TOPIC OUTLINE FOR CHAPTER 8 : SPECIAL SENSES

(OUTLINED BY ALGERICO F. BAIñO, JR., RN )

PART 1 : THE EYE AND VISION

8.1 ANATOMY OF THE EYE

8.1.A. EXTERNAL AND ACCESSORY STRUCTURES
8.1.B. INTERNAL STUCTURES : THE EYEBALL
8.2. PHYSIOLOGY OF VISION
8.2.A. PATHWAY OF LIGHT THROUGH THE EYE AND LIGHT REFRACTION
8.2.B. VISUAL FIELDS AND VISUAL PATHWAYS TO THE BRAIN ( IN SEQUENCE )
8.2.C. EYE REFLEXES

PART II : THE EAR : HEARING AND BALANCE

8.3. ANATOMY OF THE EAR

8.3.A. OUTER EAR
8.3.B. MIDDLE EAR
8.3.C. INNER EAR
8.4. HEARING ( IN SEQUENCE )
8.5. HEARING ( IN SEQUENCE )
8.5.A STATIC EQUILIBRIUM
8.5.C. DYNAMIC EQUILIBRIUM
8.5.C. HEARING AND EQUILIBRIUM DEFICITS

PART III : CHEMICAL SENSES : SMELL AND TASTE

8.6. OLFACTORY RECEPTORS AND THE SENSE OF SMELL

8.7. TASTE BUDS AND SENSE OF TASTE

PART IV : DEVELOPMENTAL ASPECTS OF THE SPECIAL SENSES

 CHAPTER 8
SPECIAL SENSES
( outlined by Algerico F. Baiño, Jr., RN )
PART 1 : THE EYE AND VISION

8.1 ANATOMY OF THE EYE

8.1.A. EXTERNAL AND ACCESSORY STRUCTURES
 ADULT EYE IS A SPHERE THAT MEASURES 1 INCH IN DIAMETER
 ANTERIOR 1/6 OF THE EYE’S SURFACE IS NORMALY SEEN, THE REST IS ENCLOSED AND
PROTECTED BY A CUSHION OF FAT AND WALLS OF THE BONY ORBIT
 ACCESSORY STRUCTURES INCLUDES YOUR – EYELIDS, CONJUCTIVA,LACRIMAL
APPARATUS AND EXTRINSIC EYE MUSCLES
ACCESSORY STRUCTURES SUB – PARTS CHARACTERISTIC AND
FUNCTION
EYELIDS – protects the anterior of Medial Commissure ( Canthus ) and Median and lateral corners of the
the eyes Lateral commissure ( canthus ) eye where eyelids meet

Palpebral Fissure The Space between the eyelids in

an open eye
Eyelashes It Projects from the border of each
eyelid
Tarsal Glands Modified sebaceous glands
associated with the eyelid edges
and produces an oily secretion that
lubricates the eye
Ciliary Glands Modified sweat glands that lies
between the eyelashes and their
ducts open at the eyelash follicles
Lacrimal Caruncle A raised area containing
sebaceous and sweat glands that
produce an oily, whitish secretion
that also lubricates the eye
CONJUCTIVA A delicate membrane that lines the
eyelids and covers part of the
outer surface of the eyeball

Also secretes mucus, which helps to

lubricate the eyeball and keep it
moist

LACRIMAL APPARATUS
Protects , moistens and lubricates
the eye
Empties into the nasal cavity
Lacrimal Glands Are located above the lateral end
of each eye and continually
release a dilute salt solution
( tears ) onto the anterior surface
of the eyeball through several
small ducts
Lacrimal Canaliculi These 3 are the small ducts wherein
Lacrimal Sac Tears passes through
Nasolacrimal Ducts

EXTRINSIC EYE MUSCLES Lateral Rectus ( VI Abducens ) Moves Eye Laterally

( External Eye Muscles ) –
produce gross eye movements and
make it possible for the eyes to
follow a moving object
Medial Rectus ( III oculomotor )
Superior Rectus ( III oculomotor )
Inferior Rectus ( III oculomotor )
Inferior Oblique ( III oculomotor )
Superior Oblique ( IV trochlear )
Moves Eye Medially
Elevates eye and turns it medially
Depresses eye and turns it medially
Elevates eye and turns it laterally
Depresses eye and turns it laterally
 8.1.B. INTERNAL STUCTURES : THE EYEBALL
 Eye / Eyeball : a hollow sphere composed of three tunics or layers and its interior is filled fluid called
humors that help maintains its shape
LAYERS THAT FORMS THE WALL OF THE EYEBALL
LAYER SUB – PARTS FUNCTION
FIBROUS Protective Sclera  Seen anteriorly as the “white of the eye”
LAYER – Transparent Cornea  Through which the light enters
Outermost  Well supplied with nerve endings (mostly pain fibers )
Layer  Blinking and increased tear production if cornea is touched
 Exposed part of the eye, vulnerable to damage
 Can repair itself
 Has no blood vessels, thus can be transplanted without rejection

