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Key Term AssessmentA. Definitions?1.?L9.F?2.?J10.H?3.?E11.B?4.?I12.D?5.?C13.K?6.?M?7.?G?8.?AB. Word PartsDirections: Indicate the meaning of each word part in the space provided. List as many medical terms as possible that incorporate the word part in the space provided.Word PartMeaning of Word PartMedical Terms That Incorporate Word Part?1. a-without?2. stigma/apoint?3. -ismstate of?4. audi/ohearing?5. -meterinstrument used to measure?6. hyper-above, excessive?7. -opiavision?8. ot/oear?9. -scopeto view, to examine10. tympan/oeardrum11. -icpertaining toEvaluation of Learning1.What is the name of the tough white outer layer of the eye?Sclera.2.What is the function of the lens?To focus the light rays on the retina.3.What is the function of the retina?Light rays are focused on the retina and transmitted to the brain to be interpreted.4.What parts of the eye are covered with conjunctiva?The eyelids and the front of the eye, except for the cornea.5.What is visual acuity?Acuteness or sharpness of vision.6.What type of symptoms might be experienced with myopia?Squinting and headaches as a result of eye strain.7.What methods can be used to correct myopia?Corrective lenses such as eyeglasses and contact lenses; laser eye surgery.8.What causes an individual with astigmatism to have distorted and blurred vision?Light rays focusing on two different points on the retina.9.What are each of the following eye professionals qualified to perform?a.Ophthalmologist An ophthalmologist is a physician who specializes in diagnosing and treating diseases and disorders of the eye. An ophthalmologist is qualified to prescribe ophthalmic and systemic medications and to perform eye surgery.b.Optometrist An optometrist is a licensed primary health care provider who has expertise in measuring visual acuity and prescribing corrective lenses. An optometrist can also diagnose and treat disorders and diseases of the eye and prescribe ophthalmic medication.c.Optician An optician is a professional who interprets and fills prescriptions for eyeglasses and contact lenses.10.What condition can be detected by measuring distance visual acuity?Myopia.11.What type of patient would warrant use of the Snellen Big E eye chart? (Give two examples.)Preschool children, non–English-speaking people, and nonreaders.12.Explain the significance of the top number and bottom number next to each line of letters on the Snellen eye chart.The number above the line represents the distance (in feet) at which the test is conducted. The number below the line represents the distance from which a person with normal visual acuity can read the row of letters.13.List two conditions that can be detected by measuring near visual acuity.Hyperopia and presbyopia.14.Explain the difference between congenital and acquired color vision defects.A congenital color vision defect is inherited and present at birth; an acquired color vision defect is obtained after birth, resulting from eye or brain injury, disease, or certain drugs.15.What is a polychromatic plate?A polychromatic plate consists of primary colored dots arranged to form a numeral against a background of similar dots of contrasting colors.16.List three reasons for performing eye irrigation.To cleanse the eye, to relieve inflammation, and to apply an antiseptic solution.17.List three reasons for performing eye instillation.To treat eye infections, to soothe an irritated eye, to dilate the pupil, and to anesthetize the eye.18.What is the function of the ear auricle?To receive and collect sound waves and to direct them toward the external auditory canal.19.What is the function of cerumen?To lubricate and protect the ear canal.20.Explain why the external auditory canal must be straightened when viewing it with an otoscope.The canal has an S-shaped curve as it leads inward.21.What is the normal appearance of the tympanic membrane?Pearly gray semitransparent membrane.22.What is the purpose of the eustachian tube?It connects the middle ear to the nasopharynx.23.What is the function of the semicircular canals?To maintain equilibrium.24.What is the range of frequencies for normal speech?300 to 4000?Hz.25.List five conditions that may cause conductive hearing loss.Obstruction in the external ear canal (impacted cerumen, swelling, foreign body, benign growths such as polyps); fluid (serous otitis media) or infection (acute otitis media) in the middle ear; a perforated tympanic membrane; and otosclerosis.26.List four conditions that may result in sensorineural hearing loss.Hereditary factors, degenerative changes from normal aging process (presbycusis), intense noise exposure over time, tumors, ototoxicity caused by certain medications, and infectious diseases (measles, mumps, meningitis).27.How