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Exam 2: [ENT & Eyes] Flashcards

1
Q

What are Tears composed of?

A

Water, Oil & Mucus

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2
Q

What is the Center of the Fiel of VIsion?

A

Fovea Centralis

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3
Q

Innervation of the Eye Muscles

A

Superior Oblique: CN 4
Lateral Rectus: CN 6
Inferior Oblique, Medial Rectus, Superior Rectus, Inferior Rectus: CN 3

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4
Q

Presbyopia Definition

A

Farsightedness caused by loss of elasticity of the lens of the eye

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5
Q

SNellen Chart

A

[Distance Vision]
- has to get more than 1/2 letters correct
- stands 20 feet away
- 20/70 = what pt reads from 20, normal eye can read from 70.

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6
Q

What reading on the SNellen chart is legally blind?

A

20/200 or worse

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7
Q

Rosenbaum Chart

A

[Near Vision]
- 14 inches from face

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8
Q

Ishihara Plates

A

[Color blindness]
- stands 75cm from plates
- must read within 3 seconds
- less than or equal to 9 correct = deficient color vision

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9
Q

Blind spot is where?

A

15 degrees temporal to the line of gaze

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10
Q

Anopsia Definition

A

[Visual Field Defect]
-hemianopia
- quadrantic defect
- mononuclear defect

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11
Q

Sparing of the Macula is seen when?

A

In Infarction of Occipital lobes due to PCA occlusion.
May be caused by collateral vascular supply to the macular region

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12
Q

If the Posterior cerebral artery is occulted…

A

Contralateral homonymous hemianopia with macular sparing

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13
Q

What types of light to use for Cornea & Lens, Iris & Corneal Reflection

A

Cornea & Lens: Oblique light
Iris: Tangenital light
Corneal Reflection: direct light

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14
Q

One eye vs both eyes protruding

A

One Eye: Cancerous growth in the eye
Both Eyes: abnormality of the thyroid

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15
Q

Strabismus definition

A

Eyes will not look straight ahead together

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16
Q

Lateral sparseness of the eyebrows indicates:

A

Hypothyroidism

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17
Q

Scaliness of the eyebrows indicates

A

Seborrheic dermatitis (dandruff)

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18
Q

Ptosis of the eyelids

A

[upper eye lid droop] (lazy eye)
NORMAL MAD = 4-4.5MM
- Upper eye lid should not cover the pupil
Myasthenia Gravis: CN III
Horner Syndrome: Congenital

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19
Q

Entropion of Eyelid

A

[Inward turning of lid margin]
- irritates conjunctiva & sclera
- MC in elderly

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20
Q

Ectropion of eyelid

A

[Outward turning of lid margin]
- If punctum turns outward, eye cant drain well
- MC in elderly

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21
Q

Lid Lag vs. Von Grafe’s Sign

A

Lid Lag: Static situation (lid higher than normal in downgaze)
Von Grafe’s: Dynamic sign (lid descends during downgaze)

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22
Q

Blepharitis

A

Chronic inflammation of eyelids at the base of the hair follicles
- S. Aureus
- Seborrheic dermatitis
- clogged sebaceous gland
- rosacea

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23
Q

Lesions of the Eye: Stye vs. Chalazion

A

Stye: Infection of margin, Ext = lash, Int = Obstructed Meibomian gland
Chalazion: Painless Obstructed Meibomian gland

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24
Q

Xanthelasma

A

Raised, yellowish cholesterol plaque on nasal portion of eyelid
- Hyperlipidemia
- Primary Biliary Cirrhosis

