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Physical Exam > Exam I > Flashcards

Exam I Flashcards

1
Q

Pulse and Respiration Evaluation

A

Count for 30 multipply by 2
Tachycardia count to 60sec.

Resp. 60 sec. or 15 Sec. X4

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2
Q

Orthostatic Hypotension Evaluation

A

Drop in Systolic BP of >= 20mmHg (Wait 3min.)

Drop in Diastolic BP of >=10mmHg

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3
Q

Examination skills from least invasive to most invasive

A

Inspection
Auscultation
Percussion
Palpation

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4
Q

Stethoscope bell-side lightly applied detects______sounds

A

Low -Pitched sounds

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5
Q

Stethoscope diaphragm detects________sounds

A

High-pitched sounds

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6
Q

Sphygmomanometer BP evaluation width should be

A

40% of upper arm circumference

Length- Should almost encircle upper arm

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7
Q

Blood Pressure evaluation

A
  1. Avoid smoking/coffee for 30 min.
  2. Sit x5 min. quietly arm supported at heart level
  3. Arm free of clothing, injury or I.V
  4. Inflate Cuff 30 mmHg
  5. BP both arms X1 Ea.
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8
Q

Tuning Fork Large

A

128 C (Hz) Used for vibratory sensation

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9
Q

Tuning Fork Small

A

512 C (Hz) Weber and Rinne Test

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10
Q

Joint Range of Motion evaluation tool

A

Goniometer

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11
Q

Eye Chart evaluation tool______ held ___” from PT

A

Snellen; 14 Inches

Snellen Chart= 20 feet

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12
Q

Prior to Examining Eye obtain

A
  1. Last eye exam
  2. Wear Glasses or contacts
  3. Hx of Ocular Disease
    (Do not Press on the Globe)
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13
Q

Eye chart notation N: indicates?

A

Distance from chart

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14
Q

Eye Chart notation D: indicates?

A

Distance a normal eye can read the line

20/15= You can read at 20’ what a normal reads at 15’

20/40= you can read at 20’ what a normal reads at 40’

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15
Q

What if patient cannot see largest letter?

A

Walk the PT toward chart until they see the E

Record: 10/400 if seen at 10 ‘

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16
Q

What if patient is unable to see big E at 3’?

A

Count fingers, hand motion, light perception

>20-200= Legally blind

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17
Q

A visual field is the entire area seen by an eye when it looks at a central point

A

Visual Fields by confrontation

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18
Q

A lack of retinal receptors at the optic disc produces an oval blind spot in the

A

normal field of each eye 15 Degrees Temporal to the line of Gaze

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19
Q

Looking down and to the right: the left eye cannot look down when turned inward

A

L CN IV Paralysis

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20
Q

is a form of strabismus in which one or both eyes turns inward.

A

Esotropia

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21
Q

Looking straight: esotropia appears.

Looking to left: left eye does not move laterally.

A

L CN VI

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22
Q

Drooping of an upper eyelid

A

Ptosis

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23
Q
  • Looking straight: the eye is pulled outward by action of CN VI.
  • Upward, downward, and inward movements are impaired or lost.
  • Ptosis and pupillary dilation may be associated
A

L CN III Paralysis

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24
Q

Ask pt to follow your finger or pencil as you move it in toward the bridge of the nose. Poor= Hyperthyroidism

A

Convergence

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25
Q

Ask pt to focus on a distant object, then a new object.

pupil normally constricts when focusing on near objects

A

Accomodation

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26
Q

A condition in which binocular fixation is not present.

