Anatomy and Physiology

Somatic and Special Senses

 Sensory Receptors
• Detect environmental changes and
trigger nerve impulses that travel on
sensory pathways into the CNS for
processing and interpretation.
Two Categories of Receptors
• Somatic Senses: touch, pressure,
temperature, and pain. Distributed
throughout skin and deeper tissues.
• Special senses: smell, taste, hearing,
equilibrium, vision. (more complex)
 Selective Response
• Each type of receptor is particularly
sensitive to a distinct type of
environmental change and less
sensitive to other forms of stimulation
Five Types of Sensory Receptors
• Chemoreceptors: stimulated by changes in
the chemical concentration of substances.
• Pain receptors: stimulated by tissue damage
• Thermoreceptors: changes in temp.
• Mechanoreceptors: changes in pressure or
movement
• Photoreceptors: by light energy
 Sensations
• A feeling that occurs when the brain
interprets sensory impulses
• All the nerve impulses that travel away
from sensory receptors into the CNS
are alike. The resulting sensation
depends on which region of the brain
receives the impulse.
 Somatic Senses
• Senses associated with receptors in
the skin, muscles, joints, and viscera
 Touch and Pressure Senses
• Derived from 3 kinds of receptors that
sense mechanical forces that deform or
displace tissues
• Sensory Nerve Fibers: sense touch and
pressure and are located in epithelial
tissue
Touch and pressure receptors include A.) free ends of sensory nerve fibers, B.)
Meissner’s corpuscles and C.) Pacinian corpuscles.
• Meissner’s Corpuscles: respond to
very light touch and are located in
connective tissues of hairless portions
of the skin
• Pacinian corpuscles: respond to heavy
pressure and are located in deeper
subcutaneous tissues, muscle tendons,
joint ligaments.
 Temperature Senses
• Two types of nerve endings stimulate
pain receptors.
• Both adapt rapidly (fade within 1
minute of continuous stimulation)
• Warm receptors: 25˚ - 45˚C – burning
sensation
• Cold receptors: 10˚ - 20˚C -- freezing
sensation
 Sense of Pain
• Widely distributed throughout the skin and internal
tissues (except nervous tissue of brain)
• Protects the body. Tissue damage stimulates pain
which is perceived as unpleasant and signals person
to take action to remove stimulation.
• Adapts poorly if at all. Pain persists.
• The way in which tissue damage stimulates pain
receptors is poorly understood.
– Injuries promote the release of certain chemicals that build
up and stimulate pain receptors.
– Ischemia in a tissue or stimulation of certain
mechanoreceptors also trigger pain sensations
 Visceral Pain
• Localized damage may not elicit pain
but wide-spread stimulation may
produce strong pain sensation
• Mechanoreceptor stimulation and
ischemia both produce visceral pain.
• Referred Pain: visceral pain may feel as
if it is coming from some part of the
body other than the part being
stimulated. May arise from common
nerve pathways.
– Example: Pain originating in the heart may
be referred to the left shoulder and left
upper limb.
Pain originating in the heart may feel as if it is coming from the skin because sensory
impulses from those two regions follow common nerve pathways to the brain.
Surface regions to which visceral pain may be referred
 Pain Nerve Fibers
• Acute Pain Fibers: conduct impulses rapidly.
Sharp pain. Restricted area of skin. Seldom
continues after stimulation stops.
• Chronic Pain Fibers: slower, dull, aching
pain. Diffuse and difficult to pinpoint. May
continue after stimulus ceases. May be felt in
deeper tissues.
• An event usually triggers both acute and
chronic pain fibers (dual sensation)
 Regulation of Pain Impulses
• Awareness of pain results when impulse
reaches the thalamus.
• Cerebral cortex determines pain intensity,
locates pain source and mediates emotional
and motor responses to the pain.
• Impulses descending from the brain
stimulate neurons to release pain-relieving
neuropeptides such as enkephalins,
serotonin, and endorphins.
 Headaches
• Nervous tissue of the brain lacks pain
receptors but nearly all other tissues of
the head including meninges and blood
vessels are richly innervated
• Many headaches are associated with
stressful life situations that cause
fatigue, emotional tension, anxiety, or
frustration
 Tension Headache
• Triggered by various physiological
changes such as prolonged contraction
of skeletal muscles in forehead, sides
of head, back of neck.
• Contractions stimulate pain receptors
 Vascular Headache
• Accompanies constriction or dilation of
cranial blood vessels.
• Ex. Throbbing headache of “hang-over”
from drinking too much alcohol may be