is hearing acuity tested with the gross screening test?By asking the patient to repeat a simple word or series of numbers whispered from a distance of 1 to 2 feet from the ear.28.What are the names of the hearing acuity tests that require the use of a tuning fork?Weber test and Rinne test.29.What information is obtained through audiometry?It provides information on the extent of hearing loss and which frequencies are involved.30.What information is obtained through tympanometry?It helps determine the cause of hearing loss, in particular, fluid in the middle ear (serous otitis media).31.List three reasons for performing ear irrigation.To cleanse the auditory canal to remove cerumen, discharge, or a foreign body; to relieve inflammation by applying an antiseptic solution, and to apply heat to the ear.32.List three reasons for performing ear instillation.To soften impacted cerumen, to combat infection with antibiotic ear drops, and to relieve pain.33.Explain how impacted cerumen is removed from the ear.First, soften the cerumen by instilling warm mineral oil or hydrogen peroxide; next, perform an ear irrigation.34.Explain how to straighten the external auditory canal in an adult and in children 3 years old or younger.In adults, pull the ear upward and backward. In children, pull the ear downward and backward.Critical Thinking ActivitiesA. Measuring Distance Visual AcuityFor each of the following situations, write C if the technique is correct and I if the technique is incorrect.1.?The patient is not given an opportunity to study the Snellen chart before beginning the test. C.2.?The Snellen chart is positioned at the medical assistant’s eye level. I.3.?The patient is instructed to use his hand to cover the eye that is not being tested. I.4.?The medical assistant instructs the patient to close the eye that is not being tested. I.5.?The first line that the medical assistant asks the patient to identify is the 20/20 line. I.6.?The medical assistant observes the patient for signs of squinting or leaning forward during the test. C.B. Interpreting Visual Acuity Results1.A patient has a distance visual activity reading of 20/30 in the right eye. Using this information, answer the following questions:a.How far was the patient from the eye chart? 20 feet.b.At what distance would a person with normal acuity be able to read this line? 30 feet.2.A patient has a distance visual activity reading of 20/10 in the left eye. Using this information, answer the following questions:a.How far was the patient from the eye chart? 20 feet.b.At what distance would a person with normal acuity be able to read this line? 10 feet.C. Charting Visual Acuity ResultsProperly chart the distance visual acuity results in the spaces provided. In all cases, the line indicated is the smallest line the patient could read at a distance of 20 feet.1.?The patient read the line marked 20/30 with the right eye with two errors and with the left eye, he read the line marked 20/30 with one error. The patient was wearing corrective lenses.Date, Time; Snellen test, cc: OD 20/30 -2. OS 20/30 -12.?The patient read the line marked 20/20 with the right eye with one error and with the left eye, he read the line marked 20/20 with no errors. The patient was wearing corrective lenses.Date, Time; Snellen test, cc: OD 20/20 -1. OS 20/203.?The patient read the line marked 20/40 with the right eye with two errors and with the left eye, she read the line marked 20/30 with one error. The patient exhibited squinting and frowning during the test. The patient was not wearing corrective lensesDate, Time; Snellen test, sc: OD 20/40 -2. OS 20/30 -1. Exhibited squinting and frowning4.?The patient read the line marked 20/15 with the right eye with no errors and with the left eye, she read the line marked 20/20 with one error. The patient was not wearing corrective lenses.Date, Time; Snellen test, sc: OD 20/15. OS 20/20 -1D. Ear ProceduresExplain the principle for each of the following procedures.Ear Irrigation1.Positioning the patient’s head so that it is tilted toward the affected ear To allow gravity to aid in the flow of solution out of the ear and into the basin2.?Cleansing the outer ear before irrigating To prevent foreign particles from entering the ear canal during the irrigation3.?Straightening the external auditory canal Permits the irrigating solution to reach all areas of the canal4.?Injecting the irrigating solution toward the roof of the ear canal To prevent injury to the tympanic membrane and to aid in the removal of foreign particles5.?Making sure not to obstruct the canal opening Obstruction of the canal opening may result in patient discomfort and injury to the tympanic membrane.Ear Instillation6.Positioning the patient’s head so that it is tilted toward the unaffected