Lecture 3: Fundus Biomicroscopy and Fundus Findings part 2 Flashcards
“Distinct Margins” is referring to the:
A) disc
B) cup
C) macula
D) Ora Serrata
A) disc
A malinserted disc is tilted along its ____ axis. and is often associated with a _____ ____
vertical, scleral cresent (disc appears to be tilted upward nasally, and nasal rim can be “heaped up” with temp depressed)
With a tilted disc, the _____ axis itself is tlted. The disc appears to be tilted _____ ____
vertical, downward nasal
Describe the Elschnig classification of ONH for each of the 4 types.
1) Type 1=flat cross sectional
2) Type 2=cylinder cross sectional
3) Type3=a sloping cross sectional
4) Type 4=a sloping with hook cross sectional
Describe the “ISNT” rule
This is for a healthy optic nerve. inferior with be thickest and temporal will be thinnest. Inferior>Superior>Nasal>Temporal
In glaucoma, the vertical C/D _____ faster than horizontal and _____ follow the “ISNT” rule
increases, doesn’t
Average C/D for caucasians is ____
Average C/D for asain/latino is ____
Average C/D for African-Americans is ____
caucausians=0.4 (0.3+/-0.2) Asain/latino=0.5 African-Americans=0.6 (0.5+/-0.15) (suspicious when C/D is 0.1 larger than normal expectation) *30% of normals have 0.1 difference *4% of normals have 0.2 difference
Which 3 cup to disc scenarios are abnormal and suspicious of glaucoma? (pick 3)
A) average to small
B) average to average
C) large to small
D) large to average
A) average to small
C) large to small
D) large to average
(T or F) A large cup to disc ratio can be a sign of glaucoma, however 2% of normals have a C/D ratio of 0.7 or more
True
(T or F) The nerve fiber layer should look dark
False, dark wedge shaped NFL is a loss of NFL
Normal arterial light reflex (ALR) is ____ or ____
1/3 or 1/4 (ratio of reflected light width to width of the artery)
Normal artery vein (A/V) ratio is ____ or ____
2/3 or 3/4
Choose the correct statement:
A) veins are 25% smaller than arteries
B) arteries are 25% smaller than veins
C) A healthy person’s arteries will be the same size as their veins
D) A healthy A/V ratio is 1:10
B) arteries are 25% smaller than veins
also, artieries are lighter and veins are darker
There are ___ pairs of vessels in each quadrant of the posterior pole
4
The ____ vessels arc around the macular area
temporal
Veins too wide, think _____. Arteries too narrow, think_____
diabetes, HTN
The A/V estimation should be made after the ____ bifurcation and before the ____ bifurcation
1st, 3rd
As the walls of the artery thickens, ____ light is allowed to pass thru the artery and ____ is reflected back.
A) more, more
B) less, less
C) more, less
D) less, more
D) less, more
ALR _____ with arteriosclerosis and HTN
increases
“nicking” or “pinching” of the vein is abnormal and could be a sign of _____
high cholesterol (arteriolar sclerosis)
Tortuous vessels look crooked/winding/wiggly. This could be either congenital or pathological. However:
A) if both arteries and veins are wiggly, then its most likely congenital
B) if arteries are more wiggly than veins its most likely congenital
C) if veins are more wiggly than arteries, its most likely congenital
A) if both arteries and veins are wiggly, then its most likely congenital
(T or F) An albino has no RPE layer
true (albino’s have no macualr pigment)
Tigrid is a blotchy striped pattern found in the posterior retina and is most common in:
A) African-Americans
B) Caucasians
C) Asians
D) Columbians
C) Asians
When viewing the macular area, you are looking for what 5 things?
1) even pigmentation 2) +FLR 3) “red stuff”=hemorrhages 4) “white stuff”=drusen 5) “dark stuff”=pigmented lesions
Which is constitutes as “reduced acuity”?
A) 20/25
B) 20/40
C) 20/80
D) 20/200
A) 20/25 (really, its all of them) anything worse than 20/20 is considered “reduced acuity”
The FLR is the Foveal Light Reflex that shines back at you when you shine your light onto the fovea. Where is the FLR actually focused?
In the vitreous (as a result of the shape of the retina and the depression in the fovea). The fovea acts like a concave mirror which gathers light from the ophthamloscope and focuses it slightly in front of the retina as a point of light.