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Comprehensive Health Assessments > Chapter 10: HEENT > Flashcards

Chapter 10: HEENT Flashcards

1
Q

Accommodation

A

adjustment, especially of the eye for seeing objects at various distances

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2
Q

Cardinal Fields of Gaze

A

determine how well the 6 extraocular eye muscles are working along with Cranial Nerves 3, 4, 6

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3
Q

Consensual Reaction

A

reaction of the other pupil after a light test in the first
- identical change in pupil size in both eyes when light is shone into one eye

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4
Q

Constriction

A

closing of the eye pupil
- to limit the amount of light that enters the pupil
- for close vision

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5
Q

Dilation

A

widening of the eye
- to allow more light to enter the eye

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6
Q

Cornea

A

clear, bowl-shaped structure at the front of the eye, located in front of the colored part of the eye (iris)
- controls and focuses the light that enters the eye

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7
Q

Cover and Uncover Test

A

observing movement and response of uncovered eye while the other is covered

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8
Q

Exophthalmos

A

abnormal protrusion of the eyeballs
- sign of hyperthyroidism

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9
Q

Helix

A

margin of the ear’s auricle

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10
Q

Hirschberg Test

A

corneal light reflex test
-shine light in eyes and the light reflection should be at the same point in each eye

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11
Q

Inner and Out Canthus

A

inner and outer angular junction of the eyelids at either corner of the eyes
- corner of the eyes

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12
Q

Iris

A

circular opening that allows light into the eye

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13
Q

Limbus

A

edge of corneas where it joins the sclera

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14
Q

Nystagmus

A

involuntary movement of the eye

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15
Q

Palperbral Fissure

A

elliptic space between the medial and lateral canthi of the two open lids

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16
Q

Perrla

A

Acronym
- Pupils are Equal, Round, Reactive to Light with Accommodations

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17
Q

Pinna

A

projecting part of the ear

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18
Q

Peripheral Vision

A

angle between the axis of the eye looking directly at the examiner and the peripheral axis where the object is first seen

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19
Q

Presbyopia

A

loss of the eyes’ lens to accommodate to near vision; occurs around age 40
- leads to Farsightedness
- will see patient move the cards further away to see clearly

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20
Q

Pupil

A

black circular area of eye that lets in light

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21
Q

Rinne Test

A

evaluates hearing loss in one ear
- place tuning fork at mastoid process and then in front of the patient’s ear

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22
Q

Sclera

A

tough fibrous tunic forming the outer envelope of the eye and covering all of the eyeball except the cornea
- white outer layer of the eyeball

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23
Q

Snellen Charts

A

traditional eye chart with a large letter E at the top followed by progressively smaller print

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24
Q

Strabismus

A

cross-eyed, optic axes cannot be directed to the same object
- caused by weakness of extraocular muscles

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25
Q

Thyroid

A

hormone glad that plays an important role in metabolism, growth, and development of human body

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26
Q

Tonsils

A

soft organs located at each side of the back of the throat; part of the immune system

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27
Q

Visual Acuity (Distance)

A

ability of the eye to distinguish shapes and the details of objects at a given distance

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28
Q

Visual Acuity (Near Vision)

A

measurement of how well you can see close objects; usually 16-18 inches

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29
Q

Trachea

A

tube about 4 inches long and less than an inch in diameter allowing air to pass into the body; commonly called the windpipe

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30
Q

Weber Test

A

hearing screening test done with a tuning fork to detect one-sided conductive hearing loss in the middle ear and unilateral sensorineural inner ear hearing loss

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31
Q

Dizziness vs. Vertigo

A
  • D: feeling like you will faint
  • V: feeling like the world is spinning
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32
Q

What is presyncope ?

A

feelings of faintness

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33
Q

What is disequilibrium ?

A

feeling of falling

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34
Q

What is Bell’s Palsy ?