Misalignment of the eyes

A

Strabismus

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27
Q

also called lazy eye; Reduced Visual acuity not correctable by refractive means

A

Amblyopia

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28
Q

misalignment that is always there, even when both eyes are open and attempting to work together

A

Tropia

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29
Q

misalignment that only occurs some of the time,

such as when the synchronization between the eyes is broken by covering one eye

A

Phoria

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30
Q

Types of Tropia

A 
Exotropia= Eye vears lateral
Esotropia= Eye Vears medial
Hypertrophia= Eye vears Superior
Hypotrophia = Eye vears Inferior
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31
Q

Stand in front of the patient and shine a penlight in front of their nose directed toward a center point

(between the eyebrows). Observe reflection of light on cornea with respect to pupil

A

Hirschberg’s Test (Pos. = Tropia)

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32
Q

For every 1mm of asymmetry, there is approx____degrees of misalignment

A

7 Degrees (3mm= 21 Degrees)

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33
Q

In a positive Hirschberg’s The dominant eye

A

Does not correct itself (Does not move)

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34
Q

is the subjective complaint of seeing 2 images instead of one and is often referred to as double-vision

A

Diplopia

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35
Q

Nearsightedness

A

Myopia

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36
Q

Farsightedness

A

Hyperopia

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37
Q

an abnormal curvature of the cornea can cause two focal points to fall in two different locations,

making objects up close and at a distance appear blurry.

A

Astigmatism

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38
Q

How to break through a phoria

A

Cover one eye then cross over immediatley to cover the other.(Both eyes will move subtle, when uncovered)

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39
Q

Normal size of a pupil

A

4-6mm

40
Q

Constriction of a pupil

A

Miosis

41
Q

Dilation of a pupil

A

Mydriasis

42
Q

Inequality of the pupils

A

Anisocoria

43
Q

Pupillary constriction of the opposite eye

A

Consensual Reaction

44
Q

Pupillary constriction of same eye

A

Direct Reaction

45
Q

Bilateral small pupils that constrict when the patient focuses on a near object, but do not constrict when exposed to bright light

A

Argyll Robertson Pupils

46
Q

Positive Argyll Robertson Pupils indicates

A

Neurosyphilis

Dorsal midbrain damage-Light-near dissociation

47
Q

dilated right pupil (above) constricts slowly and progressively until it becomes slightly smaller (below) than the simultaneously constricted left pupil

A

Tonic Pupil

48
Q

can be caused by local disorders such as tumor, inflammation, surgery or infection within the orbit

A

Tonic Pupil

49
Q

RAPD stands for

A

Relative Afferent Pupillary Defect

50
Q

In RAPD Less constriction to both eyes with light into affected eye.

Light light into unaffected eye=Bilat constriction

A

Marcus Gunn Pupil

51
Q

The most common cause of Marcus Gunn pupil is a

A

Lesion of the Eye

52
Q

Other causes of Marcus Gunn pupil

A
  • Optic neuritis
  • Retinal Detachment
  • -Central Artery or Vein occlusion
53
Q

lateral sparseness of eyebrow can be related to

A

Hypothyroidism

54
Q

Scales on the eyebrows “Scurf”

A

Seborrheic Dermatitis

55
Q

red inflamed lid margins.

A

Blepharitis

56
Q

painful, tender red infection in a gland at the lid margin.

A

Stye

57
Q

nontender, usually painless nodule of the meibomian gland

A

Chalazion

58
Q

Xanthelasma

A

yellowish, slightly raised, plaques.

59
Q

eyeball protrudes forward (Graves’ hyperthyroidism).

A

Exopthalmus

60
Q

inward turning of the lid margin

A

Entropion

61
Q

Outward turning of the lid margin

A

Ectropion

62
Q

lacrimal gland and lacrimal sac swelling

Suggests Blockage of lacrimal duct

A

Dacryocystitis

63
Q

yellow sclera

A

Icterus

64
Q

dilatation of the conjunctival vessels; Local or diffuse

A

Injection
(Diffuse) Conjunctivitis
(Localized) Episcleritis

65
Q

Bleeding underneath of conjunctiva; Hypertension or trauma

A

Hyposphagma

66
Q

Edema of the conjunctiva

A

Chemosis

67
Q

Blue or cyanotic sclera is seen in children with

A

Osteogenis Imperfecta

68
Q

thin grayish white arc or circle not quite at the edge of the cornea (accompanies normal aging).

