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Advanced Health Assessment > module 8 eyes > Flashcards

module 8 eyes Flashcards

1
Q

CN II

A

optic nerve
transmits visual signals to the brain
visual acuity

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2
Q

CN III

A

oculomotor nerve
superior, medial, and inferior rectus, and inferior oblique muscles
- up and out, down and out, up and in

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3
Q

CN IV

A

trochlear nerve
superior oblique muscle
- down and in

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4
Q

CN VI

A

abducens nerve
lateral recuts muscle
- lateral gaze

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5
Q

CN V

A

trigeminal nerve

sensory, corneal reflex

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6
Q

CN VII

A

facial nerve
motor: blink
corneal reflex

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7
Q

nerves in charge of small eye movement

A

III
IV
VI

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8
Q

lacrimal gland

A

lateral upper portion of eyelid, under brow.

- produces tears

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9
Q

lagophthalmos

A

eyes do not close completely

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10
Q

ptosis

A

eyelid drooping

- covers upper portion of iris or pupil

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11
Q

corneal arcus

A

lipid deposit around iris

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12
Q

anisocoria

A

pupils different sizes

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13
Q

miosis

A

pupillary constriction

  • iridocyclitis
  • miotic eye drops
  • opioid abuse
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14
Q

mydriasis

A

pupillary dilation

  • iridocyclitis
  • mydratic or cycloplegic drops
  • midbrain lesions or hypoxia
  • oculomotor (CN III) damage
  • acute-angle glaucoma
  • stimulant use; cocaine, amphetamines
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15
Q

failure to respond with light stimulus

A
  • iridocyclitis
  • retinal degeneration
  • CN II destruction
  • midbrain synapses or CN III
  • impairment of efferent fibers (PSNS), sphincter pupillae muscle
  • mydriatics
  • brain herniation
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16
Q

argyll robertson pupil

A

bilateral, miotic, irregularly shaped pupils that fail to constrict with light, but retain constriction with convergence

  • may or may not be equal in size
  • neurosyphilis
  • lesions in midbrain
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17
Q

Anisocoria

A

unequal pupil size

  • congenital: 20%
  • local eye meds
  • unilateral SNS or PSNS pathway destruction
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18
Q

Iritis constrictive response

A

acute uveitis, commonly unilateral

- constriction of pupil accompanied by pain and reddened eye, especially adjacent to iris

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19
Q

oculomotor nerve damage CNIII

A

pupil dilated and fixed

  • eye deviated laterally and downward
  • ptosis
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20
Q

Adie pupil (tonic pupil)

A

affected pupil dilated and reacts slowly or fails to react to light, responds to convergence

  • impairment of postganglionic PSNS innervation of sphincter pupillae muscle
  • ciliary malfunction
  • often accompanied by diminished tendon reflexes
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21
Q

exophthalmos patho

A

bulging of eye anteriorly out of orbit

  • inc. in volume of orbital contents
  • Graves disease: abnml CT deposition in orbit and extraocular muscles
  • when unilateral consider retro-orbital tumor
22
Q

exophthalmos subjective

A

change in eye position or valsalva maneuver

23
Q

exophthalmos objective

A

apparent eye protrusion, lids do not reach pupil

24
Q

episcleritis patho

A

inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles

  • Simple: intermittent episodes of moderate to severe inflammation. 1-3 month intervals, lasting 7-10 days, and resolving after 2-3 weeks
  • Nodular: prolonged attacks of inflammation, typically more painful than simple
25
Q

episcleritis subjective

A

acute onset of mild to moderate discomfort or photophobia

- painless injection (redness) and/or watery discharge without crusting

26
Q

episcleritis objective

A

diffuse or localized redness of the bulbar conjunctiva
purplish elevation of a few mm.
watery discharge

27
Q

band keratopathy patho

A

deposition of calcium in the superficial cornea

- most common in pt with chronic corneal disease

28
Q

band keratopathy subjective

A

dec. in vision as deposition progresses

foreign body sensation and irritation

29
Q

band keratopathy objective

A

line just below the pupil, passes over the cornea rather than around the iris as with arcus senilis
- horizontal grayish bands interspersed with dark areas that look like holes