VESICULAR Choroid  Posterior Region

LAYER –  Blood rich tunic that contains the dark pigment, which prevents
Middle / light from scattering inside the eye
Vascular Ciliary Body  Anterior to the Choroid
Layer and  Composed of Smooth Muscle
has 3  Is attached to the lens by a suspensory ligament called the
regions ciliary zonule
Iris  Is pigmented and has a rounded opening called the pupil
through which light passes
 Fibers from the Iris arranged radially and circularly acts like a
diaphragm of a camera
 Iris also regulates the amount of light entering the eye so that
we can see as clearly as possible in the available light
 Close vision and bright light – circular muscles contract and
pupil constricts / gets smaller
 Distant vision and Dim light – Radial Fibers contract to enlarge
/ dilate the pupil which allows more light to enter the eye
 Cranial Nerve III ( Occulomotor ) Controls the muscles of the Iris
SENSORY Retina  Is two layered :
LAYER – 1. Outer pigmented Layer – composed of pigmented cells
Innermost that absorb light and prevent light from scattering
Sensory inside the eye. Also acts as phagocytes to remove dead
Layer or damaged receptor cells and store vitamin A needed
for vision
2. Transparent Neural Layer – has millions f receptor cells,
RODS and CONS, which are called photoreceptors
because they respond to light

LENS
 A Flexible biconvex crystal-like structure
 Is held uptight in the eye by the ciliary zonule to the ciliary body
 It focuses the light entering the eye
CHAMBERS / LOCATION FUNCTION
SEGMENTS
ANTERIOR / Anterior to the lens  Contains a clear watery fluid called Aqueous humor
AQUEOUS  It helps maintain intraocular pressure (pressure inside
SEGMENT the eye )
 Provides nutrients for the avascular lens and cornea
 Is reabsorbed into the venous blood through the
scleral venous sinus or canal of Schlemm

POSTERIOR / Posterior to the lens  Has a gel like substance called vitreous humor, which
VITREOUS SEGMENT helps prevent the eyeball from collapsing inward
and by reinforcing it internally
 GLAUCOMA
Causes Result Signs and Symptoms Management
Caused by Pressure within the eye  No symptoms at first  Commonly treated
blocked increases to dangerous levels  Halos around lights with eyedrops to
drainage of and compresses the delicate  Headaches and blurred increase the rate of
Aqueous retina and optic nerve can vision aqueous humor
Humor lead to blindness unless drainage
detected early  Laser or surgical
enlargement of the
drainage
 Tonometer is used to
measure the
intraocular pressure

8.2. PHYSIOLOGY OF VISION

8.2.A. PATHWAY OF LIGHT THROUGH THE EYE AND LIGHT REFRACTION
 Light rays are bent in the eye as they encounter the cornea, aqueous humor, lens and vitreous
humor
 Refractive / Bending power of the cornea and humors are Constant
 Refractive / Bending power of the lens can be changed by changing its shape by making it more
or less convex, so that the light can be properly focused on the retina
 The greater the lens convexity / bulge /thicker - the more it bends the light
 The flatter / thinner the lens - less it bends the light
 A light from 20 feet away approaches the eye as parallel rays, and those that light that came
from a close object tends to scatter and diverge / bulge, thus, the lens must bulge to make close
vision possible
 ACCOMODATION : Is the ability of the eye to focus specifically for close objects
 REAL IMAGE : Is the image formed on the retina as a result of the light bending activity of the
lens that is Reversed Left to right and upside down

VISION PROBLEMS
TYPE OF DESCRIPTION CAUSE CORRECTION
VISION
EMMETROPIA  Normal Vision  NONE  No Correction Needed
or “harmonious
Vision”
Myopia  Nearsightedness  Occurs when the parallel light  Requires Concave corrective
/ short vision rays from distant objects are lenses that diverge the light
 Can see near focused in front of the retina rays before they enter the
objects but need  Nearby objects are in focus eye allowing the rays to
corrective lenses because the lens converge farther back on the
to see distant “accommodates” ( bulges) to retinal surface
objects focus the image properly on
the retina
Hyperopia  Farsightedness  Occurs when parallel light rays  Requires Convex corrective
 Can see distant from distant objects are lenses that converge the light
objects clearly focused behind the retina rays before they enter the
but need  Can see distant objects clearly eye
corrective lenses  Nearby Objects appear blurry
to see nearby  Subjected to eyestrain
objects
Astigmatism  Multiple focal  Presence of uneven curvatures  Special cylindrically ground
points on the in the cornea or lens lenses or contacts
Retina and  Blurry images occur because
blurry vision points of light are focused not
as points on the retina but as
lines
 8.2.B. VISUAL FIELDS AND VISUAL PATHWAYS TO THE BRAIN ( IN SEQUENCE )

