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140 Cards in this Set
- Front
- Back
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Where do cataracts occur?
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lens
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____ are the only common abnormalities of the lens.
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cataracts
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epi-
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above
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-itis
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inflammation/irritation
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Glaucoma pushes the optic disc ____.
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in
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Papilledema pushes the optic disc ____.
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out
increased cup due to increased pressure from behind. |
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Why do we say that the eyes are the gateway to the body?
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only place you can directly see arteries, veins and pulsations
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Are venous pulsations visible with papilledema?
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no - venous hemorrhages
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Papilledema is a swelling of the ____ ____ where it meets the ____.
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optic nerve, eye
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In glaucoma, disc margins are ____ with a ____ central area.
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raised, lowered
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Papilledema decreases cupping of the optic disc due to ____ ____.
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intracranial pressure
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Glaucoma increases cupping of the optic disc due to ____ ____.
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intraocular pressure
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What is the average diameter of the optic disc?
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1.5 mm
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def - Drusen Bodies
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Small, discrete spots that are slightly more yellow than the retina.
Most commonly a consequence of agin process. **precursor of senile macular degeneration |
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def - Hemianopia
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loss of vision on one side of the eye
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def - Episcleritis
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inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles.
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def - Strabismus
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condition in which both eyes do not focs on an object simultaneously
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def - Xanthelasma
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flat, slightly raised, irregularly shaped, yellow tinted lesions on the periorbital tissues that represent depositions of lipids and may suggest the patient has abnormal lipid metabolism
**high cholesterol |
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def - Ectropion
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lower lid turned away from the eye and may result in excess tearing
the inferior punctum, which serves as the tear collecting system is pulled outward and cannot collect the secretions of the lacrimal gland. |
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def - Entropion
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lower lid turned inward
eye lashes may cause corneal and conjunctival irritation increasing risk of secondary infection |
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def - Hordeolum
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an acute suppurative inflammation of the follicle of the eyelashes - can cause an erythematous or yellow lump
**aka sty - generally staph related |
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def - Ptosis of eyelid
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drooping of superior eyelid, indicating a congenital or acquired weakness of the levator muscle or paresis of CNIII
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def - Midrasis
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papillary dilation of more than 6mm and failure of pupils to constrict with light
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def - Hyperopia
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(farsightedness) a refractive error in which light rays entering the eye are focused behind the retina
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def - Presbyopia
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Impaired near vision from the loss of lens elasticity, generally developing during middle age (accommodation response)
**don't confuse with hyperopia |
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def - Myopia
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(nearsightedness) a condition resulting from a refractive error in which light rays entering the eye are brought into focus in front of the retina
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def - Anisocoma
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unusual pupil size
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The optic disc is in the ____ direction.
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nasal
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The macula is in the ____ direction.
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temporal
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What does visual acuity of 20/40 mean?
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pt can read at 20 ft what the average person can read at 40 ft
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What does visual acuity of 20/200 mean?
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pt can see at 20 ft what the average person can see at 200 ft... NOT GOOD!
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What is the first step of every eye exam (even if there's a foreign body)?
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VISUAL ACUITY!!!
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A diaphragm is best for hearing ____-pitched sounds.
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high
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A bell is best for hearing ____-pitched sounds.
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low
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Muscle percussion is ____.
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flat
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Percussion of a hyper-inflated lung sounds ____.
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hyperresonant
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Percussion of the liver produces ____ sound.
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dull
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If you percuss a lung with pneumonia, it will sound ____.
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dull
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pulse = +4/4
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full and bounding
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pulse = +3/4
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full/increased
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pulse = +2/4
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average
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pulse = +1/4
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diminished
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pulse = 0/4
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absent
NO BUENO!!! |
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def - Tachycardia
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(fast heart rate)
>100 bpm |
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def - Brachycardia
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(slow heart rate)
<60 bpm |
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def - Tachypnea
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(fast breathing)
>20-22 b/m |
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def - Bradypnea
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(slow breathing)
<12 b/m |
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When taking blood pressure, the bladder width should be no greater than ____ the length of the upper arm.
