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Chapter Thirteen
Special Senses: Eye and Ear
Quote
“A beautiful eye makes silence eloquent, a kind
eye makes contradiction an assent, an enraged
eye makes beauty deformed. This little member
gives life to every part about us.”
– Joseph Addison
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2
Functions and Specialties/Specialists

Functions



Specialties

Vision (opt/o, optic/o)
Hearing (audi/o,
acous/o)




Ophthalmology
Optometry
Audiology
Otorhinolaryngology
Specialists




Ophthalmologist
Optometrist
Audiologist
Otorhinolaryngologist
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3
The Eye (ophthalm/o, ocul/o)

Ocular adnexa

Orbit
 Eyebrows
 Canthi
 Eyelids
(palpebr/o, blephar/o)
 Palpebral fissure
 Conjunctivae (conjunctiv/o)
Ocular adnexa
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The Eye (Cont.)

Glands


Meibomian
Lacrimal (lacrim/o)
• Lacrimation




Lacrimal glands (dacryoaden/o)
Lacrimal sacs (dacryocyst/o)
Nasolacrimal ducts
Extraocular muscles


Rectus
Oblique
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The Eye (Cont.)

The eyeball

Outer layer/fibrous tunic
• Sclera (scler/o)
• Cornea (kerat/o, corne/o)
• Limbus
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6
Did You Know?

The combining form kerat/o means hard or
horny and refers to both the skin and the cornea.
This is because the cornea is formed from the
same tissue as the epidermis.
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7
The Eye (Cont.)

Middle layer/vascular tunic

Uvea (uve/o) (choroid, ciliary body, iris)
•
•
•
•
•
Iris (ir/o, irid/o)
Pupil (pupill/o, cor/o, core/o)
Ciliary body (cycl/o)
Lens (phac/o, phak/o)
Aqueous and vitreous (vitre/o) humors
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8
The Eye (Cont.)

Inner layer/nervous tunic

Retina (retin/o)
•
•
•
•
•
Rods
Cones
Macula lutea (macul/o)
Fovea
Optic disk (papill/o)
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9
Clicker Question

A combining form for the lens is:
A. palpebr/o
B. phak/o
C. cor/o
D. cycl/o
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Terms Related to Eyelid Disorders






Blepharedema
Blepharitis
Blepharochalasis
Blepharoptosis
Ectropion
Entropion
Ectropion
Entropion
From Seidel: Mosby’s guide to physical
examination, ed 5, Mosby
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11
Terms Related to Eyelash
Disorders

Chalazion


Meibomian cyst
Chalazion
Hordeolum
Hordeolum
From Zitelli: Atlas of pediatric physical
diagnosis, ed 5, Mosby
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12
Terms Related to Tear Gland
Disorders




Dacryoadenitis
Dacryocystitis
Epiphora
Xerophthalmia
Dacryocystitis
From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
13
Terms Related to Conjunctiva
Disorders


Conjunctivitis
Ophthalmia
neonatorum
Conjunctivitis
From Seidel: Mosby’s guide to physical examination, ed 5, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
14
Clicker Question

What is the term for a drooping of the upper
eyelid?
A. blepharitis
B. blepharochalasis
C. blepharoptosis
D. entropion
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15
Terms Related to Eye Muscle and
Orbital Disorders





Amblyopia
Diplopia
Emmetropia
Exophthalmia
Strabismus
Exophthalmia
From Seidel: Mosby’s guide to physical examination, ed 6, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
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Terms Related to Eye Muscle and
Orbital Disorders (Cont.)



Esotropia
Exotropia
Photophobia
Esotropia
From Zitelli: Atlas of pediatric phsyical diagnosis, ed 5, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
17
Did You Know?

Photophobia may mean “sensitivity to light”
when used to describe the eyes, or “fear of light”
when used to describe a psychiatric condition.
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18
Terms Related to Refraction and
Accommodation Disorders




Myopia
Hyperopia
Astigmatism
Presbyopia
Refraction
errors
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19
Terms Related to Sclera Disorders


Corneal ulcer
Keratitis
Corneal ulcer
From Seidel et al: Mosby’s guide to physical examination, ed 6, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
20
Terms Related to Uvea Disorders



Anisocoria
Hyphema
Uveitis
Anisocoria
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21
Terms Related to Lens Disorders


Aphakia
Cataract
Cataract
From Black and Hawks: Medical-surgical nursing, ed 8, Saunders
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
22
Terms Related to Lens Disorders
(Cont.)

