Bài giảng Medical Assisting - Chapter 39: Providing Eye and Ear Care

ChapterPowerPoint® to accompany Second EditionRamutkowski  Booth  Pugh  Thompson  WhickerCopyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.Medical AssistingChapter 391Objectives:39-1 Describe the anatomy and physiology of the eye. 39-2 State the ways that vision changes with age.39-3 Describe ways to detect vision problems.39-4 List treatment of eye disorders.39-5 Identify ways that patients can practice preventive eye care.39-6 Describe the anatomy and physiology of the ear.Providing Eye and Ear Care 2Objectives (cont.)39-7 State ways that hearing changes with age.39-8 List the types of hearing loss.39-9 Explain the procedures for screening and diagnosing ear problems.39-10 Describe treatments for ear and hearing disorders.39-11 Explain how patients can be educated about preventive ear care.Providing Eye and Ear Care3Introduction Duties may involve performing basic tests for vision and hearingYou may also assist the doctor in providing treatment related to eyes and ears You will need to know the basic structure and function of these organs and to advise patients about general eye and ear care and concerns.4Vision EyeScleraCorneaChoroidIris, pupil, ciliary body, lens, aqueous humor & vitreous humorInner layerRetina Rods ConesCan you identify the parts of this eye?5Process of SeeingEye works like a cameraLight passes through the cornea, pupil, lens & fluids of the eye which focuses the light onto the retinaThe image is projected upside down on the retinaRetina converts the light into nerve impulses that are sent to the brain The brain interprets these impulses, turns the image right-side up and develop a picture of the object.6The Aging Eye With age, changes occur in the eye:Amount of fat tissue diminishes – may cause droopy eyelidsQuality & quantity of tears decreaseConjunctiva becomes thinnerCornea begins to appear yellowSclera may develop brown spots7The Aging Eye (cont.)With age, changes occur in the eye:Iris causes the pupil to become smallerLens becomes denser and more rigidChanges in the retina may make vision fuzzyAbility to adapt to changes in light intensities may be reducedNight vision may be impaired8The Aging Eye (cont.) With age, changes occur in the eye:Peripheral vision is reducedVitreous humor breaks down causing the patient to see floatersRubbing of the vitreous humor on the retina produces flashes of lights or “sparks’9Vision TestingOphthalmologist – medical doctor who is an eye specialist.Vision Tests performed:Distance vision – Snellen chartNear vision – handheld chartsContrast sensitivity – Pelli-Robson contrast sensitivity chartColor Vision – Richmond pseudoisochromatic color testCan you identify the number in this portion of the color vision test?10Treating Eye ProblemsCommon eye problems Conjunctivitis – inflammation of the conjunctivaBlepharitis – inflammation of the eyelidCorneal abrasions – scratching of the cornea11Administration of Eye MedicationsTeach the patient to check medication labels carefully before administering them at home.Optic medications for use in the eye can easily be confused with Otic medications for the ear.Medications other than optic meds may be too concentrated and injure sensitive eye tissue. 12Eye Irrigation Foreign materials in the eye must be flushed out.Flushing or irrigation should be done with sterile solution formulated for this purpose.Will relieve discomfort from smog, pollen, chemicals, or chlorinated water.13Vision AidsCommon refractive disorders MyopiaHyperopiaPresbyopiaAstigmatismOptometrist – trained to prescribe corrective aids 14Apply Your Knowledge You are performing vision testing on a patient who wears glasses. What is a common order for testing the eyes? Number the list from 1 to 6. _____ Both eyes without glasses_____ Left eye with glasses_____ Right eye without glasses_____ Both eyes with glasses_____ Left eye without glasses_____ Right eye with glasses15Apply Your Knowledge -Answer You are performing vision testing on a patient who wears glasses. What is a common order for testing the eyes? Number the list from 1 to 6. __1__ Both eyes without glasses__6__ Left eye with glasses__2__ Right eye without glasses__4__ Both