eyes, ears and mouth Flashcards
pupillary light reflex ?
: normal constriction of pupils when bright light shines on retina
what is accommodation ?
adaptation of eye for near vision, Accomplished by increasing curvature of lens through movement of ciliary muscles
components include convergence and pupillary constriction
eyes in aging adults?
Lens loses elasticity, becoming hard and glasslike, which decreases ability to change shape to accommodate for near vision
glaucoma is
increased intraocular pressure; chronic open-angle glaucoma is most common type- this one is painful
Age-related macular degeneration (AMD)
breakdown of cells in macula of retina; loss of central vision
what is diabetic retinopathy
Leading cause of blindness in adults ages 25 to 74 years of age
what is the corneal light reflex, what test is performed
Assess parallel alignment of eye axes by shining a light toward the person’s eyes
Note reflection of light on corneas; should be in exactly same spot on each eye
what is nystagmus ?
what is the arcus senilis ?
Blue ring that develops around the eye as we age
What does perrla stand for ?
or Pupils Equal, Round, React to Light, and Accommodation.
fight or flight response, what happens to pupil?
They will be dilated- seen with coccaine consumption
Pinpoint pupils happens when ?
from taking opiods( heroin ext
why is it important to do red reflex ?
if they don’t have this reflex, it is an indicator of cancer
what is setting sun with newborns
sign common; eyes appear to deviate down with white rim of sclera visible over iris
Blephritis
inflammation of the eyelids
chalazion
cyst that doesnt cause irritation
Dacryocystitis
inflamtion in the tear duct ( lacrimal gland
eunequal pupils we worry about
head injury or a bleed in the head
dilated and fixed pupils
Mydriasis
horners syndrome
droopy eyelids
Pterygium
not to worry about unless it effects the pupil
corneal abrasion
hyphema
blood in anterior chamber in the eye, happens with trauma to the eyeball
hypopyon
pus in the anterior chamber of the eye
auditory system is divided into 3 levels :
Peripheral, brainstem, and cerebral cortex
At peripheral level, ear transmits sound
converts its vibrations into electrical impulses, which can be analyzed by brain.
conductive hearing loss
mechanical dysfunction of external or middle ear. sticking a cotton ball in ear, earwax. Partial loss because a person is able to hear if sound amplitude is increased enough to reach normal nerve elements in inner ear
Sensorineural (or perceptive) hearing loss:
signifies pathology of inner ear, cranial nerve VIII, or auditory areas of cerebral cortex
Increase in amplitude may not enable a person to understand words.
May be caused by presbycusis and by ototoxic drugs, which affect hair cells in cochlea.
Mixed hearing loss:
combination of conductive and sensorineural types in the same ear
why do children get a lot of ear infections ?
Infant’s eustachian tube is relatively shorter and wider and more horizontal than adult’s
easier for pathogens from nasopharynx to migrate through to middle ear
Otosclerosis
Common cause of conductive hearing loss in young adults between ages of 20 and 40, Gradual hardening that causes footplate of stapes to become fixed in oval window
- Impeding transmission of sound and causing progressive deafness
what happens to ears of aging adults?
In aging persons, cilia lining ear canal become coarse and stiff,
May cause cerumen to accumulate and oxidize, which greatly reduces hearing
Cerumen is drier with aging because of atrophy of apocrine glands.
Impacted cerumen is a common but reversible cause of hearing loss in older people
Presbycusis
type of hearing loss that occurs with aging, even in people living in quiet environment
Gradual sensorineural loss caused by nerve degeneration in inner ear or auditory nerve
Onset usually occurs in 50s and slowly progresses.
why is the cone light important
Paranasal sinuses:
air-filled pockets within the cranium
Communicate with nasal cavity and are lined with same type of ciliated mucous membrane
, serve as resonators for sound production, and provide mucus, which drains into nasal cavity
Two pairs of sinuses are accessible to examine
Frontal sinuses in frontal bone above and medial to orbital, Maxillary sinuses in maxilla (cheekbone) along side walls of nasal cavity
other set of sinuses
Ethmoid sinuses between the orbits
Sphenoid sinuses deep within skull in the sphenoid bone
Bifid uvula
A condition in which uvula is split either completely or partially; occurs in 10% of some American Indian groups
Torus palatinus
A bony ridge running in middle of hard palate is seen in 20% to 35% of the US population
cranial nerve 6
abducens nerve, innervates lateral rectus muscle, which abducts eye
Cranial nerve IV
trochlear nerve, innervates superior oblique muscle
Cranial nerve III
oculomotor nerve, innervates all the rest: the superior, inferior, and medial rectus and the inferior oblique muscles
what is the test used for visual acuiity ?
snellen chart
testing near vision ?
with handheld vision screener with various sizes of print (e.g., a Jaeger card).
confrontation test
Gross measure of peripheral vision; compares the person’s peripheral vision with yours
- comparing what your patient sees with what you see
six cardinal positions of gaze
checking cranial nerves 3,4 and 6 Follow movement of penlight or object proceeding clockwise,
checking for : EOM muscle weakness, nystagmus, or lid lag
what can the conjunctiva tell us
pale could be anemic, look for shiny, moist and glossy. dull and dry not good
checking lacrimal apparatus
Normally puncta drain tears into lacrimal sac.