Glaucoma
Glaucoma
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23
Clicker Question

What is the term for unequally sized pupils?
A. anisocoria
B. aphakia
C. hyphema
D. glaucoma
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24
Terms Related to Retina Disorders


Achromatopsia
Age-related
macular
degeneration
(ARMD/AMD)
Macular degeneration
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25
Terms Related to Retina Disorders
(Cont.)



Diabetic retinopathy
Hemianopsia
Nyctalopia
Diabetic retinopathy
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Terms Related to Retina Disorders
(Cont.)



Retinal tear, retinal
detachment
Retinitis pigmentosa
Scotoma
Retinal tear detachment
From Monahan et al: Phipps’ medical-surgical nursing, ed 8, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
27
Terms Related to Optic Nerve
Disorders


Nystagmus
Optic neuritis
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28
Terms Related to Benign and
Malignant Neoplasms of the Eye

Benign


Choroidal
hemangioma
Malignant

Intraocular
melanoma
 Retinoblastoma
Retinoblastoma
From Damjanov: Anderson’s pathology, ed 10, Mosby
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29
Clicker Question

What is the term for loss of half of one’s visual
field?
A. nyctalopia
B. scotoma
C. achromatopsia
D. hemianopsia
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30
Age Matters

Pediatrics

Conjunctivitis

Geriatrics




ARMD
Cataracts
Diabetic retinopathy
Presbyopia
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31
Terms Related to Diagnostic
Procedures







Amsler grid
Diopters
Fluorescein angiography
Fluorescein staining
Gonioscopy
Ophthalmic sonography
Ophthalmoscopy
Amsler grid showing visual changes
caused by fluid leakage under the retina
From Seidel: Mosby’s guide to physical examination, ed 6, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
32
Terms Related to Diagnostic
Procedures (Cont.)




Schirmer tear test
Slit lamp examination
Tonometry
Visual acuity
(VA) assessment

Snellen
chart
Snellen chart
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33
Terms Related to Diagnostic
Procedures (Cont.)

Visual field
(VF) test
Assessment of visual fields
From Black and Hawks: Medical-surgical nursing, ed 8, Saunders
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
34
Clicker Question

Which diagnostic procedure is used to visualize
the angle of the anterior chamber of the eye?
A. ophthalmoscopy
B. gonioscopy
C. ophthalmic sonography
D. tonometry
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35
Terms Related to Interventions of
the Eyeball and Adnexa






Blepharoplasty
Blepharorrhaphy
Dacryocystorhinostomy
Enucleation of the eye
Evisceration of the eye
Exenteration of the eye
Enucleation
From Swartz: Textbook of physical diagnosis, history and
examination, ed 5, Saunders
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36
Terms Related to Scleral and
Corneal Procedures


Anterior ciliary sclerotomy
Corneal incision
procedure




Astigmatic keratotomy (AK)
Photorefractive keratectomy
(PRK)
Corneal transplant
Flap procedure

Laser-assisted in situ
keratomileusis (LASIK)
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LASIK
37
Terms Related to Lens
Interventions



Cataract extraction
Intraocular lenses
(IOLs)
Phacoemulsification
and aspiration
of a cataract
Cataract extraction
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38
Terms Related to Iris Interventions



Coreoplasty
Goniotomy
Trabeculotomy
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39
Terms Related to Retina
Interventions



Retinal photocoagulation
Scleral buckling
Vitrectomy
Scleral
buckling
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40
Clicker Question

Which of the following is a procedure to repair
the pupil?
A. scleral buckling
B. goniotomy
C. trabeculectomy
D. coreoplasty
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41
Pharmacology





Antibiotics
Antiglaucoma drugs
Antihistamines
Cycloplegics
Lubricants
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42
Pharmacology (Cont.)





Miotics
Mydriatics
Ophthalmic angiogenesis inhibitors
Ophthalmics
Topical anesthetics
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43
Clicker Question

Which type of medication is used to dilate the
pupil for the purpose of examination of the eye?
A. cycloplegic
B. antihistamine
C. miotic
D. mydriatic
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44
The Ear (ot/o, aur/o, auricul/o)




Outer
ear/external ear
Middle ear
Inner ear/labyrinth
(labyrinth/o)
Mastoid process
The ear
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45
The Ear (Cont.)