due to blood pulsating through dilated
cranial vessels
 Migraine
• Form of vascular headache
• Certain cranial vessels constrict producing a
localized cerebral blood deficiency
• Variety of symptoms: seeing patterns of bright light
that obstruct vision, numbness in limbs or face
• Vasoconstriction subsequently leads to vasodilation
of affected vessels causing severe headache usually
on one side of the head.
• Can last several hours or more
• Drug treatments are available
 Other Causes of Headaches
• Sensitivity to food additives
• High blood pressure
• Increased intracranial pressure due to
tumor or hematoma
• Decreased cerebrospinal fluid pressure
following lumbar puncture
• Sensitivity to or withdrawal from
certain drugs
 Special Senses
• Those whose • Smell: olfactory
sensory receptors organs
are within large,
• Taste: taste buds
complex, sensory
organs in the head. • Hearing,
equilibrium: ears
• Sight: eyes
Sense of Smell
 Sense of Smell
• Associated with complex sensory
structures in the upper region of the
nasal cavity
• Olfactory Receptors and taste
receptors are chemoreceptors
– Chemicals dissolved in liquids stimulate
them
• Smell and taste function closely
together and aid in food selection
 Olfactory Organs
• Contain olfactory receptors.
• Yellowish-brown masses that cover the
upper parts of the nasal cavity,
superior nasal conchae and a portion
of the nasal septum
• Olfactory receptor cells are bipolar
neurons surrounded by columnal
epithelial cells
Olfactory receptors. A.) Columnar epithelial cells support olfactory receptor cells, which have cilia
at their distal ends. B.) The olfactory area is associated with the superior nasal concha.
• Hair-like cilia cover tiny knobs at the distal
ends of these neuron’s dendrites
• Cilia project into the nasal cavity and harbor
500 types of olfactory receptor proteins
• Oderant molecules
– Enter the nasal cavity as gases but must dissolve
partially in watery fluids before receptors can
detect them
– Bind to the receptors in different patterns and
stimulate the receptors.
 Olfactory Nerve Pathways
• Stimulated olfactory receptor cells send nerve
impulses along their axons which form the first
cranial nerves and synapse with neurons located in
enlargements called olfactory bulbs.
• Impulses are analyzed in the olfactory bulbs and
travel along olfactory tracts to the limbic system
• Major interpreting areas (olfactory cortex) for these
impulses are located within the temporal lobes and
at the bases of the frontal lobes
 Olfactory Stimulation
• One hypothesis suggests that the shapes of
gaseous molecules fit complementary
shapes of membrane receptor sites. Binding
to a receptor triggers a nerve impulse.
• Each odor stimulates a distinct set of
receptor subtypes. The brain interprets
different combinations as an olfactory code.
– Ex. Parsley stimulates receptors 3, 4, 8
– Chocolate stimulates receptors 1, 5, 10
• Olfactory organs are located high in the
nasal cavity above the usual pathway
of inhaled air.
– May have to sniff and force air up to the
receptor areas to smell a faint odor
• Olfactory receptors undergo sensory
adaptation rapidly
– If receptors are adapted to one scent,
sensitivity to other odors persists
 Anosmia
• Partial or complete loss of smell
• May result from a variety of factors
including inflammation of the nasal
cavity lining due to respiratory
infection, tobacco smoke, or using
certain drugs such as cocaine
Sense of Taste
 Taste Buds
• Special organs of taste
• Located primarily on the surface of the
tongue and are scattered on the roof of
the mouth and walls of throat.
(1000/10,000 taste buds are not on
tongue)
• Associated with tiny elevations called
papillae and epithelial supporting cells
Taste receptors. A.) Taste buds on the surface of the tongue are associated with nipple-like
elevations called papillae. B.) A taste bud contains taste cells and has an opening, the taste pore, at
its free surface.
 Taste cells / Gustatory Cells
• A group of modified epithelial cells on a
taste bud that function as receptors
• 50-150 receptor cells per taste bud;
replaced every 3 days
• Taste Pore: opening at the free surface
• Taste hair: tiny projections that
protrude from outer ends of taste cells
and extend from taste pore
– Believed to be the sensitive parts of the
receptor cells
• A network of nerve fibers is interwoven
among the taste cells. Stimulation of
receptor cells triggers an impulse
• Before a particular chemical can be tasted it
must dissolve in the watery fluid (provided
by the salivary gland) surrounding taste
buds
• Similar hypothesis as smell – food molecules
combine with specific receptor sites on taste
