Podcast
Questions and Answers
Which sense is NOT considered essential for growth, development, and survival?
Which sense is NOT considered essential for growth, development, and survival?
What is the role of sensory perception in the context of stimuli?
What is the role of sensory perception in the context of stimuli?
Which of the following is NOT an external stimulus?
Which of the following is NOT an external stimulus?
What can cause vertigo, making it difficult to diagnose?
What can cause vertigo, making it difficult to diagnose?
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Which aspect is NOT part of the sensory process?
Which aspect is NOT part of the sensory process?
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What is the leading cause of blindness in the USA?
What is the leading cause of blindness in the USA?
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Which condition is characterized by difficulty in differentiating individual sounds in words?
Which condition is characterized by difficulty in differentiating individual sounds in words?
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What visual impairment is most prevalent among American Indians and Native Americans?
What visual impairment is most prevalent among American Indians and Native Americans?
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Which type of glaucoma has no identifiable cause?
Which type of glaucoma has no identifiable cause?
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Which finding in infants can indicate visual impairment?
Which finding in infants can indicate visual impairment?
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What is the most common disease of the eye associated with aging?
What is the most common disease of the eye associated with aging?
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What condition may result from repeated bouts of otitis media in children?
What condition may result from repeated bouts of otitis media in children?
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Which is a risk factor for developing cataracts?
Which is a risk factor for developing cataracts?
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Which of the following assessments is least commonly routine for infants?
Which of the following assessments is least commonly routine for infants?
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What intervention can help manage acute sensory deficits?
What intervention can help manage acute sensory deficits?
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What is the primary indicator of vision loss associated with aging?
What is the primary indicator of vision loss associated with aging?
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Which therapy is indicated for hearing disorders?
Which therapy is indicated for hearing disorders?
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What should be maintained when caring for patients with impaired balance?
What should be maintained when caring for patients with impaired balance?
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Which option describes a reversible cause of vertigo?
Which option describes a reversible cause of vertigo?
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What is a key characteristic of nonexudative age-related macular degeneration (AMD)?
What is a key characteristic of nonexudative age-related macular degeneration (AMD)?
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Which risk factor is associated with increased likelihood of developing glaucoma?
Which risk factor is associated with increased likelihood of developing glaucoma?
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What is a common symptom of acute angle closure glaucoma?
What is a common symptom of acute angle closure glaucoma?
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What lifestyle change is recommended for preventing macular degeneration?
What lifestyle change is recommended for preventing macular degeneration?
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What is a method used for nonpharmacologic therapy for cataracts?
What is a method used for nonpharmacologic therapy for cataracts?
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Which of the following contributes to sensorineural hearing loss?
Which of the following contributes to sensorineural hearing loss?
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Which of the following is NOT a risk factor for developing cataracts?
Which of the following is NOT a risk factor for developing cataracts?
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In children, which sign may indicate congenital cataracts?
In children, which sign may indicate congenital cataracts?
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What is a common symptom of presbycusis?
What is a common symptom of presbycusis?
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Which of the following is a preventative measure for noise-induced hearing loss?
Which of the following is a preventative measure for noise-induced hearing loss?
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Which condition is associated with congenital hearing loss?
Which condition is associated with congenital hearing loss?
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Which of the following is not a typical symptom of glaucoma?
Which of the following is not a typical symptom of glaucoma?
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Which of the following is a recommended preventative strategy for cataracts?
Which of the following is a recommended preventative strategy for cataracts?
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Which of the following describes juvenile macular degeneration?
Which of the following describes juvenile macular degeneration?
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Study Notes
Common Eye Problems
-
Refractive errors are common eye problems, including:
- Myopia (nearsightedness): Difficulty seeing distant objects clearly.
- Hyperopia (farsightedness): Difficulty seeing near objects clearly.
- Astigmatism: Altered vision at any distance due to an irregularly shaped cornea.
- Presbyopia: Impaired vision related to aging, making it difficult to focus on near objects.
Visual & Hearing Problems in Infants
- Infants at high risk for visual or hearing problems include:
- Premature infants.
- Infants whose mothers were infected prenatally with rubella, toxoplasmosis, or other viruses.
- Infants with congenital or hereditary disorders.
- Infants with genetic abnormalities.
- Infants with absence of other problems or in conjunction with other genetic syndromes.
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Blindness or visual impairments in children can be caused by:
- Retinopathy of prematurity: A condition that affects the blood vessels in the retina.
- Low birth weight.
- Congenital cataracts: Clouding of the lens of the eye at birth.
- Prenatal visual and hearing disturbances can be associated with fetal alcohol syndrome.
Auditory Processing Disorder
- Auditory processing disorder involves difficulty differentiating individual sounds in words.