1. AXONS CARRYING IMPULSES FROM THE RETINA

2. OPTIC NERVE
3. OPTIC CHIASMA - Where the fibers from the medial side of each eye cross over to the opposite side of the
brain
4. OPTIC TRACTS - The resulting Fiber tracts from the optic chiasma. Each optic tract contains fibers from the
lateral side of the eye on the same side and the medial side of the opposite eye
5. OPTIC RADIATION - these are the axons that are formed when the optic tract fibers synapse with the
neurons in the thalamus

8.2.C. EYE REFLEXES

EYES MUSCLES NECESSARY FOR PROPER EYE FUNCTION
EYE MUSCLES STIMULATION EXAMPLES
INTERNAL EYE MUSCLES  Autonomic Nervous  Ciliary Body - alters lens curvature
System  Radial and Circular muscles of the Iris - controls
pupil size
EXTERNAL EYE MUSCLES  Somatic Fibers of the  Rectus and Oblique muscles which control eye
( EXTRINSIC ) cranial nerves III, IV and movements and make it possible to follow
VI moving objects

REFLEXES
TYPE OF REFLEX ACTION MUSCLES INVOLVED
CONVERGENCE  Reflexive Movement of the eyes medially  External Eye Muscles
when we view close objects
 Both eyes are aimed toward the near
object being viewed
PHOTOPUPILLARY  When the eyes are suddenly exposed to  Internal Eye Muscles
REFLEX bright light, the pupils constrict
 Is Also a protective reflex that prevents
excessively bright light from damaging the
delicate photoreceptors
ACCOMODATION  When pupils constrict reflexively when we  Internal Eye Muscles
PUPILLARY REFLEX view close objects and provides more
acute vision
 PART II : THE EAR : HEARING AND BALANCE
 MECHANORECEPTORS - THE RECEPTORS THAT RESPONDS TO SOUND VIBRATIONS AND GROSS
MOVEMENTS OF THE HEAD

8.3. ANATOMY OF THE EAR - THERE ARE 3 MAJOR AREAS OF THE EAR
AREAS SUB - PARTS DESCRIPTION
EXTERNAL Auricle / Pinna Shell Shaped structure surrounding the auditory canal opening
( OUTER ) EAR External Auditory Short, Narrow chamber carved into the temporal bone of the skull
- Involved with Meatus / Auditory Has ceruminous glands in its skin lined walls which secrete waxy
hearing Canal yellow cerumen
Tympanic membrane / Where sound waves hits and vibrate
eardrum
MIDDLE EAR - Middle ear cavity / Is a small, air filled, mucosa lined cavity within the temporal bone
Involved with Typanic cavity
hearing Oval Window and 2 openings
Round Window
Pharyngotympanic Tube It is normally flattened and closed however, it opens during
/ Auditory Tube swallowing and yawning to equalize the pressure in the middle ear
cavity with the external , or atmospheric pressure
Ossicles Are the Collective term of the 3 smallest bones which are
1. Hammer / Malleus
2. Anvil / Incus
3. Stirrup /Stapes

Transmit and amplify the vibratory motion of the eardrum to the

fluids of the inner ear like dominoes

INTERNAL EAR Bony Labyrinth / Osseus Are the Bony chambers located deep within the temporal bones
- Involved with Labyrinth behind the eye socket
equilibrium 3 subdivisions
and hearing 1. Cochlea - Spiraling , Pea sized
2. Vestibule
3. Semicircular Canals

8.4. HEARING ( IN SEQUENCE )

1. SOUND WAVES ( ANY )
2.PASSES IN THE EXTERNAL EAR
3.PASSES IN THE MIDDLE EAR - SOUND WAVES AMPLIFIED
4. REACHES THE TINY OVAL WINDOW , SETS THE FLUIDS OF THE INNER EAR INTO MOTION, PRESSURE
WAVES SET UP VIBRATIONS IN THE BASILAR MEMBRANE
5. RECEPTOR CELLS IN THE BASILAR MEMBRANE ARE STIMULATED BY VIBRATING MOVEMENT OF THE BASILAR
MEMBRANE
6. THE HAIRS OF THE RECEPTOR CELLS BENDS
7. HAIR CELLS TRANSMITS IMPULSES ALONG THE COCHLEAR NERVE ( DIVISION OF CRANIAL NERVE VIII /
VESTIBULOCOCHLEAR NERVE ) TO THE AUDITY CORTEX IN THE TEMPORAL LOBE, WHERE INTERPRETATION OF
THE SOUND, OR HEARING, OCCURS

