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Oral Surgery > L2- Exam Pt. 2 > Flashcards

L2- Exam Pt. 2 Flashcards

1
Q

major differences between arteries and veins in the eye

A

arteries

  • lighter red
  • smaller

veins

  • darker red
  • larger
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2
Q

pupillary reaction to light - direct reaction

A

pupillary constriction in the same eye

  • light in right eye and right eye constricts
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3
Q

consensual reaction -

A

pupillary constriction in the opposite eye

  • put in right eye and both right and left eyes the pupil constricts
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4
Q

whisper technique for auditory acuity

A

stand 2 feet behind the patient so that the patient cannot read your lips

occlude the non-test ear with a finger and gently rub the tragus in a circular motion

exhale a full breath before whispering to ensure a quiet voice

whisper a combination of three numbers and letters

use a different number/ letter combination for the other ear

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5
Q

conductive hearing loss

A

hear better through bone conduction than air

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6
Q

sensorineural hearing loss

A

congenital or hereditary hearing loss

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7
Q

weber test

A

hearing test

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8
Q

upper eyelid covers?

A

portion of iris – but does not normally overlay the pupil

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9
Q

opening between eyelids called

A

palpebral fissure

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10
Q

conjuctiva

A

clear mucous membrane with two visible components

  • bulbar conjuctiva
  • palpebral
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11
Q

bulbar conjuctiva

A

covers most of the anterior eyeball, adhering lossely to the underlying tissue

  • meets cornea at limbus
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12
Q

papebral conjuctiva lines

A

the eyelids

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13
Q

tarsal plates

A

firm strips of connective tissue within the eyelids

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14
Q

levator palpebrae

A

raises the upper eyelid – innervated by CN III

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15
Q

meibomian glands

A

in the tarsal plates – parallel rows of them and open on the lid margin

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16
Q

controls the pupillary size

A

the muscles of irsi 8

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17
Q

controlling the thickness of the lens

A

muscles of the ciliary body

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18
Q

what allows to focus on near or distant objects

A

muscles of ciliary body

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19
Q

aqueous humor found? flow?

A

fills anterior and posteior chambers of the eye

circulates from posterior to anterior through the pupil

drains out through the canal of schlemm

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20
Q

canal of schlem

A

drains the aqueous humor of the eye

- controls the pressure inside the eye

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21
Q

lacrimal location

A

superior lateral aspect of the eyelid

- mostly in bony orbit, above and lateral to the eyeball

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22
Q

what protects conjuctiva and cornea

A

fluid from the meiboma glands, conjuctivcal glands, and lacrimal glands

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23
Q

tears drain?

A

medially through the lacrimal puncta

they pass into the lacrimal sac and into the nose via the nasolacrimal duct –> inferior meatus

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24
Q

cranial nerves associated with the eye

A

III, IV, VI

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25
Q

superior oblique what nerve

A

IV

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26
Q

CN VI

A

lateral rectus

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27
Q

CN III regulates which muscles

A
  1. superior rectus
  2. inferior rectus
  3. medial rectus
  4. inferior oblique
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28
Q

lateral rectus controlled by

A

CN VI

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29
Q

entropin

A

lower eyelid pushed underneath

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30
Q

ectropin

A

lower eyelid is lower

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31
Q

subconjunctival hemorrhage

A

leakage of bloos outside the vessels, producing a hemorhagenous sharpply demarcated, red area that resolves over 2 weeks

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32
Q

fundus is where

A

posterior part of the eye

  • also see retina, choroid, fovea, macula, optic disc and retinal vessels in this area
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33
Q

describe arteries of the eye

A
  1. light red in color
  2. smaller (2/3 to 3/4 the diameter of veins)
  3. light reflex is bright
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34
Q

describe veins of the eye

A
  1. dark red in color
  2. larger

inconspicuous or absent in the light reflex

35
Q

arteries of eye in light reflex

A

bright

36
Q

chalazion

A

subacute nontender, usually painless nodule involving a blocked meibomian gland

may become acutely inflammed, unlike a sty – usually points insidie the lid rather than on the lid

37
Q

pterygium

A

triangular thickening of the bulbar conjuctiva that grows slowly across the outer surface of the cornea, usually from the nasal side

redenning
can interfer with vision

38
Q

wall of normal artery in the eye

A

it is TRANSPARENT –only column of blood can usually be seen

39
Q

normal light reflex – describe the artery

A

it is a NARROW – 1/4TH DIAMETER OF THE BLOOD COLUMN

40
Q

Retinal erteries in hypertension

A

focal or generalized narrowing – the light reflex is also narrowed

ARTERIAL WALL THICKENS AND BECOMES LESS TRANSPARENT

  1. copper wiring
  2. silver wiring
41
Q

Copper wiring

A

sometimes seen in hypertension and these retinal arteries are closer to the disc
- become more full and develop an increased light reflex with a bright coppery luster

42
Q

silver wiring

A

retinal arteries that become more narrow and wall becomes opaque – no blood is visible within

43
Q

what happens to arteriovenous crossing with hypertension

A

when the arterial walls loose their transparency – changes appearance in AV crosssing

