Terminal Performance Objective 6

Visual system

1. Identify the different structures involved in the visual system

Structures:

The outer covering of the eyeball consists of a relatively tough, white layer called the
sclera (or white of the eye).

Near the front of the eye, in the area protected by the eyelids, the sclera is covered by a
thin, transparent membrane (conjunctiva), which runs to the edge of the cornea. The
conjunctiva also covers the moist back surface of the eyelids and eyeballs.

Light enters the eye through the cornea, the clear, curved layer in front of the iris and
pupil. The cornea serves as a protective covering for the front of the eye and helps focus
light on the retina at the back of the eye.

After passing through the cornea, light travels through the pupil (the black dot in the
middle of the eye).

The iris—the circular, colored area of the eye that surrounds the pupil—controls the
amount of light that enters the eye. The iris allows more light into the eye (enlarging or
dilating the pupil) when the environment is dark and allows less light into the eye
(shrinking or constricting the pupil) when the environment is bright. Thus, the pupil
dilates and constricts like the aperture of a camera lens as the amount of light in the
immediate surroundings changes. The size of the pupil is controlled by the action of the
pupillary sphincter muscle and dilator muscle.

Behind the iris sits the lens. By changing its shape, the lens focuses light onto the retina.
Through the action of small muscles (called the ciliary muscles), the lens becomes thicker
to focus on nearby objects and thinner to focus on distant objects.

The retina contains the cells that sense light (photoreceptors) and the blood vessels that
nourish them. The most sensitive part of the retina is a small area called the macula,
which has millions of tightly packed photoreceptors (the type called cones). The high
density of cones in the macula makes the visual image detailed, just as a high-resolution
digital camera has more megapixels.
Each photoreceptor is linked to a nerve fiber. The nerve fibers from the photoreceptors
are bundled together to form the optic nerve. The optic disk, the first part of the optic
nerve, is at the back of the eye.

The photoreceptors in the retina convert the image into electrical signals, which are
carried to the brain by the optic nerve. There are two main types of photoreceptors: cones
and rods.

Cones are responsible for sharp, detailed central vision and color vision and are clustered
mainly in the macula.

Rods are responsible for night and peripheral (side) vision. Rods are more numerous than
cones and much more sensitive to light, but they do not register color or contribute to
detailed central vision as the cones do. Rods are grouped mainly in the peripheral areas of
the retina.

The eyeball is divided into two sections, each of which is filled with fluid. The pressure
generated by these fluids fills out the eyeball and helps maintain its shape.

The front section (anterior segment) extends from the inside of the cornea to the front
surface of the lens. It is filled with a fluid called the aqueous humor, which nourishes the
internal structures. The anterior segment is divided into two chambers. The front
(anterior) chamber extends from the cornea to the iris. The back (posterior) chamber
extends from the iris to the lens. Normally, the aqueous humor is produced in the
 posterior chamber, flows slowly through the pupil into the anterior chamber, and then
drains out of the eyeball through outflow channels located where the iris meets the
cornea.

The back section (posterior segment) extends from the back surface of the lens to the
retina. It contains a jellylike fluid called the vitreous humor.

2. define the ff. terms;

- Adaptation - temporary change in sensitivity or perception when exposed to a new or
intense stimulus, and the lingering afterimage that may result when the stimulus is
removed.
- Accommodation - is the process by which the vertebrate eye changes optical power to
maintain a clear image or focus on an object as its distance varies.
- Refraction - is the bending of light rays as they pass through one object to another.
The cornea and lens bend (refract) light rays to focus them on the retina. When the
shape of the eye changes, it also changes the way the light rays bend and focus — and
that can cause blurry vision.

3. trace the pathways involved in vision, light or optic reflexes and eye movements.
Visual pathway - refers to the anatomical structures responsible for the conversion of
light energy into electrical action potentials that can be interpreted by the brain. It begins
at the retina and terminates at the primary visual cortex (with several intercortical tracts).

Nerve signals travel from each eye along the corresponding optic nerve and other nerve
fibers (called the visual pathway) to the back of the brain, where vision is sensed and
interpreted. The two optic nerves meet at the optic chiasm, which is an area behind the
eyes immediately in front of the pituitary gland and just below the front portion of the
brain (cerebrum). The optic nerve from each eye divides in the optic chiasm. Half of the
nerve fibers from each side cross to the other side and continue to the back of the brain.
Thus, the right side of the brain receives information through both optic nerves for the
left field of vision, and the left side of the brain receives information through both optic
nerves for the right field of vision. The middle of these fields of vision overlaps. It is seen
by both eyes (called binocular vision).

An object is seen from slightly different angles by each eye, so the information the brain
receives from each eye is different, although it overlaps. The brain integrates the
information to produce a complete picture. This process is the basis of stereo vision or
depth perception.
4. understand the basic concepts that underly the ff. neurologic conditions and pathologies;
- visual field defects - a blind spot (scotoma) or blind area within the normal field of one or
both eyes. In most cases the blind spots or areas are persistent, but in some instances,
they may be temporary and shifting, as in the scotomata of migraine headache.
- pupillary size abnormalities - The main types of pupillary abnormalities include:
Anisocoria: unequal pupil sizes.

Horner's syndrome: disruption of a nerve pathway from the brain to the one side of the
face and that eye.

Third nerve palsy: one eyelid is completely closed, and that eye has moved outward and
downward.
Adie’s tonic pupil: one pupil is permanently dilated and unresponsive to light and other
stimulants

Symptoms of a pupillary abnormality include:

- Decreased or increased size of one pupil

- Difficulty focusing on objects in near visual field
- Diplopia (double vision)
- Drooping eyelids (ptosis)
- Headache
- Light sensitivity
- Problems moving your eye
Auditory system

1. Identify the different structures responsible for hearing

2. trace auditory pathways
3. understand the basic concepts that underly the ff neurologic conditions and pathologies:
- tinnitus
- deafness: conduction, sensorineural, mixed
4. differentiate the tests used in detecting hearing dysfunctions