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123 Cards in this Set

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Health History Eyes, What do you ask?
Corrective Lenses?
Any difficulty seeing?
Eye pain?
Past surgery?
Family history?
Self-care behaviors?
For a child who has adifficulty picking up objects, what would think?
astigmatism (irregularly shaped lens)
Visual acuity - assesses which cranial nerve?
CN II - Optic
To test visual acuity use what chart
Snellen Chart - 20 feet away
Normal Vision is 20/20. The numerator indicates what?
distance from the chart (20)
The denominator indicates what?
distance from which the normal eye could read that line
The larger the denominator...
The poorer the vision
Near vision is tested with what? (those older than 40 years old or those having difficulty reading)
Hand held - 14 inches from face
What test do you use to test visual fields?
confrontation test
What test do you use to inspect EOM's (extraocular muscle function)
corneal light reflex (Hirschberg test)
Cover test
Diagnostic positions test
What external eye structure do you inspect?
General appearance
Eyebrows
Eyelids and lashes
Eyeball alignment
Conjunctiva and sclera
Lacrimal apparatus
What anterior eyeball structures do you inspect?
Cornea and lens
Iris and Pupil
What do you inspect in the ocular fundus
optic disc (color, shape, margins,)
Retinal vessels
General background
macula
Newborn vision is what?
20/200
Age 2 - 3 vision is what?
20/30
EOM's are what?
6 small muscles attached to the eyeball and give the eye both straight and rotary movement
What does it mean by "yoked"?
each muscle is yoked with the corresponding muscle in the other eye, this allows the eye to remain parallel
CN III
Oculomotor
CN IV
Trochlear
CN VI
Abducens
Lt & Rt Lateral Eye
Superior Rectus - CN III
Lateral Rectus - CN VI
Inferior Rectus - CN III
Medial Eyes
Inferior Oblique - CN III
Medial Rectuus - CN III
Superior Oblique - CN IV
What are the 3 assessments for EOM's
Corneal light reflex
Cover/uncover test
Six cardinal gases
Checks alignment of eyes when fixed on a object - normal finding dot of light at 5 & 7 reflecting off of cornea
Corneal light test
checks for EOM weakness or lazy eye normal finding is no movement
Cover / Uncover Test
Checks for a weak or paralyzed muscle or dysfunction of cranial nerves, normal finding is smooth, coordinated movements
Six Cardinal Gazes
What is the opening between the eyelids called
palpebral fissures
Pupillary response assesses what CN
CN III - Oculomotor
PERRLA stands for what
Pupils equal
round
react to light and
accomidation
What are unequal pupils called
anisocoria
What is accommodation?
ability to adapt from a distand gaze to focus on a near object
What is the assessment for pupillary response?
light into eye, pupil should be brisk to constrict < 1 sec, place hand laterally at nose
What is assessment technique for accomidation?
hold object at a distance of about 3 feet, move in toward nose
What is used to perform a eye exam?
ophthalmoscope
The reflection of light of the retina is called what?
the red reflex
What color is the retina
yellowish - pinkish backgroud
What color is the optic disk
creamy yellow to pink
What is a gray - white arch on the cornea?
Arcus Senilis
What is a raised yellow plaque on or about the eyelid?
Xanthelasma
What is faulty distance vision? (nearsighted)
myopia
What is faulty near vision? (farsighted)
hyperopia
What is a loss of elasticity of lens which decreases its ability to change shape in order to accomidate for near vision, begins in the 40's, results in short-arm syndrome
presbyopia
What is double vision
diplopia
What presents with increased intraocular pressure and decreased peripheral vision
glaucoma
What meds can affect eyes?
NSAIDS = blurred vision, decreased visual acuity
BCP = worsening of myopia or astigmatism
What do you use to look in the ears?
otoscope
What do you look at to inspect the external ear?
size and shape of auricle
position oand alignment on head
skin condition
external auditory meatus
What do you examine during otoscopic exam?
external canal
cerumen, discharge, ect
redness, swelling of canal wall
What do you inspect on the tympanic membrane?
Color and characteristics
not position (flat, bulging, retracted)
Integrity of membrane
What do you do to test hearing acuity?
note behavioral response to converstaional speech
Voice test
tuning fort tests - Weber and Rinne
The part of the ear that is a canal and is a culdesac 2.5-3 cm long in the adult and terminates at the eardrum or tympanic membrane
External Auditory Canal (EAC)
What is ear wax called?
Cerumen
What is in front of the concha, and projecting backaward over the meatus?
Tragus
What is the margin of the outer ear?
Helix
What is the eardrum called?
Tympanic Membrane (TM)
Having a detrimental effect on the VIII (8) nerve or the organs of hearing?
