Cp Ii Exam 2010-Ophthalmology

Front 1

What does the optic disc look like?

Back 1

The disc should be round, have sharp borders, and be pink to yellow-orange with a center physiologic cup. The cup-to-disc ratio should be 1:2 or 1:3 or noted as .5 to 1.5 mm, respectively.

Front 2

What do the retinal vessels look like? What happens when hypertension occurs?

Back 2

-four main branches (supply four quadrants of the eye)
-Arteries are 2/3 to 4/5 the size of the veins and have a light reflex.
-arteries look brighter red and thinner.
-artery to vein ratio is normally 2:3. -When hypertension occurs, one might see A-V nicking

Front 3

Describe the macula? Where is it in relation to the optic disc

Back 3

This is an avascular area containing the cones for vision and color. The macula is lateral compared to the optic disc.

Front 4

How would you assess and interpret visual acuity using a Rosenbaum and a Snellen Eye Chart.

Back 4

-Stand 20 feet from the patient
-Pt covers untested eye
-The measurement 20/20 in one eye means that at 20 feet, the patient sees what is expected to be seen at 20 feet by a person with normal vision.

Front 5

Describe how to correctly perform and interpret findings of confrontation visual field testing and
extraocular muscle movement testing on a patient.

Back 5

-Confrontation: Examiner is about three feet in front of and at eye level with the patient, pt cover eye and dr. covers mirror image, bring wiggly fingers in
-Extraocular muscles: Use a (+) and an “X” to get the six conjugate eye movements and to check for vertical nystagmus (up and down). The examiner should hold his/her hand about 15-18 inches from the patient’s nose and must move his finger about 10-12 inches in each direction

Front 6

Discuss assessment for normal eye alignment

Back 6

-Corneal light reflex test.
-have the light source held in front of pt. at 1.5 feet and shining at the patient’s nose.
-Pt looks straight ahead and the position of the reflected light is noted on each cornea

Front 7

Discuss assessment for abnormal normal eye alignment

Back 7

-If the reflected light is not seen in congruent positions on each cornea

Front 8

Identify the six
diagnostic positions of gaze and the extra ocular muscles associated with each.

Back 8

•Medial rectus – adduction (eye moves nasally)
•Lateral rectus – abduction (eye moves temporally [away from nose])
•Superior rectus – elevation (eye moves up), intorsion (the 12 o’clock position on the cornea rotates nasally), adduction
•Inferior rectus – depression (eye moves down), extorsion (the 12 o’clock position on the cornea rotates temporally), adduction
•Superior oblique – intorsion, depression, abduction
•Inferior oblique – extorsion, elevation, abduction

Front 9

describe normal external eye anatomy.

Back 9

?

Front 10

define the normal “blind spot.”

Back 10

physiological isolated area of diminished vision within the visual field located 15-20 degrees temporal to central fixation. It corresponds to the optic nerve head.

Front 11

explain the use of the small aperture, large aperture, and red-free filter on the
ophthalmoscope.

Back 11

-Use the small aperture for the undilated pupil and the large aperture for the dilated pupil.
-The red-free filter is used to exclude rays of red light and helps the doctor visualize blood vessels and hemorrhages (they appear black with this light).

Front 12

Describe common funduscopic changes seen in hypertension

Back 12

Findings found throughout retina
-Primary findings: A-V nicking (the vein looks nicked because the artery is invisible but widened), Arteriolar narrowing, Copper wiring, flame hemorrhages
-Secondary: Hard and soft exudates, Retinal venous, occlusions, Macular stars

Front 13

describe distinguishing physical exam features and eye symptoms related to
conjunctivitis

Back 13

-Pupil is normal
-no pain
-watery or purulent discharge
-Pink eye = bacterial conjunctivitis
There is also viral conjunctivitis

Front 14

describe distinguishing physical exam features and eye symptoms related to
uveitis

Back 14

-inflammation of the iris and the anterior chamber
-Pupil is constricted
-Severe photophob. pain
-no discharge

Front 15

describe distinguishing physical exam features and eye symptoms related to narrow angle glaucoma (discussed in lecture).