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2/3
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When taking blood pressure, the bladder should wrap around ____ of the limb.
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80%
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When taking blood pressure, the bladder should cover ____ circumference.
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3/4
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Why shouldn't you use a little cuff on a big person??
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BP reading will be falsely elevated.
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How do you record the bp reading for a pt with an ascultatory gap?
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record systolic, gap and then diastolic
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Normal BP
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119/79 or below
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Prehypertention BP
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120-139/80-89
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High BP
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140/90 or above
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Symptoms of LMN lesion
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Weakness +
Atrophy + Fasiculations + Reflexes (dec) Tone (dec) Babinski - |
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Symptoms of UMN lesion
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Weakness +
Atrophy - Fasiculations - Reflexes (inc) Tone (inc) Babinski + |
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Romberg Test
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In the Romberg test, the patient is stood up and asked to close his eyes. A loss of balance is interpreted as a positive Romberg sign.
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reflexes = 0
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absent
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reflexes = 1
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reduced (hypoactive)
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reflexes = 2
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normal
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reflexes = 3
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increased (hyperactive)
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reflexes = 4
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clonus
**some use 5 for sustained clonus |
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How do you test graphesthesia?
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Draw a letter or number on pts hand with a blunt pin. Pt should be able to identify what you have drawn.
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How do you test stereognosis?
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Hand pt familiar object to identify by touch.
**tactile agnosis = inability to recognize objects by touch -- suggests parietal lobe lesion |
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CNI test
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test smell one notstril at a time
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CNII test
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visual fields, acuity, pupillary light reflexes (II&III)
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CNIII, CNIV, CNVI test
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ocular motility, eye movements
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CNV test
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facial sensation, corneal reflex, muscle of mastication strength
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CNVII test
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muscles of facial expression
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reflexes = 2
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normal
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reflexes = 3
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increased (hyperactive)
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reflexes = 4
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clonus
**some use 5 for sustained clonus |
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How do you test graphesthesia?
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Draw a letter or number on pts hand with a blunt pin. Pt should be able to identify what you have drawn.
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How do you test stereognosis?
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Hand pt familiar object to identify by touch.
**tactile agnosis = inability to recognize objects by touch -- suggests parietal lobe lesion |
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CNI test
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test smell one notstril at a time
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CNII test
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visual fields, acuity, pupillary light reflexes (II&III)
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CNIII, CNIV, CNVI test
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ocular motility, eye movements
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CNV test
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facial sensation, corneal reflex, muscle of mastication strength
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CNVII test
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muscles of facial expression
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reflexes = 2
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normal
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reflexes = 3
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increased (hyperactive)
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reflexes = 4
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clonus
**some use 5 for sustained clonus |
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How do you test graphesthesia?
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Draw a letter or number on pts hand with a blunt pin. Pt should be able to identify what you have drawn.
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How do you test stereognosis?
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Hand pt familiar object to identify by touch.
**tactile agnosis = inability to recognize objects by touch -- suggests parietal lobe lesion |
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CNI test
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test smell one notstril at a time
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CNII test
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visual fields, acuity, pupillary light reflexes (II&III)
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CNIII, CNIV, CNVI test
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ocular motility, eye movements
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CNV test
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facial sensation, corneal reflex, muscle of mastication strength
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CNVII test
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muscles of facial expression
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CNVIII test
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rubbing fingers together, light whisper, etc.
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CNIX and CNX test
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look at palate and say "aah" - observe symmetry
may not need to test gag in otherwise asymptomatic patients |
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CNXI test
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test SCM and shoulder elevation
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CNXII test
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Protrude tongue, push tounge against cheek - look for fasiculations
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How do you test cerebellar funcction?
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watch pt walk
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Gait Testing
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casual walking, tandem if age appropriate, walk on heels/toes, turning, etc.
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def - Dystonia
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sustained involuntary contractions of muscle groups, focal or generalized.
