SENSES ‣ Cornea (transparent) - allows
light to pass into the eye, only
The Eye & Vision
• Orbit: cone-shaped cavity formed by the
skull that houses and protects the eye ; is
padded with fatty tissue that cushions and
protects the eye from injury.
• Lacrimal Apparatus
- Lacrimal gland: produces tears
- Nasolacrimal duct: duct in the
inferior medial corner of the orbit it
drains tears from the lacrimal
canaliculi to the nasal cavity
• Accessory Structures
- Eyelids: so that foreign bodies
wont get in the eye / prevent gross
particles from entering the eye
- Eyebrows: prevents sweat from
the forehead getting to the eye
- Conjunctiva
‣ protects the eye
‣ Thin, transparent mucous
membrane adhering to the
anterior surface of the eye and
lining the eyelids
• Extrinsic eye muscle
Remember:
- SO4 = Superior Oblique (Cranial
nerve 4)
- LR6 = Lateral Rectus (Cranial nerve 6)
Layers of the eye
• Fibrous tunic
- Sclera (white, fibrous)
‣ Outermost layer and is a tough
fibrous tissue that serves as a
protective shield(white of eye)
being protected by the
conjunctiva
part of the body that can be
transplanted without rejection ;
has a curved surface that allows
it to bend the entering light
waves to focus them on the
surface of the retina
• Vascular Tunic
- Choroid: thin & heavily pigmented
region
- Ciliary body/muscles (intrinsic
eye muscles): surrounds the lens,
responsible for accommodation; near
objects = CM contracts + lens become
rounder; far objects = CM relaxes +
lens become ovoid
- Suspensory ligaments: where the
ciliary muscles are attached to the rim
of the lens
- Iris: colored portion of the eye that
controls the diameter of the pupil ;
sphincter (can relax/contract)
- Pupil: where light passes into the eye
‣ Parasympathetic – light
intensity increases; pupillary
constriction
‣ Sympathetic – light intensity
decreases; pupillary dilation
• Nervous Tunic
- Retina: contains the nerve endings
that receive and interpret the rays of
light into images
- Lens: refract & bend light to focus an
object
- Rods: Dim light (black & white)
- Cones: Bright light ; Color (RGB)
- Darker environment, rods tend
to concentrate because it would
help you visualize the
environment despite the
darkness
- Color blindness: green and red
- Green: deuteranopia
- Red: protanopia
Regions of the Retina
1. Macula lutea – small, yellow spot near the
center of the posterior retina
‣ Fovea centralis – region of sharpest
vision; where light is most focused
2. Optic disc – white spot through which a no.
of blood vessels enter the eye;
‣ Blind spot of the eye – contains no
photoreceptor cells and doesn’t
respond to light
Light rays —> conjunctival membrane —>
cornea —> aqueous humor —> pupil —> lens
—> vitreous humor —> retina
Acuity: sharpness of the visual image
Astigmatism: abnormal curvatures of the cornea
Accommodation: ability to adjust the focusing
apparatus to account for changes in distance from
the viewed object
Eye reflex
- Photo-pupillary reflex
- Accommodation pupillary reflex
- Start diagonal then check for
consensual response
- What to check in eye reflex? = PERLA
• Pupil size
• Equality
• Round (shape)
• Light
• Accommodation (a patient would
focus on a far object and then a
nearer object)
‣ far object = pupils dilate
‣ near object = pupils constrict
• Night blindness - rods
• Color blindness - cones
• Glaucoma - blindness bc of increasing pressure
in the eye
Chambers of the Eye
• Anterior chamber
‣ Aqueous humor – watery fluid;
provides nutrients to the eye; helps
maintain pressure within the eye,
refracts light, provides nutrients
‣ Glaucoma – increase in the intraocular
pressure due to blockage of AH flow
• Posterior chamber
‣ Vitreous Humor - transparent, jelly-
like substance; helps maintain pressure
within the eye, holds the lens and
retina in place; does not circulate ;
prevents the eye from collapsing
The Ear, Hearing and Equilibrium
• The Ear - houses hearing and balance
• Ear Structure
๏ External
- Auricle/pinna: collects sound
waves to focus on the ear ;
radiator in thermoregulation
- External auditory canal: tubelike
passage carries airborne sound
waves farther into the ear
apparatus
- Tympanic membrane: eardrum;
covers the end of the EAC to
form a boundary bet. the middle
ear, amplifies sound
๏ Middle
- Ossicles (Malleus, incus, stapes)
- Air filled cavity within the
temporal bone ; pinapalakas yung
sound waves kasi air filled
- Ossicles amplify up to 60h
- Oval window: passage into the
inner ear
- Eustachian tubes: allows
internal air pressure to equalize
with atmospheric air pressure
๏ Inner Ear
- Bony labyrinth, semicircular
canals
- Vestibule & semicircular
canals: balance
- Cochlea: long passage coiled
like a snail
- Endolymph: fluid inside the
membranous labyrinth
