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Chapter 5 Special Senses: The Eye and Ear.

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1 Chapter 5 Special Senses: The Eye and Ear

2 The Eye at a Glance Function of the Eye
Contains sensory receptors for vision

3 The Eye at a Glance Structures of the Eye Sclera Choroid Retina
Eyeball Conjunctiva Eye muscles Eyelids Lacrimal apparatus

4 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

5 Eye Combining Forms ambly/o dull or dim aque/o water blephar/o eyelid
chrom/o color conjunctiv/o conjunctiva core/o pupil corne/o cornea

6 Eye Combining Forms cycl/o ciliary muscle dacry/o tear; tear duct
dipl/o double glauc/o gray ir/o iris irid/o iris kerat/o cornea

7 Eye Combining Forms lacrim/o tears ocul/o eye ophthalm/o eye
opt/o eye, vision optic/o eye nyctal/o night papill/o optic disk phac/o lens

8 Eye Combining Forms phot/o light presby/o old age pupill/o pupil
retin/o retina scler/o sclera uve/o vascular vitre/o glassy

9 Eye Suffixes –metrist one who measures –opia vision –tropia to turn

10 Anatomy and Physiology
Ophthalmology (Ophth) is study of the eye Eyeball Organ of sight Transmits external image using sensory impulses via optic nerve to brain Brain translates sensory impulses into image

11 Anatomy and Physiology
External structures important for vision In addition to eyeball Eye muscles Eyelids Conjunctiva Lacrimal apparatus

12 Click here to view an animation on the anatomy of the eye.
Eye Anatomy Animation Click here to view an animation on the anatomy of the eye. Back to Directory

13 The Eyeball Composed of three layers: Sclera Choroid Retina

14 Sclera Outermost layer Tough protective layer
Another term for sclera is white of eye Anterior portion is cornea

15 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

16 Cornea Anterior portion of sclera Clear, transparent
Allows light to enter Bends, or refracts, light rays

17 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

18 Choroid Middle layer Provides blood supply for eye Anterior portion:
Iris Pupil Ciliary body

19 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

20 Iris and Pupil Iris Pupil Colored portion of eye
Smooth muscle that changes size of pupil Pupil Opening in center of iris Allows light to enter into eyeball

21 Ciliary Body and Lens Lens Ciliary body Behind iris
Not actually part of choroid layer Attached to ciliary body Ciliary body Pulls on edge of lens Changes shape of lens so it can focus light onto retina

22 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

23 Retina Contains sensory receptor cells that detect light rays Rods
Active in dim light See gray tones Cones Active only in bright light Color vision

24 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

25 Retina Macula lutea Fovea centralis Area of retina where image forms
Depression in center of macula lutea High number of cones Point of clearest vision

26 Figure 13.1 – The internal structures of the eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.1 – The internal structures of the eye.

27 Optic Disk Point where the optic nerve leaves eyeball
Retinal blood vessels enter and leave through optic disk No rods or cones Results in blind spot in each eye’s field of vision

28 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.2 – Photograph of the retina of the eye. The optic disk appears yellow and the retinal arteries radiate out from it.

29 Eye Fluids Aqueous humor Vitreous humor Watery fluid
Located between cornea and lens Vitreous humor Semi-solid gel Located between lens and retina

30 Word Building with blephar/o and conjunctiv/o
–itis blepharitis inflammation of eyelid –plasty blepharoplasty surgical repair of eyelid –ptosis blepharoptosis drooping eyelid –ectomy blepharectomy removal of eyelid –al conjunctival pertaining to conjunctiva –itis conjunctivitis inflammation of conjunctiva –plasty conjunctivoplasty surgical repair of conjunctiva

31 Word Building with corne/o, cycl/o & dacry/o
–al corneal pertaining to cornea –plegia cycloplegia paralysis of ciliary body cyst/o –itis dacryocystitis inflammation of tear bladder