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25
Pinguecula
[harmless yellow nodule in the bulbar conjunctiva] - deposition of protein, fat or calcium - nasal then temporal
26
Corneal Arcus (Arcus senilis)
- Gray/white arc around cornea - usually benign
27
Kayser-Fleischer Ring
Red/brown ring shading to green or blue from Copper deposition in cornea -Genetic OR Copper accumulation in Liver
28
Keratoconus
[assymetric thinning results in cone-shaped cornea] - weakening of central cornea
29
Keratoconus Results In:
Myopia & Astigmatism
30
What CN Opens & Closes the Eye Lid?
Opens: CN 3 Closes: CN 7
31
Can’t close the eyes -> suspect what?
Hyperthyroidism Bells Palsy Loss of Conscoiusness
32
Corneal Injury or Infection Causes
Abrasion Viral Bacterial
33
Acute Iritis Causes
Herpes TB Autoimmune
34
Acute Angle Glaucoma Causes
Increased introcular pressure
35
Hyphema
[polling of blood in anterior chamber of eye] - Results from: trauma, hemophilia
36
What do you inspect to cornea and lens for?
Cataracts (lens opacity) Corneal Scars (superficial grayish white opacity of cornea) Pterygium
37
Pterygium
Triangular thickening of bulbar conjunctiva that grows across the cornea
38
Increased introcular pressure results in a
Bulging Iris (shadow on medial iris w/ tangential lighting)
39
Ciliary Injecton of the Iris
Dilation of deeper vessels radiating from limbus
40
Glaucoma definition
Set of irreversible progressive optic neuropathies that can lead to severe visual field lass & bblindness
41
2 MC forms of Glaucoma
Primary open angle: family Hx, DM, Black, Hispanic Primary angle closure: Asian, female
42
With treatment of glaucoma…
1 in 7 patients will be blind in 20 years
43
Glaucoma exam findings
- Optic Disc cupping - Pain w/ eyelid palpation - medial shadow - halos around lights - loss of peripheral vision (tunnel vision)
44
Exam finding during an acute episode of angle closure glaucoma include:
- Mid-dilated pupil - conjunctival (ciliary) injection - cloudy cornea
45
What does PERRLA stand for?
[Pupil observation] Pupils Equal Round React to Light Accommodate
46
Normal pupil size in adults:
2-4mm in diameter (bright light) 4-8mm in diameter (dark)
47
Coloboma
- Congenital - Pupil loos like its drooping down the iris
48
Anisocoria
[defect in contraction or dilation of one pupil] - “Unequal pupil size” When anisocoria is greater in bright light pupil cant constrict When anisocoria is greater in dim light pupil cant dilate
49
Pupillary constriction vs. Dilation
Constriction: Parasympathetic Dilation: Sympathetic
50
Blindness is a problem with what CN?
CN 2
51
Light reaction in a blind eye
- Unilateral blindness does not cause anisocoria. - light directed into the blind eye causes no response in either eye
52
Convergence, Consteiction & Accommodation of the pupil are controlled by:
CN 3
53
Mydriasis vs. Miosis
Mydriasis: dilation of the pupil Miosis: excessive constriction of the pupil
54
Parasympathetic Anisocoria
[failure of larger pupil to constrict] - CN 3 Paralysis - Tonic (Adie) Pupil
55
Sympathetic Anisocoria
[failure of smaller pupil to dilate] - Horner syndrome - Argyll Roberson (small irregular pupils)
56
What might cause an absent red reflex?
- Detached retina - Corneal Abrasion - Cataract - Tumor/retinoblastoma
57
3 C’s of the Optic Disc
1) Cup 2) Color 3) COntour
58
Glaucomatous Cupping
- Increased introcular pressure from glaucoma - Increased cupping due to nerve fiber loss
59
Optic Atrophy
Optic cup occupies the entire optic disc Entire disc appears pale/white - Optic neuritis - MS - Temporal aretitis
60
Papilledema
Engorgement & swelling of optic disc Intracranial pressure causes edema along optic nerve - blurred disc margins - cup not visible
61
A/V Nicking