30
Q

corneal ulcer patho

A

disruption of the corneal epithelium and stroma

  • CT disease or systemic vasculitic disorder
  • infection: viral or bacterial
  • extreme dryness
31
Q

corneal ulcer subjective

A 
pain 
photophobia
hx of wearing contacts
blurry vision
feeling that something is in the eye
32
Q

corneal ulcer objective

A

visual acuity affected variably, depending on location
inflammation and erythema of the lids and conjunctiva
purulent exudates
ulcer often round or oval and the border sharply demarcated, base appearing ragged and gray

33
Q

strabismus patho

A

both eyes do not focus on an object simultaneously but can focus with either eye

34
Q

strabismus subjective

A

poor vision
may have sudden onset of double vision
report of eye deviation

35
Q

strabismus objective

A

extraocular muscle impairment: eye will not move in the direction controlled by that muscle
detected by the cover-uncover test

36
Q

horner syndrome patho

A

interruption of SNS to the eye

  • congenital, acquired, or hereditary
  • lesion of primary neuron, stroke, trauma
37
Q

Horner syndrome triad

A

ipsilateral miosis
mild ptosis
loss of hemifacial sweating

38
Q

Horner syndrome subjective

A

s/s depend on underlying cause

39
Q

horner syndrom objective

A

ptosis is subtle: note amount of iris seen superiorly
pupil on affected side round and constricted
Aniscoria (size difference) greated in darkness
affected pupil dilates more slowly than nml pupil
dry skin on same side of face as affected pupil

40
Q

cataract patho

A

opacity in lens

  • denaturation of lens protein caused by aging
  • peripheral: hypoparathyroidism
  • Meds: steroids
  • Congenital: maternal infections, fetal insult during 1st trimester.
41
Q

cataract subective

A 
cloudy or blurry vision 
faded colors
headlights, lamps, or sunlight appear too bright
halo around lights
poor night vision or double vision 
frequent Rx changes
42
Q

cataract objective

A

cloudiness of the lens

43
Q

diabetic retinopathy (nonproliferative) patho

A

dot hemorrhages or microaneurysms and the presence of hard and soft exudates

  • hard: lipid transudation through incompetent capillaries
  • soft: infarction of the nerve layer
44
Q

diabetic retinopathy nonproliferative subjective

A

asymptomatic in initial stages

blurred vision, distortion, or visual acuity loss in more advanced stages

45
Q

diabetic retinopathy nonproliferative objective

A

on ophthalmoscopic examination
- blood vessels with balloon-like sacs
blots of hemorrhages on the retina itself
tiny yellow patches of hard exudates

46
Q

diabetic retinopathy proliferative patho

A

development of new vessels as result of anoxic stimulation

- vessels grow out of retina toward vitreous humor

47
Q

diabetic retinopathy proliferative subjective

A

generally asymptomatic
floaters
blurred vision
progressive visual acuity loss in advanced stages

48
Q

diabetic retinopathy proliferative objective

A

visualization of these vessels may require change in the lens setting
- vitreous hemorrhage may also be seen, can obstruct view of retina

49
Q

glaucoma patho

A

disease of the optic nerve where the nerve cells die

  • usually due to high intraocular pressure
  • Acute angle: occur acutely with dramatically elevated pressure if iris blocks exit of aqueous humor from anterior chamber
  • Open angle: caused by dec. aqueous humor absorption
  • > inc. resistance and painless buildup of pressure in the eye
50
Q

glaucoma subjective

A

open-angle:
- gradual loss of peripheral vision over a period of years
Acute:
- intense ocular pain, blurred vision, halos around lights, red eye, dilated pupil
Occasionally: abd. pain, N/V

51
Q

glaucoma objective

A

optic nerve damage can clearly be seen during dilated eye exam and produces a characteristic appearance of the optic nerve ( increased cupping)
- visual field test may show los of peripheral vision

Advanced Health Assessment (57 decks)

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