210 Final Exam: Eyes & Ears

Front 1

s1 heard loudest at the _____

Back 1

apex

Front 2

s2 head loudest at the _____

Back 2

base

Front 3

S1 sounds caused by closeure of the ____

Back 3

AV valves

Front 4

S2 sounds due to closure of the ____ valves

Back 4

semilunar

Front 5

Landmarks of the heart

Back 5

APE to Man
aortic
pulmonic
Erbs
tricuspid
mitral

Front 6

Apical impulse/ PMI location

Back 6

5th intercostal, left midclavicular

Front 7

Arterial insufficiency

Back 7

to much activity on your feet, pain with raise in legs

Front 8

bell is for ____pitched sounds

Back 8

low

Front 9

venous insufficiency

Back 9

standing,relief with raise in legs

Front 10

5 factors that determine bp?

Back 10

vessels elasticity, fluid volume, cadio output, peripheral vascualr resistance, viscocity.

Front 11

ausculatory gap

Back 11

don't hear the korotkoff sounds

Front 12

What are korotkoff sounds

Back 12

Phase I, II, III, IV, V. tapping, swooshing, knocking, abrupt muffling

Front 13

rhumatic fever is a risk factor for?

Back 13

heart disease, stroke due to scaring on the heart that could dislodge and go into the blood stream.

Front 14

Peripheral vascular disease is less common in ______

Back 14

Peripheral vascular disease is less common in african americans

Front 15

diabetes, smoking, obesity , heart murmurs, hypertension and stroke are all risk factors for?

Back 15

heart disease

Front 16

What is considered hypertensive?

Back 16

140/90 BP

Front 17

Normal BP

Back 17

119 or less for a BP

Front 18

What are the grade pulse amplitude for radial?

Back 18

2+

Front 19

What are the grade pulse amplitude for carotid?

Back 19

3+

Front 20

-Anatomy, physiology, and landmarks on the ear.

Back 20

EAR: External ear, auricle/pinna, external auditory meatus, tympanic membrane (eardrum), mastoid process, middle ear (3 bones), inner ear

Front 21

-What will you see looking in the eye?

Back 21

Eye: 1. media (anterior chamber, lens, vitrous) 2. ocular fundus (optic disc, blood vessels, should see red light reflex from light reflecting off retina, macula)

Front 22

-Cultural considerations: some things are normal to see in some cultures, but not in others
1. EYES--darker skin
2. EYES--blacks
3. EYES-whites

Back 22

1. darker skin people have darker retinal backgrounds and brown macules
2. blacks are 3x more affected by primary open-angle glucoma
3. leading cause of blindness in whites is from macular degneration whereas for blacks and hispanics leading cause of blindness is open-angle glucoma

Front 23

-Usual hx ?’s for EAR

Back 23

hearing loss?
Occupational ? working around loud noises
Functional? Able to perform daily activities?
Last hearing test? Ear Hygiene?

Front 24

What is otitis media and who has the greatest incidence?

Back 24

Definition: middle ear infection due to obstuction of the eustachian tube .

most common illnesses in children

increased in down syndrome, native americans, hispanics, premature infants

Front 25

-Cultural considerations: some things are normal to see in some cultures, but not in others
1. EARS-Asians
2. EARS-Dark Skin

Back 25

1. Asians have dry/flaky cerumen
2. Dark skinned pp have dark cerumen

Front 26

-What will you see looking in the ear

Back 26

Ear: pearly gray tympanic membrane, see umbo/incus/ pars tensa and light reflex (right= 5o'clock, left=7o'clock)

Front 27

Usual hx ?'s for EYE

Back 27

vision difficulty? blind spots? blurring? pain? crossed eyes? eye fatigue? redness? swelling? Past ocular problems? watering/discharge? glaucoma? glasses or contacts? last vision test and who tested it? medications?