Cultural & Genetic Components to Visual Disorders
- Open-angle glaucoma is more prevalent among African Americans and Hispanics.
- Visual impairment due to refractive error is most prevalent among American Indians/Native Americans.
Illnesses & Sensory Issues
- Atherosclerosis restricts blood flow to receptor organs and the brain, potentially impacting sensory function.
- Uncontrolled hypertension can lead to blindness.
- Strokes can cause blindness, hearing loss, and changes in smell/taste.
- Uncontrolled diabetes mellitus is a leading cause of blindness in the USA.
- Maternal diabetes increases the risk of hearing impairments in the fetus.
- Repeated bouts of otitis media in children can damage eardrums.
Sensory Reception Concepts
- Sensory reception is crucial for:
- Cognition.
- Development of self-awareness.
- Safety.
- Stress and coping.
- Infection prevention.
- Communication.
Hearing & Vision Screening Guidelines
- Newborns should be screened for hearing routinely and before discharge.
- Preschoolers/school-age children should have periodic hearing screenings at school or by a healthcare provider.
- Children ages 3-5 should undergo at least one vision screening.
- Adults aged 40 and older should have a comprehensive eye exam.
- Adults with no comorbidities should have eye exams every 5-10 years.
Nursing Assessment
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Identify patients at higher risk for sensory impairments:
- Altered mobility.
- Multiple comorbidities.
- Older adults.
- Individuals involved in contact sports.
- Smokers.
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Consider comorbidities (existing medical conditions) associated with sensory issues:
- Vision impairment: Diabetes, heart problems, breathing problems, HTN, joint problems, strokes.
- Hearing loss: Diabetes, depression, kidney disease, dementia.
Physical Assessment
- Conduct specific sensory tests:
- Visual acuity: Assessment of sharpness of vision.
- Hearing acuity: Assessment of hearing ability.
- Olfactory sense: Assessment of smell.
- Gustatory sense: Assessment of taste.
- Tactile sense: Assessment of touch.
- Assess perception of heat, cold, light touch, pain, and proprioception (awareness of body position).
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Eye and vision assessment:
- Cardinal fields of vision: Testing eye movements through pen or finger movement.
- Ophthalmoscope: Examination of the internal eye structures (performed by a specialist).
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Ear and hearing assessment:
- Otoscope: Examination of the external auditory canal and tympanic membrane.
- Tuning fork: Used to determine the level of hearing loss.
Independent Interventions
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Managing acute sensory deficits:
- Encourage use of sensory aids.
- Promote use of other senses.
- Communicate effectively.
- Ensure safety.
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Adapting to limits imposed by sensory loss:
- Visually impaired patients: Encourage enjoyment of live music, podcasts, audiobooks.
- Hearing impaired patients: Encourages use of email, text instead of phone calls.
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Impaired vision:
- Monitor for depression.
- Create an uncluttered environment with good lighting.
- Clear pathways for safe movement.
- Organize things within reach.
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Impaired hearing:
- Provide devices that amplify sounds or respond to sounds with flashing lights.
- Encourage use of TV and videos with closed captioning.
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Impaired olfactory sense:
- Educate on dangers of cleaning with certain chemicals.
- Ensure gas appliances are in good working order.
- Inspect food for freshness and expiration dates.
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Impaired tactile sense:
- Adjust hot water heater temperature to prevent burns..
- Change position frequently to prevent pressure ulcers.
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Impaired balance:
- Create an uncluttered environment with good lighting.
- Encourage physical therapy (PT)/occupational therapy (OT) for balance training.
Collaborative Therapies
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Vision disorders:
- Optometrist: Eye care professional who provides routine eye care.
- Ophthalmologist: Eye doctor who diagnoses and treats eye diseases.
-
Surgery:
- Cataract, glaucoma, or laser eye surgery.
- Corneal transplant surgery.
- Repair of detached retinas.
- Eye muscle surgery.
- After direct major injury to the eye.
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Alterations in smell and taste:
- Surgery for polyps or deviated septum.
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Hearing disorders:
- Audiologist: Hearing care professional who diagnoses and treats hearing disorders.
- Otolaryngologist: Ear, nose, and throat specialist.
- Hearing instrument specialist: Provides hearing aids and other assistive devices.
- Physical or occupational therapist: Help with mobility and daily living skills.
- American Sign Language (ASL) instruction.
- Lip reading classes.
Infants & Sensory Issues
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Vision problems:
- Strabismus (crossed eyes).
- Excessive tearing.
- Amblyopia (lazy eye).
- Nystagmus (involuntary eye movement).
- Myopia (nearsightedness).
- Hyperopia (farsightedness).
- Eye cancer.
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Hearing tests:
- Otoacoustic emission test: Measures sounds produced by the inner ear.