Back 15

-Pupil is mid dilated
-Severe pain
-no discharge
-prevents adequate drainage and causes the pressure to build up
-Cornea appears steamy
-Seen in people with a shallow anterior chamber. The space between the iris and cornea is decreased.

Front 16

Discuss the usefulness of performing a cover test on a child.

Back 16

It is often done on young children with question of a “lazy eye” (strabismus) to assist in early diagnosis and treatment. The child is asked to gaze at a distant object with both eyes, and then the questionable “weak” eye is covered. Without the stimulus of vision, the covered “weak” eye will either “sneak” inward (esophoria) or outward (exophoria). When uncovered, it will be seen “moving” back to coordinate with the gaze of the other eye.

Front 17

define the various types of anopsias and their related anatomical lesions.

Back 17

Anopsia = defect of sight; blindness
* Binasal hemianopsia
* Bitemporal hemianopsia
* Homonymous hemianopsia
* Quadrantanopia

Front 18

explain the use of the small aperture, large aperture, and red-free filter on the
ophthalmoscope.

Back 18

-Use the small aperture for the undilated pupil and the large aperture for the dilated pupil.
-The red-free filter is used to exclude rays of red light and helps the doctor visualize blood vessels and hemorrhages (they appear black with this light).

Front 19

define the abbreviations OD, OS and OU.

Back 19

OS means Oculus Sinister which is your left eye. OD means Oculus Dexter which is your right eye and OU means Oculus Uterque which is both eyes.

Front 20

Describe common funduscopic changes seen in hypertension and diabetes.

Back 20

When hypertension occurs, one might see A-V nicking (the vein looks nicked because the artery is invisible but widened).

Front 21

photophobia,

Back 21

Painful oversensitivity to light

Front 22

Photosensitivity

Back 22

increased sensitivity of the skin to light and other sources of UV.

Front 23

describe distinguishing physical exam features and eye symptoms related to
conjunctivitis

Back 23

-Pupil is normal
-no pain
-watery or purulent discharge
-Pink eye = bacterial conjunctivitis
There is also viral conjunctivitis

Front 24

describe distinguishing physical exam features and eye symptoms related to
uveitis

Back 24

-inflammation of the iris and the anterior chamber
-Pupil is constricted
-Severe photophob. pain
-no discharge

Front 25

describe distinguishing physical exam features and eye symptoms related to narrow angle glaucoma (discussed in lecture).

Back 25

-Pupil is mid dilated
-Severe pain
-no discharge
-prevents adequate drainage and causes the pressure to build up
-Seen in people with a shallow anterior chamber. The space between the iris and cornea is decreased.

Front 26

Discuss the usefulness of performing a cover test on a child.

Back 26

It is often done on young children with question of a “lazy eye” (strabismus) to assist in early diagnosis and treatment. The child is asked to gaze at a distant object with both eyes, and then the questionable “weak” eye is covered. Without the stimulus of vision, the covered “weak” eye will either “sneak” inward (esophoria) or outward (exophoria). When uncovered, it will be seen “moving” back to coordinate with the gaze of the other eye.

Front 27

define the various types of anopsias and their related anatomical lesions.

Back 27

idk
* Binasal hemianopsia
* Bitemporal hemianopsia
* Homonymous hemianopsia
* Quadrantanopia

Front 28

define the abbreviations OD, OS and OU.

Back 28

OS means Oculus Sinister which is your left eye. OD means Oculus Dexter which is your right eye and OU means Oculus Uterque which is both eyes.

Front 29

photophobia,

Back 29

Painful oversensitivity to light

Front 30

Photosensitivity

Back 30

increased sensitivity of the skin to light and other sources of UV.

Front 31

diplopia

Back 31

double vision

Front 32

strabismus

Back 32

lazy eye

Front 33

scotoma

Back 33

is an area of partial alteration in one's field of vision consisting in a partially diminished or entirely degenerated visual acuity which is surrounded by a field of normal - or relatively well-preserved - vision.

Front 34

amblyopia

Back 34

Partial or complete loss of vision in one eye caused by conditions that affect the normal development of vision.

Front 35

Ectropion

Back 35

Ectropion is the turning out of the eyelid (usually the lower eyelid) so that the inner surface is exposed.

