Exam 2: HEENT Flashcards
Normocephalic
Round symmetric skull that is appropriately related to body size. Microcephaly, abnormally small head size; macrocephaly, abnormally large head.
Goiter
Enlargement of the thyroid gland
Alopecia
Hair loss
Lymphadenopathy
Enlargement of the lymph nodes
Accommodation
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
Convergence
Accomplished by the six cardinal fields of gaze; allows for single, binocular vision.
one image
Refraction
Bending of light rays from one transparent medium to another.
cornea, aqueous humor, lens, vitreous humor
Hyperopia
Far-sighted - globe is shorter and light rays would focus behind retina if they could
Diplopia
Perception of two images of a single object
Myopia
Near-sighted - globe is longer and light rays focus in front of retina
Presbyopia
In ability of the lens to accommodate for near vision
Ptosis
Drooping upper lid
Cranial nerve III w/pupil dilation and EOM paralysis
Lid lag
Forward displacement of the eyeballs and widened palpebral fissure.
Anisocoria
Unequal pupil size
Miotic
Small pupils
Mydriatic
Enlarged pupils
Exopthalmous
Protruding eyes
Nystagmus
Fine, oscillating movement of the eye
Strabismus
Disparity of the eye exes due to extraocular eye muscle dysfunction; causes inward or outward turning of eyes.
Conjugate gaze
Parallel movement of the eyes.
Tinnitus
Perception of sound without an external source.
Vertigo
Feeling of spinning of person (subjective vertigo) or of objects around the person (objective vertigo)
cranial nerves
A set of 12 peripheral nerves emerging from the brain that innervate the structures of the head, neck, thorax and abdomen
Visual physiology (pathway)
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
Physiology (pathway) of hearing
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
palpebral fissure
distance from upper to lower eyelid
lymph nodes of the head and neck
Occipital
Postauricular
Preauricular
Submandibular
Submental
Anterior Cervical
Posterior Cervical
Supraclavicular
Snellen chart
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
LR6SO4
lateral rectus -> cranial 6
superior oblique -> cranial 4
Extraocular Muscle (EOM) Function
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”
direct vs consensual reaction to light
d: constriction of pupil receiving light
c: constriction of pupil not receiving light
Nerves for pupillary light reflex
Cranial nerve II & III
Cranial nerve I
olfactory - sense of smell
not usually testing, but should be checked for someone with no appetite
Cranial nerve II
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)
Cranial nerve III
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)
Cranial nerve IV
trochlear - looking down towards nose
SO4 - superior oblique
EOM function - 6 cardinal positions of gaze (n = eyes parallel w/o nystagmus)
Cranial nerve V
trigeminal - most of face
sensory perception (sharp/soft) all over face, equal strength for masseter & temporal muscles
Cranial nerve VI
abducens - lateral eye movement
LR6 - lateral rectus
EOM function - 6 cardinal positions of gaze (n = eyes parallel w/o nystagmus)
Cranial nerve VII
facial - facial movements or expression
sensory (taste perception on the tongue)
Cranial nerve VIII
acoustic - hearing
Gross hearing test - patient repeats whispered sequence
Cranial nerve IX & X
glossopharyngeal & vagus - tongue and throat
swallow, gag reflex, and uvula midline
always tested together
Cranial nerve XI
spinal accessory - neck and shoulders
shrug shoulders and turn head w/resistance
Cranial nerve XII
hypoglossal - tongue movement
Speech/tongue strength & movement
