Health Entrance 2-EOM Flashcards by Audrey Chu

the action of a muscle referred to eye movements as a result of its

contraction

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how can muscle actions be analyzed? by considering _______ applied to the globe

vector of force

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waht is the major moving force of a muscle

primary action

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what are the additional forces based on the muscles orientation

secondary action

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what are the functional origins of the eom, mucolofibroelastic tissues located posterior to tenon’s fascia

extraocular pulleys

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what is the movement of one eye along one of the globe’s axis

duction

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what are roations along the horizontal x axis

supraduction (elevatoin) and infraduction (depression)

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what are rotations along the vertical z axis

adduction (inwards and abduction (outwards

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what are both eyes moving towards the nose called

convergence

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what are boy eyes moving outwards called

divergence

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what is the movement of both eyes by the same distance and in the same direction

version

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what is a pair of muscles that pulls one eye in the opposite directoin

antagonists

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what is a pair of muscles that pulls one eye in the same direction

synergists

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what is the increased contraction of an eom that is normally assoicated by dimished contraction of its antagonistic muscle

sherrington law of reciprocal innervation

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what is the movement of one eye along the y axis )(run through center of the eye, through pupil)

torsion

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waht is turning the upper part of your globe towards your nose

intorsion

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what is turning the upper part of your globe towards your ear

extorsion

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what happens when the MR is stimulated

adduction

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what happens when the LR is stimualted

abduction

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which muscles are stimulated for a left lateral gaze

RMR and LLR

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what muscles are stimualated for a right lateral gaze

RLR LML

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why are the vertical recti muscles more complcated

the walls of the orbit are not parallel to each other and the ir and sr are angled laterally at about 23 degrees from the sagittal plane

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what happens when the SR is stimulated

elevation

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what happens when the IR is stimulated

depression

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what are the secondary actions of the SR

adduction and intorsion

what are the secondarya ctions of the IR

adduction and extorsion

if the SR was working in isolation, how would the eye be positioned

up, out, and rotated inwards

if the IR was working in isolation, how would the eye be positioned

down, out, and rotated outwards

what would the primary action of the So be

intorsion

what would the primary action of the IO be

extorsion

what would the secondary actions of the SO be

abduction and depression

what would the secondary actions of the IO be

abduction and elevation

in the left gaze, which eom is the pure elevator, pure depressor, pure intorter, and pure extorter for the LEFT eye

LSR, LIR, LSO, LIO

in the left gaze, which eom is the pure intorter, pure extorter, pure depressor, and pure elevator for the RIGHT eye

RSR, RIR, RSO, RIO

what is the goal of eom testing

to isolate the actions of each eom

what is a mild to moderate muscular weakness

muscle paresis

what is a severe/complete loss of motor function

muscle paralysis

which nerve does bells palsy affect

cn 3

which eom mucles will bells palsy affect? what other muscles could be affected

IR, SR, MR, IO. and phincter of iris and levator palpebrae superioris

what is the standard proceudce to test eom

doctor faces pt and instructs to look at a target (light) and the doctor moves around in a particular pattern (H, X)

what are some disesases that cause the eom discomfort or pain

retrobulbar optic neuritis, orbital cellulitis, graves, myasthenia gravis

what is diplopia

double vision

for testing eom, how far away do you hold the light from the pt

40-60 cm

with or without glasses for eom testing

without

when using the double h and x patterns, how do you move the light

from center outwards until a distance euqal to distance patient (45 degrees)

what are you looking for in eom testing

misalighnemt of eyes updrift of downdrift of either eye underaction or overaction of any eom

what is the objective evaluation of binocularity using light reflected corne

hirschberg test

in hirschberg, how far away is your light

50-100 cm

where is the normal location of the lights reflection in the cornea

center of the pupil or slightly nasally displaced (0.5mm)

if the corneal reflexes of the two eyes differs you have

strabismus

how can you estimate the amount of deviation

1mm of displacement corresponds to 22 PD

when screening eoms, the deviation in each position should remain nearly the same

within 5PD

how do you record for eom

``` normal: SAFE or FESA Full Extensive Smooth Accurate ```

what are the dimension for the E in FESA

upwards 35-40 degrees, downwards about 50 and nasally and temoporral about 40

For screeenings, record eom (hirsberg) as...

Pass or REfer

bilateral, involunatry and conjugate oscillation of eyes (typical jerky movemtn)

nystagmus

what are 3 types of nystagmus

1. phsyciological (normal) 2. infantile or congenital (mild and non progressive, associated w/ disorders Downs, albinism) 3. acquires (disease, trauma, drugs, neurogical disease)

one eye is deviated and there is strabismus in the position of gaze wehre the pt saw double

binocular diplopia

should you be able to objectively see the misalisgment with the hirschberg reflexes test for binocular diplopia?

yes

why does the pt see double

bc different images reach corresponding parts on each retina

when will the pt not report seeing double

when he is suprressing one image

how can you discern binocular diplopia from nomocular

cover each eye alternatviely

what is monocular diplopia caused by

disease. ex cataracts or a problem witht he light ur using (happens with penlights)

a deviation of the same size, within 5 or fewer prism diopters

comitant

deviation that differs by more than 5

noncomitnat

what can a noncomitant deviation be an indication of

a serious, possibley life-threatening disease or neuropathology

amount of deviationd etermined in all positions of gaze w/

1. cover test 2. maddox rod 3. red lens test

eyes turned out

exotropia

what will you use to measure exotropia

prisms located w/ base towards nose

eyes turned in

esotropia

one eye deviated up

hypertropia

waht will you use to measure esotripia

prisms located w/ base towards ear

prism located w/ base down is what

hypertropia

waht if a child has a result other than FESA

referred for full eye exam