32 Word Building with dipl/o, ir/o & irid/o
–opia diplopia double vision –itis iritis inflammation of iris –al iridal pertaining to iris –ectomy iridectomy removal of iris –plegia iridoplegia paralysis of iris scler/o –otomy iridosclerotomy incision into iris and sclera

33 Word Building with kerat/o, lacrim/o & ocul/o
–itis keratitis inflammation of cornea –meter keratometer instrument to measure cornea –otomy keratotomy incision into cornea –al lacrimal pertaining to tears –ar ocular pertaining to eye intra– –ar intraocular pertaining to inside eye myc/o –osis oculomycosis abnormal condition of eye fungus

34 Word Building with ophthalm/o
–algia ophthalmalgia eye pain –ic ophthalmic pertaining to eye –logist ophthalmologist eye specialist –plegia ophthalmoplegia eye weakness –rrhagia ophthalmorrhagia rapid bleeding from eye –scope ophthalmoscope instrument to view inside eye

35 Word Building with opt/o, pupill/o & retin/o
–ic optic pertaining to eye –meter optometer instrument to measure eye –metrist optometrist one who measures eye –ary pupillary pertaining to pupil –al retinal pertaining to retina –pathy retinopathy retina disease –pexy retinopexy surgical fixation of retina

36 Word Building with scler/o and uve/o
–al scleral pertaining to sclera –malacia scleromalacia sclera softening –otomy sclerotomy incision into sclera –itis scleritis inflammation of sclera –itis uveitis inflammation of choroid

37 Eye Vocabulary emmetropia state of normal vision legally blind
severely impaired vision; having 20/200 acuity nyctalopia difficulty seeing in dim light; also called night blindness ophthalmology diagnosis and treatment of diseases of the eye optician specialist in grinding corrective lenses

38 Eye Vocabulary optometry
specializing in examining eyes, testing vision, and prescribing corrective lenses papilledema swelling of the optic disk; also called choked disk photophobia strong sensitivity to bright light presbyopia visual loss due to old age xerophthalmia dry eyes

39 Eyeball Pathology achromatopsia
unable to perceive one or more colors; color blindness monochromatism unable to perceive one specific color amblyopia loss of vision not as a result of eye pathology; commonly called lazy eye corneal abrasion scraping injury to cornea

40 Eyeball Pathology astigmatism blurred vision due to uneven cornea; light rays do not focus sharply on retina hyperopia image comes into focus behind retina; can see clearly at a distance but not up close; also called far sightedness myopia image comes into focus in front of retina; can see clearly up close but not at a distance; also called nearsightedness

41 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.9 – Hyperopia (farsightedness). In the uncorrected top figure, the image would come into focus behind the retina, making the image on the retina blurry. The bottom image shows how a biconvex lens corrects this condition.

42 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – Myopia (nearsightedness). In the uncorrected top figure, the image comes into focus in front of the lens, making the image on the retina blurry. The bottom image shows how a biconcave lens corrects this condition.

43 Eyeball Pathology cataract damage to lens causing it to become cloudy
glaucoma chronic increase in intraocular pressure; results in atrophy of optic nerve macular degeneration deterioration of macula lutea area of retina

44 Figure 13.8 – Photograph of a person with a cataract in the right eye.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.8 – Photograph of a person with a cataract in the right eye.

45 Eyeball Pathology retinal detachment separation of retina from choroid layer; damages blood vessels and nerves causing blindness retinitis pigmentosa progressive disease in which retina becomes hard and pigmented, then atrophies retinoblastoma malignant eye tumor occurring in young children

46 Conjunctiva Pathology
pterygium hypertrophied conjunctival tissue in inner corner of eye trachoma chronic bacterial infection of conjunctiva

47 Eyelid Pathology hordeolum purulent infection of sebaceous gland of eyelid; also called a stye (or sty)

48 Eye Muscle Pathology strabismus
eye muscle weakness resulting in eyes looking in different directions at same time esotropia (ST) type of strabismus with inward turning of eye; also called cross-eyed exotropia (XT) type of strabismus with outward turning of eye; also called wall-eyed

