:
• Hearing loss
• Tinnitus
• Feeling of fullness
• Otalgia
o Impacted cerumen can cause conductive hearing loss
53
54.
55. Causes swelling and edema in the semicircular canals
Triggers episodes of recurring attacks of vertigo, tinnitus,
a sensation of pressure in the affected ear, and
advancing hearing loss
55
57. Measures hearing by air conduction and bone
conduction
To activate the fork, hold it by the stem and strike the
tines softly on the palm of the hand
Weber test used if patient reports better hearing in one
ear
Rinne test compares air conduction sound with bone
conduction sound
o In normal hearing, sound is heard twice as long by air as by
bone conduction
57
58. Measures the lowest intensity of sound an individual can
hear
Wearing headphones, the patient is exposed to sounds
and is asked to signal when a sound is heard
If initial screening indicates hearing deficit, an audiologist
may be consulted
58
62. Ear irrigation
o Done to remove excessive or impacted cerumen, to remove a
foreign body, or to treat inflamed ear with an antiseptic solution
o Administer irrigating solution with applicator tilted up, toward top
of external canal
o Always chart the treatment and its results immediately after
completion
Instilling otic medications
o Medication ordered for ear instillation is given to soften impacted
cerumen, to relieve pain, or as an antibiotic drop for an infectious
pathogen
62
63. Treatment Procedures
Ear Irrigation To Remove Excess Cerumen
Direct solution toward roof of canal
Abbreviations—
Auris dextra (AD), right
Auris sinistra (AS), left
Auris uterque (AU), both
64. Adult—pull pinna up
and back
Child under 3—pull
ear lobe down and
back
65.
66. Nasal cavity examined to test mucous membrane and
nostrils
Throat includes the larynx and the pharynx
o Seen with mirror tongue depressor/gauze square
Collection of throat specimens
66
67. Use good listening skills, appropriate nonverbal
methods, and touch to communicate empathy and
understanding
Include family members in the patient's treatment plan
Offer referrals to community resources
67
Editor's Notes
The medical assistant must be familiar with the normal anatomy and physiology of the
eyes, ears, nose, and throat.
Figure 30-1 shows the anatomy of the eye.
The eyeball consists of three layers.
What are the three layers of the eye? (The outermost layer is made up of the white sclera [protects the eyeball] and cornea [allows light to enter the eye]. The choroid is the posterior portion of the middle layer of the eye, and it contains many blood vessels that supply nutrients to the outer layers of the retina. The inner layer of the eye includes the retina in the posterior portion and the lens in the anterior portion.)
What occurs in the brain when an electrical impulse is received? (The impulse is received
in the visual cortex of the occipital lobe of the brain and is interpreted, and a picture is created.)
Figure 30-2 shows myopia (A) and hyperopia (B), along with how they are corrected.
How is presbyopia treated? (A combination corrective lens, known as a bifocal lens or a
progressive lens correction, is used to focus both distal and proximal objects directly on
the retina. Conductive keratoplasty is the new laser procedure used to treat presbyopia.)
How does astigmatism affect vision? (It is like attempting to focus on objects seen through a wavy piece of window glass.)
Surgical correction of astigmatism attempts to reshape the cornea into a more spherical or uniformly curved surface.
Hyperopia is a refractive error, which results from a disorder rather than from disease.
A refractive error means that the shape of your eye does not bend light correctly,
resulting in a blurred image.
Hyperopia is a refractive error, which results from a disorder rather than from disease.
A refractive error means that the shape of your eye does not bend light correctly,
resulting in a blurred image.
Adults can develop strabismus because of a condition or disease elsewhere in the body,
such as diabetes mellitus, muscular dystrophy, or hypertension, or as the result of a head
injury; it is caused by muscle weakness in children.
A patient with signs and symptoms of nystagmus first should undergo neurological evaluation to determine the cause of the disorder with treatment based on those findings.
Eyeglasses and contact lenses are the traditional treatments for visual acuity problems caused by refractive errors.
Problems with the shape of the lens can be corrected surgically, on an outpatient basis.
The brain and eyes have to work together to produce clear vision. If the brain favors
one eye — usually due to poor vision in the other eye — the weaker eye tends to
wander inward or outward. Eventually, the brain may ignore the signals received
from the weaker eye. This condition is sometimes referred to as lazy eye (amblyopia).
