Many of us received vision and hearing tests at a very young age. Discuss the different types of diagnostic testing pertaining to the eyes or ears that you or someone you know has received. Use proper medical terminology when describing the testing and the related diagnosis.

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Nelly StrackeLv2

29 Sep 2019

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Discussion: Assessing the Ears, Nose, and Throat Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test. In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions. Note: By Day 1 of this week, your instructor will have assigned you to one of the following case studies to review for this Discussion. Also, your Discussion post should be in the SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in the Week 4 Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case. Case 1: Nose Focused Examination Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he's taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous. To prepare: Review this week's Learning Resources and consider the insights they provide. Consider what history would be necessary to collect from the patient. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient's condition. How would the results be used to make a diagnosis? Identify at least 10 possible conditions that may be considered in a differential diagnosis for the patient. Note: Before you submit your initial post, replace the subject line (âWeek 5 Discussionâ) with âReview of Case Study ___,â identifying the number of the case study you were assigned. Post a description of the health history you would need to collect from the patient in the case study to which you were assigned. Explain what physical exams and diagnostic tests would be appropriate and how the results would be used to make a diagnosis. List five different possible conditions for the patient's differential diagnosis and justify why you selected each.

What bones, muscles, ligaments, and/or tendons do you think are affected? Why? Note: Since you are a physician, be sure to use the correct anatomical name(s) for muscles and bones (e.g. use "gluteus maximus" instead of "butt muscle").

Which type of diagnostic imaging will you use to determine if your prediction is correct? Why? Is there a known treatment for problem? If so, what would you prescribe?

Keep in mind that there may be multiple correct answers for each case study, as pain may be caused by a variety of factors. You are only required to describe one possible scenario and how you would proceed as a physician. Feel free to use any available resources to help you diagnose and treat your patients as accurately as possible.

Case Studies

Case Study #1 Age: 75 Sex: Female Report: The patient was admitted to the emergency room with complaints of severe right hip pain after falling down the stairs. The upper leg and hip area are swollen and bruised, and the patient is unable to put weight on the right leg. In addition, the patient has a family history of osteoporosis.

Case Study #2

Age: 23 Sex: Male Report: The patient was taken to the emergency room via ambulance after falling at a ski jump competition. The patient is describing severe pain in the back of the left knee with significant swelling. Onlookers reported hearing a faint popping sound when the patient fell.

Case Study #3

Age: 34 Sex: Male Report: The patient, a soccer player in the 2014 FIFA World Cup, is complaining of sharp pain in the back of the left thigh. The area is slightly swollen and tender to the touch, and the patient reports weakness in the left leg. Case Study #4 Age: 42 Sex: Female Report: The patient, a cyclist, fell off of her bike after hitting a pothole in the road. She extended her right arm to break the fall, then immediately had a sharp, persistent pain in her shoulder. Her arm and shoulder are sagging, and she is unable to lift her arm.

ivorycheetah911

Exercise #5: The Nervous system and Perception

Task #1: Color vision

Introduction

In the human retina, there are two kinds of light-sensitive cells: rods and cones. These cells are located on the outside of the retina, away from the vitreous humor and against the choroid layer, and are covered by a later of bipolar and ganglion cells as well as neurons. Light enters the posterior chamber through the lens and must pass through several cell layers before it is absorbed by the rods and cones.

Cones are involved in color vision at daylight intensities. Generator potentials in a cone excite one neuron, giving high-level resolution vision. Cones will not cause neural firing at low light intensities and are, therefore, nonfunctional at night.

Rods provoke black-and-white vision at low light intensities. A bipolar cell associates with several rods, so that generator potentials sum in their effect. This assures neuronal firing at low light intensities and provides a highly sensitive vision but with less resolution.

Receptor convergence. A ganglion cell, which receives input from a number of rods, spread out over the retina, cannot pinpoint the source of a light stimulus as well as a ganglion cell, which is stimulated by a single photoreceptor. In the case of a ganglion cell receiving the added input of several rods, light hitting any one of the rods can cause a neural spike in the ganglion cell, but the brain has no way to know which rod was excited. It is therefore harder to pinpoint the location of light stimuli on the retina when the stimulus is detected by rods (as compared to cones). The result is that our ability to see detail, or our resolving power, is considerably lower under dim light conditions than under bright light conditions.

Dark adaptation. If you go from a lighted area to a very dark room, you will not be able to see. After about ten minutes, however, you begin to be able to see again. This occurs because the rhodopsin pigment, which gets broken down when it absorbs light, is continually re-synthesized in the rods. When there is very little light, very little rhodopsin gets broken down and the amount of rhodopsin gradually builds up, making the rod much more sensitive to dim light.

When light strikes a receptor cell, it triggers a photo-chemical reaction that leads to neuronal firing. If a rod or cone receives high-intensity light, the visual pigments will be temporarily bleached and will not absorb any more light. Within a matter of a few seconds, enzyme systems in the cells will restore the visual pigment to its light-absorbing form. This can be easily demonstrated. If, after viewing a bright light, the eye is quickly shut or turned to a dark wall, the bright image will persist as a positive afterimage because the high generator potential causes the continued firing of neurons. If the eye is cast on a lighter background after a few seconds, a negative afterimage, or a dark image of the object will appear. This is because the still bleached cells are not receptive to the light coming from the light background.

According to the Young-Helmholtz theory of color vision, there are three types of cone cells, which respond respectively to red, green, and blue light.

All other colors are perceived as the brain interprets impulses coming from a mix of these receptors. If an object of one color is viewed for a long period of time at high light intensity, the cones for that color will become bleached. The afterimage of the object will be seen in the complementary color.

The Exercise 6 PowerPoint will demonstrate afterimages to you. Use the slide show option to project the square of red light on your entire screen in a dark room. After staring intensely at the square for 30 seconds or so, without shifting your gaze, click enter to change the slide to a soft white. Continue staring at the screen as the change is made. What do you see? What was the color of the afterimage?

Repeat this experiment using a blue square. Before doing the experiment, hypothesize what color the afterimage will be according to the Young-Helmholtz theory.

Hypothesis to be tested: (2 pts)

What did you see when the experiment was conducted? (2 pts)

Was you hypotheses accepted or rejected? (1 pt)

Explain the colors seen in these afterimages using the Young-Helmholtz theory. (5 pts)