Front 28

-Anatomy, physiology, and landmarks on the EYE

Back 28

EYES: Eyelids, conjunctiva (pink part), Sclera (white part), Cornea (covers front of the eye), lacrimal apparatus, iris, pupils, lens, vitreous body, retina, optic disc, retinal vessels,

Front 29

Weber test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 29

1. vibrating tuning fork midline.
2. Person should hear tone by bone conduction equally loud in both ears.
3. If sound lateralizes to one ear--conductive loss

Front 30

Rinne's Test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 30

1. vibration on mastoid process until sound goes away, then vibration in air near ear canal
2. Person should still hear the sound when you move tuning fork to ear canal (air conduction) AC>BC (positive Rinne's test)
3. BC>AC= conductive hearing loss

Front 31

Whispered Voice test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 31

1. testing one ear at a time (shield your lips) whisper two-syllable word and have person repeat word.
2. person should correctly repeat word
3. if cannot repeat word, means high tone hearing loss

Front 32

Inspection of external Canal:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 32

1. looking for redness, swelling, lesions, foreign bodies, discharge, odor, hearing aid irritation (if applicable)
2. none of the above should be seen
3. redness and swelling=otitis externa
purulent otorrhea suggests otitis media
blood or watery drainage suggests basal skull fracture
lesions=foreign body, polyp, furuncle, exostosis

Front 33

The Romberg test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 33

1. measure of ability of the vestibular apparatus in the inner ear to help maintain standing balance. also cerebellum and proprioception
2. should be able to stand still with eyes closed
3. wobbling when standing with eyes closed means vest. app or cerebellum not functioning correctly

Front 34

Weber test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 34

1. vibrating tuning fork midline.
2. Person should hear tone by bone conduction equally loud in both ears.
3. If sound lateralizes to one ear--conductive loss

Front 35

Rinne's Test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 35

1. vibration on mastoid process until sound goes away, then vibration in air near ear canal
2. Person should still hear the sound when you move tuning fork to ear canal (air conduction) AC>BC (positive Rinne's test)
3. BC>AC= conductive hearing loss

Front 36

Whispered Voice test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 36

1. testing one ear at a time (shield your lips) whisper two-syllable word and have person repeat word.
2. person should correctly repeat word
3. if cannot repeat word, means high tone hearing loss

Front 37

Inspection of external Canal:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 37

1. looking for redness, swelling, lesions, foreign bodies, discharge, odor, hearing aid irritation (if applicable)
2. none of the above should be seen
3. redness and swelling=otitis externa
purulent otorrhea suggests otitis media
blood or watery drainage suggests basal skull fracture
lesions=foreign body, polyp, furuncle, exostosis

Front 38

The Romberg test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 38

1. measure of ability of the vestibular apparatus in the inner ear to help maintain standing balance. also cerebellum and proprioception
2. should be able to stand still with eyes closed
3. wobbling when standing with eyes closed means vest. app or cerebellum not functioning correctly

Front 39

Weber test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 39

1. vibrating tuning fork midline.
2. Person should hear tone by bone conduction equally loud in both ears.
3. If sound lateralizes to one ear--conductive loss

Front 40

Rinne's Test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 40

1. vibration on mastoid process until sound goes away, then vibration in air near ear canal
2. Person should still hear the sound when you move tuning fork to ear canal (air conduction) AC>BC (positive Rinne's test)
3. BC>AC= conductive hearing loss

Front 41

Whispered Voice test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 41

1. testing one ear at a time (shield your lips) whisper two-syllable word and have person repeat word.
2. person should correctly repeat word
3. if cannot repeat word, means high tone hearing loss

Front 42

Inspection of external Canal:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 42

1. looking for redness, swelling, lesions, foreign bodies, discharge, odor, hearing aid irritation (if applicable)
2. none of the above should be seen
3. redness and swelling=otitis externa
purulent otorrhea suggests otitis media
blood or watery drainage suggests basal skull fracture
lesions=foreign body, polyp, furuncle, exostosis

Front 43

The Romberg test:
1. What is it?
2. normal findings
3. what does an abnormal finding mean?

