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99 Cards in this Set
- Front
- Back
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Prebycusis |
-gradual nerve degeneration (occuring w/age) begin at 40 lose high frequency sound 1st
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Vertigo |
Whirling sensation, staggering gait |
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Tinnitus |
ringing, crakling, buzzing
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microtia and macrotia |
small ear (<4 cm) and big ear (>10 cm) |
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Darwin tubercle |
painless nodule on helix (normal variation)
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Tophi |
yellow non-tender nodules on helix 2nd to gout (uric acid crystals) |
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Furuncle |
boil from infected hair follicle |
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Atresia |
Absence or closure of ear canal |
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Exostosis |
Small hard bony structures in ear canal hypertrophic baone which is common in cold water swimmers, benign and no need for tx |
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Cholesteatoma |
overgrowth of epidermal tissue following a TM perforation: produce dark/yellow-gray foul odor |
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Weber test |
place tuning fork on top of head should hear sound equal on AU=sound equalized bilaterally -Conductive loss: sound lateralizes to bad ear-No middle ear/TM conduction-sound conducted directly through bone to bad ear. -Sensorineural loss: Sound lateralizes to good ear- this is NOT good. It means the bad ear cannot conduct sounds via bone or air conduction. |
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Rinne |
vibrating tunning to detect conduction of sound via bone or air. NL: AC>BC (2:1 ratio) Conductive loss: BC>AC (can't hear when fork is placed by ear-only hear when on mastoid process) Sensorineural loss: AC>BC but both are diminished |
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Acoustic Neuroma |
benign tumor on the acoustic nerve |
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Otosclerosis |
fixation of the stapes (does not conduct sound through oval window to inner ear) hereditary condition -tinnitus, progressive sensorineral loss -late teen to 30s |
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Labyrithitis |
-inflammation of the labyrinth of inner ear -complication from URI -Vertigo and nystagmus
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Meniere Disease |
-affects the vestibular labyrinth leading to profound hearing los -attacks of vertigo, tinnitis -uni or bilateral |
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amaurosis fugas |
temporary monocular vision loss |
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scotoma |
blind spot -glaucoma, visual pathway disorders (ex ocular migraines-may have vision loss rather than HA) |
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strabismus>>>amblyopia |
-crossed eye-lazy eye -very important to not miss in chidhood-best before 6 yr -dx test: corneal light reflex, cover test & EOMs -can cause amblyopia: loss of vision or blindness d/t disuse |
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diplopia |
double vision |
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myopia |
near-sighted (cannot see far) |
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Epiphora |
excessive tearing-may be due to irritants, infection or obstruction of lacrimal duts |
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Diabetic retinopathy |
diabetes and HTN need dilated annual eye exam leading cause of blindness-eye may change w/in 10 years of dx |
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Myopia v.s. Hyperopia |
near-sighted versus far-sighed (near/far vision is impaird) d/t inappropriate refraction of light rays on retina |
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xanthelamas |
lipid deposit at innner canthus |
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Oh, Oh, Oh, To Touch And Feel Vaginas Give Vincent A Hard-on! |
* CN 0 – Terminal |
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Extraocular muscles (EOM) |
1. Straight muscles: lateral, medial superior, inferior rectus 2. Oblique muscle: superior and inferior oblique 3. Lateral rectus-enervated by cn6 4. Superior oblique-enervated by cn4 The rest enervated by cn 3. |
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What each muscle controls for the eye movement? |
Horizontal-temporal: LR Up-temporal: SR Down-temporal: IR Horizontal-nasal: MR Up-nasal: IO Down-nasal: SO |
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CN 3,4,6-What tests do we do? |
Ad by WebsteroidsXX
