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Chapter 42
Sensory System
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Sensation, Perception, and Cognition
• Sensation– Ability to receive and process stimuli through
sensory organs
• Perception– Ability to experience, recognize, organize, and
interpret sensory stimuli
• Cognition– Intellectual ability to think
(continued)
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Anatomy and Physiology Review
• Central and peripheral nervous systems act to accomplish three purposes:1. Collect stimuli from receptors at end of
peripheral nerves
2. Transport stimuli to brain
3. Conduct responses to stimuli from brain to responsive motor centers in body
(continued)
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Anatomy and Physiology Review
• Sensation and perception consists of afferent and efferent nerve pathways
• Cognition includes memory, affect, judgment, perception, and language
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Assessment
• Focuses specifically on client’s ability to:– Hear– See– Taste– Smell– Touch
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Disorientation
• Mentally confused state
• Person’s awareness of time, place, self, and/or situation impaired
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Sensory Disorders
• Change in perception of sensory stimuli
• Can affect all five senses
• Sensory deprivation– State of reduced sensory input from internal
or external environment
• Sensory overload– State of excessive and sustained multi-
sensory stimulation
(continued)
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Eye Anatomy
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Eye Anatomy
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Anterior Parts of the Eye
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Impaired Vision
• Blindness– Central visual acuity 20/200 or less with
corrective lenses
• Partially sighted– Visual acuity between 20/70 and 20/200 in
better eye with glasses
• Many visual aids available
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Refractive Errors
• Myopia– Nearsightedness
• Hyperopia– Farsightedness
• Astigmatism– Asymmetric focus of light rays on retina
(continued)
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Refractive Errors
• Presbyopia– Inability of lens to change curvature in order
to focus
• Strabismus– Inability of eyes to focus in same direction
• Corrected with glasses or contacts
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Normal Vision
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Hyperopia Far Sighted
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Myopia-Near Sighted
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Foreign Bodies
• May cause excessive tearing and redness
• If particle not located and removed, instill sterile fluorescein drops or strips to visualize minute foreign bodies not readily visible with naked eye
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Cataracts
• Disorder that causes lens or its capsule to lose transparency and/or become opaque
• As clouding develops, visual impairment occurs
• Treatment:– Surgical removal of lens
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Cataracts
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CataractsNormal
• Cataract
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Glaucoma
• Disorder characterized by abnormally high pressure of fluid inside eyeball
• Treatment:– Drug therapy to reduce intraocular pressure
and iridectomy• Procedure to facilitate drainage of aqueous humor
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Normal
Mild Glaucoma
Severe Glaucoma
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Conjunctivitis (Pink Eye)• Inflammation of conjunctiva• Contagious• Causes:
– Bacterial, viral, or rickettsial organisms, allergens, and irritants
• Symptoms:– Burning, itching, discharge, swelling, pain, and
redness of eyes
• Treatment:– Warm compresses and antibiotic ointment
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Conjunctivitis
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Retinal Detachment
• Painless separation of retina from choroid
• May result from trauma or intraocular disorders
• Treatment:– Procedures that create inflammatory reaction
that results in retina reattaching to choroid and surgery
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Retinal Detachment
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Macular Degeneration
• Atrophy or deterioration of macula
• Central vision lost, but peripheral vision remains
• May be caused by aging, injury, infection, or inflammation of macula
• Help client maximize ability and prevent further damage if exudative
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Macular Degeneration
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Severe Macular Degeneration
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Keratitis
• Inflammation of cornea
• Causes:– Infection, irritation, injury, and allergies
• Symptoms:– Severe eye pain, red and watering eye,
photophobia, reduced vision, and sometimes rash
• Treatment:– Optical anesthetics, mydriatics, and antibiotic
solutions
(continued)
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Stye (Hordeolum)
• Pustular inflammation of eyelash follicle or sebaceous gland on lid margin
• Cause:– Staphylococcal organisms
• Symptoms:– Pain, redness, and swelling
• Treatment:– Warm compresses and topical antibiotics
(continued)
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Chalazion
• Cyst of meibomian glands
• Symptoms:– Painless localized swelling that develops over
period of weeks
• Treatment:– Surgical excision
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Chemical Burns
• Emergency treatment:– Immediate lavage of eye with tap water
• No attempt should be made to neutralize chemical– May cause further injury
• Both eyes should be patched for comfort
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Impaired Hearing
• Conductive hearing loss– Inability of sound waves to reach inner ear
• Sensorineural hearing loss– Inner ear or cochlear portion of cranial nerve
VIII abnormal or diseased
• Once cause determined, client and doctor can decide on best therapy
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Otitis Media
• Inflammation of middle ear
• Symptoms:– Ear pain, fever, redness of auricle and ear
canal, and sometimes enlarged lymph nodes
• Treatment:– Topical heat, analgesics, antihistamines,
decongestants, antibiotics, myringotomy, and tympanoplasty
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Otitis Media
• What treatments would be used for this problem
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Myringotomy
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Otitis Externa
• Also known as swimmer’s ear
• Bacterial infection of external ear canal
• Symptoms:– Red and edematous canal skin, mild
conductive hearing loss, and discharge
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Ménière’s Disease
• Also known as endolymphatic hydrops
• State of hearing loss characterized by tinnitus and vertigo
• Symptoms:– Classic triad of vertigo, tinnitus, and unilateral
fluctuating hearing loss
• Treatment:– Drugs, surgery, and dietary changes
(continued)
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Otosclerosis
• Most common conductive hearing loss• Secondary to pathologic change of bones
in middle ear• Symptoms:
– Subtle changes in hearing and low-pitched tinnitus
• Treatment:– Do nothing, hearing aids, and surgical
stapedectomy
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Acoustic Neuroma
• Slow-growing and usually benign tumor of vestibular portion of inner ear cranial nerve VIII
• Symptoms:– Dizziness, tinnitus, and hearing loss– May involve other cranial nerves with tumor growth
• Treatment:– Short-term pharmacological therapy and surgical
excision of tumor
(continued)
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Mastoiditis
• Inflammation of mastoid
• Causes:– Chronic or recurrent bacterial otitis media
• Symptoms:– Earache, fever, headache, and malaise
• Treatment:– Antibiotics and surgical intervention
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Taste
• Serves as protector
• Provides delightful sensations
• Can be altered secondary to neurological disorders or trauma
• Works very closely with sense of smell
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Smell
• Serves as guardian from danger
• Disorders of olfactory sense often go unnoticed
• Body cannot regenerate olfactory cells
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Touch
• Sensations pertaining to skin
• Tactile receptors located throughout integumentary system
• Clients with reduced or loss of tactile sensation risk injury when condition confines them to bed
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Chapter 60
Infants with Special Needs:Birth to 12 Months
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Otitis Media
• Inflammation of middle ear
• Symptoms:– Irritability, pulling at infected ear, diarrhea, vomiting,
fever, and hearing loss
• Prevention:– Proper positioning when feeding and smoke-free
environment
• Treatment:– Medications and myringotomy for recurrent
infections(continued)