hair surfaces stimulating sense of taste.
Combinations generate sensory impulses on
nerve fibers.
• Taste cells appear alike microscopically but are of at
least 4 types. Each type is most sensitive to a
particular kind of chemical stimulus.
• 4 Primary Taste (gustatory) Sensations
– Sweet: sugar
– Sour: lemon
– Salty: table salt
– Bitter: caffiene, quinine
• Other Taste Sensations
– Alkaline
– Metallic
– Umami: detects MSG (monosodium glutamate) a flavor
enhancer
• A flavor results from one or a
combination of primary sensations
• Experiencing flavors involves taste as
well as odor, texture (touch), and
temperature. Also stimulation of pain
receptors (burning from chili peppers
or ginger)
• All taste cells are responsive to at least
2 taste sensations although one may
predominate.
• Distribution of Taste Cells:
– Sweet: greatest at tip of tongue
– Sour: greatest at margins of tongue (sides)
– Bitter: back of tongue
– Salty: widely distributed
Locations of the four primary taste sensations.
• Due to the fact that all receptors are
sensitive to all stimuli to some degree –
a wide range of individual variations in
responses
• The pattern of responses from
differentially sensitive receptor cells
provides the brain with information
necessary to create what we call taste.
• Taste receptors (like olfactory
receptors) undergo sensory adaptation
rapidly.
• Moving bits of food over the surface of
the tongue stimulates different
receptors at different moments
avoiding loss of taste from sensory
adaptation.
 Taste Nerve Pathway
• Sensory impulses from taste receptors in the
tongue
• Fibers of the facial, glossopharyngeal, and
vagus nerves
• Medulla oblongata
• Impulses ascend to the thalamus
• Then are directed to the gustatory cortex in
the parietal lobe of the cerebrum
Sense of Hearing
 Ear
• Organ for hearing
• Also functions in sense of equilibrium
• 3 sections: external, middle, inner
Major parts of the ear
 External Ear
• Auricle (pinna):
– Outer funnel-like structure
– Collects sound waves traveling through air and
directs them into the external auditory meatus
• External Auditory Meatus
– Also called External Auditory Canal
– S-shaped tube that leads inward through the
temporal bone for 2.5 cm
 Middle Ear
• Tympanic Cavity: air-filled space in the
temporal bone
• Tympanic Membrane (eardrum)
– Semitransparent membrane covered by a thin
layer of skin on the outer surface and by mucous
membrane on the inside
– Oval margin, cone-shaped with apex directed
inward toward the malleus
– The eardrum moves back and forth in response to
sound waves entering the external auditory
meatus reproducing the vibrations of the sound
wave source.
Major parts of the ear.
• Auditory Ossicles
– Malleus, Incus, Stapes
– Tiny ligaments attach these bones to the wall of
the tympanic cavity
– Covered by mucous membrane
– Bridge the eardrum and inner ear, transmitting
vibrations between these parts
– Ligaments hold the stapes to an opening in the
wall of the tympanic cavity, called the oval
window, that leads to the inner ear
– Amplify (increase force of) vibrations as they pass
from eardrum to oval window. Vibrations are
concentrated as the move from a relatively larger
surface area to a smaller area
Auditory Ossicles bridge the tympanic membrane and the inner ear.
 Auditory Tube
• Also called eustachian
tube
• Connects middle ear to
throat
• Conducts air between
the tympanic cavity and
the outside of the body
by way of the throat
(nasopharynx) and
mouth
• Helps maintain equal air pressure on
both sides of the eardrum, which is
necessary for normal hearing (this
function is noticeable when you hear a
popping sound during rapid changes in
altitude)
• Mucous membrane infections of the
throat may spread through these tubes
and cause middle ear infection
 Inner Ear
• Labyrinth
– Complex system of communicating
chambers and tubes
– 2 in each ear
• Osseous Labyrinth: bony canal in the temporal
bone
• Membranous Labyrinth: tube that lies within
the osseous labyrinth
• Perilymph: fluid between osseous and
membranous labyrinths
• Endolymph: fluid within membranous
labyrinths
Perilymph separates the osseous labyrinth of the inner ear from the membranous
labyrinth, which contains endolymph.
 Parts of the Labyrinths
• 3 semicircular canals provide sense of
equilibrium
• Cochlea:
– Functions in hearing
– Contains a bony core and a thin bony shelf
that winds around the core like threads of
a screw
– 2 compartments
• Upper scala vestibuli leads from oval window to apex of
the spiral
• Lower scala tympani extends from apex of cochlea to
membrane-covered opening in the wall of the inner ear,
called the round window

