November 11, 2015

SPECIAL SENSORY SYSTEM

DR. LEONARDO A. TORRES, FPSECP,
FPSP, FPSA, RBA-ABI

Aquaeous humor- anterior,

watery clear fluid, produced in
middle layer
Cataract- prolonged steroids,
alcohol
Glaucoma- diabetes
CORNEA
Conjunctival fluid secreted by
lacrimal gland
PUPIL- passage of light
IRIS-curtain of the eye, regulates
the opening and closing of the
smooth muscle (an effect of ANS)
MYDRIASIS- dilatation (SNS)
MEOSIS- constriction
(PNS/cholinergic)
APERTURE-dilate and constrict
NORMAL PUPILLARY REFLEX
POSTERIOR CHAMBER- contains
gel-like vitreous humor
RETINA- where image is produced,
image is inverted. Most important
structure-contains RODS AND
CONES. Has 10 layers
RODS AND CONES- for reception
of vision, 2nd layer of retina
Inner membrane is internal limiting
membrane

VISION (EYEBALL):
VISUAL ACUITY- clearness of vision
Error of refraction common in the
young

Test for visual acuity:

1. SNELLENS- 20 feet distance,
identify letters
NORMAL-emmetropia= normal
vision 20/20.
2. JAEGERS- near distance
3. ISHIHARAS- test for color vision
FACTORS FOR VISUAL AQUITY
1) length of time
2) contrasts
3) illumination (brightness)

4) retinal: rods and cones

5) image-forming mechanism of
retina (inverted)

Unit of measurement for refraction:

DIOPTERs 10 Diopters= 1/ 10 M. =
10 CM.

REFRACTIVE ERRORS
Emmetropia - 20 / 20
Normal, light focuses on the
retina
Hyperopia (farsighted) aphakia (absence of crystalline
lens)
light focuses behind the retina
and is corrected with a convex
lens
Myopia (nearsighted) prematurity, common in the
young
light focuses in front of the retina
and is corrected with a
biconcave lens
Presbyopia
Senility
Loss of accommodation power of
the lens that occurs with aging
Corrected with convex lens
Astigmatism
abnormal curvature of cornea and
lens. Can be due to keratitis
corrected with cylindric lens
*most common keratitis- herpes
simplex virus of the eye

*uvea- middle, choroid, iris and

cillary body
*ciliary muscle- smooth muscle
and suspensory ligament=
responsible for accomodation
RECEPTOR POTENTIALS of RETINA
Pigment cells
Needed in synthesis of vitamin Aretinoic acid.
convert all-trans-retinal to 11-cisretinal (vitamin a)
absorb stray light
Rods and cones
Only special sense that produce
negative active potentialHyperpolarization

Not present on the optic disk=

blind spot
Bipolar cells
Receptor cells synapse on bipolar
cells, which synapse on the
ganglion cells
Hyperpolarization
Horizontal cells and Amacrine
cells

**NYCTALOPIA- nightblindness
**XEROSIS/XEROPTHALMIAdeficiency of vitamin a leading to dryness
Functions of RODS and CONES
sensitivity
acuity

Dark
adaptation
Color
vision
produce

RODS
Greater
sensitivity
(night)
Lower
(absent
fovea
centralis)
Late
adaptation
no

CONES
Low
sensitivity
(day)
High
(present
fovea
centralis)
Occur first

Rhodopsin
(black and
white)

Photopsin/
scotopsin
(color)

yes

Photoreception pathway:
a. 11-cis-retinal (light)
b. all-trans-retinal (ab
-Photoisomerization)
c. metarhodopsin II
d. g-protein activation
(transducin)
e. pde (phosphodiesterase)
f. (cgmp) cyclic guanosine
monophosphate decrease
g. na-channel blocked
h. hyperpolarization
i. decreased excita./ inhibition
neurotransmitters- glutamate
VISUAL PATHWAYS:

Combination of hyperpolarization /
-lateral inhibition Depolarization
Ganglion cells Output cells of retina
spike-potential- highest peak of
action potential ( depolarization)
Part of cn2 optic