“Apparent nicking at arteriovenous crossings” Vein appears to taper down on either side of the artery - Hyoertension
62
Cotton Wool Patches
White ovoid lesion with soft edged Extruded Axoplasm - HTN - DM
63
Flame Hemorrhages
Superficial bundles of nerve fibers - HTN - Papillaedema - Occlusion of retinal vein
64
Drusen
Yellow spots between optic disc & macula Dead retinal pigment epithelial cells - age related macular degeneration - Scotsman vs. loss of peripheral vision
65
Conduction phase of the ear
External & Middle ear (Air & Bone Conduction)
66
Sensorineural Phase of the ear
Inner Ear
67
Causes of Conductive External Ear hearing loss
- Ceruman impaction - Infection (otitis external) - Trauma - foreign objects - squamous cell carcinoma - Benign bony outgrowths (exostosis & osteomas)
68
Causes of Conductive Middle Ear hearing loss
- otitis media - congenital - cholesteatomas - otoscleosis - tumors - perforation of tympanic membrane
69
Causes of Sensorineural Inner Ear hearing loss
- congenital & hereditary - presbycusis - viral infections - Meniere disease - noise exposure - ototoxic drug exposure - acoustic neuromas
70
How many decibels is dangerous/painful?
120db (ambulance siren)
71
Whisper voice test at how many decibels?
20-40
72
Weber test
- In patients w/ unilateral hearing loss - on top of head Sound louder in bad ear = conductive hearing loss Sound louder in good ear = Sensorineural loss
73
Sound lateralizes toward what ear?
Bad ear w/ conduction loss Good ear w/ sensorineural loss
74
Rinse test
Normal: Air conduction (AC) > Bone conduction (BC) Conductive Loss: AC < BC OR AC = BC Sensorineural Loss: AC > BC
75
Causes of Sinus Obstruction
- Allergies - Infections - Deviated septum - Environmental/chemical irritants
76
Abnormal Nasal Passage findings
- Swelling - Bleeding - Exudates - Growths (polyps, tumors, ulcers) - Deviated septum - Perforated septum
77
Viral Rhinitis vs. Allergic RHinitis
Viral: red & swollen mucosa Allergic: mucosa pale or grayish
78
Deviated vs perforated septum
Deviated: congenital, trauma Perforated: trauma surgery, cocaine, anphetamines
79
What is Epistaxis & where does it occur?
Nose bleed - Occurs in anterior portion of septum (children) Kiesselbach’s plexus - Occurs in Posterior portion of septum (adults) in the, HTN & ASVD
80
Exudates
CSF Leak (Salty, Unilateral, copious, clear) Typically follow head trauma
81
Thyroglossal Duct Cyst
Will rise when tongue is protruded AND when a patient swallows
82
The tongue deviates __________ the side of a CN 12 Lesion
Toward
83
CN X Inspection in the throat includes:
Soft palate rise (Soft palate will not rise on side of the lesion)
84
Gag reflex tests
CN 9 by touching the posterior pharynx
85
What is Horseness?
Change in voice quality, described as husky, rough, harsh or lower pitched than usual
86
MC Causes of Hoarseness
Voice overuse Viral Laryngitis Neck Trauma
87
If hoarseness lasts more than 2 weeks…
Refer to larynoscopy
88
Attrition of teeth
Teeth worn down by repetitive use (Dentin exposed)
89
Recession of gums
Exposes roots Infection, genetics, brushing
90
Erosion of teeth
Chemical action Dentin exposed
91
Hutchinson teeth
Congenital syphilis Widely spaced teeth taper toward the biting surface
92
Abrasion of teeth w/ notching
Repetitive trauma Bobby pin in mouth
93
Gingivitis (gum disease)
Red, swollen gingival margins Poor oral hygeine
94
Actinic Chelitis
Predisposes to squamous cell carcinoma
95
Carcinoma of te lip
Squamous cell carcinoma Scaly plaque or ulcer
96
Angular chelitis
B2, no teeth, poor fitting dentures
97
Exudative Tonsilitis
Fever & Enlarged anterior cervical nodes Strep = anterior nodes Mono = Posteriorr nodes

Physical Diagnosis (7 decks)

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