– Cochlear duct
• Portion of the membranous labyrinth within the cochlea.
Contains endolymph
• Lies between the 2 bony compartments and ends as a
closed sac at the apex of the cochlea
• Separated from the scala vestibuli by a vestibular
membrane (Reissner’s membrane)
• Separated from scala tympani by a basilar membrane
Cochlea. A.) Cross section of the cochlea. B.) Organ of Corti and the tectorial
membrane.
– Basilar membrane
• Contains many thousands of stiff, elastic fibers
• Sound vibrations entering the perilymph at the
oval window travel along the scala vestibuli,
pass through the vestibular membrane into the
endolymph of the cochlear duct where they
move the basilar membrane
• Then vibrations enter the perilymph of the
scala tympani to the round window and
dissipate into the tympanic cavity
– Organ of Corti
• Contains the hearing receptors
• Located on the upper surface of the basilar
membrane and stretches from the apex to base
of the cochlea
• Receptor cells (hair cells) are organized in
rows and have many hairlike processes that
project into the cochlear duct
Cochlea. A.) Cross section of the cochlea. B.) Organ of Corti and the tectorial
membrane.
SEM of hair cells on the organ of Corti
– Tectorial membrane
• Attached to the bony shelf of the cochlea,
passing over the receptor cells and contacting
the tips of their hairs
• As sound vibrations move back and forth
against the tectorial membrane causing
mechanical deformation and stimulating the
receptor cells
• Various receptor cells have slightly different
sensitivities to deformation.
– A particular sound frequency may excite certain receptor
cells and another frequency excites a different set of hair
cell
• Hearing receptor cells are epithelial but
function somewhat like neurons
– Membrane is polarized when at rest and
depolarized when stimulated and more permeable
to Ca+ ions
– Has no axons or dendrites but has
neurotransmitter-containing vesicles near its base
– As Ca+ ions diffuse into the cell, some fuse with
cell membrane and release neurotransmitter
which stimulates the ends of nearby sensory
nerve fibers
– Impulses are transmitted along the cochlear
branch of the vestibulocochlear nerve to the
auditory cortex of the temporal lobe of the brain
 Auditory Nerve Pathway
• Nerve fibers associated with hearing
• Pass into the auditory cortices of the
temporal lobe of the cerebrum where they
are interpreted on both sides of the brain
• Some fibers cross over so that impulses
from each ear are interpreted on both sides
of the brain
• Damage to the temporal lobe on one side
does not necessarily cause complete hearing
loss on that side
 Decibels (dB)
• Measure of sound intensity
• Scale begins at 0dB = intensity of
sound least perceptible by a normal
human ear
• Scale is logarithmic: 10dB is 10x as
intense as 0dB, 20dB is 100x more
intense, 30dB is 1000x more intense
• Whisper = 40dB
• Normal Conversation = 60-70dB
• Heavy traffic = 80dB
• Rock Concert = 120dB, causes discomfort
• Jet plane take off = 140dB, pain
• Frequent or prolonged exposure to sounds
with intensities above 90dB can damage
hearing receptors and cause permanent
hearing loss.
 Hearing Loss
• Conductive deafness:
– Interference with transmission of vibrations to the
inner ear
– May be due to plugging of the external auditory
meatus or to changes in the eardrum or auditory
ossicles
• Ex. Eardrum may harden as a result of disease and be
less responsive to sound waves
• Ex. Disease or injury may tear or perforate the eardrum
• Sensorineural Deafness:
– Damage to the cochlea, auditory nerve or
auditory nerve pathways
– Can be caused by loud sounds, tumors in
the CNS, brain damage as a result of
vascular accidents or use of certain drugs
 Sense of Equilibrium
• Two senses that come from different
sensory organs
• Static Equilibrium: senses position of
the head, maintaining stability and
posture when the head and body are
still
• Dynamic Equilibrium: sense sudden
movement or rotation of the head and
body. Aid in maintaining balance
 Static Equilibrium
• Organs located within the vestibule, a bony
chamber between the semicircular canals
and the cochlea
• There are two expanded chambers inside the
vestibule – the utricle and the saccule
• Each chamber has a tiny structure called a
macula that contains numerous hair cells
which serve as sensory receptors
• When the head is upright, the hairs project upward
into a mass of gelatinous material containing grains
of calcium carbonate (called otoliths)
• When the head bends forward, backward, or to one
side, the hair cells are stimulated as the gelatinous
masses of the maculae sag in response to gravity
causing the hair to bend
• Stimulated hair cells signal nerve fibers resulting in
impulses traveling to the CNS on the vestibular
branch of the vestibulocochlear nerve and informing
the brain of the head’s new position
• Brain responds by sending motor impulses to
skeletal muscles to contract/relax to maintain
balance
The macula responds to changes in head position. A.) Macula with the head in an
upright position. B.) Macula with the head bent forward.
 Dynamic Equilibrium
• Semicircular canals are the organs of
dynamic equilibrium and are located in
the labyrinth
• Detect motion of the head and aid in
balancing the head and body during
sudden movement
• Semicircular canals lie at right angles
to each other and correspond to the
different anatomical planes
• Ampulla: swelling at the end of a
membranous canal that is suspended
in the perilymph of the bony portion of
each semicircular canal
– Contains sensory organs called crista
ampullaris which are made up of sensory
hair cells and supporting cells
– Hair cells extend upward into a dome-
shaped gelatinous mass called the cupula
A crista ampullaris is located within the ampulla of each semicircular canal.
• Rapid turns of the head or body stimulate the
hair cells of the crista ampullaris
(semicircular canals move with the head but
the fluid, remains stationary)
• Hair cells signal associated nerve fibers to
send impulses to the brain – cerebellum
• Analysis of info allows the brain to predict
the consequences of the rapid body
movements and signal appropriate skeletal
muscle to maintain balance
Equilibrium. A.) When the head is stationary, the cupula of the crista ampullaris remains
upright. B.) When the head is moving rapidly, C.) the cupula bends opposite the motion
of the head, stimulating sensory receptors.
Other Sensory Structures Aid in
Maintaining Equilibrium
• Mechanoreceptors associated with
joints of neck inform the brain about
position of body parts
• Eyes detect changes in posture
• Visual info is important. Even if organs
of equilibrium are damaged, a person
may be able to maintain normal balance
(eyes open and move slowly)
 Motion Sickness
• Boat, airplane, car
• Caused by abnormal and irregular body
motions that disturb the organs of
equilibrium
• Symptoms include nausea, vomiting,
dizziness, headache, and prostration
(weakness, collapse, exhaustion)
Sense of Sight
 Sense of Sight
• Eye: organ containing visual receptors
– Provides vision with assistance of
accessory organs
• Visual accessory organs
– Eyelids, lacrimal apparatus (protects eye),
and a set of extrinsic muscles (move eye)
 Orbital Cavity
• Location of eye and accessory organs
• Pear-shaped
• Lined with the periosteum of various
bones and contains fat, blood vessels,
nerves, and connective tissues.
 Eyelid (4 layers)
• Skin: thinnest skin of body. Covers the lids
outer surface.
• Muscle:
– Orbicularis oculi: acts as a sphincter and closes
lid when it contracts.
– Levator palpebrae superioris: raises the upper lid
• Connective tissue
• Conjunctiva: mucous membrane that lines
the inner surfaces of the eyelids and anterior
surface of eyeball except for the central
portion (cornea).
Sagittal section of the closed eyelids and anterior portion of the eye.
 Lacrimal Apparatus
• Lacrimal Gland: secretes tears continuously.
Located in the orbit and series of ducts that
carry tears into nasal cavity.
– Tears exit lacrimal gland through tiny tubules and
flow downward and medially across the eye.
– Superior and inferior canaliculi collects tears 
into lacrimal sac located in groove of lacrimal
bone  nasolacrimal duct which empties into
nasal cavity
– Moistens and lubricates surface of the eye
and lining of lids
– Tears contain lysozome – antibacterial
agent reducing risk of eye infections.