- Auditory brainstem response test: Measures the brain's response to sounds.
- Sense of touch: Not routinely assessed, but nurses can observe for potential issues.
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Vertigo is associated with factors like:
- Gender.
- Stress.
- Muscle pain in the neck and shoulder area.
- Amount of sleep.
- Migraines.
- Dizziness.
Pregnancy & Sensory Changes
- Tinnitus (ringing in the ears).
- Vertigo (dizziness).
- Heightened sense of smell: Often associated with nausea, vomiting, and food cravings. These changes are temporary and usually resolve after delivery.
Common Eye Diseases
- Cataracts: Clouding of the lens of the eye.
- Glaucoma: A condition that damages the optic nerve.
- Age-related macular degeneration (AMD): Degeneration of the macula, the central part of the retina.
Causes of Eye Inflammation
- Local or systemic allergic reactions.
- Conjunctivitis (pink eye).
- Uveitis (inflammation of the middle layer of the eye).
- Eye injury.
- Glaucoma.
- Macular edema (swelling of the macula).
- Dry eye syndrome.
Cataracts
- Opacification (clouding) of the lens of the eye, interfering with light and image perception.
- Most cataracts are a result of the aging process.
-
Four types of cataracts occur independent of aging:
- Secondary cataracts: Form after surgery for other eye disorders or as a side effect of medication.
- Traumatic cataracts: Result from eye injury.
- Radiation cataracts: Caused by exposure to radiation.
- Congenital cataracts: Present at birth.
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Risk Factors: Age, genetics, environmental, and lifestyle factors:
- Long-term sun exposure.
- Cigarette smoking.
- Heavy alcohol consumption.
- Eye trauma.
- Diabetes mellitus.
- Certain medications.
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Prevention: No known methods to prevent cataracts, but risk reduction strategies include:
- No smoking.
- Avoiding heavy alcohol consumption.
- Protecting eyes from UVB rays.
- Eating a diet rich in vitamins C and E, lutein, and zeaxanthin.
Glaucoma
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Primary glaucoma: No identified cause.
- Open-angle glaucoma: Chronic, gradual vision loss, the most common form in adults.
- Angle-closure glaucoma: Rapid, permanent vision loss if untreated.
- Secondary glaucoma: Develops as a complication of other eye conditions.
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Risk factors:
- Age: More common with increasing age.
- Race: More common among African Americans and Hispanics.
- Family history: A family history of glaucoma increases risk.
- Long-term steroid use: Steroids can raise intraocular pressure.
- Eye trauma: Can lead to secondary glaucoma.
- Myopia (nearsightedness).
- High blood pressure (HTN).
- Thin corneas: More susceptible to pressure changes.
- Diabetes.
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Prevention:
- Regular eye exams to detect early stages.
- Exercise to lower intraocular pressure.
- Healthy diet high in vitamins, zinc, fatty acids, and omega-3s.
- Prevent overexposure to sunlight.
- Refrain from smoking.
Macular Degeneration
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Degeneration of the macula (central part of retina) that affects central vision.
- Nonexudative (dry) AMD: Gradual accumulation of deposits (drusen), slow vision loss.
- Exudative (wet) AMD: Growth of blood vessels between the choroid and retina, distorts vision, and can cause acute vision loss.
-
Risk factors:
- Aging.
- Race.
- Eye color: Lighter eye color may increase risk.
- Family history: A family history of AMD increases risk.
- Smoking.
- Obesity.
- Poor cardiovascular health.
- Excessive UV exposure.
- Heavy alcohol consumption.
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Prevention:
- No smoking.
- Reduce UV exposure.
Sensory Perception Changes with Specific Eye Conditions
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Cataracts:
- Decreased visual acuity: Affecting both near and distant vision.
- Causes glare.
- Bilateral unless due to trauma (often one eye is affected more than the other).
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Glaucoma:
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Open-angle glaucoma: Often asymptomatic in early stages.
- Blank spots in the visual field may start to appear.
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Angle-closure glaucoma:
- Intermittent pain, photophobia (sensitivity to light).
- Seeing halos around lights.
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Acute angle-closure glaucoma:
- Severe eye and face pain.
- Malaise (general discomfort), nausea, vomiting.
- Rapid decrease in visual acuity.
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Open-angle glaucoma: Often asymptomatic in early stages.
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AMD (Age-related Macular Degeneration):
- Blurred vision.
- Blind or blurry spots in the central visual field.
- Colors appear less bright.
- Difficulty recognizing faces.
- Patients rely more on peripheral vision.
Nonpharmacologic Therapy for Eye Conditions
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Cataracts:
- Magnifying glass.
- Stronger prescription lenses.
- Brighter lighting.