Presence of excessive tearing may indicate blockage of nasolacrimal duct
testing for acccomodation includes
by asking the person to focus on a distant object.- this will dilae the pupil
then have the person shift gaze to near object, such as your finger held about 7 to 8 cm
Normal response =
pupillary constriction.
convergence of axes of eyes.
occular fundus exam
pt stares at object far away, use opthamoloscope, we are looking for red reflex , ( light coming back out is red,( we look at this at an angle around 15 degrees)
both eyes should have the same red reflex
when inspecting the fundus, what structures are important to look for ?
optic disc, the macula and the general retinal vessels
findings of the optic disk
creamy yellow, orange to pink, will be round or oval, distinct and sharply demarcated, although nasal edge may be slightly fuzzy
normal macula
will be a darker color than the fundus,
what is eversion of the upper lid ?
when one suspects foreign body or eye pain
extraoccular muscle dysfunction
Strabismus
esotropia - inward turning of the eye
exotropia- outward turning of the eye
Exophthalmos
protruding eyes
Ptosis
(drooping upper lid)
Ectropion
Lower lid rolling out
Entropion
Lower lid rolling in
Blepharitis
inflammation of the eyelids
Hordeolum
stye
Dacryocystitis
inflammation of the lacrimal sac)
Anisocoria
Unequal pupil size
Miosis
Constricted and fixed pupils
true or false :Infant’s and young child’s external auditory canal is shorter and has a slope opposite to that of adult’s.
true
subjective data of an ear exam
Earache
Infections
Discharge
Hearing loss
Environmental noise
Tinnitus
Vertigo
abnormal findings for ear
Excessive cerumen
Otitis externa
Osteoma
Foreign body
Polyp
abnormalities of tympanic membrane
Retracted drum
Otitis media with effusion (OME)
Acute otitis media
Perforation
Tympanostomy tubes
Cholesteatoma
Scarred drum
what are hair cells ?
hair cells, lie at roof of nasal cavity and upper third of septum, These receptors for smell merge into olfactory nerve
olfactory nerve is known as
cranial nerve 1, which will translate to the temporal lobe in brain
what is the mouth ?
First segment of digestive system and an airway for the respiratory system
what is the oral cavity ?
short passage bordered by lips, palate, cheeks, and tongue
what is the palate ?
arching roof of mouth divided into two parts
what is the hard palate ?
anterior part made up of bone
soft palate ?
posterior part, an arch of muscle that is mobile
uvula
free projection hanging down from middle of soft palate
floor of the mouth contains
horseshoe-shaped mandible bone, tongue, and underlying muscles
tongue
: striated muscle arranged in a crosswise pattern so that it can change shape and position
papillae
rough, bumpy elevations on its dorsal surface
Frenulum
midline fold of tissue connecting tongue to floor of mouth
mouth contains 3 pairs of salivery glands
parotid glands - lies within cheeks in front of ear
submandibular gland - lies beneath mandible at angle of jaw
sublingual - smallest almond shape, lies in floor of mouth, under tongue
oropharynx
separated from mouth by a fold of tissue on each side, the anterior tonsillar pillar
tonsils
behind folds, each is a mass of lymphoid tissue look more granular, and surface shows deep crypts
Nasopharynx
continuous with oropharynx above oropharynx and behind nasal cavity
Touching posterior wall with tongue blade elicits
the gag reflex , ; this tests cranial nerves IX and X, the glossopharyngeal and vagus.
Asking a person to stick out tongue
Test cranial nerve XII, hypoglossal nerve
should protrude in midline; note any tremor, loss of movement, or deviation to side
where are oral malignancies most likely seen ?
U-shaped area under tongue behind teeth
tonsil grading
1+ Visible
2+ Halfway between tonsillar pillars and uvula
3+ Touching uvula
4+ Touching each other
tongue inspection
Normally, there should be no white patches or lesions present
color of tonsils should be
same pink as oral mucosa, and their surface peppered with indentations, or crypts; there should be no exudate on tonsils
retnetion cyst
mucousy cyst (mucocele)
Angular cheilitis
vitamin deficiency, bleeding and cracking around edges of mouth
Aphthous ulcers
canker sore
koplik spots
little red dots that appear with measles
candidiassis
steroid treatment, chemotherapy, rheumatoid arthitiis treatments, inhalers, not rinsing their mouth, breast fed babies , treatments impacting the immune system
migratory glossitis
geographic tongue
Oral Kaposi’s sarcoma
associated with HIV
one swollen tonsil
Peritonsillar abscess
very dangerous, travel and compromise the airway