ear Gravity aids in the flow of medication into the ear canal.7.?Instructing the patient to lie on the unaffected side after the instillation Lying on the unaffected side prevents the medication from running out and allows complete distribution of the medication.8.?Placing a cotton wick in the patient’s ear Prevents the medication from running out when the patient stands or sits up.E. Dear GabbyG. Eye and Ear Conditions1.?You and your classmates work at a large clinic. It is National Eye and Ear Week. The physicians at your clinic ask you to develop informative, creative, and colorful brochures about eye and ear conditions. Choose a condition and design a brochure using the blank Frequently Asked Questions (FAQ) brochure provided on the following page. Each student in the class should select a different topic. On a separate sheet of paper, write three true/false questions related to the information in your brochure.2.?Present your brochure to the class. After all the brochures have been presented, each student should ask his or her three questions to the entire class to see how well the class understands eye and ear conditions. (Note: You can take notes during the presentations and refer to them when answering the questions.)Eye1.Amblyopia (lazy eye)2.Age-related macular degeneration3.Astigmatism4.Blepharitis5.Cataracts6.CMV retinitis7.Corneal ulcer8.Corneal abrasion9.Strabismus (cross-eyed)10.Diabetic retinopathy11.Drooping eyelids (ptosis)12.Dry eyes13.Floaters and spots14.Glaucoma15.Keratoconus16.Ocular hypertension17.Presbycusis18.Retinal detachment19.Retinitis pigmentosa20.StyeEar1.?Acute mastoiditis2.?External otitis3.?Meniere’s disease4.?Noise-induced hearing loss5.?Serous otitis mediaAPPLY YOUR KNOWLEDGEChoose the best answer to each of the following questions.1. A. 2.D 3. B4. D5. B6. A7. B8. B9. D10.AVIDEO EVALUATION for CHAPTER 6: EYE AND EAR ASSESSMENT AND PROCEDURESName: Directions:a.Watch the indicated videos.b.Mark each true statement with a T and each false statement with an F. For each false statement, change the wording of the question so that it becomes a true statement.Video: Procedure 6-1: Assessing Distance Visual Acuity____F___1.The distance visual acuity test is performed to screen for the presence of hyperopia.____T___2.Preschool children, non–English-speaking people, and nonreaders are tested using a Snellen Big E chart.____F___3.The Snellen eye test is performed at a distance of 10 feet.____T___4.The patient should be instructed to wear his glasses or contact lenses for a distance visual acuity test unless they are for reading.____F___5.The occluder should be placed over the eye being tested.____T___6.Squinting in the eye being tested can temporarily improve vision leading to inaccurate test results.____T___7.During the test, you should check for squinting, head tilting and eye watering.____T___8.If the patient misses more than three letters on a line, the previous line is recorded.____T___9.Chart whether or not the patient is wearing corrective lenses during the test.____F___10.The abbreviation for the right eye is OS.Video: Procedure 6-2: Assessing Color Vision____T___1.The Ishihara test is a convenient and accurate method to detect congenital color blindness and red-green blindness.____T___2.Patients with color vision defects see no number at all or a different number on the plates.____F___3.Using natural lighting may change the shades of the colors on the plates, and this could cause an inaccurate reading.____T___4.The first plate is a practice plate that is designed to be read correctly by everyone.____F___5.Hold the first plate 60 inches away from the patient at a right angle to the patient’s line of vision.____F___6.The patient should be given 15 seconds to identify each plate.____T___7.Do not allow the patient to touch the plate with his fingers as any dirt or grime on the fingers can alter the colors over time.____F___8.Chart an “X” if the patient reads a plate correctly.____T___9.Chart “Traceable” if the patient could correctly trace a winding line.____T___10.Store the book in a closed position to keep light from fading the colors on the plates.Video: Procedure 6-3: Performing an Eye Irrigation____T___1.An eye irrigation involves washing the eye with a flowing solution.____T___2.An eye irrigation may be performed to wash away foreign particles, ocular discharges, or harmful chemicals.____F___3.If both eyes are to be irrigated, one set of equipment is used to prevent cross-infection from one eye to the other.____T___4.Normal saline, also known as sodium chloride, usually is used to irrigate the eye.____T___5.Check the solution label three times.____T___6.If the solution is outdated, it may produce undesirable effects.____F___7.Warm the solution to room temperature.