Front 36

Entropion

Back 36

Entropion involves the turning in of the edges of the eyelid (usually the lower eyelid) so that the lashes rub against the eye surface.

Front 37

Hypertropia

Back 37

Hypertropia is a condition of misalignment of the eyes (strabismus), whereby the visual axis of one eye is higher than the fellow fixating eye.

Front 38

Describe common funduscopic changes seen in diabetes

Back 38

Findings are found in the posterior pole
-Primary: Microaneurysms, neovasculariation, Retinitis proliferans
Secondary: Hard exudates, Deep hemorrhages, Retinal venous occlusions, Vitreous hemorrhages

Front 39

Marcus Gunn pupil

Back 39

-Paradoxial dilation of the pupil when testing papillary light reflex
-associated with an afferent limb defect

Front 40

State the relevant symptoms related to eye problems and disease:

Back 40

a. Sties
b. Inflammation
c. Discharge
d. Pain

Front 41

Explain visual acuity using Rosenbaum and a snellen eye shart.

Back 41

- Snellen = 20 Feet from pt
- Rosenbaum = 14 inches
“Jaeger” is used for near vision (J-1 scale
-Distance vision (20/20)

Front 42

Describe normal external eye anatomy

Back 42

Facial assym, Unilateral Exopthalmus, Lid lag up gaze/down gaze, Abnormal CN5, Blunt trauma, Lid lesion, Lymphoma, Lid bags, Foreign body under lid, Ptosis, Entropion, Exctopion

Front 43

Esophorias

Back 43

Weak eye sneaks inward on cover test (nasal deviation)

Front 44

Exophorias

Back 44

Weak eye sneaks OUTward on cover test (temporal deviation)

Front 45

Hyperphorias

Back 45

Upward Deviation

Front 46

Xanthelasma

Back 46

Collection of cholesterol around eye lids

Front 47

Chalazion

Back 47

is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid

Front 48

Hordeolum

Back 48

External stye, an infection of the sebaceous glands of Zeis at the base of the eyelashes

Front 49

Icterus

Back 49

Yellowing of eyes due to jaundice

Front 50

Chemosis

Back 50

is the swelling (or edema) of the conjunctiva. It is usually caused by allergies or viral infections, as well as eye rubbing.

Front 51

Arcus senilis

Back 51

white or gray opaque ring in the corneal margin (peripheral corneal opacity) present at birth or appearing later in life and becoming quite frequent near death… It results from cholesterol deposits in or hyalinosis of the corneal stroma and may be associated with ocular defects or with familial hyperlipidemia.

Front 52

Cataract

Back 52

clouding that develops in the crystalline lens of the eye or in its envelope, varying in degree from slight to complete opacity and obstructing the passage of light

Front 53

Kayser Fleischer ring

Back 53

are dark rings that appear to encircle the iris of the eye. They are due to copper deposition as a result of particular liver diseases…ASSOCIATED WITH WILSONS DXS.

Front 54

Anisocoria

Back 54

a condition characterized by an unequal size of the pupils.

Front 55

Mydriasis

Back 55

Dilated pupil

Front 56

Miosis

Back 56

Constricted pupil

Front 57

What is Layer 5 (Session Layer) responsible for?

Back 57

defines how to start, control and end conversations. includes control and management of multiple bidirectional messages so that the application can be notified if only some of a series of messages are completed. This allows the presentation layer to have a seamless view of an incoming stream of data

Front 58

Argyll Robertson pupil

Back 58

i. are bilateral small pupils that constrict when the patient focuses on a near object (they “accommodate”), but do not constrict when exposed to bright light (they do not “react” to light). They were formerly known as "Prostitute's Pupils" because of their association with tertiary syphilis and because of the convenient mnemonic that, like a prostitute, they “accommodate but do not react.”

Front 59

Myopia

Back 59

-nearsightedness
- eyeball is too long so light is focused in front of the retina

Front 60

presbyopia

Back 60

-hyperopia and impairment of vision due to old age
-diminution of power of accommodation from loss of elasticity of the crystalline lens, causing the near point of distinction vision to be removed further from the eye

Front 61

Astigmatism

Back 61

-light not uniformly focused in all directions. Commonly due to a cornea that is not perfectly spherical