49 (Bart's Medical Library/Phototake NYC)
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 13.4 – Photograph of an infant with strabismus. The left eye is turned inward, called esotropia. (Bart's Medical Library/Phototake NYC)

50 Brain-related Vision Pathology
hemianopia loss of vision in half of visual field; often result of a stroke nystagmus jerky involuntary eye movements; indicator of brain injury

51 Eye Examination Tests color vision tests
use of multicolored charts to determine ability to recognize colors fluorescein angiography injection of fluorescein dye into bloodstream to observe blood flow within eye fluorescein staining applying fluorescein eye drops to cornea to look for corneal abrasions

52 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – An example of color blindness test. A person with red-green color blindness would not be able to distinguish the green 27 from the surrounding red circles.

53 Eye Examination Tests keratometry measures curvature of cornea
ophthalmoscopy examination of interior of eye refractive error test vision test for defect in ability of eye to focus image on retina; tests for hyperopia and myopia slit lamp microscopy examining posterior surface of cornea

54 Eye Examination Tests Snellen chart used for testing distance vision
tonometry measures intraocular pressure visual acuity (VA) measures sharpness of vision

55 Surgical Treatments cryoextraction
use of extremely cold probe to lift cataract from lens phacoemulsification use of high-frequency sound waves to liquefy lens with a cataract which is then removed with a needle keratoplasty surgical repair of cornea with a cornea transplant enucleation surgical removal of eyeball

56 Surgical Treatments laser-assisted in-situ keratomileusis (LASIK)
correction of myopia using laser surgery to remove corneal tissue photorefractive keratectomy (PRK) use of laser to reshape cornea; treats myopia radial keratotomy (RK) spoke-like incision around cornea to flatten it; treats myopia

57 Surgical Treatments cryoretinopexy
surgical fixation of retina using extreme cold laser photocoagulation use of laser to destroy very small precise areas of retina scleral buckling placing band around outside of sclera to stabilize detached retina strabotomy incision into eye muscles to correct strabismus

58 Eye Pharmacology anesthetic ophthalmic solution
eyedrops to deaden pain Ocu-Caine, Pontocaine antibiotic ophthalmic solution eyedrops to treat bacterial infection Del-Mycin, Ilotycin ophthalmic decongestant constricts arterioles of eye to reduce redness and itching Visine, Murine

59 Eye Pharmacology antiglaucoma medication reduces intraocular pressure
Betimol, Timoptic artificial tears treats dry eyes Akwa Tears, Refresh Plus miotic constricts pupil Eserine Sulfate, Miostat mydriatic dilates pupil Atropine-Care, Atropisol Ophtalmic

60 Eye Abbreviations ARMD age-related macular degeneration Astigm
astigmatism c. gl. correction with glasses D diopters (lens strength) DVA distance visual acuity ECCE extracapsular cataract extraction EENT eye, ear, nose, throat

61 Eye Abbreviations EM emmetropia EOM extraocular movement ICCE
intracapsular cataract extraction IOP intraocular pressure LASIK laser assisted in-situ keratomileusis OD right eye Ophth. ophthalmology

62 Eye Abbreviations OS left eye OU each eye/both eyes PERRLA
pupils equal, round, reactive to light and accommodation PRK photorefractive keratectomy REM rapid eye movement s. gl. without correction or glasses SMD senile macular degeneration

63 Eye Abbreviations ST esotropia VA visual acuity VF visual field XT
exotropia

64 The Ear at a Glance Function of the Ear
Contains sensory receptors for hearing and equilibrium (balance)

65 The Ear at a Glance Structures of the Ear Auricle External ear
Middle ear Inner ear

66 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

67 Ear Combining Forms acous/o hearing audi/o hearing audit/o hearing
aur/o ear auricul/o ear cerumin/o cerumen

68 Ear Combining Forms cochle/o cochlea labyrinth/o labyrinth (inner ear)
myring/o eardrum ot/o ear salping/o eustachian tube staped/o stapes tympan/o eardrum, middle ear

