HEENT Flashcards
Unequal pupils - Anisocoria (2) in bright light and dim light
bright light the larger pupil cannot constrict properly. Causes: blunt truama, OAG, Impaired parasympathetic nerve supply to the iris.
dim light the smaller pupil cannot dilate properly, (Horners syndrome) caused by an interupption of sympathetic nervous system.
Tonic Pupil (Aide’s Pupil)
Pupil is large regular and usually unilateral. Reaction to light is severely reduced and is slowed, or absent. Near reaction although slow, is present. Slow accommodation causes blurred vision. Deep tendon reflexes are often decreased.
Oculomotor Nerve CN III Paralysis
Dilated pupil fixed to light and near effort. ptosis of upper eyelid and lateral deviation of the eye are almost always present.
Horner’s Syndrome eyes
the effected pupil (small) reacts briskly to light and near effort. Ptosis of the eyelid is present, perhaps with loss of sweating on the forehead. In congenital Horner’s syndrome, the involved iris is lighter in color than its fellow (heterochromia)
Small irregular pupils
small irregular pupils that do not react to light indicate Argyll Robertson pupils. Seen in central nervous system syphilis.
Dizziness
nonspecific term encompassing several disorders - get a detailed hx to identify primary etiology.. vertigo, presyncope, disquilibrium, psychiatric, mutifactorial
Vertigo Dizzy
a spinning sensation accompanied by nystagmus, and ataxia, usually fromperipheral vestibular dysfunction (40%), but may be brainstem lesion, also althersclerosis, MS, vertebrobasilar migraine, TIA
Presyncope Dizzy
a near faint from “feeling faint of lightheaded - causes include orthostatic hypotn, medication, arrhthmias and vasovagel attacks
Disequilibrium Dizzy
unsteadiness or imbalance when walking. esp. in older pt., (fear of walking, visual loss, weakness musc skeletal, perepheral neuopathay.
Psychiatric Dizzy
anxiety, panic disorder, hyperventilation, depression, somatization disorder, alcohol, and substance use.
Multifactorial Dizziness
unknown up to 20% of pt.s
Cushing syndrome Facial Swelling
increased adrenal cortisol prduction of cushing’s syndrome produces a round or “moon” face with red cheeks.excessive hair growth - side burns, moustach, and chin
Nephrotic Syndrome Facial Swelling
face is edematous and often pale. Swelling appareas first around the eyes and in the morning. eyes may become slitlike when edema is severe
Myxedema Facial Swelling
severe hypothyroidism ahs a dull puffy face. edema often pronounced around the eyes does not pit with pressure. Hair and eyebows are dry coarrse and thinned. the skin is dry.
Parotid Gland Enlargement
chronic bilateral asymptomatic parotic gland enlargement may be associated ith obesity, diabetes, cirrhosis, and other conditions. Swellings anterior to the ear lobes and above the angles of the jaw. Gradual unialteral enlagement suggests neoplasm . Acute enlargement is seen in mumps.