Bacterial infections are treated with antibiotic ophthalmic preparations.
Symptoms of corneal abrasion include pain, inflammation, tearing, and photophobia.
Most cataracts develop slowly and progressively as a result of the natural aging
deterioration of the lens of the eye and typically occur after age 60.
Caused by:
Something hits your eye
Something gets in your eye
Foreign body
High-speed particles (metal, wood)
Figure 37-3 shows corneal abrasion stained with fluorescein.
Figure 37-4 shows corneal abrasion stained with fluorescein and highlighted by cobalt blue light.
What are the two types of glaucoma? (The two types are chronic open-angle glaucoma
and acute closed-angle glaucoma. Chronic can be suffered for a long time without
noticing symptoms, whereas acute has more obvious symptoms, such as severe pain,
headache, and inflammation.)
How do physicians screen for glaucoma? (The ophthalmologist first uses a tonometer with a slit lamp to measure increased intraocular pressure. Gonioscopy also can be used to examine the aqueous fluid drainage system and to determine whether the glaucoma is the open- or closed-angle type.)
Figure 30-5, A shows open-angle glaucoma; B shows closed-angle glaucoma.
Glaucoma refers to a category of eye disorders often associated with a dangerous
buildup of internal eye pressure (intraocular pressure or IOP), which can damage
the eye's optic nerve that transmits visual information to the brain.
A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil.
The lens works much like a camera lens, focusing light onto the retina at the back of
the eye. The lens also adjusts the eye's focus, letting us see things clearly both up
close and far away.
What is PERRLA? (PERRLA stands for Pupils, Equal, Round, Reactive to Light, and
Accommodation. It is charted by the physician if the pupils are reacting normally.)
How do you record the results of this test? (The numerator [top number] is the distance
of the patient from the chart [always 20 feet], and the denominator [bottom number] is
the lowest line read satisfactorily by the patient. For example, if the patient reads the 20
line at 20 feet, the fraction 20/20 is recorded for that eye. The last line the patient can read
without squinting or straining and with no more than two mistakes is the line recorded in
the patient’s chart for that eye.)
Figure 37-7 shows different types of Snellen charts.
Procedure 37-1 on p. 754 outlines the procedure for measuring distance visual
acuity with the Snellen chart.
This test frequently is given to patients initially to screen for presbyopia or hyperopia.
The patient reads the card, starting at the top, until reaching the smallest print that can be read.
Near visual acuity is tested with a near-vision acuity chart; size of type varies.
Helps with diagnosis of presbyopia
Give in well-lit room, with patient holding card 14 to 16 inches away
Given in each eye; monitor patient for squinting or straining
Figure 37-9 shows the chart for the near vision acuity test.
If the score is 7 or lower, the patient is suspected of having a color deficiency, and
the ophthalmologist performs additional assessment tests using more precise
color vision testing equipment.
Procedure 30-2 provides the protocol for assessing color acuity using the Ishihara test.
The eye is irrigated to relieve inflammation, remove drainage, dilute chemicals, or
wash away foreign bodies.
Newly opened sterile solutions should be used for each patient and should be
discarded after instillation or given to the patient for home use.
Procedure 37-3 on pp. 758-759 details how to perform eye irrigation, and
Procedure 37-4 on pp. 759-760 details how to instill eye medication
Notify the physician immediately if a patient comes into the office with something in his or her eye.
If the physician’s order is for you to remove the foreign body, do so with irrigation only.
If this technique is unsuccessful, cover both of the patient’s eyes with a gauze dressing and notify your supervisor immediately.
The auricle collects sound waves and sends them down the auditory canal.
The middle ear contains the auditory ossicles or bones: malleus, incus, and stapes.
These three tiny bones are linked by minute ligaments to form a bridge across the
space of the tympanic cavity.
The inner ear, called the labyrinth, is divided into the cochlea and the semicircular canals, which are joined by the vestibule.
The organ of Corti, which contains the receptors for sound, is located within the cochlea.
Figure 30-12 shows the anatomy of the ear.
Figure 30-13 shows the semicircular canals of the inner ear.
Describe the process of conductive hearing loss. (Conductive hearing loss is caused by
a problem that originates in the external or middle ear, which prevents sound vibrations
from passing through the external auditory canal, limits the vibration of the tympanic
membrane, or interferes with the passage of bone-conducted sound in the middle ear.)