69 Ear Suffixes –cusis hearing –otia ear condition

70 Anatomy and Physiology
Otology (Oto) is study of the ear Audiology is study of hearing disorders Ear responsible for two senses: Hearing Equilibrium or sense of balance Sensory information carried to brain by vestibulocochlear nerve Cochlear nerve – hearing information Vestibular nerve – balance information

71 The Ear Ear is subdivided into three regions: External ear Middle ear
Inner ear

72 External Ear Auricle or pinna Only portion visible
Captures sound waves Directs them through external auditory meatus

73 External Ear Auditory canal Cerumen Sound moves along canal
Produced by oil glands in auditory canal Oily wax slowly flows out of ear canal removing dirt that has stuck to it

74 External Ear Tympanic membrane
Commonly called eardrum Sound waves strike membrane Causes it to vibrate Tympanic membrane separates external ear from middle ear

75 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – The internal structures of the outer, middle, and inner ear.

76 The Middle Ear Small cavity Located in temporal bone of skull
Contains three tiny bones called ossicles Malleus Incus Stapes

77 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – The internal structures of the outer, middle, and inner ear.

78 Ossicles Tympanic membrane vibrates incus
Vibrations amplify as they move from one ossicle to next Stapes transmits vibration to oval window Start of inner ear

79 Figure 13.15 – Close-up view of the ossicles within the middle ear.
Medical Terminology: A Living Language, Fourth Edition Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – Close-up view of the ossicles within the middle ear.

80 Eustachian Tube Also called auditory tube
Connects nasopharynx with middle ear Opens with each swallow Equalizes pressure between middle ear cavity and atmospheric pressure

81 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – The internal structures of the outer, middle, and inner ear.

82 The Inner Ear Labyrinth Contains sensory organs
Cavity within temporal bone Houses inner ear Contains sensory organs

83 Sensory Organs of Inner Ear
Hearing Cochlea Organs of Corti Equilibrium Semicircular canals Utricle Saccule

84 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – The internal structures of the outer, middle, and inner ear.

85 How We Hear Sound waves travel down external auditory canal, strike eardrum Eardrum vibrates

86 How We Hear Ossicles conduct vibrations across middle ear from eardrum to oval window Oval window movements initiate vibrations in fluid that fills cochlea

87 How We Hear Fluid vibrations strike hair cells, bending small hairs and stimulating nerve endings Nerve ending sends electrical impulse to brain on cochlear portion of vestibulocochlear nerve

88 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – The path of sound waves through the outer, middle, and inner ear.

89 Inner Ear Anatomy Animation
Click here to view an animation on inner ear anatomy. Back to Directory

90 Hearing Loss Conductive hearing loss
Disease or malformation of outer or middle ear All sound is weaker and muffled since it is not conducted correctly to inner ear Sensorineural hearing loss Damage or malformation of inner ear (cochlea) or the cochlear nerve Sounds are distorted because nerve impulse is incorrect

91 Word Building with acous/o, audi/o & audit/o
–tic acoustic pertaining to hearing –gram audiogram record of hearing –meter audiometer instrument to measure hearing –logist audiologist hearing specialist –ory auditory pertaining to hearing

92 Word Building with aur/o, auricul/o, cochle/o and salping/o
aural pertaining to ear –ar auricular pertaining to ear –ar cochlear pertaining to cochlea –itis salpingitis inflammation of eustachian tube –otomy salpingotomy incision into eustachian tube

93 Word Building with labyrinth/o & myring/o
–ectomy labyrinthectomy removal of labyrinth –otomy labyrinthotomy incision into labyrinth –itis myringitis inflammation of eardrum –ectomy myringectomy removal of eardrum –plasty myringoplasty surgical repair of eardrum

94 Word Building with ot/o
–algia otalgia ear pain –ic otic pertaining to ear –itis otitis inflammation of ear –logist otologist ear specialist –rrhagia otorrhagia bleeding from ear