The lacrimal apparatus

consists of a tear-
secreting gland and a
series of ducts.
 Extrinsic Muscles
• Arise from bones of the orbit and
attach (insert) by broad tendons on the
eye’s tough outer surface.
• 6 extrinsic muscles move the eye in
various directions. Eye movements
may utilize more than one muscle.
Extrinsic muscles of the right eye (lateral view)
 Diplopia
• Double vision caused by one eye
deviating from the line of vision.
• If condition persists, brain must
suppress image from deviated eye
 Suppression Amblyopia
• Turning eye becomes blind.
• Treatment early in life with exercises,
eyeglasses and surgery can prevent
monocular blindness (one eye)
 Structure of the Eye
• Hollow, spherical structure 2.5cm in
diameter
• 3 layers: fibrous outer tunic, vascular
middle tunic, nervous inner tunic
• Spaces within eye filled with fluids that
support its wall and internal parts and
help maintain its shape.
 Outer Tunic – Fibrous Tunic
• Cornea
• Sclera
• Optic Nerve: in the back of the eye
• Blood Vessels: pierce sclera
 Cornea
• Anterior 6th of outer tunic
• Bulges forward
• Transparent window of the eye (contains few cells,
no blood vessels, cells and collagenous fibers form
unusually regular patterns)
• Helps focus entering light rays
• Composed largely of connective tissue with a thin
layer of epithelium on its surface.
• Continuous with the sclera (white portion of the eye)
Transverse section of the right eye (superior view)
 Sclera
• White portion of the eye
• Posterior 5/6th of the outer tunic
• Opaque due to many large,
disorganized collagenous and elastic
fibers.
• Protects the eye and is an attachment
for the extrinsic muscles
 Most Common Cause of
Blindness
• Loss of transparency of the cornea
• Corneal Transplant (penetrating
keratoplasty): treat condition by
replacing central 2/3 of the defective
cornea with similar-sized portion of
cornea from a donor eye
– Corneal tissues lack blood vessels,
transplanted tissue usually not rejected
– Success rate of procedure is very high.
Middle Tunic – Vascular Tunic
• Choroid Coat
• Ciliary Body
• Iris
 Choroid Coat
• Posterior 5/6th of globe of the eye
• Loosely joined to the sclera
• Honeycombed with blood vessels
which nourish surrounding tissues
• Contains many pigment-producing
melanocytes which absorbs excess
light and helps keep the inside of the
eye dark.
 Ciliary Body
• Thickest part of the middle tunic
• Extends forward from the choroid coat and
forms an internal ring around the front of the
eye.
• Many radiating folds called ciliary processes
• Groups of muscle fibers called ciliary
muscles.
• Suspensory ligaments: extend inward from
the ciliary processes and hold transparent
lens and capsule in position.
Lens and ciliary body viewed from behind
 Lens
• Lies directly behind the iris and pupil
• Composed of differentiated epithelial
cells called lens fibers.
 Lens Capsule
• Surrounds the lens
• Clear, membrane-like structure
composed largely of intercellular
material
• Elastic nature keeps it under constant
tension. Can assume a globular shape.
• Suspensory ligaments attached to
margin of capsule and the ciliary
muscles. Changing tension changes
the shape of the capsule and lens for
focusing.
• Accommodation: the ability of the lens
to adjust shape to facilitate focusing.
Close objects= lens thickens; distant
objects= thinner, less convex
In accommodation, A.) the lens thins as ciliary muscle fibers relax. B.) The lens thickens
as ciliary muscle fibers contract.
 Cataract
• Common eye disorder in older people
• Lens or capsule slowly becomes cloudy and
opaque.
• Without treatment it eventually causes
blindness
• Treatment:
– In past, surgical procedure with 2 week recovery
– Now, laser treatment on out-patient basis.
 Iris
• Thin diaphragm composed mostly of
connective tissue and smooth muscle fibers
• The colored portion of the eye
• Extends forward from the periphery of the
ciliary body and lies between the cornea and
the lens.
• Divides the space (anterior cavity) into the
anterior chamber (between the cornea and
the iris) and posterior chamber (between iris
and vitreous body containing the lens)
 Aqueous Humor
• Watery fluid secreted by the epithelium
on the inner surface of the ciliary body
into posterior chamber.
 Pupil
• Circular opening in the center of the
iris. Fluid flows through from posterior
to anterior chamber.
• Aqueous humor fills space between
cornea and lens. Nourish these parts
and aids in maintaining shape of the
front of the eye.
– Leaves anterior chamber through veins
and special drainage canal – scleral
venous sinus (canal of Schlemm)
 Glaucoma
• Eye disorder that develops when the
rate of aqueous humor formation
exceeds the rate of its removal.
• Fluid accumulates in anterior chamber
of the eye, fluid pressure rises and is
transmitted to all parts of the eye.
• Building pressure squeezes shut blood
vessels that supply the receptor cells
of the retina.
• Cells robbed of nutrients and oxygen may
die and permanent blindness can result.
• Early diagnosis allows successful treatment
with drugs, laser therapy, or surgery to
promote outflow of aqueous humor
• Early stages typically produce no symptoms.
Discovery of the condition by tonometer, an
instrument that measures intracellular
pressure.
 Smooth Muscle Fibers of Iris
• Control size of the pupil through which
light passes as it enters the eye.
• 2 groups
– Circular set: acts as a sphincter.
Contracts smaller, less light enters.
– Radial set: contracts to increase diameter
of pupil allowing more light to enter.
Dim light stimulates the radial muscles of the iris to contract, and the pupil dilates. Bright
light stimulates the circular muscles of the iris to contract, and the pupil constricts.
 Inner Tunic
• Consist of the retina which contains
visual cells (photoreceptors)
• Nearly transparent sheet of tissue that
is continuous with the optic nerve in
the back of the eye and extends
forward as the inner lining of the
eyeball
• Ends just behind the margin of the
ciliary body
 Retina
• Thin and delicate. Complex structure
with a number of distinct layers.
– Macula lutea: central region. Yellowish
spot
– Fovea centralis: depression in its center.
Region that produces sharpest vision.
– Optic disc: medial to fovea centralis. Nerve
fibers from the retina leave the eye and
join the optic nerve.
