HEENT Exam Flashcards
Conjunctiva (define)
protective membrane that covers all parts of the anterior globe, folding back on itself at superior and inferior fornix then extending onto the inner surface of upper and lower palpebra
Limbus (define)
where the conjunctiva meets the cornea
Palpebra
eyelid
Ptosis
eyelid partially or fully closed; drooping without specific anatomical markers to define it
Expothalmos
globe bulging forward so at rest, the lid is not able to reach the upper edge of the iris. Most typical for posterior fat pad growth stimulated in hyperthyroidism/Graves disease
Anisocoria
Unequal Pupils
Nystagmus
Involuntary rapid, rhythmic movement of eye in any direction
Strabismus
Misalignment of eyes relative to each other. If untreated can cause amblyopia (visual loss) of one eye
Patulous Eustachian Tube Dysfunction
Chronically Open
Autophony: hear yourself talk and breath. Intermittant. Mucosal dyhadration, chronically open
Dilatory Eustachian Tube Dysfunction.
Chronically Closed:
Dilatory failure. Mucosal inflammation, pressure (diving), anatomic abnormality. Pressure, pain, hearing loss, tinnitus.
Causes of a non-mobile tympanic membrane
fluid, mass, sclerosis
Causes of a Hyper-mobile tympanic membrane
ossicle bones disrupted
conductive hearing loss
bone conducting sound better than air.
Sound waves are not reaching or being conducted through the middle ear bone apparatus.
Causes include foreign body, otitis media, perforated eardrum, and otosclerosis of ossicles
sensorineural hearing loss
cochlear nerve is abnormal-both bone and air conduction is poor.
Causes include loud noise exposure (>85 db), inner ear infections, trauma, tumors, congenital and familial disorders, and aging
Weber Hearing Test
Weber: Lateralization of sound
Rinne Hearing Test
Rinne: Compare time of air vs. bone conduction (air should be better).
Weber: Conductive v. sensorineural
- Conductive loss: Hear sound better in bad ear.
- Sensorineural loss: Hear sound better in good ear.
Lymph Nodes are located where?
Pre/Post auricular Anterior and posterior cervical Submental, Submaxillary Occipital Supraclavicular
Common causes for sudden vision loss? (5)
retinal detachment, vitreous hemorrhage, central retinal artery occlusion, CVA, trauma
Common causes for gradual vision loss? (10)
Aging, cataracts, glaucoma, HIV-CMV infection, autoimmune disease, diabetes, congenital, macular degeneration, neoplasm, pseudotumor cerebri
Hyperopia
farsightedness – difficulty seeing near objects.
Myopia
nearsightedness – difficulty seeing distant objects.
Presbyopia
Presbyopia – aging vision – progressive difficulty seeing near objects.
Diplopia
Diplopia – double vision
Heterophoria
failure of the visual axes to remain parallel.
Esophoria vs
Exophoria –
Esophoria – one eye deviates inward
Exophoria – one eye deviates outward
Use cover test to evaluate
Homonymous Hemianopsia
Right or Left visual fields gone (optic tract or visual cortex lesion)
Bilateral Hemianopsia
Left field gone on Left eye and Right field gone on right eye (Optic Chiasm lesion)
Quadratic defects
A quarter of visual field gone(optic radiation lesion)
Blepharitis
inflamed lid margins
Entropion vs Ectropion
Entropion – Eyelid turns inward
Ectropion – Eyelid turns outward
Bulbar conjunctiva
covers the anterior eye
Palpebral conjunctiva
lines the eyelids
Jaundice causes…
yellow sclera
Osteogenesis Imperfecta causes….
Blue sclera
Pupillary Reaction to Light
Direct Reaction
Constriction of the same pupil
Pupillary Reaction to Light
Consensual Reaction
Constriction of the opposite pupil
Pupillary Reaction to Light
Accommodation
– Change in pupil and lens for near and far objects
Pupillary Reaction to Light
Convergence
– Eyes look inward to focus on a near object
Pinguecula
small nodule on the
bulbar conjunctiva, does not cross
over to the cornea.
Pterygium
Pterygium – thickening of the bulbar conjunctiva which grows across the cornea
Sty
Sty – infection at the margin
of the eyelid
Chalazion
Chalazion – painless nodule involving
the Meibomian gland
Xanthelasma
Xanthelasma – flat yellow plaques Found under the eye. Associated with hyperlipidemias. No treatment, investigate lipids and Cholesterol.
Ptosis
Ptosis – drooping of the upper eyelid.
can be caused by
Horner’s Syndrome – ptosis, miosis and anhydrosis –
Bell’s Palsy – CN VII
Conjunctivitis
Conjunctivitis – infection or
inflammation of the conjunctiva. Red eye-
Discomfort, discharge.
Topical antibiotics.
Subconjunctival hemorrhage
Subconjunctival hemorrhage – leakage of
Blood under the conjunctiva.
Painless, sharply demarcated, resolves on
its own.
Funduscopic findings: papilledema.
Disc is swollen with blurred margins, physiologic cup not visible; sign of increased intracranial pressure.
Funduscopic findings: glaucomatous cupping.
Increased intraocular pressure, causes increased disc cupping. Physiologic cup is enlarged, occupying more than half of disc’s diameter.
Cilliary Injection
– inflammation of the radiating vessels around the limbus.
Very painful, vision affected.
Can be a ocular emergency.
Causes : Glaucoma, Acute Iritis, Corneal Infection or Injury
Hyphema
– Blood in the anterior chamber.
Due to trauma.
A-V Nicking
Hypertensive Retinopathy Arterial walls become thickened and lose transparency due to atherosclerotic changes. The veins appear to taper as the artery crosses.
Cotton wool Spots
– infarcted nerve fibers.
Can be seen in patients with
hypertension and diabetes.
Copper or Silver wiring
Also a Hypertensive retinopathy finding