If the sensorineural hearing loss cannot be improved by hearing aids, an option is
surgical implantation of an artificial cochlea.
Figure 30-14 shows different causes of deafness.
A cochlear implant is a small, complex electronic device that can help to provide a
sense of sound to a person who is profoundly deaf or severely hard-of-hearing.
The implant consists of an external portion that sits behind the ear and a second
portion that is surgically placed under the skin (see figure). An implant has the
following parts:
A microphone, which picks up sound from the environment.
A speech processor, which selects and arranges sounds picked up by the
microphone.
What is the difference between otitis externa and otitis media? (Otitis externa affects
the external ear canal and is called swimmer’s ear. Otitis media is an inflammation of
the normally air-filled middle ear that results in a collection of fluid behind the
tympanic membrane.)
Swimmers frequently have otitis externa, because water collects in the ears and mixes with cerumen to form an ideal culture medium for bacteria and fungus.
Figure 30-15 shows inflammation and infection of the ear and surrounding canals.
How is otitis diagnosed? (An otoscopic examination reveals that the normally pearly gray tympanic membrane is inflamed and bulging. Areas of fluid or pus may be visible through the membrane.)
A tympanogram may be done to determine the air pressure of the middle ear and
the mobility of the tympanic membrane. Figure 37-14 shows a normal tymponogram
test with a peak at normal pressure.
Figure 37-15 shows a tympanic membrane with a tympanostomy tube.
The American Academy of Pediatrics recommends an initial delay of treatment with antibiotics, giving the child's immune system a chance to fight the infection by itself. If the condition does not improve, antibiotics may be prescribed.
How is impacted cerumen removed? (This can be done by softening the wax with oily drops,
such as carbamide peroxide [Debrox], and then irrigating the ear with warm water until the
plug is removed.)
Ménière's disease is treated during active periods with medications for nausea and vomiting.
A salt-restricted diet, diuretics, and antihistamines may be prescribed to control edema in
the labyrinth.
Surgical destruction of the affected labyrinth is an option. Although this relieves symptoms,
it may also result in permanent deafness if the cochlea is damaged.
Figure 37-16 shows instruments used in otoscopic testing.
A number of tests are used to assess hearing acuity.
Remember that in bone conduction, the sound vibrates through the cranial bones to the inner ear.
Striking the tines too forcefully creates a tone that is too loud for diagnostic use.
The results are printed on a graph, called an audiogram, or the medical assistant charts
the results on a graph sheet.
An adult with normal hearing can hear tone frequencies below 25 decibels, and children
with normal hearing can hear those below 15 decibels.
Figure 30-20 shows an audiometer and how to correctly place the headphones.
Routine examination instruments should be disinfected or sterilized after each use according to office policy and stored in a clean area.
Procedure 30-5 describes the protocol for measuring hearing acuity with an audiometer.
1) Distinguishes between conductive and sensorineural hearing.
2) Strike a 512 Hz tuning fork softly
3) Place the vibrating fork on the middle of the client's head
4) Ask client if the sound is heard better in one ear or the same in both ears
Patients with ear conditions may be in considerable pain and may have difficulty hearing,
which makes health teaching a challenge.
Wait until after the procedure has been completed and the patient is more comfortable
to reinforce health behaviors.
Procedure 37-6 (pp. 767-769) outlines how to irrigate a patient's ear.
Procedure 37-7 (p. 770) provides the steps for instilling medicated ear drops.
The physician may use a nasal speculum to visualize the nostrils and examines the nasal
sinuses by palpation and transillumination.
The physician may spray the patient's throat with a topical anesthetic before the
examination to prevent the gag reflex.
Throat cultures are collected by gently swabbing the back of the throat and the surfaces
of the tonsils with a sterile swab.
Procedure 37-8 (p. 771) describes how to collect a specimen for a throat culture.
What are some modifications one can make to help patients with sensory loss?
(A person with a vision loss benefits from large-print forms and handouts, increased
levels of lighting, and verbal rather than written instructions to reinforce learning.
For an individual with a hearing deficit, printed instructions, demonstrations of how
to manage treatments, or even sign language interpretation should be available to
ensure accurate communication.)