• Central artery and vein also pass through optic
nerve and vessels are continuous with the
capillary networks of the retina and with
vessels in the underlying choroid coat.
• Supply blood to cells of inner tunic
• Known as the blind spot of the eye. Lacks
receptor cells.
The retinal consists of several cell layers.
Note the layers of cells and nerve fibers in this light micrograph of the retina.
Retina. A.) Nerve fibers leave the eye in the area of the optic disc (arrow) to form the
optic nerve. B.) Major features of the retina.
 Posterior Cavity
• Space bounded by the lens, ciliary
body, and retina is the largest
compartment of the eye.
• Filled with transparent, jelly-like fluid
called vitreous humor, along with
collagenous fibers it comprises the
vitreous body.
• Vitreous body: supports internal parts
of the eye and helps maintain its shape.
 Floaters
• Specks or clumps of gel or deposits of
crystal-like substances that form in the
vitreous humor. Cast shadows on the
retina.
• Person sees small, moving specks in
the field of vision. Most apparent when
looking at a plain background.
• More numerous as a person ages.
 Light Refraction
• When a person sees something, the object is
giving off light or light waves are reflected
from it.
• Light waves enter the eye and an image of
the object is focused on the retina.
• Refraction: bending of light waves to focus
them.
• Occurs when light waves pass at an oblique
angle from a medium of one density into a
medium of another density.
A lens with a convex surface causes light waves to converge.
• Convex surface causes light waves to
refract and converge (cornea, lens,
fluids)
• If eye shape is normal, light waves
focus sharply on the retina.
– Image is upside down and reversed from
left to right.
– Visual cortex interprets the image in its
proper position.
 Visual Receptors
• Visual receptor cells are modified
neurons of two distinct kinds. (rods
and cones)
 Rods
*Long, thin projections at their
ends.
*Human eye has 125 million
*Hundreds of times more
sensitive to light than cones.
*Can provide vision in dim light
*Produce colorless vision
*General outlines of objects.
Less precise images because
nerve fibers from many rods
converge their impulses and
transmit them to the brain on the
same nerve fiber.
Cones
*Short, blunt projections.
*Human eye has 7 million
*Detect color
*Provide sharp images (higher visual
acuity)
*Convergence of impulses less
common. Brain can pinpoint
stimulation more accurately.
*Fovea centralis: Area of sharpest
vision.
*Lacks rods but contains densely
packed cones with few to no
converging fibers.
*To view something in detail, a
person moves the eyes so that the
important part of an image falls on
the fovea centralis.
Rods and Cones. A.) A single sensory nerve fiber transmits impulses from several rods to the brain.
B. Separate sensory nerve fibers transmit impulses from cones to the brain. C.) Scanning electron
micrograph of rods and cones.
• Rods and cones are located in a deep
portion of the retina, closely associated
with the layer of pigmented epithelium.
• Epithelial pigment absorbs waves not
absorbed by receptor cells.
• Along with pigment of choroid coat, it
keeps light from reflecting off surfaces
inside the eye.
• Projections from receptors are loaded with
light-sensitive visual pigments and extend
into this pigmented layer.
• Visual receptors are stimulated only when
light reaches them. A light image focused on
an area of the retina stimulate some
receptors and sends impulses to the brain.
This provides only a fragment of info
required for the brain to interpret a total
scene.
Pigmented epithelium and receptor cells
 Visual Pigments
• Both rods and cones contain light-sensitive
pigments that decompose when they absorb light
energy.
• Decomposition of the pigments triggers a complex
series of reactions that initiate a nerve impulse
• Pigments are synthesized from vitamin A.
• Night blindness: poor vision in dim light results from
vitamin A deficiency which reduces the supply of
retinal (a type of visual pigment) causing low rod
sensitivity. Treated with Vitamin A supplements.
• Color vision comes from 3 sets of cones
containing different light-sensitive pigments
• Each type of pigment is sensitive to different
wavelengths (colors- red, green, blue) of
light.
• The color a person perceives depends on
which set of cones or combination of sets
the light in a given image stimulates. (all
three =white; none=black)
• Different forms of color blindness result from
lack of different types of cone pigments.
 Visual Nerve Pathway
• Axons of retinal neurons leave eyes to form optic
nerves.
• X-shaped optic chiasma. Some fibers cross over
• Right and left optic tracts
• A few nerve fibers enter nuclei that function in
various visual reflexes
• The rest enter the thalamus
• Visual impulses enter nerve pathways called optic
radiations which lead to the visual cortex of the
occipital lobes.
The visual pathway includes the optic nerve, optic chiasma, optic tract, and optic
radiations.
Clinical Terms Related to the
Senses
 Amblyopia
• Dim vision due to a cause other than a
refractive disorder or lesion
Amblyopia is the medical term for poor
development of vision in one eye. The word comes
from the Greek. [ambly- (dull) + -opia (vision)]
Amblyopia is often referred to as "lazy eye." It
affects just two to three percent of the population.
Central vision does not develop properly, usually in
one eye, which is called amblyopic. The eye is
anatomically normal, but visual acuity is reduced
even with glasses. Amblyopia develops sometime
between birth and 8 or 9 years of age, the critical
period of time when the visual system develops
and matures. Amblyopia causes more visual loss in
the age group under 40 than all the injuries and
diseases combined.
 Anopia
• Absence of an eye
 Audiometry
• Measurement of auditory acuity for
various frequencies of sound waves
 Blepharitis
• Inflammation of the eyelid margins
 Causalgia
• Persistent, burning pain usually
associated with injury to a limb
Also called complex regional pain
syndrome.Most common between ages 40-
60. Diagnosis through observation,
thermography, and radiography.Treatment
includes physical therapy, corticosteriods,
local anesthetic, vasodilaters and
antidepressants.
 Conjunctivitis
• Inflammation of the conjunctiva