____T___8.Palm the label of the container to prevent the solution from dripping on the label and obscuring it or loosening the label.____F___9.Ask the patient to tilt her head to the side in the direction of the unaffected eye.____F___10.Before irrigating, cleanse the eyelids from the outer to the inner canthus.____T___11.Instruct the patient to keep both eyes open during the procedure.____T___12.Gently release the solution onto the eye at the inner canthus.____F___13.Direct the solution toward the cornea of the eye.____T___14.Do not allow the tip of the syringe to touch the eye as this can cause an injury.____T___15.Following the procedure, dry the eyelids with a gauze pad.Video: Procedure 6-4: Performing an Eye Instillation____T___1.An eye instillation involves the dropping of a liquid into the lower conjunctival sac of the eye.____T___2.An eye instillation may be performed to treat infection, soothe irritation, dilate the pupil, or anesthetize the eye during examination or treatment.____F___3.Never place a medication in the eye unless it says otic or eye to avoid injury to the eye.____F___4.If the patient wears contact lenses, they can be left in for the procedure.____T___5.If the medication requires mixing, roll or shake the container well.____F___6.Ask the patient to look down to keep the dropper from touching the cornea and to keep the patient from blinking when the drops are instilled.____F___7.Invert the eye dropper container and hold the tip of the dropper approximately 2 inches above the eye sac.____T___8.Placing the drops directly on the eyeball can be uncomfortable for the patient.____T___9.Ask the patient to close his eyes gently and move the eyeballs to distribute the medication over the entire eye.____F___10.The abbreviation for a drop is dp.Video: Procedure 6-5: Performing an Ear Irrigation____F___1.Ear irrigation is washing of the inner ear with a flowing solution.____T___2.Ear irrigations are performed to cleanse the external auditory canal to remove cerumen, discharge, or a foreign body.____F___3.Impacted cerumen can be softened by instilling warm salt water into the ear.____T___4.Normal saline, also known as sodium chloride, typically is used to irrigate the ear.____T___5.Ear irrigation should never be performed if the tympanic membrane is perforated.____T___6.If the irrigating solution is too hot or too cold, it might stimulate the inner ear and make the patient dizzy.____F___7.Remove the cap of the irrigating solution container and place it on a flat surface with the open end facing downward to prevent contamination of the cap.____F___8.Pour the solution into the basin at a height of approximately 12 inches to reduce splashing.____T___9.The patient should be asked to tilt her head toward the affected ear to allow gravity to help the solution flow out of the ear and into the basin.____T___10.Expel air from the syringe to avoid forcing air into the patient’s ear, which can be uncomfortable for the patient.____F___11.To straighten the ear canal of an adult or a child over age 3, gently pull the ear downward and backward.____T___12.Make sure the tip of the syringe does not obstruct the canal to prevent patient discomfort and possible injury to the tympanic membrane.____F___13.Inject the irrigating solution directly onto the tympanic membrane.____T___14.The patient may experience a minimal amount of dizziness, fullness, and warmth as the ear solution comes in contact with the tympanic membrane.____T___15.After the procedure, ask the patient to lie with the affected side downward to allow any remaining solution to drain out.Video: Procedure 6-6: Performing an Ear Instillation____F___1.An ear instillation involves the dropping of a liquid into the middle ear.____T___2.Ear instillations are performed to soften impacted cerumen, to combat infection with the use of antibiotic ear drops, and to relieve pain.____T___3.The medication label must bear the word otic or ear drops indicating it is for the ear.____F___4.Position the patient in a prone position.____F___5.Warm the ear drops to body temperature by placing the medication container in hot water.____T___6.If the drops are too cold or too warm, they may stimulate the inner ear causing the patient to become dizzy.____T___7.If the medication requires mixing, shake the container well.____T___8.Tilt the patient’s head in the direction of the unaffected ear to allow gravity to help the medication flow into the ear canal.____T___9.Straighten the external ear canal to permit the medication to reach all areas of the canal.____T___10.After the procedure, instruct the patient to keep her head tilted toward the unaffected side for 2 to 3 minutes to prevent the medication from running out of the ear. ................
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