eyes with glasses__3__ Left eye without glasses__5__ Right eye with glasses16Hearing Hearing depends on normal transmission of nerve impulses from the ear to the brain17The EarExternal earAuricleTympanic membraneMiddle earMalleusStapesIncusInner ear - labyrinthCochleaSemicircular canalsCan you identify the parts of this ear?18Hearing ProcessSound enters the external ear which makes the eardrum vibrate.The middle ear amplifies the vibrations and the waves cause the tiny hairs to the cochlea to bend.Movement of the hairs triggers nerve impulses.The impulses are transmitted via auditory nerve to the brain.The brain perceives the sound.19Ear and BalanceThe brain constantly monitors the position of one’s body on the information received from the semicircular canals, eyes, and muscles. A change in position is detected by the canal and passed to the brain. The brain uses this information to maintain balance.20The Aging Ear The external ear appears larger – caused by growth of cartilage and loss of skin elasticity.Ear lobe gets longer and may be wrinkled. Less production of cerumen.Middle ear begins to shrink and appears dull and gray.Bones of the middle ear degenerate and don’t move as freely.Semicircular canals become less sensitive and cause a reduced sensitivity affecting balance.21Hearing LossTypes of hearing lossConductive – caused by interruption in transmission of sound waves to the inner earCaused by obstruction of the ear canal,Infection of the middle earReduced movement of the incusSensorineural –caused when there is damage to the inner ear, the nerve that leads from the ear to the brain, or the brain itself.22Working with Patients with a Hearing ImpairmentOne-third of patients between 65 and 75 and one-half of patients between 75 and 79 have some hearing loss.Many patients wear hearing aids to amplify normal speech.23Improving CommunicationsSpeak at a reasonable volumeDon’t shoutSpeak in clear, low-pitched tonesAvoid speaking directly into the patient’s ear.Stand 3 to 6 feet away and face the patientAvoid overemphasizing your lip movements.Avoid hand gesturesTreat patients with a hearing impairment with patience and respect24Hearing Tests Hearing TestsAudiometer – electronic device that measures hearing acuity by producing sounds in specific frequencies and intensitiesTuning forks – differentiating conductive from sensorineural hearing loss25Diagnostic TestingTympanometry – measures eardrum’s ability to move and gauges pressure in the middle ear.Used to detect diseases and abnormalities of the middle ear.Uses a small, soft rubber cuff placed over the external ear producing an airtight sealMeasures and prints out a graph of results26Treating Ear and Hearing ProblemsProblemsCerumen impactionRupture of the eardrumOtitis media (inflammation of the middle ear)Otitis externa (inflammation of the outer ear)27Ear Meds and IrrigationYou will teach patients how to administer ear medications at homeIrrigation of the ear may relieve inflammation or irritations of the ear.Irrigation may loosen earwax or foreign body28Hearing AidsHearing aids consist of the following parts:A tiny microphone to pick up soundsAn amplifier to increase the volume of soundsA tiny speaker to transmit sounds to the ear29Hearing Aids (cont.)Otologist – medical doctor specializing in the health of the ear.Audiologist – non-physician specialist who focuses on evaluation and correcting hearing problems.Hearing aids run on batteries for about 2 weeks30Apply Your KnowledgeA six-month old is seen at your clinic. The mother states that the infant has been cranky and pulling at her ears especially when she lays her down. What do you think might be wrong?31Apply Your Knowledge -AnswerThe infant may have otitis media, however a thorough examination of the infant by the physician is necessary.A six-month old is seen at your clinic. The mother states that the infant has been cranky and pulling at her ears especially when she lays her down. What do you think might be wrong?32Summary Medical Assistant You can help prevent, detect and treat eye and ear problems. A basic understanding of the anatomy and physiology of the eyes and ears will help you provide good eye and ear care to patients.33End of ChapterEnd of Chapter34