Viruses, bacteria, irritating substances

(shampoo, dirt, smoke, pool chlorine),
sexually transmitted diseases (STDs) or
allergens (substances that cause allergies)
can all cause conjunctivitis. Pink eye
caused by bacteria, viruses or STDs can
spread easily from person to person but is
not a serious health risk if diagnosed
promptly; allergic conjunctivitis is not
contagious.
 Diplopia
• Double vision
 Emmetropia
• Normal condition of the eyes; eyes with
no refractive defects.
 Enucleation
• Removal of the eyeball
 Exophthalmos
• Abnormal protrusion of the eyes

Associated with hyperthyroidism and Grave’s disease. In the case of Graves Disease,
the displacement of the eye is due to abnormal connective tissue deposition in the orbit
and extraocular muscles (Epstein et al, 2003) which can be visualized by CT or MRI.
If left untreated, exophthalmos can causes the eye lids to fail to close during sleep
leading to corneal damage. The process that is causing the displacement of the eye may
also compress the optic nerve or ophthalmic artery leading to blindness
 Hemianopsia
• Defective vision affecting half of the
visual field
 Hyperalgesia
• Heightened sensitivity to pain

Caused by injury, or allergic/inflammatory reaction. One unusual cause is

platypus venom (venomous ankle spurs)
 Iridectomy
• Surgical removal of part of the iris

Treatment for one type of glaucoma

where the iris sags and blocks normal
drainage.
 Iritis
• Inflammation of the iris
Also called anterior uveitis. It is the 3rd leading cause of blindness in the developed
world. White blood cells are shed into the anterior chamber of the eye in the
aqueous humor. These cells can accumulate and cause adhesions between the iris
and the lens. Iritis is associated with over 90 different pathogens and autoimmune
disorders. Some treatments include antibiotics and steroids.
 Keratitis
• Inflammation of the cornea

Symptoms include pain, and profuse tearing. Can be caused by infection, trauma,
dry eyes, UV exposure, contact lens over-wear, degeneration.

Herpes simplex keratitis

 Labyrinthectomy
• Surgical removal of the labyrinth
 Labyrinthitis
• Inflammation of the labyrinth

Usually caused by a viral infection, occasionally bacterial. Symptoms

include reduced hearing or distortion, ringing in the ear, dizziness,
imbalance, nausea and vomiting. Often follows the common cold. Viral
form improves on its own within a few weeks. Anti-nausea medication can
be prescribed.
 Meniere’s Disease
• Inner ear disorder that causes ringing
in the ears, increased sensitivity to
sounds, dizziness, and hearing loss

Meniere’s disease is a problem with the inner ear, the part of the ear responsible
for balance as well as hearing. When you have Meniere’s disease, too much
endolymph (fluid) backs up in the canals, a condition called endolymphatic
hydrops. Extra fluid causes pressure to build up, so the canals swell and can’t
work right. This leads to problems with the ear’s hearing and balance systems.
 Neuralgia
• Pain resulting from inflammation of a
nerve or a group of nerves.

