HEENT abnormal

Question 1

What would cause a Blind right or left eye (unilateral blindness)?

Answer 1

lesion of the right or left optic nerve

Question 2

a lesion at the optic chiasm causes what?

Answer 2

bitemporal hemianopsia: loss of outer half of vision of both eyes

Question 3

A lesion of the optic tract causes what?

Answer 3

left homonymous hemianopsia (lesion in right optic tract): loss of half of each field (left half of each field)

Question 4

strabismus

Answer 4

deviation of the eyes from thier normally conjugate postition

Question 5

Nonparalytic stabismus is caused by what?

Answer 5

imbalance of extraocular muscle tone

Question 6

Paralytic stabismus is caused by what

Answer 6

weakness or paralysis of one or more extraocular muscles

Question 7

CN that innervates lateral rectus; superior oblique; all other extraocular muscles

Answer 7

LR6 SO4 AO3

Question 8

convergent stabismus

Answer 8

esotropia: eye moves medially

Question 9

divergent stabismus

Answer 9

exotropia: eye moves laterally

Question 10

what test tests for strabismus? When would you use it?

Answer 10

• cover-uncover test
• Use when the corneal light reflection is asymmetrical

Test: one eye is covered for 1-2 seconds; when it is uncovered, look for motion of the uncovered eye

Question 11

what clinical signs would indicate 3rd Nerve Paralysis in paralytic stabismus

Answer 11

• dilated pupil; ptosis of upper lid; lateral deviation of eye

Question 12

what clinical signs would indicate left 4th Nerve Paralysis in paralytic stabismus

Answer 12

ask patient to look to the right and down; left eye will not look down when turned inward

Question 13

what clinical signs would indicate left 6th Nerve Paralysis in paralytic stabismus

Answer 13

when patient is asked to look left; the left eye is not able to look laterally

Question 14

What three signs in conjunction indicate Horner’s syndrome? What type of dysfunction does Horner’s syndrome indicate?

Answer 14

1) Ptosis 2) Miosis (excessive constriction of pupil) 3) Anhidrosis (absent sweating on affected side) **sympathetic nerve dysfunction

Question 15

What clinical signs indicate Tonic (adie’s) Pupil? What type of dysfunction does this indicate?

Answer 15

• reduced reaction to light; mydriasis (dilation of pupil) - slowed near reaction - impaired parasympathetic function

Question 16

Entropion vs. Ectropion

Answer 16

lid inversion and lid eversion

Question 17

chalazion

Answer 17

meibomian gland inflammation; points inward

Question 18

Hordeolum (stye)

Answer 18

tender, red infection near hair follicle of eyelashes

Question 19

Hypopyon

Answer 19

pus in the anterior chamber, behind cornea but anterior to the iris

Question 20

How do you distinguish between arteries and veins in an ophthalmoscopic exam

Answer 20

• arteries: light red; smaller in size; bright light reflex
• veins: dark red; larger in size; minimal light reflex

Question 21

Copper wire, silver wire, A-V nicking, flame hemorrhages and cotton wool patches are indicative of what

Answer 21

hypertensive retinopathy

Question 22

normal physiologic cup to optic disc ratio

Answer 22

1:2

Question 23

deposit of uric acid crystals on the external ear caused by yeras of chronically elevated uric acid

Answer 23

gouty tophi

Question 24

Which test involves putting the vibrating tuning fork on the top of the head and asking the patient where they hear the sound?

Answer 24

weber test

Question 25

what indicates a normal weber test

Answer 25

with vibrating tuning fork on top of the head, patient should hear sound in both ears equally

Question 26

Unilateral conduction loss. Where is the problem in the ear? What diseases can cause this

Answer 26

• ear is recieving input from the bone conduction and no air conduction
• middle ear
• otitis media; perforation, cerumen

Question 27

Unilateral sensorineural loss. What part of ear is affected? What diseases are associated with this

Answer 27

• damaged ear is not receiving input from bone conduction
• inner ear hearing loss
• presbycusis; noise exposure; head trauma

Question 28

what test involves placing the tip of the tuning fork on the mastoid bone, asking the patient if they can hear it, and having them tell you when the sound stops and then moving the tuning fork in front of the ear and asking them if they still hear the noise?

Answer 28

Rinne test

Question 29

in the rinne test; if the patient can still hear the sound when the tuning fork is in front of his/her ear after he/she stopped hearing the sound when the fork was at the mastoid process, then which is better: air conduction or bone conduction?

Answer 29

AC>BC

Question 30

Weber test: sound laterized to right ear. Rinne test: Right ear: AC>BC (+); Left ear AC >BC (+). What is the diagnosis?

Answer 30

Left Sensorineural loss

Question 31

Weber test: sound laterized to right ear. Rinne test: Right ear: BC>AC (-); Left ear AC >BC (+). What is the diagnosis?

Answer 31

Right Conduction loss

Question 32

there are how many cardinal fields of vision

Answer 32

6