Exam 3

Question 1

ANATOMY OF THE EYE

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Answer 1

The eyeball has 3 layers: the inner retina; the middle uvea (choroid, ciliary body, and iris); and the outer sclera, which includes the transparent cornea.

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Question 2

What is Anisocoria?

Answer 2

Unequal pupil sizes.

Question 3

What is a retinal detachment?

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Answer 3

Retinal detachment is separation of the neurosensory retina from the underlying retinal pigment epithelium. There 3 types of detachment: rhegmatogenous, (the most common) which involves a retinal tear, traction, and serous (exudative) detachment. Traction and serous retinal detachments do not involve a tear and are thus called nonrhegmatogenous.

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Question 4

What is diabetic retinopathy?

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Answer 4

Divided into 2 groups: Nonproliferative Diabetic Retinopathy (NPDR) consists of blot, dot hemorrhages, exudate, & macular edema; & Proliferative Diabetic Retinopathy (PDR), consists of abnormal new vessels and fibrotic tissue.
Marked by microaneurysms, hemorrhage, macular edema or macular ischemia, or retinal exudates in patients with longstanding diabetes mellitus. This common complication of long-standing diabetes may result in blindness. Strict control of blood sugar levels and of high blood pressure reduces the incidence of the disease. Regular ophthalmological screening helps to detect the disease before it causes irreversible visual loss. Treatment includes retinal laser surgery or vitrectomy.
Approximately 50% of patients who have had diabetes for more than 15 years will have some form of diabetic retinopathy.

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Question 5

Where is the optic disc located & describe it?

(This will be a “select all that apply”)

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Answer 5

The optic disc is located on the nasal side of the retina; is a creamy yellow orange to pink color; round or oval; has distinct, sharply demarcated margins.

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Question 6

Describe Acute-angle/Closed-angle Glaucoma?

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Answer 6

Less common and sudden onset, is treated as an emergency situation. Obstruction of the outflow of aqueous humor occurs by anterior displacement of the iris against the cornea, caused when the pupil enlarges too much or too quickly. Symptoms include eye pain, headache, nausea and/or vomiting, and blurred or sudden loss of vision, especially at night.

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Question 7

Describe Open-angle Glaucoma?

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Answer 7

The most common form, the drainage canals of the eye gradually become clogged.

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Question 8

Mneumonics for Cervical Nerves and their Impulse?

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Answer 8

“Oh, Oh, Oh, Tiny Tits Are Fun And Give Very Akward Hips”

“Some Say Money Matters But My Brother Says Big Brains Matter Most”

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Question 9

Graphesthesia

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Answer 9

numbers written on the skin

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Question 10

Rhomberg Test

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Answer 10

Inability to stand with feet together and eyes closed indicates impaired position sense in the lower extremities.

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Question 11

Chorea

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Answer 11

Movements are nonrhythmic, jerky, rapid, and nonsuppressible, primarily in distal muscles or the face.

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Question 12

Athetosis

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Answer 12

Movements are nonrhythmic, slow, writhing, and sinuous, primarily in distal muscles; alternating postures of the proximal limbs often blend continuously to produce a flowing stream of movement.

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Question 13

Myoclonus

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Answer 13

Very rapid and jerky, nonsuppressible, shocklike twitches occur; they may be focal, segmental, or generalized.

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Question 14

Dysmetria

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Answer 14

Tremor

Tremors are involuntary, rhythmic, oscillatory movements of reciprocal, antagonistic muscle groups, typically involving the hands, head, face, vocal cords, trunk, or legs.

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Question 15

Rest Tremor

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Answer 15

Resting tremors are visible at rest and occur when a body part is completely supported against gravity. Resting tremors are minimal or absent during activity.

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Question 16

Papilledema

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Answer 16

Papilledema is swelling of the optic disk due to increased intracranial pressure.

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Question 17

Intentional Tremor

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Answer 17

Intention tremors occur during voluntary movement toward a target, but amplitude is high and frequency is low during the complete movement, while the tremor worsens as the target is reached (as seen in finger-to-nose testing)

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Question 18

Myxedema

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Answer 18

Caused by Hypothyroidism; Periorbital edema, coarse facial features, dry skin, and dry, coarse hair and eyebrows.

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Question 19

Hypothyroidism

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Answer 19

Primary hypothyroidism is due to disease in the thyroid; thyroid-stimulating hormone (TSH) is increased. It usually results from Hashimoto’s thyroiditis and is often associated with a firm goiter.

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Question 20

Graves Disease

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Answer 20

Graves’ disease (toxic diffuse goiter), the most common cause of hyperthyroidism, is characterized by hyperthyroidism and one or more of the following:

Goiter

Exophthalmos

Infiltrative dermopathy

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Question 21

Parkinson’s Syndrome

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Answer 21

Low-frequency alternating tremor, often of the thumb against the index finger (pill rolling) but sometimes also affecting the chin or a leg

Usually accompanied by other symptoms, such as micrographia, bradykinesia (slow movement), cogwheel rigidity, and shuffling gait

Often no family history of Parkinson tremor and no reduction in tremor after alcohol consumption

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Question 22

Guilliain-Barre

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Answer 22

Guillain-Barré syndrome is an acute, usually rapidly progressive but self-limited inflammatory polyneuropathy characterized by muscular weakness and mild distal sensory loss. Cause is thought to be autoimmune. Diagnosis is clinical. Treatment includes IV immune globulin, plasma exchange, and, for severe cases, mechanical ventilation

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Question 23

CN 4

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Answer 23

Have patient look at finger/pen once it is close to face; both eyes should rotate inward

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Question 24

Nystagmus

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Answer 24

Rapid, rythmic movement of the eyeball.

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Question 25

Dysphagia

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Answer 25

Difficult swallowing

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Question 26

Myasthenia Gravis

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Answer 26

Myasthenia gravis involves episodic muscle weakness and easy fatigability caused by autoantibody- and cell-mediated destruction of acetylcholine receptors. It is more common among young women but may occur in men or women at any age. Symptoms worsen with muscle activity and lessen with rest. Diagnosis is by measurement of serum acetylcholine receptor (AChR) antibody levels, electromyography, and sometimes IV edrophonium challenge, which briefly lessens the weakness.

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