HEENT abnormal Flashcards
What would cause a Blind right or left eye (unilateral blindness)?
lesion of the right or left optic nerve
a lesion at the optic chiasm causes what?
bitemporal hemianopsia: loss of outer half of vision of both eyes
A lesion of the optic tract causes what?
left homonymous hemianopsia (lesion in right optic tract): loss of half of each field (left half of each field)
strabismus
deviation of the eyes from thier normally conjugate postition
Nonparalytic stabismus is caused by what?
imbalance of extraocular muscle tone
Paralytic stabismus is caused by what
weakness or paralysis of one or more extraocular muscles
CN that innervates lateral rectus; superior oblique; all other extraocular muscles
LR6 SO4 AO3
convergent stabismus
esotropia: eye moves medially
divergent stabismus
exotropia: eye moves laterally
what test tests for strabismus? When would you use it?
- 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
what clinical signs would indicate 3rd Nerve Paralysis in paralytic stabismus
- dilated pupil; ptosis of upper lid; lateral deviation of eye
what clinical signs would indicate left 4th Nerve Paralysis in paralytic stabismus
ask patient to look to the right and down; left eye will not look down when turned inward
what clinical signs would indicate left 6th Nerve Paralysis in paralytic stabismus
when patient is asked to look left; the left eye is not able to look laterally
What three signs in conjunction indicate Horner’s syndrome? What type of dysfunction does Horner’s syndrome indicate?
1) Ptosis 2) Miosis (excessive constriction of pupil) 3) Anhidrosis (absent sweating on affected side) **sympathetic nerve dysfunction
What clinical signs indicate Tonic (adie’s) Pupil? What type of dysfunction does this indicate?
- reduced reaction to light; mydriasis (dilation of pupil) - slowed near reaction - impaired parasympathetic function
Entropion vs. Ectropion
lid inversion and lid eversion
chalazion
meibomian gland inflammation; points inward
Hordeolum (stye)
tender, red infection near hair follicle of eyelashes
Hypopyon
pus in the anterior chamber, behind cornea but anterior to the iris
How do you distinguish between arteries and veins in an ophthalmoscopic exam
- arteries: light red; smaller in size; bright light reflex
- veins: dark red; larger in size; minimal light reflex
Copper wire, silver wire, A-V nicking, flame hemorrhages and cotton wool patches are indicative of what
hypertensive retinopathy
normal physiologic cup to optic disc ratio
1:2
deposit of uric acid crystals on the external ear caused by yeras of chronically elevated uric acid
gouty tophi
Which test involves putting the vibrating tuning fork on the top of the head and asking the patient where they hear the sound?
weber test
what indicates a normal weber test
with vibrating tuning fork on top of the head, patient should hear sound in both ears equally
Unilateral conduction loss. Where is the problem in the ear? What diseases can cause this
- ear is recieving input from the bone conduction and no air conduction
- middle ear
- otitis media; perforation, cerumen
Unilateral sensorineural loss. What part of ear is affected? What diseases are associated with this
- damaged ear is not receiving input from bone conduction
- inner ear hearing loss
- presbycusis; noise exposure; head trauma
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?
Rinne test
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?
AC>BC
Weber test: sound laterized to right ear. Rinne test: Right ear: AC>BC (+); Left ear AC >BC (+). What is the diagnosis?
Left Sensorineural loss
Weber test: sound laterized to right ear. Rinne test: Right ear: BC>AC (-); Left ear AC >BC (+). What is the diagnosis?
Right Conduction loss
there are how many cardinal fields of vision
6