Ad by WebsteroidsXX Ad by Websteroids X X Ad by Websteroids X X 1. EOM test: following a moving object in 6 cardinal positions while head stays in 1 place-compare both eyes- Both eyes should move in unison to the same position. Ok to have 1-2 beats of nystatus in extrem lateral gaze only-Nystamus: involuntary movement of the eyeball. 2. Cornea light reflex: Test parallel alignment of the eyes: pt looks straight ahead-direct a light toward the nasal bridge. Light should fall on the same spot of each eye. -Strabimus: deviation of an eye-weakness of muscle: Esotropia-inward turn, exotropia: outward turn. 3. Cover test: detect eye ms weakness pt to focus on a fixed object->cover 1 eye>>remove the covered eye. If detect covered eye drifted>>abnl finding |
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tricholilomania |
irresitible urge to pull out hair |
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Hordeolum |
Stye: localized staph infection of hair follicle at lid margin (painful, red and swollen) |
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Chalazion: |
Infection or retention cyst of a meibomian gland-swelling w/nontender, firm, discrete nodule on lid |
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Blepharitis |
Inflammation of eyelids 2nd to staph infection or seborrheic dermatitis-red, scaley, crusted lid margin-tx: no tear baby shampooE |
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Entropion vs Ectropion Eye lids |
1. inward curve of lid and lashes (iritate conjunctiva-age &weak ms) 2. excessive outward curve of lash and lid (age, weak ms, can cause conjunctivitis d/t exposure of palpebral conjunctiva) |
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Lid lag |
visible white rim of sclera bwt upper lid and iris during downward movement of eye-hyperthyroidism & facial paralysis |
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Ptosis of lid/Pseudoptosis |
-drooping of upper lid-may involve cn 3,5,7-the 1st symptom of Myestenia gravis. -pseudoptosis: lids droop d/t fat, ms atrophy and cause loose skin. |
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Lacrimal apparatus |
Lacrimal gland located in brow>>secrete tears into puncta>>lacrimal sac>>inferior meatusD |
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Dacryocystitis |
Infection and blockage of lacrimal sac & duct. -pain, warm, swelling and purulent discharge from punta when pressure applied on lacrimal sac |
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Enophthalmos vs Exophthalmos |
sunken eyeball (dehydration) vs. bulging eyeball (hyperthyroidism) |
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Conjunctivitis-S&S |
-c/o itching, burning, foreign body sensation -eyes red and irritated but iris is clear -assess adenopathy (preauricular nodes) -can be viral, bacterial, foreign object, allergic |
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Subconjunctival hemorrhage |
-red sclera 2nd to IOP -resolved on its own-no tx needed |
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Pinguecula |
yellowish nodules on bulbar conjunctiva at 3 and 9 o'clock-due to thickening of bulbar conjunctiva 2nd to sun, wind an dustP |
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Pterysium |
overgrowth of conjunctival tissue -start at inner canthus>>cornea -triangular in shape |
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Palpebral conjunctiva |
continuation of mucous membrane that covers inner eyelid- |
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Cornea |
transparent; covers and protects the pupil and iris -help refract (bend) light rays to focus on the inner retina>>being damaged will cause vision loss -nl: shine and smooth C |
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Corneal arcus |
grayish-white circle around cornea at limbus: nl for >65 but indication of hyperlipidemia <65 yo |
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Ketaritis |
inflammation of cornea |
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Astigmatism |
spherical curve of cornea is asymmetric around the eye, thus light rays are spread over a diffused area rather than on a focal pt on the retina>>blurry vision. |
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Cornea Reflex |
testing CN 5, 7-blink test -decreased blink: may be neuro lesion or frequent use of contact |
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Iris |
nl: round w/even color-varied color
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Iritis-S&S |
-emergency and need STAT referal -marked photophobia, blurry vision, throbbing pain -red eye up to iris instead of in the sclera -may cause constricted & ragged edges of pupil |
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Pupil |
-mydriasis=pupil dilate=SNS -Miosis=pupil constrict=PSNS- -control by cn 2, 3 |
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Anisocoria |
