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HPI > Eye, Ear, Nose And Throat > Flashcards

Eye, Ear, Nose And Throat Flashcards

1
Q

Keratitis

A

Inflammation of cornea

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2
Q

Conjunctivitis

A

Inflammation of the conjunctiva

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3
Q

Scotoma

A

Areas or specks where a patient is unable to see

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4
Q

Scintillation

A

Flashing or sparkling light, abnormal vision finding

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5
Q

Eye structures before the lateral geniculate nucleus

A

Retina, optic nerve, optic chiasm, optic tract

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6
Q

Eye structures after the lateral geniculate nucleus

A

Optic radiation, visual cortex

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7
Q

What is eyeritis?

A

Erythema haloed or circumferential around the iris of the eye. Usually indicative of a serious complication needing optho consult ASAP

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8
Q

Which cranial nerves are you testing if someone can see?

A

Cranial nerves 3, 4 & 6

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9
Q

Testing extraocular movement

A

Make a wide H in the air, asking the patient to follow you as you move through the six cardinal directions of gaze. Check for smooth, symmetric, nystagmus, lid lag

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10
Q

How to test for convergence or accommodation upon completing the test for extraocular movements

A

Your patient should be able to follow an object within 5 to 8 cm of their eyes. You look for pupillary construction as the eyes converge, making sure they are symmetric and not deviating. Ensure that the patient’s head does not move with your hand moving

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11
Q

Esotropia

A

Obvious misalignment of eyes as eye is uncovered. Nasal medial deviation

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12
Q

Exotropia

A

Obvious misalignment of eyes as eye is uncovered. Temporal lateral deviation

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13
Q

Exophoria

A

Latent misalignment of eyes after eye is covered and then is uncovered. Temporal lateral deviation

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14
Q

Esophoria

A

Latent misalignment of eyes after eye is covered and then is uncovered. Nasal medial deviation

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15
Q

AV nicking

A

And observation through ophthalmic exam which shows an artery in front of the vein looking like it’s cutting the vein in half. Some space may be shown on either side of the artery where the vein should be

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16
Q

Documentation of ophthalmoscopic exam

A

Disc margins are sharp, vessels appear normal without evidence of arteriolar narrowing or AV nicking, No retinal hemorrhages or exudates are seen

17
Q

Eye Exam documentation

A

Visual acuity 2020 bilaterally, visual fields are intact to confrontation. Gaze is conjugate, EOMs full. Lids and eyelashes appear normal, Perry orbital areas are normal in appearance and nontender to palpation. Sclera or white, palpebral conjunctiva are pink without exudate. Gross examination of the cornea and lens reveal no evidence of lesions. Pupils are 4 mm, round, and symmetric with risk direct or consensual response to light and accommodation (PERRLA).

18
Q

Normal ear canal otoscope finding

A

Smooth pale flesh toned color of canal

19
Q

Otitis externa otoscope finding

A

Bacterial infection involving the canal which is quite swollen and erythematous. There may be purulent clear drainage. It’s super painful

20
Q

Seborhheic dermatitis

A

Note skills without significant signs or symptoms of infection. Often associated with itching. The eardrum is obscured because of edema

21
Q

Cerum impaction

A

Almost all of the Tim panic membrane is totally obscured

22
Q

Anatomical areas of the eardrum

A

Pars flaccida, incus, pars tensa

Short process of malleus, handle of malleus, umbo, cone of light

23
Q

perforated eardrum

A

White arrow seen in otoscopic exam; can see middle of the ear

24
Q

Tympanosclerosis findings

A

Calcium phosphate & hyaline deposit scar seen on tympanic membrane. Yellow arrow

25
Q

Serous effusion findings on otoscope

A

amber fluid noted behind eardrum and air / fluid levels; decreased hearing may be found, especially with chronic allergies / asthma

26
Q

acute otitis media otocscope finding

A

bulging eardrum; most landmarks are obscured. Red tympanic membrane and poor cone of light

27
Q

auditory acuity-whispered voice test

A

90 - 100% sensitive but not super specific (70 - 87%)
Will not detect mild hearing loss- will only detect > 30 db
Stand 2 feet behind seated patient and occlude non-test ear w/ finger and gently rub tragus in a circular motion; exhale and then whisper a combo of 3 numbers and letters and repeat with other ear using a different combo. If 4 of 6 numbers and letters are incorrect, test for conductive v. sensorineural hearing loss with 256 or 512 Hz tuning fork

28
Q

Weber test looks for what?

A

Lateralization of hearing. In unilateral sensorineural hearing loss, sound is heard only in good ear

29
Q

Rinne test looks for what?

A

Compare air conduction v. bone conduction hearing.
If conductive hearing loss BC = AC or BC > AC.
If sensorineural hearing loss, AC > BC, which is also a normal finding

30
Q

Ear exam documentation

A

External ear: Non-tender w/o evidence of lesions, swelling or drainage.
Otoscopic: External auditory canal is clear, w/o lesions or drainage. The TMs ar translucent w/ normal landmarks and cone of light.
Hearing: Acuity to whispered voice is normal bilaterally. Weber-midline; Rinne AC > BC.

31
Q

What to note regarding color and character of nasal mucosa

A

Inflammation, pallor, bogginess, swelling, bleeding, exudate, lesions / polyps
Septum - deviation, inflammation, perforation, lesions present?

32
Q

Nose documentation

A

Nose: No external lesions / abnormalities noted. Septum midline, no lesions noted. Nasal mucosa pink.
Sinuses: Frontal and maxillary sinuses non-tender to palpation

33
Q

xanthelasma

A

soft, yellow spot / plaque in groups around eyelid

34
Q

arcus senilis

A

dull grey / white ring surrounding edges of the cornea; r/t fat deposits / tissue breakdown in cornea

35
Q

Diabetic retinopathy

A

Disorder of the blood vessels n the retina of the eye; you may see bleeding

36
Q

Papilledema opthalmoscopic exam finding

A

swelling of optic disk, irregular or non-distinct margins of optic disc

HPI (3 decks)

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