- Perilymph: fluid outside the
membranous labyrinth
 - Scala vestibuli: space outside
the vestibular membrane
- Scala timpani: space outs the
basilar membrane
- Motion sickness - associated
with the endolymph
- Spiral organ of Corti -
houses cochlea and cochlear
nerve
Vestibule
- Central area of the inner ear, contains sac-like
portions of the membranous labyrinth called
the saccule and utricle. Each has a patch of
sensory hair cells called macula
- Otoliths: gelatin coating membrane,
embedded with hard, tiny crystals of the
macula
Organs for equilibrium
• Static equilibrium
- determines head position
- most important part is the maculae
- maculae will determine if your head position
is upward, downward, or sideways
• Direction of movement
- forward, backward, circular
- The crista ampullaris is the sensory organ of
rotation
Rinne’s test
-  evaluates hearing loss by comparing air
conduction to bone conduction. Air
conduction hearing occurs through air near
the ear, and it involves the ear canal and
eardrum. Bone conduction hearing occurs
through vibrations picked up by the ear’s
specialized nervous system.
- Air conduction physiologically is greater
than bone conduction
- If BC>AC = sensory neural hearing loss
Weber’s test
- Whether there is lateralization in the right
or the left
- Lateralization = the vibration is greater in
one side
Romberg’s test
- Test for balance or position
- Cerebellar function test that demonstrates
a subject’s ability to use intro sensed by the
utricle and saccule alone
Nerves & Reflexes
- Reflex: response of the body to a sudden
change in environment ; any response of the
body towards a change in the environment
- Reflex arc: basic functional unit of the
nervous system ; processes and transmits
information to the different parts of the body
For a reflex to happen you must have
these 5:
1. Receptor - any part of the body which
can receive stimulus
2. Sensory neuron - aka afferent neuron
; bring/transmit impulses from the
receptor organ to the processing center
or integration (spinal cord/brain)
3. Motor neuron - efferent neuron,
transmit information/signals towards the
effector organ
4. Effector organ - any organ that would
respond to the stimulus
Classifications of reflexes:
• According to development
‣ Innate reflexes: newborn reflexes/
primitive reflexes, present at birth, use is
for protection (ex. Sucking reflex, routing
reflex)
‣ Acquired reflexes: adults (ex. Patellar
reflex, knee-jerk reflexes)
• According to response
‣ Superficial: corneal reflex (blink when
you touch the cornea)
‣ Deep: deep tendon reflex/patella reflex
• According to complexity
‣ Monosynaptic reflex: one neuronal pathway
that would process the information ; most
common is the stretch reflex
 ‣ Polysynaptic reflex:  one or more
interneurons connect afferent (sensory)
and efferent (motor) signals. ex. Withdrawal
reflex
• According to processing site
‣ Cranial nerve reflex: originating from the
brain
‣ Spinal nerve reflex: originating from the
spinal cord
Monosynaptic Reflex
- RECEPTOR: Apply stimulus to receptor organ
- SENSORY NEURON: When you strike the
patella the receptor organ is the intrafusal
muscle fiber
- Muscle spindle —> Receptor organ
(receive signal) —> Sensory neuron will
transmit from intrafusal to spinal cord
- MOTOR NEURON: Efferent neuron sends
signal to extrafusal
- EFFECTOR ORGAN: Extrafusal muscle fiber
- Then will cause your joints to relax causing the
knee-jerk effect
Babinski Reflex
- Not normal in adults but normal in infants
- bc babies dont have a fully developed
nervous system ; nag mmyelinate pa lang
ang neurons nila then once nag mature
nawawala yung babinski reflex and is
being replaced by the plantar reflex
- Fanning of the toes
- Adults who have babinski reflex = abnormal, it
means there is something wrong with the
upper motor neurons (may tumor/lesions)
• Hyper-reflexion: stronger than normal
reflex
• Clonus: sudden uncoordinated movement
after reflex
• Hyporeflexia: no response (ex. Overdosing
of magnesium sulfate
• Hyperreflexia happens when there is a
hyper excitatory of the effector organ (problem
is in the effector neuron or effector organ)

Polysynaptic reflex
- RECEPTORS: Nociceptors (pain)
- When you step on something sharp or would
cause something painful you withdraw your leg
- Difference from monosynaptic is that it
polysynaptic has interneurons and is inhibitory

Triceps reflex
- Sharp end: indirect ; strike on top of the
tendon
- Blunt end: strike directly to the tendon
- To locate the tendon: extend the arm and it
will be found above the elbow then once
located flex extremities
- Extension/contraction of the muscle will result
to a movement in the hand

Plantar Reflex
- normal in adults
- Result: plantar flexion or inward motion of
toes