95 Word Building with ot/o
–scope otoscope instrument to view ear –plasty otoplasty surgical repair of ear myc/o –osis otomycosis abnormal condition of ear fungus py/o –rrhea otopyorrhea discharge of pus from ear

96 Word Building with tympan/o
–ic tympanic pertaining to eardrum –itis tympanitis inflammation of eardrum –meter tympanometer instrument to measure eardrum –plasty tympanoplasty surgical repair of eardrum –rrhexis tympanorrhexis ruptured eardrum –otomy tympanotomy incision into eardrum –ectomy tympanectomy removal of eardrum

97 Word Building with –otia
macro– macrotia large ears micro– microtia small ears

98 Ear Vocabulary American Sign Language (ASL)
nonverbal method of communicating using hands and fingers to represent words and concepts binaural referring to both ears monaural referring to one ear decibel (dB) measures loudness of sound hertz (Hz) measures pitch of sound

99 Ear Vocabulary otorhinolaryngology (ENT)
diagnosis and treatment of diseases of ear, nose, and throat presbycusis normal loss of hearing with age residual hearing amount of hearing remaining after damage has occurred tinnitus ringing in ears vertigo dizziness

100 Hearing Loss Pathology
anacusis total absence of hearing; total deafness deafness inability to hear or having some degree of hearing impairment

101 External Ear Pathology
ceruminoma excessive accumulation of earwax forming hard wax plug otitis externa (OE) external ear infection; often by fungus; also called otomycosis or swimmer’s ear

102 Middle Ear Pathology otitis media (OM) infection of middle ear; most commonly seen in children; watery fluid (serous otitis media) or pus (purulent otitis media) accumulates in middle ear cavity otosclerosis loss of mobility of stapes bone; leads to hearing loss as it cannot vibrate

103 Inner Ear Pathology acoustic neuroma
benign tumor of cochlear nerve; symptoms include tinnitus, headache, dizziness, and hearing loss labyrinthitis inner ear infection; causes hearing and equilibrium symptoms Ménière’s disease progressive hearing loss, vertigo, and tinnitus; causes not well understood

104 Audiology Tests audiometry test of hearing ability in regards to both intensity and pitch person is able to hear Rinne & Weber tuning fork tests use of a tuning fork placed either next to ear or against skull to assess both nerve and bone conduction of sound

105 Otology Tests otoscopy examination of ear canal and eardrum
tympanometry measurement of movement of tympanic membrane to asses pressure inside middle ear

106 Medical Terminology: A Living Language, Fourth Edition
Bonnie F. Fremgen and Suzanne S. Frucht Copyright ©2009 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure – An otoscope, used to visually examine the external auditory ear canal and tympanic membrane.

107 Balance Tests falling test assesses equilibrium; balancing on one foot with eyes open and then closed

108 Audiology Procedures mechanical device used to amplify sound
hearing aid mechanical device used to amplify sound

109 Surgical Treatments cochlear implant
mechanical device surgically placed behind outer ear; converts sound into magnetic impulses to stimulate auditory nerve; treats sensorineural hearing loss myringotomy incision into eardrum to drain fluid accumulated in middle ear cavity pressure equalizing tube (PE tube) surgical placement of tube in eardrum to allow for continuous drainage of fluid from middle ear cavity stapedectomy replacement of damaged stapes

110 Ear Pharmacology antibiotic otic solution
eardrops to treat otitis externa Neomycin, Otocort antiemetics treats nausea associated with vertigo Antivert, Compazine anti-inflammatory otic solution reduces inflammation and itching of otitis externa Allergan Ear Drops wax emulsifiers softens ear wax Debrox Drops

111 Ear Abbreviations AD right ear AS left ear ASL American Sign Language
AU both ears BC bone conduction dB decibel EENT eye, ear, nose, throat ENT ear, nose, throat

112 Ear Abbreviations HEENT head, eyes, ears, nose, throat Hz hertz OM
otitis media Oto otology PE tube pressure equalizing tube PORP partial ossicular replacement prosthesis SOM serous otitis media TORP total ossicular replacement prosthesis


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