Trigeminal neuralgia
 Neuritis
• Inflammation of a nerve
Optic neuritis is acute visual loss owing
to demyelination of the optic nerve. It
may be an isolated autoimmune
condition or part of multiple sclerosis.
Fortunately, vision recovers to normal or
near normal in over 90% of patients
within six months. No treatment
improves those chances.
Optic neuritis
 Otitis media
• Inflammation of the
middle ear
Bacterial or viral infection occurs in the
fluid buildup after a respiratory illness
 Otosclerosis
• Formation of spongy bone in the inner
ear, which often causes deafness by
fixing the stapes to the oval window
Treatment
In the early stages of otosclerosis, or when the condition
is mild, you might not need any treatment. Hearing aids
are very useful initially. However, as the calcium buildup
on the stapes progresses you will gradually lose your
hearing. Sodium fluoride tablets have been shown to
help prevent the progression of otosclerosis, but only if
the condition has also affected the inner ear.
At some point, most people usually have an operation -
a stapedectomy or stapedotomy - where a tiny piston
replaces the stapes so that sound can travel to the inner
ear. This operation has a high success rate.
 Pterygium
• Abnormally thickened patch of
conjunctiva that extends over part of
the cornea Pterygium occurs more often in people who
spend a great deal of time outdoors, especially
in sunny climates. Long-term exposure to
sunlight, especially ultra-violet (UV) rays, and
chronic eye irritation from dry; dusty conditions
seem to play an important causal role. When a
pterygium becomes red and irritated, topical
eye-drops or ointment may be used to help
reduce the inflammation. If the pterygium is
large enough to threaten sight, is growing or is
unsightly, it can be removed surgically
 Retinitis pigmentosa
• Inherited, progressive retinal sclerosis
characterized by pigment deposits in
the retina and by retinal atrophy
In the progression of symptoms for RP, night blindness
generally precedes tunnel vision by years or even decades.
Many people with RP do not become legally blind until their
40s or 50s and retain some sight all their life. Others go
completely blind from RP, in some cases as early as
childhood. Progression of RP is different in each case.
RP is a group of inherited disorders in which abnormalities of
the photoreceptors (rods and cones) or the retinal pigment
epithelium (RPE) of the retina lead to progressive visual
loss. Affected individuals first experience defective dark
adaptation or nyctalopia (night blindness), followed by
constriction of the peripheral visual field and, eventually, loss
of central vision late in the course of the disease.
 Retinoblastoma
• Inherited, highly malignant tumor
arising from immature retinal cells
Retinoblastoma is a rare cancer of the
retina (the innermost layer of the eye,
located at the back of the eye, that
receives light and images necessary for
vision). About 300 children will be
diagnosed with retinoblastoma this year. It
accounts for 3 percent of childhood
cancers. Treatments include surgery,
radiation, chemotherapy, laser therapy,
phototherapy, thermal therapy, and
cryotherapy.
 Tinnitus
• Ringing or buzzing noise in the ears.

Ringing, buzzing, whistling, or roaring

noises in the ear). These noises may
come and go or may always be present.
The noises may get louder just before a
vertigo attack.
 Trachoma
• Bacterial disease of the eye that causes
conjunctivitis, which may lead to
blindness
Trachoma, an infection of the eye caused by
Chlamydia trachomatis, ranks worldwide as the most
common preventable cause of blindness and the
second most common cause of blindness after
cataract. It has been estimated to cause 15% of the
world's blindness.1,20 The disease is endemic in 48
countries in Latin America, Africa, the Middle East,
Asia, and Australasia [see Fig. 1], and is most
prevalent in poor, rural communities with lower
standards of hygiene and sanitation.2 The WHO
currently estimates that 6 million people are blind due
to trachoma, and that an additional 146 million people
have active forms of the disease.
 Tympanoplasty
• Surgical reconstruction of the middle
ear bones and the establishment of
continuity from the eardrum to the oval
window.
 Uveitis
• Inflammation of the uvea, the region of
the eye that includes the iris, ciliary
body, and choroid coat.
There are different types of uveitis, depending on
which part of the eye is affected:
When the uvea is inflamed near the front of the iris, it
is called iritis. If the uvea is inflamed in the middle of
the eye, it is called cyclitis. Cyclitis affects the
muscle that focuses the lens.An inflammation in the
back of the eye is called choroiditis.
Eye drops, especially steroids and pupil dilators, can
reduce inflammation and pain. For more severe
inflammation, oral medication or injections may be
necessary.
Uveitis can have these complications: Glaucoma
(increases pressure in the eye); Cataract (clouding of
the eye's natural lens); Neovascularization (growth of
new, abnormal blood vessels).
 Vertigo
• Sensation of dizziness
 Lab Review
• Visual Acuity
• Astigmatism
• Accomodation
• Blind Spot
• Photopupillary Reflex
• Accommodation Pupillary Reflex
• Convergence Reflex
*clinical connection p276