Opthalmology, Cranial Nerves and Ear exams

Question 1

Be able to name eye parts

Answer 1

Question 2

What is this thing?

Answer 2

A Finoff Transilluminator

Question 3

What is this thing?

Answer 3

Direct Opthalmoscope

Know its parts

Question 4

What are the five main parts of the ocular exam?

Answer 4

1. Distant ocular exam
2. Neuro-­‐ophthalmic exam
3. Ocular diagnostic testing
   
   • Schirmer tear test, Fluorescein staining, Tonometry
4. Pupillary dilation
5. Orbital, Ocular and Intraocular examinations
   
   • Intraocular examination by:
   • Direct fundoscopy
   • Indirect fundoscopy

Question 5

How far away do you stand when testing the tapetal reflex with the transilluminator?

Answer 5

~5-6 feet

Question 6

Menace Response evaluates what?

Answer 6

CN 2 & 7

orbicularis oculi muscle

Question 7

Palpebral reflex evalutates what?

Answer 7

CN 5 & 7

Question 8

Vestibulo-ocular reflex evaluates what? (this one you are looking at nystagmus)

Answer 8

CN 3,4,6,8

Question 9

The Pupilarly light reflex evaluates what?

Answer 9

CN 2,

parasympathetic fibers of CN 3;

retina,

iris constrictor/sphincter muscle,

mid-­‐brain

Question 10

The Dazzle reflex tests what? How?

Answer 10

CN 2 and 7
retina
rostral colliculus

involuntary aversion response (blinking, globe retraction,

third eyelid protrusion, and/or head movement) to intense light

This subcortical reflex will be present in dogs with cortical blindness

and absent in dogs with blindness due to lesions of retina or optic nerve

Question 11

What is an abnormal result of a STT after a minute of testing, indicating decreased tear productin for a dog?

cat (with clincal signs)?

Answer 11

Dog: <15 mm/min

Cat: <5 mm/min

Question 12

What setting on the direct opthalmoscope do you use to examine an eye with fluorescein stain?

Answer 12

Cobalt Blue cirle

Question 13

T/F: I put fluorscein stain in my dogs eyes, but am not seeing any stain at the nares/pharyxn. He must have an obstruction in his nasolacrimal duct.

Answer 13

False

Question 14

What is a normal IOP?

Answer 14

10-25 mmHg

Question 15

How long does it take 1% tropicamide to dialate pupils?

Answer 15

15-30 minutes

Question 16

What is a good use of time while waiting for the pupil to dialate?

Answer 16

Identify nictitans

Identify Meibomian gland opening on upper and lower eyelid

Observe the dorsal and lateral lacrimal puncta

Retropulse the eye to determine amount of orbital contents (should easily retropulse)

Elevate third eyelid to inspect

Question 17

How do you look behind the third eyelid?

Answer 17

After retropulsing the eye and making the third eyelid visible, you would gently pick up the leading edge with atraumatic forceps

Question 18

Indirect fundoscopy is prefred when first learned because you have a bigger field of view. What are 2 percieved downfalls of this method?

Answer 18

1. less magnified image
2. inverted and reversed image

Question 19

T/F: Direct fundoscopy provides are highly magnified, upright image of a very large region.

Answer 19

FALSE

Direct fundoscopy provides are highly magnified, upright image of a very small region.

Question 20

Which tonometers require a topical anesthetic, proparacaine?

Answer 20

• Indentation: Shiotz - meassures how much force to indent cornea
• Applanation: Tonopen, Accupen - measure amt of force to flatten pre-determined are of cornea. Cornea is tapped, not indented

Rebound types do NOT need anesthetic

Ex - TonoVet - Calc IOP based on acceleration and deceleration of a probe o/from corneal surface

Question 21

How do you position an otoscope in an ear?

Answer 21

Pull the pinnae laterally and ventrally to visualize vertical ear canal (straightening “L”)

place the otoscope into ear canal

at bottom of ventral canal, drop handle of otoscope to more vertical position and advance cone into horizontal canal while looking into far field for tympanic membrane, pars tensa (gray/blue ventral), pars flaccida (white/pink dorsal)