A
  • whole 1 side of face is paralyzed or numb
  • affects CN VII
  • usually temporary
  • has wrinkles on side of face that can still be moved and none of the side that can’t be moved
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35
Q

What is CVA (cerebral vascular accident) ?

A
  • think of stroke
  • affects CN VII
  • has wrinkles on both side of face
  • opposite site of injury will be the side that if affected
  • motor response in upper part is normal
  • caused by blood clot or hemorrhage
  • loss of blood flow (oxygen) to the brain
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36
Q

From what side of the brain does the innervation to the muscles of the upper face come from ?

A
  • both sides of the brain
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37
Q

From what side of the brain does the innervation to the muscles of the lower face come from ?

A
  • from the opposite side of the brain only
38
Q

How do we test for visual acuity ?

A

Snellen chart (CN II)

39
Q

What are the conditions to use the Snellen chart ?

A
  • stand 20 ft away from chart
  • cover one eye at a time
  • well lighted room
  • read smallest line possible
  • when documenting say if they use correction glasses or contacts
40
Q

What eye chart can we use for people who can’t read letters ?

A

e-chart

41
Q

What is considered legally blind ?

A

20/200

42
Q

What are the conditions to use the Jaeger/Rosenbaum chart ?

A
  • hold chart about 14 inches away from the eye
  • use to test for near vision for ages 40 and over
43
Q

What does 20/25 mean for visual acuity ?

A

you can see at 20 feet what someone with normal vision can see at 25
- the larger the denominator the poorer the vision

44
Q

What is myopia ?

A
  • nearsighted
45
Q

What is hyperopia ?

A

farsighted

46
Q

What is Astigmatism ?

A

visual distortion resulting from an irregular corneal curvature that prevents light rays from being focused clearly on the retina

47
Q

What is Strabismus ?

A

when eyes aren’t in alignment with each other
- moves to focus after being uncovered
- caused by extraocular muscle weakness or paralysis

48
Q

What is Nystagmus ?

A

involuntary movement of the eyeball in a horizontal, vertical, rotary, or mixed direction
- can be congenital or acquired from multiple causes

49
Q

How do we test for strabismus ?

A

cover-uncover test

50
Q

What does the confrontation test assess for ?

A

assess for peripheral vision

51
Q

How do you perform the confrontation test ?

A
  • face patient and stand or sit at a distance of 2-3 ft
  • ask patient to cover one eye with an opaque card and look directly at you
  • cover your own eye directly opposite the patient’s covered eye
  • bring your finger or pencil from the farthest periphery and bring it gradually closer to the midline
  • you and the patient should see the object at the same time
52
Q

What is enophthalmos ?

A

eyelid and lashes are rolled in (trauma, congenital, syndromes)
- eyes are sunken in

53
Q

What is coloboma ?

A

a hole in a structure of the eye

54
Q

What is Ptosis ?

A

lid is covering a portion of the pupil

55
Q

Conjunctiva

A

the mucous membrane that covers the front of the eye and lines the inside of the eyelids
- doesn’t cover the cornea

56
Q

What is conjunctivitis ?

A

red conjunctiva with purulent drainage

57
Q

What is the Hirschberg test used for ?

A

corneal light reflex for symmetry

58
Q

How do you perform the Hirschberg test ?

A
  • patient stares straight ahead with both eyes open
  • shine penlight toward the bridge of the nose (middle of both eyes) about 12-15 inches away
  • light reflections should appear symmetric in both corneas
59
Q

What does asymmetrical light reflections in the eye indicate ?

A

weak extra-ocular muscles
- perform cover-uncover test if found

60
Q

When do you perform the cover-uncover test ?

A

if corneal light reflex is asymmetric

61
Q

How do the pupils react when you look at a close and distant image ?

A
  • Close: pupils constrict
  • Distant: pupils dilate
62
Q

When assessing for PERRLA should you check for pupil size before or after you shine the light ?

A
  • before because the light will change the size of the pupil
63
Q

How and when should your further access for hearing ?