- Anti-glare sunglasses.
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Glaucoma:
- Relaxation techniques.
- Regular exercise to lower intraocular pressure (not effective for angle-closure glaucoma).
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AMD:
- Magnifiers.
- Large-print books and magazines.
- High-intensity lighting.
- E-readers.
- Audiobooks and podcasts.
Sensory Issues in Infants & Children
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Congenital cataracts:
- Lack of reaction to bright light.
- Failure to notice toys or faces.
- Possible developmental delays.
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Pediatric glaucoma:
- Difficult to diagnose in early stages.
-
Juvenile macular degeneration:
- Not treatable or preventable.
- Inherited.
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Pregnant women:
- Glaucoma: Rare in childbearing age, surgery may be considered before pregnancy.
-
Older adults:
- Dry eye syndrome: Can be worsened by medications, chronic conditions, tremors, and cognitive decline.
Sensory Issues in Adults
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Diagnosis:
- Patient advocacy, psychological and emotional support, and teaching/learning needs are high priorities.
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Common problems for patients with eye diseases:
- Anxiety.
- Fear.
- Inadequate health management skills.
- Inadequate health maintenance skills.
- Risk for injury.
Hearing Loss
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Conductive hearing loss: Disruption in the transmission of sound.
-
Causes:
- Obstruction of the external ear canal (most common): Impacted earwax, foreign objects.
- Perforated tympanic membrane: Hole in the eardrum.
- Disruption or fixation of the ossicles: Small bones in the middle ear.
- Chronic and untreated ear infections.
-
Causes:
-
Sensorineural hearing loss: Affects the inner ear or auditory nerve pathway.
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Causes:
- Congenital (present at birth) or genetic.
-
Acquired:
- Noise exposure (major cause).
- Ototoxic drugs.
- Prenatal exposure to rubella.
- Infections, tumors, vascular disorders, degenerative diseases.
- Aging.
-
Causes:
-
Presbycusis: Hair cells in the cochlea (inner ear) degenerate with aging.
- Begins in early adulthood and progresses throughout life.
- Higher-pitched tones and conversational speed are often lost first.
-
Congenital hearing loss: Hearing loss present at birth.
-
Causes:
- Genetic factors (often the cause).
- Part of a syndrome (e.g., Down syndrome, Usher syndrome).
- Infections, maternal diabetes, prematurity, low birth weight, maternal drug and alcohol use.
-
Causes:
Hearing Loss Risk Factors
- Age: Infants, children, and older adults are more at risk.
-
Infants and children:
- Family history: Genetic component.
- NICU stay for more than 5 days: Increased risk of complications.
- Infection while in utero: Viral infections can damage the developing ear.
- Craniofacial abnormalities: Structural differences can impact hearing.
- Otitis media: Repeated ear infections.
Hearing Loss Prevention
-
Noise-induced hearing loss (NIHL): Prolonged exposure to sounds greater than 85 dB.
- Use of ear buds or headphones at high volume.
-
Ototoxic medications: Drugs that can damage hearing.
- Aminoglycosides (antibiotics).
- Platinum analogs (chemotherapy drugs).
- Loop diuretics (water pills).
- Others (chloroquine, quinine, salicylates).
Sensory Perception
-
Sensory stimuli: Give meaning to events in the environment.
-
Five senses essential for growth, development, and survival:
- Vision.
- Hearing.
- Touch.
- Smell.
- Taste.
-
Sensory perception is protective, helping us avoid danger and navigate our surroundings.
-
Sensory reception: The process of receiving stimuli or data.
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External stimuli:
- Visual: Sight.
- Olfactory: Smell.
- Auditory: Sound.
- Tactile: Touch.
- Gustatory: Taste.
-
Internal stimuli:
- Kinesthetic: Awareness of body position and movement.
- Balance: Sense of equilibrium essential for movement, position, and coordination.
- Stereognosis: Ability to perceive and understand objects through touch.
- Visceral: Stimuli from internal organs (e.g., hunger, fullness).
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Sensory perception: Involves consciously organizing stimuli into meaningful information.
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Four primary aspects of sensory perception:
- Stimulus: Sensory input.
- Receptor: Specialized cell that detects the stimulus.
- Impulse conduction: Transmission of the signal along nerve pathways.
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Perception: Interpretation of the signal by the brain.
- Level of consciousness affects perception.
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Brain adaptation: Adapts to stimuli, does not respond to every single one immediately.
- Some stimuli are stored in memory for later use.
Non-Specific Sensory Perception Alterations
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Vertigo: Feeling of rotation or imbalance.
- Can cause nausea and be difficult to diagnose.
- Possible causes include stroke, head trauma, vestibular infection, or calcium crystals in the inner ear.
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