Ototoxic
Subjective ringing in the ears, buzzing, tinkling, or hissing sound in the ear
Tinnitus
type of hearing loss that occurs with aging, even in peple living ina quiet environment
presbycusis
small, whitish-yellow, hard, nontender nodules in or near helix or antihelix, sign of gout
tophi
growth of nodules on the helix of the ear
chondrodermatitis
babies at most risk for ear infections are
bottle fed babies
babies exposed to second had smoke
Clues of hearing loss:
lip reading
frowning when listening
posturing
repeat message
speaks loudly
problem with own speech
When should a child start babbling?
>6 mo old
If wax is hard or dry, what would you soften with?
mineral oil and H2O2
Tympanic Membrane should be what color?
translucent pearly gray
What is the light reflex in the ear? Reflection of the light on the TM?
cone of light
What is the auditory function test?
Tests CN VIII auditory or vestibulocochlear, conducts nerve impulses to the auditory area of the brain. Most general test is response to converstational speech.
What test is performed by occulding one ear and standing 1 - 2 feet behind person.
whisper test
Helpful when pt reports hearing is better in 1 ear, place tuning fork in middle of skull
Weber Test
Compares air conduction and bone conduction of sound
Rinne Test
Drugs that cause tinnitus, vertigo, and hearing loss
Aminoglycosides, Nsaids, salicylates
Drugs that cause temporary hearing loss is iv administration is too rapid
Lasix, give 10 mg / min to avoid hearing loss.
Three bony projections located on the lateral walls of each nasal cavities, the superior, middle, and inferior. Increase surface area so more blood vessels are available to warm, humidify, and filter inhaled air
turbinates
rich network of veins on the anterinferior portion of the nasal septum, common site of most nose bleeds
Kiesselbach's plexus
two hollow spaces in the frontal bone lying above the orbits. causes the skull to be lighter
frontal sinus
the opening of the parotid gland, across from the second molar
Stensen's duct
gland located under the tongue, duct of the submandibular gland
Wharton's duct
What is a nosebleed called?
epistaxis
What is clear watery discharge from the nose called?
rhinorrhea
what is a dry mouth?
xerostomia
inflammation of the lip, fissures at the corners of the mouth
cheilitis
formation of white spots or patches on the mucous membranes of the tongue or cheek
leukoplakia
What is bad breath called?
halitosis
A canker sore is a vesicle at first, then a small, round, punched-out ulcer with white base surrounded by a red halo
aphthous ulcers
the elongation of filiform papillae and painless overgrowth of mycelial threads of fungus infection on the tounge
black hairy tongue
painless enlargement of the gums, sometimes overreaching the teeth
gingival hyperplasia
Temporomandibular joint
TMJ
What is the piece of tissue hanging down in back of throat
Uvula
Where would you first assess a patient for jaundice?
hard and soft palate
The place where sutures intersect
fontanels
What is the largest salivary glands?
parotid glands
Small fleshy mass containing sebaceous glands on inner eye
caruncle
the corner of the eye, the angle where the lids meet
canthus
the border between cornea and sclera
limbus
what provides constant irrigation to keep the conjunctiva and cornea moist and lubricated?
lacrimal apparatus
transparent protective covering of the exposed part of the eye
conjunctiva
enlarged upper eye lid sagging down over lid
pseudoptosis
protruding eyes
exophthalmos
drooping upper lid
ptosis
constricted and fixed pupils
miosis
unilateral dilated pupil with no reaction to light or accomidations
Cranial nerve III damage
what promotes equilibrium in the ear
the labyrinth in the inner ear
swimmers ear, severe swelling of ear canal, inflammation, tenderness
otitis externa
overgrowth of scar tissue, which invades original site of trauma
keloid
inner ear infection
otitis media
What is the largest salivary glands?
parotid glands
Small fleshy mass containing sebaceous glands on inner eye
caruncle
the corner of the eye, the angle where the lids meet
canthus
the border between cornea and sclera
limbus
what provides constant irrigation to keep the conjunctiva and cornea moist and lubricated?
lacrimal apparatus
transparent protective covering of the exposed part of the eye
conjunctiva
enlarged upper eye lid sagging down over lid
pseudoptosis
protruding eyes
exophthalmos
drooping upper lid
ptosis
constricted and fixed pupils
miosis
unilateral dilated pupil with no reaction to light or accomidations
Cranial nerve III damage
what promotes equilibrium in the ear
the labyrinth in the inner ear
swimmers ear, severe swelling of ear canal, inflammation, tenderness
otitis externa
overgrowth of scar tissue, which invades original site of trauma
keloid
inner ear infection
otitis media
how many teeth do an adult have
32
condition where uvula is split
bifid uvula
what is tongue tie, a short lingual frenulum
ankyloglossia