Back 43

1. measure of ability of the vestibular apparatus in the inner ear to help maintain standing balance. also cerebellum and proprioception
2. should be able to stand still with eyes closed
3. wobbling when standing with eyes closed means vest. app or cerebellum not functioning correctly

Front 44

How to use the otoscope (adult, child)?

Back 44

Adult: up and back
Child: pull ear down

Front 45

Inspect eyelids:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 45

1. droopy eyelids

Front 46

Confrontation test:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 46

1. gross measure of peripheral vision. card over one eye--pt looks at you, wagging fingers from 6 directions
2. pt should see wagging finger when you see it
3. peripheral field loss

Front 47

Conjunctiva
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 47

1. color
2. pink
3. if pale=anemia

Front 48

cornea
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 48

1. check from smoothness and clarity with light at an oblique angle.
2. smoothness and clarity
3. cloudiness in cornea, corneal abraiion causes irreg ridges in reflected light, producing shattered look to light rays

Front 49

iris and pupils:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 49

1 and 2: inspect if iris is round, flat and even coloration
3. unequal sized pupils -CNS injury

(5% of population has anisocoria--two different pupil sizes--normal finding)

Front 50

a ring around the cornea of the eye is called a _____ and is an expected finding in _______?

Back 50

corneal areus--elders

Front 51

Snellen's eye chart:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 51

1. position person 20 feet from chart. person should wear their corrective lenses
2. 20/20 vision, person should be able to read the smallest line from 20 feet
3. abnormal findings: hesitancy, squinting, leaning forward, misreading letters

Front 52

What is presbyopia?

Back 52

decrease in power of accomodation with aging (person will move snellen chart farther away)

Front 53

corneal inspection (the hirschberg test)
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 53

1. direct pt to look at distant spot, shine light in eye, note reflection of light on the corneas
2. light should be exactly the same spot on each eye
3. asymmetry of the light reflex indicates deviation in alignment from eye muscle weakness or paralysis

Front 54

Cover test:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 54

1. test to detect small degrees of deviated alignment by interrupting the fusion reflex. ASK THE PERSON to stare straight ahead at your nose with card covering eye
2. normal-steady fixed gaze
3. if eye jumps to fixate on the designated point, it was out of alignment before.

Front 55

What is phoria?

Back 55

mild weakness noted only when fusion is blocked (cover test)

Front 56

What is Tropia?

Back 56

more severe than phoria--a constant malalignment of the eyes

Front 57

What is nystagmus?

Back 57

fine oscillating movement best seen around the iris. occurs with disease of the semicircular canals in the ears, a paretic eye muscle, MS, or brain lesions

Front 58

An eye abnormality that occurs with hyperthyroidism?

Back 58

lid lag

Front 59

What is sclera icterus?

Back 59

even yellowing of the sclera extending to the cornea, indicating jaundice

Front 60

Pupillary light reflex:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 60

1. darken room and ask person to gaze into distance and shine light
2. normal: constriction of the same side pupil (a direct light reflex) AND simultaneous constriction of the other pupil (a consentual light reflex).
3. intracranial pressure increasing if no or unequal response to light

Front 61

What is a normal finding in asian infants?

Back 61

upward slant of the palpebral fissures...make sure eyelashes do not abrade the corneas

Front 62

What is pseudostrabismus?

Back 62

epicanthal folds give a false appearance of malalignment

Front 63

6 Cardinal field of gaze:
1. What are you looking for?
2. What are the normal findings?
3. What do abnormal findings mean?

Back 63

1. hold head steady and follow the mvmt of finger or penlight only with eyes
2. normal, able to move eye
3. failure to follow in a certain direction indicates weakness of an extraocular muscle (EOM) or dysfunction of cranial nerve innervating it.

Front 64

Hyperopia

Back 64

Farsightedness--- can't see close up

Front 65

Myopia

Back 65

Nearsightedness--- can't see far away

Front 66

What numbers do you use with myopia on the othalmascope?

Back 66

negative numbers

Front 67

What numbers do you use with hyperopia on the opthalmascope

Back 67

positive numbers