Unequal pupil-5% population |
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Pupil testing |
1. pupillary light reflex: pt look straight ahead, shine a light on to 1 eye>>>direct: constriction of that pupil and consensual: constriction of the other pupil 2. Accommodation test: ability to adjust vision from far to near: pt focus on a distant object then look at a finger moving toward the nose-nl finding: both pupil constricts and converge 3. If everything is normal, document PERRLA |
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IOP=Intraocular pressure-range |
13-22 mmHg |
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Glaucoma |
-IOP>22 mm Hg blood subpply is cut to retina -affect peripheral vision -two type: open and closed angle: impaired drainage of aqueous humor fluid vs not functioning angle -S&S: assymptomatic until very late: clouding vision, sudden eye pain, halos around light, H/A |
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Nose structures-outward |
Bridge, tip, nares, columella and ala nasi
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Internal structures of nose |
1. Nasal cavity, nasal hair, nasal mucosa, kiesselbach's plexus (KBP), nasal septum, turbunates and oldfactory receptors. -nasal hair: coarse and ciliated-no plucking hair -nasal mucosa: redder than buccal mucosa -KBP: common site for epistasis -Turbinates: superior, middle and inferior with 3 meatus responding to each-Nasal parasinuses drain to middle meatus while nasolacrimal duct drains to inferior meatus -Olfactory receptors-located upper 1/3 of septum, transmit sensation to the CN 1 and to temporal lobe |
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Mouth (vermillion border, roof, uvula, tongue) |
1. roof of mouth: -hard palate: bone, whittish -sof palate: muscle, pink soft mobile 2. Uvula: in middle of soft palate- bifid uvula-spit of uvula-nl finding 3. Tongue: -dorsal surface: smooth, rough with papilla-where taste bud found -ventral surface: shinny w/prominent veins |
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Saliva Glands-types, location and functions |
Secret saliva containing salivary amylase (ptyalin) to disgest food. 1. Parotid glands: drain to Stensen's duct located by upper 2nd molar-they are embedded in cheek, anterior to ears & down to angle of jaw 2. Submandibular gland: drain to Wharton's duct which can be located on ventral surface of tongue next to frenulum. It locates beneath the mandible at the angle of jaw 3. Sublingual gland: drain to small opening along sublingual fold of the tongue- It locates on floor of mouth |
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Teeth |
-32 permanent with 3rd molar=wisdom teeth for adult and 20 deciduous/baby teeth -Gingiva |
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Pharynx-Area behind mouth and nose |
1. Oropharynx: anterior tonsillar pillars separate mouth from oral pharynx -tonsils (palatine): lymphoid tissue located bwt anterior & posterior pillars-Appear grandular w/deep crypts-4 grades. 2. Nasopharynx: abover oropharynx, behind nasal cavity where phyaryngeal tonsils and eustachian tube outlet are located |
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Asonemia |
change in sense of smell |
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Dysphagia |
Difficulty w/swallowing |
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Bruxism |
teeth grinding |
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Allergic salute |
deep crease on the nose due to severe allergy |
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rhinorrhea |
nasal discharge or "runny nose" |
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Acute rhinitis-S&S |
-internal nose inflammation -often viral -swelling w/bright red mucosa -rhinorrhea |
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Allergic rhinitis-S&S |
-pale mucosa -associated w/itchy eyes, sneezing, etc. -look for allergic salute in children -foreign body-purulent unilateral d/c w/o URI symptoms -sore/lesion-furuncle (boil), cancer |
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Sinuses Transilumination |
1.can start examing at 8yr 2. test patency of sinuses-not too reliable: shine light under superorbit and watch for redglow over forehead for frontal sinus. Do the same thing over buccal mucosa and watch for red glow over cheek for maxillary sinus |
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Cheilosis=angular stomatitis |
Cracking at the corners, may be caused by riboflavin and niacin deficiency |
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What causes discolored teeth? |
-brown: excessive fluoride -yellow: tobacco -dark brown: tetracycline during 3rd trimester |
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Gingivitis |
swelling, hypertrophy of gums: poor dental hygiene |
