Exam 2: HEENT

Question 1

Normocephalic

Answer 1

Round symmetric skull that is appropriately related to body size. Microcephaly, abnormally small head size; macrocephaly, abnormally large head.

Question 2

Goiter

Answer 2

Enlargement of the thyroid gland

Question 3

Alopecia

Answer 3

Hair loss

Question 4

Lymphadenopathy

Answer 4

Enlargement of the lymph nodes

Question 5

Accommodation

Answer 5

Adaptation of the eye for near vision.

This is accomplished by contraction of the
ciliary muscles that causes the elastic lens to
bulge.

not able to accommodate as well - hold reading materials out farther

Question 6

Convergence

Answer 6

Accomplished by the six cardinal fields of gaze; allows for single, binocular vision.

one image

Question 7

Refraction

Answer 7

Bending of light rays from one transparent medium to another.

cornea, aqueous humor, lens, vitreous humor

Question 8

Hyperopia

Answer 8

Far-sighted - globe is shorter and light rays would focus behind retina if they could

Question 9

Diplopia

Answer 9

Perception of two images of a single object

Question 10

Myopia

Answer 10

Near-sighted - globe is longer and light rays focus in front of retina

Question 11

Presbyopia

Answer 11

In ability of the lens to accommodate for near vision

Question 12

Ptosis

Answer 12

Drooping upper lid

Cranial nerve III w/pupil dilation and EOM paralysis

Question 13

Lid lag

Answer 13

Forward displacement of the eyeballs and widened palpebral fissure.

Question 14

Anisocoria

Answer 14

Unequal pupil size

Question 15

Miotic

Answer 15

Small pupils

Question 16

Mydriatic

Answer 16

Enlarged pupils

Question 17

Exopthalmous

Answer 17

Protruding eyes

Question 18

Nystagmus

Answer 18

Fine, oscillating movement of the eye

Question 19

Strabismus

Answer 19

Disparity of the eye exes due to extraocular eye muscle dysfunction; causes inward or outward turning of eyes.

Question 20

Conjugate gaze

Answer 20

Parallel movement of the eyes.

Question 21

Tinnitus

Answer 21

Perception of sound without an external source.

Question 22

Vertigo

Answer 22

Feeling of spinning of person (subjective vertigo) or of objects around the person (objective vertigo)

Question 23

cranial nerves

Answer 23

A set of 12 peripheral nerves emerging from the brain that innervate the structures of the head, neck, thorax and abdomen

Question 24

Visual physiology (pathway)

Answer 24

Refraction (clear image), accommodation (lens bulge and curve), pupillary constriction, convergence (extraocular muscles move together)
->
Image formed on retina (reversed, upside down)
–>
Optic Nerve (CNII)
–>
Optic Chiasm
–>
Optic tract
–>
Occipital lobe of brain

Question 25

Physiology (pathway) of hearing

Answer 25

Sound Waves --> Strike tympanic membrane --> Vibrations transmitted through auditory ossicles of ear (malleus, incus, stapes) to oval window --> Vibrations travel to cochlea and then to the round window --> CN VIII (acoustic) --> Brain

Question 26

palpebral fissure

Answer 26

distance from upper to lower eyelid

Question 27

lymph nodes of the head and neck

Answer 27

Occipital Postauricular Preauricular Submandibular Submental Anterior Cervical Posterior Cervical Supraclavicular

Question 28

Snellen chart

Answer 28

visual acuity test larger the denominator, worse the vision (20/200 = legally blind w/correction) numerator - how far it takes the patient denominator - how far it takes the "normal" eye

Question 29

LR6SO4

Answer 29

lateral rectus -> cranial 6 superior oblique -> cranial 4

Question 30

Extraocular Muscle (EOM) Function

Answer 30

muscles that track the eye together innervated by cranial nerve III, IV, & VI LR6 SO4, all others 3 paralysis of III - ptosis, pupillary dilation, "lazy eye"

Question 31

direct vs consensual reaction to light

Answer 31

d: constriction of pupil receiving light c: constriction of pupil not receiving light

Question 32

Nerves for pupillary light reflex

Answer 32

Cranial nerve II & III

Question 33

Cranial nerve I

Answer 33

olfactory - sense of smell not usually testing, but should be checked for someone with no appetite

Question 34

Cranial nerve II

Answer 34

optic - central & peripheral vision Visual acuity - Snellen chart (n = 20/20) Reaction to light - shine light from side for pupil constriction (n = PERRL, direct & consensual)

Question 35

Cranial nerve III

Answer 35

oculomotor - pupil constriction and looking up & down away from nose EOM function - 6 cardinal positions of gaze (n = eyes parallel w/o nystagmus) Reaction to light - shine light from side for pupil constriction (n = PERRL, direct & consensual)

Question 36

Cranial nerve IV

Answer 36

trochlear - looking down towards nose SO4 - superior oblique EOM function - 6 cardinal positions of gaze (n = eyes parallel w/o nystagmus)

Question 37

Cranial nerve V

Answer 37

trigeminal - most of face sensory perception (sharp/soft) all over face, equal strength for masseter & temporal muscles

Question 38

Cranial nerve VI

Answer 38

abducens - lateral eye movement LR6 - lateral rectus EOM function - 6 cardinal positions of gaze (n = eyes parallel w/o nystagmus)

Question 39

Cranial nerve VII

Answer 39

facial - facial movements or expression sensory (taste perception on the tongue)

Question 40

Cranial nerve VIII

Answer 40

acoustic - hearing Gross hearing test - patient repeats whispered sequence

Question 41

Cranial nerve IX & X

Answer 41

glossopharyngeal & vagus - tongue and throat swallow, gag reflex, and uvula midline always tested together

Question 42

Cranial nerve XI

Answer 42

spinal accessory - neck and shoulders shrug shoulders and turn head w/resistance

Question 43

Cranial nerve XII

Answer 43

hypoglossal - tongue movement Speech/tongue strength & movement