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Rinne test
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- compares air to bone conduction
- tuning fork placed on mastoid until pt no longer hears, then placed just lateral to ear - BC > AC = conductive hearing loss |
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Weber test
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- compares bone conduction in the two ears
- tuning fork placed in midline of skull - lateralized to affected ear in conductive deafness - lateralized to unaffected ear |
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def - Gingivitis
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inflammation
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def - Gingivitus
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inflammation of gums around teeth
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def - Stomatitis
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inflammation of the mucus lining any structures of the mouth
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def - Cheilosis
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a disorder of the lips marked by scaling and fissures at the corners of the mouth -- caused by deficiency of riboflavin
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def - Chelitis
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inflammation of the lip
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def - Glossitis
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inflammation or infection of the tongue
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What direction does the cone of light point?
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toward the nose!
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def - Pars Tensa
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the drumlike part of the tympanic membrane.
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def - Pars Flaccida
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the small, triangular portion of the tympanic membrane lying between the lateral process of the malleus and the margins of the tympanic incisure.
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def - Cochlea
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the spiral cavity of the inner ear containing the organ of Corti, which produces nerve impulses in response to sound vibrations.
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def - Semicircular Canals
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three fluid-filled bony channels in the inner ear. They are situated at right angles to each other and provide information about orientation to the brain to help maintain balance.
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def - Eustachian Tube
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a narrow passage leading from the pharynx to the cavity of the middle ear, permitting the equalization of pressure on each side of the eardrum.
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Pt comes in with an auditory sensation in the absence of sound heard in one or both ears such as hissing, buzzing, ringing or clicking.
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tinnitus
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Which sinuses can you transilluminate?
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frontal and maxillary
**if you can't transilluminate, you have fluid in sinuses |
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Where is the most common site for oral cancers to begin?
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trigone area
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What are some risk factors for oral cancer?
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>40yo
Men (2x) Black Alcohol Ill fitting dentures Tobacco |
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What do tonsils harbor?
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bacteria!
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What is the significance of black hairy tongue?
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Black, hairy tongue is a temporary, harmless (benign) oral condition that gives your tongue a dark, furry appearance. The distinct look of black, hairy tongue usually results from an overgrowth of bacteria in the mouth.
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tonsils = grade 1
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visible
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tonsils = grade 2
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take up half of the space, don't pass pillars
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tonsils = grade 3
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take up a little over half and pass pillars
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tonsils = grade 4
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come close to meeting at mid-line
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What is Fremitus and how do you test for it?
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palpable vibration, 99
** heard more distinctly in areas of consolidation, pneumonia, pleural effusion |
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def - Emphysema
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long term, progressive disease of the lung that primarily causes shortness of breath.
in people with emphysema, long tissues necessary to support physical shape and function of the lung are destroyed. |
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def - Pleurisy
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inflammation of the membrane that surrounds and protects the lungs (pleura)
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def - Empyema
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the presence of pus in the pleural sac which is between the outer surface of the lung and the chest
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def - Pneumothorax
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the presence of air or gas in the cavity between the lungs and the chest wall, causing collapse of the lung.
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def - Pleural Effusion
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loss of fluid from the blood vessels or lymphatics into the tissues or a body cavity
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def - Adolectisis
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collaped lung tissue -- incomplete expansion of the lung, either congenital or acquired
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def - Dyspnea
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labored breathing
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def - Orthopnea
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having difficulty breathing lying down
**condition where pillows must be used to breathe comfortably |
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def - Hypopenea
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shallow, slow breathing
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def - Hyperpnea
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respiration that is deeper and more rapid than expected
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Vesicular sounds are ____ sounds.
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normal
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Adventitious sounds are ____ sounds.
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abnormal
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def - Crackles
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produced by sudden opening of small airways with rapid equalization of pressures
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def - Wheezes
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mainly expiratory musical sounds
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def - Rhoncus
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(sonorus ronchi) - snoring sounds
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def - Pleural Friction Rub
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insp and exp - sounds like leather on leather
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def - Hemothorax
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condition resulting from blood accumulation in the pleural cavity
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What are some landmarks associated with tracheal bifurcation?
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sternal angle is anterior, T4/T5 posterior
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