Outer/external ear





Pinna/auricle
External auditory canal
Cerumen (cerumin/o)
External auditory meatus (meat/o)
Tympanic membrane (tympan/o, myring/o)
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46
The Ear (Cont.)

Middle ear

Ossicles/ossicular chain (ossicul/o)
• Malleus
• Incus
• Stapes (staped/o)


Oval window
Eustachian tube (salping/o)
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47
The Ear (Cont.)

Inner ear/labyrinth (labyrinth/o)



Membranous and bony labyrinth
Perilymph and endolymph
Bony labyrinth
• Vestibule (vestibul/o)


Utricle
Saccule
• Semicircular canals

Crista ampullaris
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48
The Ear (Cont.)

Parts of the bony labyrinth

Cochlea (cochle/o)
• Organ of Corti
• Vestibulocochlear nerve/eighth cranial nerve
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49
Clicker Question

Which of the following combining forms names a
structure in the middle ear?
A. cochle/o
B. meat/o
C. staped/o
D. mastoid/o
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50
Terms Related to Symptomatic
Disorders




Otalgia/otodynia
Otorrhea
Tinnitus
Vertigo
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51
Terms Related to Outer Ear
Disorders




Impacted cerumen
Macrotia
Microtia
Otitis externa
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52
Terms Related to Middle Ear
Disorders





Cholesteatoma
Infectious myringitis
Mastoiditis
Otitis media (OM)
Otosclerosis
Mastoiditis
From Stone and Garbach: Atlas of infectious diseases, Saunders
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53
Clicker Question

A condition of abnormally large auricles is:
A. macrotia
B. microtia
C. otosclerosis
D. cholesteatoma
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54
Terms Related to Inner Ear
Disorders



Labyrinthitis
Meniere disease
Ruptured tympanic
membrane
Tympanic membrane perforation
From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
55
Terms Related to Hearing Loss
Disorders





Anacusis
Paracusis
Presbycusis
Conductive hearing loss
Sensorineural hearing loss
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56
Terms Related to Benign
Neoplasms of the Ear


Acoustic neuroma
Ceruminoma
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57
Clicker Question

Which term is a loss of hearing common in old
age?
A. anacusis
B. paracusis
C. presbycusis
D. Meniere disease
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58
Age Matters

Pediatric


Otitis media
Hearing loss

Geriatrics

Presbycusis
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59
Terms Related to Hearing Tests

Audiometric
testing


Audiometer
Audiogram
Audiograms
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60
Terms Related to Hearing Tests
(Cont.)




Pure tone audiometry
Speech audiometry
Rinne tuning fork test
Weber tuning fork test
A, Weber test. B, Rinne test
From Seidel: Mosby’s guide to examination, ed 6, Mosby
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61
Terms Related to Hearing Tests
(Cont.)

Otoscopy


Otoscope
Tympanometry

Tympanogram
Otoscopy
From Seidel: Mosby’s guide to examination, ed 6, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
62
Terms Related to Hearing Tests
(Cont.)

Universal newborn hearing screening
(UNHS)


Otoacoustic emissions (OAEs)
Auditory brainstem response (ABR)
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63
Terms Related to Therapeutic
Interventions





Cochlear implant
Hearing aid
Mastoidectomy
Otoplasty
Stapedectomy
Cochlear implant
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64
Terms Related to Therapeutic
Interventions (Cont.)



Tympanoplasty
Tympanostomy/
myringostomy
Tympanotomy/
myringotomy
Tympanostomy tube in place
From Zitelli: Atlas of pediatric physical diagnosis, ed 5, Mosby
Copyright © 2016, 2013, 2010, 2006, 2003, by Mosby, an affiliate of Elsevier Inc.
65
Clicker Question

Which of the following is a surgical or plastic
repair of the external ear?
A. otoplasty
B. cochlear implant
C. tympanoplasty
D. stapedectomy
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66
Pharmacology




Antibiotics
Ceruminolytics
Decongestants
Otics
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67
Clicker Question

Which type of medication is administered to
break down earwax?
A. antibiotic
B. ceruminolytic
C. decongestant
D. otic
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68
Sort these Terms into their Correct
Categories
Terms
1. diopters
2. tympanometry
3. canthus
4. stapes
5. xerophthalmia
6. otalgia
7. scleral buckling
8. cochlear implant
Categories
__ A+P
__ Pathology
__ Diagnostic Procedures
__ Therapeutic
Interventions
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69
Parting Thought
“Become the change you want to see—those are
words I live by.”
–Oprah Winfrey
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70