  1. AV nicking / concealment
  2. tapering
  3. banking
44
Q

concealment or av nicking

A

the vein appears to stop abruptly on either side of the artery

45
Q

tapering in AV

A

vein appears to taper down on either side of artery

46
Q

describe banking

A

vein is twisted on the distal side of the artery - and forms a dark, wide knickle

47
Q

normal AV crossing in eye

A

becasue arterial wall is transparent, a vein crossing beneath the artery can be seen right up to the column of blood on either side

48
Q

anisocoria

A

unequal pupils

49
Q

simple anisocoria

A

difference in pupillary size of 0.04mm or greater – is seen in approx. 35% of healthy people

if reactions in pupil are normal – considered benign

50
Q

miosis

A

constriction of pupils

51
Q

mydriasis

A

dilation of pupils

52
Q

painful on ‘tug test’

describe movement

A

movement of the auricle and tragus

- acute otitis externa (inflammation of the middle ear canal)

53
Q

tenderness behind the ear may present in?

A

otitis media

54
Q

describe whispered voice test

used for?

A

for audiotory acuity

stand 2 feet behind

occlude non test ear

exhale to be at a true whisper

whisper combination of three numbers and letters

repeat for other ear - using different comination

55
Q

normal response to whisper test

A

patient repeats initial sequence

fail once then on second try patient repeats ATLEAST 3 OUT OF 6 of the possible numbers/ letters correctly

56
Q

abdnormal response to whisper voice test

A

4 /6 possible number / letters are incorrect

conduct further testing using audiometry (weber and rinne)

57
Q

two ways sound gets conducted

A
  1. air – faster

2. through bone – not as conductive

58
Q

conductive hearing loss hear better through?

A

through bone because here the external and middle ear are the problem

59
Q

sensorineural hearing loss caused by?

- general

A

disorder of the inner ear

60
Q

causes of external ear

A

infection (otitis externa), trauma, benign bony growths such as extoses or osteomas

61
Q

causes of middle ear problems

A

congenital conditions, benign cholesteatomas, and otosclerosis, tumiors, and perforations of the tympanic membrane

62
Q

disorders causing senorineural hearing loss

A
  1. congenital and hereditary conditions
  2. presbycusis
  3. viral infections
    - rubella
    - cytomegalovirus
  4. meniere’s disease
  5. noise exposure
  6. acoustin neuroma
63
Q

describe (basic) conduction with senorineural hearing loss

A

conduction through the middle ear/ bone is good but once in inner ear – bad

64
Q

otitis media causes

A

conductive hearing loss

65
Q

*pathophysiology of conductive hearing loss

A

EXTERNAL OR MIDDLE EAR DISORDER
- impairs sound conduction to inner ear

causes

  • foregin body
  • otitis media
  • perforated eardrum
  • osteosclerosis of ossicles
66
Q

pathophysiology of sensorineural loss

A

inner ear disorder involves cochlear nerve and neuronal impulse transmission to the brain

causes inlude

  • load noise exposure
  • inner ear infections
  • trauma
  • acoustic neuroma
  • congenital and familial disorders
  • aging
67
Q

loud noises can cause

A

sensorineural loss

68
Q

inner ear infections and trauma can cause

A

sensorineural loss

69
Q

weber test in unilateral hearing loss with conductive hearing loss

A

tuning fork at vertex

sound lateralized to IMPAIRED EAR

room noise NOT well heard – so detection of vibrations IMPROVE

70
Q

weber test in unilateral hearing loss with sensorineural hearing loss

A

tuning for at vertex

sound lateralizes to GOOD EAR

inner ear or cochlear nerve damage impairs transmission to affected ear

71
Q

which does detection of vibrations improve

A

weber test with conductive hearing loss

72
Q

sound lateralizes to IMPAIRED EAR

A

conductive loss

73
Q

sound lateralizes to GOOD EAR

A

sensorineural loss

74
Q

bone conduction is longer than or equal to air conduction

A

conductive loss

75
Q

air conduction longer than bone conduction

A

sensorineural loss

76
Q

vibrations reach the cochlea in?

A

conductive – although the external or middle ear is impaired, vibrations through bone bypass the problem to reach the cochlea

  • cochlear nerve can transmit
77
Q

which hearing loss is the cochlear nerve more affected?

A

sensorineural loss

- the inner ear or cochlear nerve is less able to transmit impulses regardless of how the vibrations reach the cochlea

78
Q

tuning fork where in weber? where in rinne?

A

weber – at vertex – on top of the head – and see if it lateralizes

rinne – at external audiotry meatus – then on mastoid bone

79
Q

*conductive hearing loss does what?

basic

A

LATERALIZES to the impaired ear

80
Q

if poor hearing in the right ear and lateralizes to right ear?

A

conductive hearing loss

81
Q

if poor hearing in the right ear and lateralizes to left ear?

A

sensorneural loss in the right ear

82
Q

after weber test which next?

A

Rhinne

83
Q

if cannot hear tuning fork next to ear after had it against mastoid process what does this indicate?

A

conductive hearing loss – because conduction through air is lost

Oral Surgery (26 decks)

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