Rods and cones

Inner nuclear layer
ganglion cell layer
optic nerve- cutting causes blindness
in the ipsilateral eye.
optic chiasm- most common
optic tract
superior colliculi (optic ganglia)
lateral geniculate body- 4 nerve fiber:
2 upper, 2 lower (optic radiation)
calcarine (occipital): 17, 18-19, 20-21
LESIONS IN VISUAL PATHWAYS:
Total blindness optic nerve
bitemporal heteronomous
hemianopsia
o optic chiasm
ipsilateral nasal hemianopsia
o optic chiasm ( 1-side )
Contralateral homonymous
hemianopsia
Optic radiation
1. Contralateral lower quadrantic
anopsia- Lower optic radiation
2. Contralateral uppper quadrantic
anopsia- Upper optic radiation
**calcarine area- ALEXIA
DIRECTIONS OF GAZE
Superior rectus / inferior rectus
Medial rectus / inferior oblique
N.s. : 3rd cn
Lateral rectus n.s. : 6th cn
Superior oblique n.s. : 4th cn
Other ocular defects: sx / sy:
Ametropia- total blindness,
absence of vision (ophthalmoscope)
Asthenopia- aye fatigue/strain
(tonometer)
Anisometropia- different size and
shape of the image

Aniseikonia- eye dust

Alexia

Hearing
Sound waves:
frequency- hertz (hz)
intensity- decibels (db)
**audiometry
Sound conduction (air):
1. EXTERNAL EAR
pinna
external auditory canal
2. MIDDLE EAR
Air-filled
tympanum- boundary, part of middle
ear
-most common injured
-otitis media
3 pairs of ossicles
malleus- hammer
incus- bell
stapes- cup
(tensor tympani- attached to
tympanum / stapedius-attached to
stapes)

3. INNER EAR
Fluid-filled
membranous labyrinth (oval window)
COCHLEA
scala vestibuli (perilymph)-upper /
s.tympani (perilymph)- lower
basilar membrane
reception for hearing
apex (helicotrema) /base ( round
window)
organ of corti (scala media-with clear
fluid endolymph at the middle )
outer and inner hair cells (receptors)
spiral ganglion of corti (modiolus)
cochlear (acoustic) nerve - VIII CN
medial geniculate body (auditory
radiation)
located at the superior Temporal
gyrus:
1st (primary) reception (gyrus of
heschel)
2nd (secondary) interpret (auditory
Aphasia)

RECEPTOR POTENTIAL:
Back and forth bending of hair cells

basilar fibers bend upward (s.v.):

depolarization
basilar fibers move downward (s.t.):
hyperpolarization
endocochlear potential:
Scala Media (endolymph)
high k/low na
resting membrane potential = + 80
mv.
Scala Vestibuli / scala Tympani
(perilymph)
high na/low k

POWER LAW: changes in loudness

( decibels )
BONE CONDUCTION:
Mastoid, temporal, fluids
FREQUENCY RANGE:
NORMAL YOUNG= 20 20,000 C / SEC.
OLD AGE= 50 8,000 C / SEC.
Attenuation reflex : protective

1st auditory cortex:

reception
Discrimination (pitch)
place principle: high frequency
Tone / sequence
resonance /
2nd interpretative area:
wernickes area
amplitude of vibration
Auditory agnosia

Hearing defects:
Nerve deafness - CN VIII
Old age (cochlear)
**streptomycin-deafness, 8th CN
damage
Rock band /jet airplane (low)
Drug toxicities: (high)
Conduction deafness:
middle ear disease- otitis media- most
common in young children
Fibrosis (infections)-collagenous tissue,
impacting ear
Otosclerosis (hereditary cause of
conduction deafness)- hardening of the
ear
Bone conduction normal
Audiometry: dx detect hearing

REMEMBER:

Primary auditory receptive area: GYRUS OF

HESCHEL
HAIR CELL BENDING OUTWARD,
DEPOLARIZATION

OLFACTION
Olfactory membrane/meatus (nose)
upper /middle
Olfactory hair cells (bipolar)
receptive: =100 million cells
Sustentacular cells
Glands of bowmans - produce mucus,
responsible for stimulation for sense of
smell
Olfactory stimulants:
Volatile, least h20-soluble, fat-soluble

Receptor potential:
Olf. Hair cells: odor stimulants
Activated G-proteins increased
Camp Na-channel opens
Depolarization
Adaptation: slow = 50% only

Olfactory stimulants:
low threshold, low gradations
affective
camphoraceous
musky
floral
pepperminty
ethereal
pungent
putrid
Cns pathways:
olfactory cells olfactory bulb mitral
cells (tufted) olf.nerve ( cn i and cn v
) olfactory Tractlateral Olfactory
Area (at temporal lobe):pre-pyriform
cortex / amygdala (limbic system)
Odor blindness:
Anosmia- loss of sense of smell
Hyposmia- decreased
Hyperosmia- increased
Dysosmia- distorted sense of smell