8.5. EQUILIBRIUM
 it responds to various head movements
 The vestibular apparatus is the equilibrium receptor of the inner ear
 2 branches : STATIC EQUILIBRIUM AND DYNAMIC EQUILIBRIUM

BRANCH FUNCTION SEQUENCE OF EVENTS to ACHIEVE

8.5.A  It reports on changes in the position of the
STATIC head in space with respect to the pull of
EQUILIBRIUM gravity when the body is not moving
 Helps keep our head erect
 Extremely important to divers because it
enables them to tell which way is up to the
surface
 Our sense of Static equilibrium - position of
the head with respect to gravity - is due to
the receptors of the vestibule
8.5.B.  Responds to angular or rotational
DYNAMIC movements of the head rather than to
EQUILIBRIUM
1. The Vestibule consists of 2 fluid filled cavities,
the utricle and saccule
2. The utricle and the saccule contain hair cells
with overlapping gelatinuous material.
Embedded in the gelatinous material are
granules of calcium carbonate called otoliths
3. When the head is tilted, otoliths in the
gelatinous material slide “downhill”over the hair
cells stimulating them. Hair cells sends signals to
the brain
4. The brain interprets the signal to know the
position of the head
1. The three semicircular canals are oriented
perpendicularly to one another. At the base of
 EQUILIBRIUM straight line movements
 Our sense of Dynamic equilibrium -
equilibrium when the body or head is
moving - is due to semicircular canals,
which report rotational movements of the
head, including those caused by
acceleration or deceleration
each canal is a gelatinuous mass called the
curpula in which the hair cells are embedded.
2. The canals and the chambers are filled with a
fluid that moves when the head does. The
movement of fluid pushes the cupula and
stimulates hair cells that send messages to the
brain regarding body position and movement
3. The brain interprets the signal and maintains
our balance

8.5.C. HEARING AND EQUILIBRIUM DEFICITS

DEFICIT DESCRIPTION CAUSE SIGNS AND SYMPTOMS

Conduction Results when  Build up of earwax  Will still be able to hear by bone
Deafness something interferes  Fusion of the ossicles conduction although her ability to hear air
with the conduction of ( otosclerosis ) conducted sounds ( normal conduction
sound vibrations to  Ruptured eardrum route ) is decreased or lost
the fluids of the inner  Otitis media -  Hearing aids are helpful
ear and can be inflammation of the
permanent or middle ear
temporary  Thus, it results from
Mechanical factors
Sensorineural Occurs when there is  Extended listening to  Cannot hear better by either conduction
Deafness degeneration or excessively loud sounds route
damage to the  Thus, it results from a  Hearing aids are not helpful
receptor cells in the problem with nervous
spiral organ of corti, system structures
to the cochlear nerve,
or to the neurons of
the auditory cortex
Meniere’s A serious pathology  Exact cause is Unknown  Progressive deafness occurs
Syndrome affecting the inner  Suspected Causes :  Affected individuals become nauseated ,
ear Arteriosclerosis, often have howling or ringing sounds in
degeneration of the their ears and vertigo ( sensation of
cranial nerve VIII, spinning ) which is so severe that they
increased pressure of cannot stand up without extreme
the inner ear fluids discomfort
 PART III : CHEMICAL SENSES : SMELL AND TASTE
 CHEMORECTORS : RECEPTORS FOR TASTE AND OLFACTION

8.6. OLFACTORY RECEPTORS AND THE SENSE OF SMELL

PARTS OF THE OLFACTORY RECEPTORS
 Are the receptors for the sense of Smell
 It occupies a postage stamp- sized area in the roof of each nasal cavity
 Are exquisitely sensitive and olfactory neurons tend to adapt rather quickly when they are exposed to an
unchanging stimulus ( Odor )
 The olfactory pathways are closely tied into the limbic system ( emotional - visceral part of the brain ) thus, it
is long lasting and very much a part of our memories and emotions
PARTS CHARACTERISTIC
OLFACTORY RECEPTOR CELLS Sensory Neurons of the olfactory receptor equipped with olfactory hairs
When Stimulated by chemicals dissolved in the mucus, they transmit
impulses along the olfactory filaments
OLFACTORY HAIRS Long cilia that protrudes from the nasal epithelium and are continuously
bathed by a layer of mucus secreted by the underlying glands
OLFACTORY FILAMENTS Are bundled axons of olfactory neurons that collectively make up the
olfactory nerve ( cranial nerve I )
OLFACTORY NERVE Conducts the impulses to the olfactory cortex of the brain where the odor
is interpreted

