Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Optometric theory and techniques > External Exam and Pupils > Flashcards

External Exam and Pupils Flashcards

1
Q

When does the exam start?

A

before you even begin taking case history. Look at patient’s eyes as soon as you walk in the room

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What should you try to observe?

A
  • gate and mobility as they enter the room
  • observe their speech and apparent mental status
  • does anything look unusual?
  • head and face (symmetry/tilt)
  • ocular adnexa and eyes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

If something looks funny..

A
  • ask patient about it

- record Hx and observations in EMR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Prior to SLE use naked eye, penlight, or trans-illuminator to examine…

A
  • large lesions
  • eyelid postions
  • eyelid movements
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What eyelid positions would you need to observe?

A
  • palpebral aperture (vertical distance between upper and lower lid)
  • ptosis/refraction vs exophthalmos/enophthalmos
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

palpebral aperture

A

vertical distance between upper and lower lid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What eyelid movements should you obeserve?

A
  • checking forced closure bilaterally

- checking upper lid movement with up gaze may be diagnostic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What if you find something abnormal?

A
  • ask pt without implying abnormality (previous trauma, surgery..onset/duration)
  • old photos helpful
  • additional testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pupil - optics

A

aperture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

pupil - physiological

A

tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Pupil

A

not a structure you can touch. opening in iris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the importance of pupil evaluation

A
  • neurological
  • ocular
  • systemic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is considered one of the ophthalmic sign?

A

Pupils

vision/pupil/pressures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do we evaluate pupils?

A
  • shape/position/color (iris)
  • size
  • light reflexes
  • “swinging flashlight” test
  • near response
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Pupil: shape, position, color (iris)

A
  • normal vs ab (round, near-centered)
  • position (off to side, abnormal)
  • heterochromia, transillumination, atrophy, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

corectopia

A

eccentricity of pupil

usually not centered or shaped correctly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

heterochromia iridis

A

2 different colors of iris

18
Q

What increases pupil size?

A

sympathetic activation of radial dilator muscle

19
Q

what decreases pupil size

A

parasympathetic activation of sphincter muscle

20
Q

dilation

A

enlargement of pupil via sympathetic activation (homatropine) or parasympathetic block (tropicamide)

21
Q

homatropine

A

sympathetic activation

22
Q

tropicamide

A

parasympathetic block

23
Q

What conditions are pupil size measured?

A

normal light (photopic) and dark (scotopic) conditions

24
Q

hippus

A

normal fluctuation. fluctuates constantly

25
Q

pupil size: age 20

A

5mm (light)

8mm (dark)

26
Q

pupil size: age 80

A

2mm (light)

2.5mm (dark)

27
Q

what happens to pupil size with age?

A

decreases. Lose sympathetic tone

28
Q

abnormal findings of the pupils…

A
  • bilateral/unilateral

- apparent at all light levels or greater in dark or light

29
Q

anisocoria

A

a significant difference in size between pupils

30
Q

What is considered to be a significant difference in pupil size?

A

1mm or more

31
Q

How do you measure size of someone’s pupils with anisocoria?

A

in the dimmest possible light and brightest possible light. allows you to determine which pupil is abnormal

32
Q

physiologic anisocoria

A

fairly common, non pathological, but a Dx of exclusion requiring you to rule out any pathology

33
Q

afferent

A

sensory nerve fibers leave each eye via optic nerve and about half cross to opposite side at optic chiasm

34
Q

efferent

A

motor fibers leave the brain from EW uncle on each side of the brain, each of which sends signals to both eyes

35
Q

light received in one eye…

A

should cause constriction in both pupils

36
Q

swinging flashlight test

A
  • afferent pupillary defects
  • pupils usually of equal size; unlike with efferent defects which cause anisocoria
  • compares the direct and consensual light responses of the same eye
37
Q

What will cause a weaker direct response than consensual response in pupil?

A
  • an eye with a relative afferent pupillary defect (RAPD or MG)
  • can be recorded subjectively or objectivley
38
Q

pupillary near reflex

A
  • accommodation
  • convergence
  • pupillary miosis
39
Q

PERRL

A 
Pupils
Equal
Roud
Reactive to 
Light with no APD
40
Q

APD

A

afferent pupillary defect

Optometric theory and techniques (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions