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Clinical Medicine 1 > Eyes > Flashcards

Eyes Flashcards

1
Q

This results in an imaged being focused outside of the retina, often resulting in farsightedness

A

Hyperopia

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2
Q

This often results in multiple focal points within the retina.

A

Astigmatism

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3
Q

This results in the focal point occurring prior to the retina, often resulting in nearsightedness.

A

Myopia

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4
Q

Having two eyes gives us binocular vision improving stereopsis, which is what?

A

Depth Perception

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5
Q

These glands make the oily portion of tears

A

Meibomian Glands

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6
Q

This is the opening in the eyelid to drain tears

A

Puncta

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7
Q

This drains tears into the lacrimal sac

A

Canaliculi

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8
Q

These are the rigid cartilage structure of the lids

A

Tarsal plates

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9
Q

This muscle helps close the eyelid

A

Orbicularis oculi muscle

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10
Q

This muscle opens the eyelid

A

Levator palpebra

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11
Q

These are the Fibrous tissue separates eyelid structures from orbital structures

A

Orbital septum

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12
Q

This gland makes the aqueous potion of tears

A

Lacrimal gland

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13
Q

What 5 thing compose orbital contents

A
  1. Orbital septum
  2. Lacrimal gland
  3. Orbital fat
  4. Ophthalmic artery/veins
  5. Nerves
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14
Q

Which cranial nerve controls vision?

A

CN II (Optic Nerve)

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15
Q

Which cranial nerve is involved in movement of the eyes AND pupils?

A

CN III (Oculomotor Nerve)

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16
Q

Which cranial nerve ONLY controls eye movement?

A

CN IV (Trochlear nerve)

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17
Q

Which cranial nerve control sensory component of the eye?

A

CN V (Trigeminal Nerve)

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18
Q

Which cranial nerve abducts the eye?

A

CN VI (Abducens Nerve)

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19
Q

What “nerves” control pupil dilation?

A

Ciliary ganglion

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20
Q

What are the six muscles that control eye movement?

A
  1. Medial Rectus
  2. Superior Rectus
  3. Lateral Rectus
  4. Inferior Rectus
  5. Superior Oblique
  6. Inferior Oblique
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21
Q

What are the 7 orbital bones?

A
  1. Frontal (Roof)
  2. Maxillary (Floor)
  3. Zygomatic (Lateral Wall)
  4. Sphenoid
  5. Lacrimal
  6. Ethnoid
  7. Palatine
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22
Q

This is the smooth, moist outer covering of the eye

A

Conjunctiva

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23
Q

Which of the two types of conjunctiva line the eyelid?

Which lines the surface of the eye?

A

Palpebral

Bulbar

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24
Q

This is the opaque fibrous outer white wall of the eye

A

Sclera

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25
Q

This is the clear dome over the front of the eye which helps to refract light

A

Cornea

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26
Q

This is the space between the cornea and the lens which is filled with aqueous humor to provide nourishment to the cornea and lens?

A

Anterior Chamber

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27
Q

This is the anterior surface that determines color in the eye, has sphincter and dilator muscles to control the amount of light let through the pupil.

A

Iris

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28
Q

This structure finishes refracting light to focus the image on the retina.

A

Lens

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29
Q

This muscle controls the amount lens movement for image focus and helps produce aqueous humor

A

Ciliary body

30
Q

What 5 things did Dr. Porfilio refer to as the “vital signs” of the eyes?

A
  1. Visual Acuity (“Can you see?”)
  2. Pupils (“Are they reactive”)
  3. Visual Fields
  4. Motility (“Can your eyes move”)
  5. Intraocular pressures
31
Q

When testing for visual acuity, if you use a pocket eye chart in should be ___ ______ away from the patient. I

If using a wall chart, the patient should be __ _____ away.

A

14 inches

20 feet

32
Q

Define 20/200 vision, 20/20 vision, 20/10 vision

A

20/200 - The individual sees at 20 feet what a normal individual should see at 200 feet (IMPAIRED)

20/20 - The individual sees at 20 feet what a normal individual should see at 20 feet (NORMAL)

20/10 - The individual sees at 20 feet what a normal individual should see at 10 feet (BETTER THAN NORMAL)

33
Q

Images that “come into the eye” temporally have to do what?

A

Crossover the optic chiasm into into the opposite optic tract and into the brain (opposite side from which they entered)

34
Q

T/F: Images that enter the eyes nasally have to also cross the optic chiasm

A

False, they do not cross

35
Q

This is referrd to as the loss of vision in half of the visual field?

A

Hemianopsia

36
Q

If a patient complained of loss of vision in the temporal field of both eyes, what might you expect there to be a problem with?

A

Optic chiasm

37
Q

Normal pupils should be describe on a physical examination as what?

What does the acronym stand for?

A

PERRLA

Pupils are Equal, Round, Reactive to light and Accommodation

38
Q

Pupil diameter is measured in what?

A

Milimeters

39
Q

Unequal pupil diameter is referred to as what?

When is this problematic?

A

Anisocoria

This becomes problematic when they do not react to light

40
Q

When testing the pupillary reflex, what two responses should be observed in a normal patient?

A

Direct Response - Pupils should constrict when stimulated by light

Consensual response - The pupil not being stimulated by light should also constrict

41
Q

What is a Marcus-Gunn pupil?

A

While testing pupillary reflex, if the eye DIALATES when stimulated by light with a consensual response from the other eye (it also dilates) then it “signals” a defect in the optic nerve

Basically, the eye is not conducting light to the brain

42
Q

How do you test accommodation?

A

Have the patient stare at a distant object and place your finger centrally in front of them

As they go from focusing on the distant object to focusing on your finger, their pupils should react and constrict.

43
Q

The cover/uncover test is used to test for what?

A

Strabismus

44
Q

When testing EOMs what THREE things should you be looking for?

What three CNs are being tested?

A
  1. Conjugate gaze
  2. Nystagmus
  3. Lid Lag

CN III, IV, VI

45
Q

The lateral rectus is innervated by what CN?

The Superior oblique is innervated by what CN?

The other four EOMs are innervated by what CN?

REMEMBER: LR6SO4

A

LR = CN VI

SO = CN IV

The Rest are CN III

46
Q

Know which muscles are moving when testing EOMs

Right and Left Gaze

Upward and Diagonal

Downward and Diagonal

Upward and Downward

A

Right/Left: Lateral and Medial Rectus

Upward/Diagonal: Inferior Oblique and Superior Rectus

Downward/Diagonal: Inferior rectus and Superior Oblique

Upward/Downward:
Superior Rectus and Inferior Oblique

47
Q

When staring at a fixated target, if one eye turns outward that is referred to as what?

48
Q

When staring at a fixated target, if one eye turns inward that is referred to as what?

49
Q

When doing a fundoscopic examination of the eye, what FOUR things should you being examining?

A
  1. Arteries/Veins
  2. Optic Disc/Cup
  3. Fovea/Macule
  4. Retina
50
Q

The optic disc should have _______ margin on the temporal side and _______ margins on the nasal side

A

Crisp/Clear

Blurred

51
Q

What color should the optic disc be?

A

Yellowish Creamy color

Color may vary between individuals

52
Q

What is the optimal cup-to-disc ratio?

53
Q

T/F: Vasculature should always “initiate” on the nasal side of the optic disc

54
Q

T/F: The Fovae/Macule is located nasal when compared to the optic disc?

A

False, it is located temporal

55
Q

T/F: Veins are narrower than arteries in the eye?

A

False, arteries are narrower

56
Q

How do arteries look when compared to veins in the eye?

A

Arteries should be narrower and a brighter red

Veins will be thicker and a darker red

57
Q

This is the normal reflex that you “follow in” during a fundoscopic examination

A

Red Reflex

58
Q

What is the sequence you should use when preforming an eye examination with the opthalmoscope?

A

After locating the optic disc….

  1. Superior nasal
  2. Inferior nasal
  3. Inferior temporal
  4. Superior Temporal
  5. Macula/Fovea
59
Q

This occurs when arteries in the eye compress veins?

What is a likely structural change in the arteries of that eye?

What disease is this commonly seen with?

A

AV Nicking

Atherosclerosis

Hypertensive retinopathy

60
Q

Dursen, or speckled yellow dots, over the macula/fovea is like a sign of what in the eye?

A

Age-related-macular degeneration

61
Q

When referring to the eyes what does each of these stand for?

O.D.
O.S.
O.U.
EOMI

A

O.D. - Right Eye

O.S. - Left Eye

O.U. - Both Eyes

EOMI - Extraocular muscles/movements intact

62
Q

What are indications to preform a flourescein stain examination of the eye?

A
  1. Corneal Abrasion
  2. Foreign Bodies
  3. Injury
  4. Infection
  5. Trauma
63
Q

Understand how to preform a flourescein stain examination?

A

THINK: Anesthetic, Dye, Wood’s Lamp

64
Q

What are you evaluating when preforming tonometry?

A

Intraocular pressures (Gluacoma screening)

65
Q

What is the normal IOP?

A

10-21 mm Hg

66
Q

Understand how to preform tonometry, mostly using the tonopen

A

THINK: Anesthetic, Pen, Measure Pressures

67
Q

The pH litmus test evaluates what of the eye?

68
Q

What is the normal pH of the eye?

A

7.0 - 7.3

UpToDate lists it as 6.5-7.5

69
Q

What would you do if there was an abnormal pH, for example, from a chemical burn?

When you retest the pH of the eye, if it is still abnormal what should you do?

A

Irrigation with a Morgan Lens for 15-30 minutes

Repeat irrigation until the pH normalizes

70
Q

Which are burns typically cause more severe damage, acid or alkali?

71
Q

Why do alkali burns usually cause more damage to the eyes?

A

They cause rapid epithelial death and can penetrate deep into the eye

72
Q

What is the risk for acid burns in the eye?

A

coagulation necrosis resulting in scarring, ulceration, visual lose

Clinical Medicine 1 (6 decks)

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