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Gingival hyperplasia=gingival hypertrophy |
-pregnancy, puberty, leukemia, long use of dilantin |
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Tongue |
-should be pink and uniform in color, may have thin white coating, rough w/papillae
-smooth, glossy tongue: iron, b12, folic acid deficiency
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Macroglossia |
enlarged tongue d/t down syndrome, acromegaly (increased growth hormone), mydexema, or cretinism |
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Mydexema |
severe hypothyroidism |
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Cretinism |
congenital hypothyroidism |
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Acromegaly |
increased growth hormone (anterior pituitary) |
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Leukoplakia vs. fungus tongue |
1. Leukoplakia: white patch, non painful, precancerous, doesn't scrape off 2. Fungus tongue: white cheesy or black hairy tongue that can be scrapped off -Peptobismol can cause black tongue |
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Candidiasis or monilial infection |
-due to destruction of normal bacteria from taking many abx. |
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Apthous ulcers=canker soress |
-unknown cause |
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Torus palatinus |
-common midline bony ridge in hard palate -more common in native amer. and asian |
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Cleft lip and cleft palate |
-incomplete fusion of maxillary process -more common in native amer. and asian |
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Uvula |
-check CN 10--say "ahhh" nl: rise and mid line -abnl: deviation: r/t tonsil abcess, nerve damage, polio, diphtheria, cn 9 damage |
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What tests are used to test CN 2? |
1. Test visual acuity-use snellen chart for far vision-nl 20/20, minimal vision to drive 20/40 w/corrected lense, 20/200 legal blind. Use newsprint for near vision- 2. Visual Fied: or Confrontation test: face pt at 2ft, assess when pt can see finger at periphery-test 1 eye at a time. If nl, document as: visual field full by confrontation, CN 2 intact |
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Prebyopia |
-decreased power of accommodation with aging -requires bifocasl for age 42-46 -young ppl able to accommdate>>no need bifocals |
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Bifid uvula |
partial or complete split of uvula: not sig. common in native amer. and asian. |
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Tonsil grading |
1. visible 2. half way to uvula 3. almost touching uvula +4: touching each other |
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Tonsil conditions |
1. Acute Tonsilitis: bright red, swollen tonsils w/exudate 2. Tonsil w/exudate or large white spots: mononucleosis, leukemia 3. Tonsil with PND: yellow mucoid film in back of throat. |
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Halitosis |
bad breath r/t sweet breath of DKA, dental infection, smoke, ETOH |
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Ankyloglossia |
tongue-tied: short frenulum>>tongue not mobile>> impaired speech |
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External ear |
-include auricle (pinna), tragus, antitragus, helix, antihelix, lobule -EAC: 2-2.5 cm long, lined with cilia and ends at TM-cerumen to lubricate and prevent infection -TM (ear drum): separate EAC from middle ear: gray, pearly gray, shinny, translucent: cone of light 5 o'clock on right and 7 o'clock on left, umbo, manubrium, short process of malleus, pars flacidda/tessa, annulus
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Middle ear |
-conduct sound vibration to inner ear -include: incus, maleus and stapes -air cavity -equalize pressure: open to oropharynx via eustachian tube. |
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Inner ear |
-vestibule, semicircular cannals, cochlea -cochlea contains the organ of corti transmitting sounds to CN 8. |
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Otitis externa |
-painful tragus -watery/serosanguineous discharge, pruritic |
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Otitis media |
-painful mastoid process -bright red TM -loss of landmark |
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Inspection of the eyebrow |
-symmetrical movement (if not, it could indicate problem w/cn7 -any skin issue -full or loss (hypothyroidism loss of outter 1/3) |
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Inspection of eyelids |
-proctect from injury and dust, strong light -contain meibomian glands (inside eyelid): lubricate lids, prevent evaporation of tears and air tight seal when eyes are closed -note for lessions, rashes, swelling, redness or d/c P |