A

Corneal Arcus (Arcus Senilis)

69
Q

opacities of the lens, most common in old age.

A

Cataract

70
Q

Pooling of blood inside the anterior chamber; results form severe trauma

A

Hyphema

71
Q

collection of fat, medial or lateral to the iris, which DOES NOT extend onto the cor

A

Pinguecula

72
Q

triangular thickening of the bulbar conjunctiva that grows (insidious) across the outer surface of the cornea

May interfere with if on pupil LOS; Usually nasal side.

A

Pterygium

73
Q

iris bows forward (forming a narrow angle with the cornea) or crescent shadow; Usually flat= no shadow

A

Narrow-Angle Glaucoma

74
Q

Eye pain, photophobia, blurry vision, redness.

A

Iritis

75
Q

numbers are used for people who have longer globe.

A

Red=Nearsighted (Myopic)

76
Q

numbers correct a shorter globe.

A

Farsighted (Hyperopic): ((black)) or ((green))

77
Q

Opthalmoscope Technique

A

about 15 inches away from the patient and 15 degree angle lateral to their line of vision,

shine the light beam on the pupil and check the red reflex

78
Q

If Red Reflex is absent, could indicate

A
  • Tumor in infants
  • congenital catarct
  • Central artery occlusion
  • retinal detachment
79
Q

Inspect the optic disc for

A
  • Margins; Slightly Blury
  • Color; Yellowish-orange
  • Size of cup; Cup-to Disk 1:2 1/2
80
Q

If Disk is red suspect

A

Papilladema

81
Q

Id the disk is pale suspect

A

Atrophy

82
Q

If cup to dsik ratio is greater than 1/2 (.5) indicates

A

Glaucoma

83
Q

Papilladema-Swelling of the optic disc with bulging of the physiologic cup indicates______

Signals D/O of brain such as

A

ICP

Meningitis, SubArachnoid hemorrhage, Trauma

84
Q

arteriole crosses a venule resulting in impaction of the vein with bulging on either side of the crossing

Seen in hypertensive retinopathy

A

Nicking

85
Q

can be caused by hypertension or retinal vein occlusion (a blockage of a retinal vein), or Diabetes M.

(Shaken Baby Syndrome)

A

Retinal Hemorrhage

86
Q

(cotton-wool spots): white, yellowish or grayish, ovoid lesions with irregular “soft” borders

Diabetes or hypertension

A

Retinal Lesions (Soft Exudates)

87
Q

White, creamy or yellowish, often bright lesions with well-defined “hard” borders. Retinal Edema

Protein and lipid accumulation; Vision may be lost if on macula

A

Retinal Lesions (Hard Exudates)

88
Q

yellowish round spots with soft or hard borders; occurs w/ age but also macular degeneration (Central Blind)

A

Drusen (Retinal Lesion)

89
Q

Represent proliferative retinopathy. These are new vessels that grow

tend to be poor quality and leak or rupture, thus causing blindness.

A

Neovascularization

90
Q

Covers most f the Ant. eyeball adhering loosely to the underlying tissue.

A

Bulbar conjunctiva

91
Q

Lines the eyelids

A

Palpebral cojunctiva

92
Q

Lie within the eyelids as firm strips that containi a parallel ro of Meibomian Glands

A

Tarsal Plates

93
Q

Lid elevation is raised by the_____ muscle innervated by CN______

A

Levator Palpebrae; CN III

94
Q

When a person shifts gaze from a far object to a near one pupils constrict; this is mediated by the____ Nerve

A

Oculomotor Nerve CNIII

95
Q

COnvergence and accommodation is controlled by the

A

Ciliary Msucles

96
Q

Poor central vision suggests

A

Macular degeneration

97
Q

Constricted field of vision 20 degrees or less in the better eye is suggests

A

Legal Blindness

Physical Exam (2 decks)

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