A

based on conversation
- if patient leans forward as you talk
- watches lips as you speak
- asks to repeat yourself
- misunderstands questions

64
Q

What does low set ears indicate ?

A
  • abnormal
  • congenital diseases like down syndrome
65
Q

What is the Whisper voice test ?

A
  • have patient occlude 1 ear
  • while stand 1-2 ft in front of or bedside whisper 1 or 2 syllable words
  • patient should hear 50% of words
  • do with both ears
66
Q

What is the Finger rubbing test ?

A
  • have patient close eyes
  • hold your fingers 3-4 inches from the patients ear, briskly rub your index finger against your thumb
  • patients with high-frequency hearing loss may not be able to hear the noise
67
Q

What does failure of eyes to move in parallel mean when doing the 6 cardinal fields of gaze ?

A

weakness of the extraocular muscles or abnormality associated with the cranial nerve
- nystagmus

68
Q

What is conduction hearing loss in the Weber test ?

A

sound will lateralize to the defective ear because its traveling through the bone

69
Q

What is sensorineural hearing loss in the Weber test ?

A

sound lateralizes to the unaffected ear

70
Q

What does tenderness of the mastoid area mean ?

A

indicate mastoiditis

71
Q

What does tenderness of the helix of the ear mean ?

A

an inflammation within the auditory canal

72
Q

If you have conductive hearing loss what does that mean for your bone and air conduction ?

A

bone conduction longer than air conduction in the affected ear

73
Q

If you have sensorineural hearing loss what does that mean for your bone and air conduction ?

A

air conduction longer than bone conduction in the affected ear

74
Q

With is considered a normal finding when performing the Rinne test for hearing loss ?

A
  • you should hear the air conduction twice as long as the bone conduction
75
Q

What does tenderness of sinuses indicate ?

A

sinus congestion or infection

76
Q

What does dry, flaking, cracked lips mean ?

A
  • dehydration
  • wind exposure
77
Q

What does pale lips mean ?

A
  • anemia or shock
78
Q

What does cyanotic or circumoral lips mean ?

A

hypoxemia or hypothermia

79
Q

What does cracks and erythema in corner of mouth mean ?

A

Vit B deficiency

80
Q

What does smooth, beefy-red, edematous with a slick appearance of the tongue mean ?

A

possible vit B difciency

81
Q

What does irregular patches, map-like appearances of the tongue mean ?

A

geographic tongue

82
Q

What does a enlarged tongue indicate ?

A

down syndrome or hypothyroidism

83
Q

What is Leukoplakia ?

A

white patch or plaque on oral mucosa that can’t be scraped off

84
Q

What is Goiter ?

A

enlarged thyroid
- may be seen as fullness in the neck

85
Q

What are signs of Hyperthyroidism ?

A

excessive secretion of thyroid hormone; commonly caused by Graves disease
- Increased metabolism
- weight loss
- enlargement of thyroid gland
- exophthalmos
- auscultation of the goiter may reveal a bruit
- decreased skin thickness
- diaphoresis
- warm/hot skin

86
Q

What are signs of Hypothyroidism ?

A

decreased production of thyroid hormone
- decreased metabolism
- weight gain
- slow motion with depressed effect
- goiter may be seen because of increases in thyroid stimulation hormone
- enlarged tongue
- dull, coarse, brittle hair

87
Q

What can cause hypothyroidism ?

A
  • autoimmune thyroiditis
  • iodine deficiency
  • decreased section of thyroid-releasing hormone from the hypothalamus
  • congenital defects
  • as a result of the treatment of hyperthyroidism
  • atrophy of thyroid gland or iodine deficiency
88
Q

What is myopia ?

A

nearsightedness

89
Q

What is hyperopia ?

A

farsightedness

90
Q

What is presbyopia ?

A

lens gradually loses ability to bring close objects into clear focus
- natural part of aging

Comprehensive Health Assessments (13 decks)

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