8.7. TASTE BUDS AND SENSE OF TASTE

PARTS CHARACTERISTIC
TASTE BUDS These are the receptors for the sense of taste and are widely scattered in
the oral cavity.
Most are located in the tongue, few are scattered on the soft palate,
superior part of the pharynx, inner surface of the cheeks
Are subjected to huge amounts of friction and are burned by hot foods
because of their location

PAPILLAE These are small peg like projections Located on the dorsal tongue surface
Vallate Papillae ( Circumvallate ) - large round papillae where taste
buds are located
Fungiform Papillae - Papillae that are found on the top of the tongue
and are more numerous
Foliate papillae - Papillae that are found at the sides of the tongue
GUSTATORY CELLS Specific receptor cells ( Epithelial Cells ) that that responds to chemicals
dissolved in the saliva
GUSTATORY HAIRS Are long microvilli that protrude through the taste pore and when
stimulated they depolarize and the impulse are transmitted to the brain
CRANIAL NERVES CRANIAL NERVES VII ( facial ), IX( glossopharyngeal ) AND X ( vagus ) -
all of these carry taste impulses from the various taste buds to the
gustatory cortex
BASAL CELLS Stem cells found in the deeper regions of the taste buds, they replace the
taste bud cells every 7 to 10 days

FIVE BASIC TASTE SENSATIONS

RECEPTORS SUBSTANCES THAT RESPONDS
SWEET RECEPTORS Sugars, sacharine, alcohols, amino acids and some lead
salts
SOUR RECEPTORS Hydrogen ions or the acidity of the solution
BITTER RECEPTORS Alkaloids
SALTY Metal ions in a solution
UMAMI ( discovered by the Japanese ) Elicited by the amino acids Glutamate and Aspartate
Responsible for the beef taste of steak
 PART IV : DEVELOPMENTAL ASPECTS OF THE SPECIAL SENSES

STAGE DESCRIPTION
NEWBORN  Is the only special sense that is not fully functional
when the baby is born
 Eyeballs are fore shortened
 All babies are born hyperopic ( farsighted )
 Newborn sees only in gray tones
 Makes uncoordinated eye movements
 Often sees using only one eye at a time
 Lacrimal glands are not fully developed until
about 2 weeks after birth, so within 2 weeks the
baby’s cry is tearless
5 MONTHS  Able to focus on articles within easy reach
 Can follow moving objects
 Visual acuity is till poor
 Their vision is 20/200 - meaning that a mature
individual clearly sees the object 200 feet away,
and an infant can see the same object if it is
moved 20 feet away from them.
5 YEARS OLD  Color vision is well developed
 20/30 visual acuity
 Depth perception is present, providing a readiness
to begin reading
SCHOOL AGE  Hyperopia replaced by Emmetropia ( normal
vision ) which continues about age 40
AGE 8 - 9  Eyeballs continue to enlarge until this age, Lens
grow throughout life
Age 40  Presbyopia ( Farsightedness ) begins to set in due
to decreased lens elasticity making it difficult to
focus for close vision
AGING OCCURS  Lacrimal glands are less active
 Eyes tend to become dry and more vulnerable to
bacterial infection and irritation
 Lens loses its crystal clarity and becomes
discolored , thus , it scatters light causing a
distressing glare when the person drives at night
 Pupils are somewhat constricted because dilator
muscles of the iris becomes less efficient
AGE 70  Decreased amount of light reaching the retina and
visual acuity is lowered
 HOMEOSTATIC IMBALANCES
CONDITION DESCRIPTION CAUSE MANAGEMENT COMPLICATIONS
STRABISMUS A Congenital Unequal pulls by the SURGERY Brain may stop recognizing
eye problem external eye muscles signals from the deviating eye
commonly called that prevents the causing the eye to become
as “Crossed baby from functionally blind
Eyes” coordinating
movement of the two
Unable to focus eyes
both eyes
simultaneously
on the same
object
CONGENITAL Maternal Rubella ( Germal
BLINDNESS OR Infection that Measles )
CATARACTS occur during
early pregnancy
OPTHALMIA Infection of the Gonorrhea Antibiotics Baby’s eyelids become red,
NEONATURUM baby’s eye swollen and produces pus
/ conjuctivitis during delivery