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PE Block 1 Flashcards

1
Q

Define Hyperopia
Define Presbyopia
Define Myopia

A

Farsightedness
Aging vision
Nearsightedness

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2
Q

Gradual loss of vision is usually due to what two issues?

A

Cataracts

Macular degeneration

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3
Q

Slow central loss of vision in nuclear cataract is due to ?

Peripheral loss of vision is usually due to ?

A

Macular degeneration

Open angle glaucoma

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4
Q

One sided loss of vision is usually due to?

A

Hemianopsia

Quadrantic defect

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5
Q

Pt complains of specks or floating debris in field of view, what causes this?

A

Moving- vitreous floaters

Fixed- scotomas, lesion on retina or in visual pathway

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6
Q

PT complains of moving specks or flashing lights is suggestive of what?

A

Detached vitreous from retina

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7
Q

What can cause diplopia in adults?

A

Lesion in brainstem/cerebellum

Weak/paralyzed extraocular muscle

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8
Q

Horizontal diplopia can be attributed to palsy in what nerve?
Vertical diplopia can be attributed to palsy in what nerve?

A

CN3 or 6

CN 3 or 4

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9
Q

PTs with vertigo point to a problem with what CN?

A

CN8

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10
Q

What are the two types of hearing impairment?

A

Conductive loss- problem with external/middle ear

Sensorineural- inner ear, cochlear nerve, connection to brain

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11
Q

What types of difficulties do PTs with sensorineural hearing loss experience?

A

Understanding speech
Complain others mumble
Difficult hearing in noisy environments

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12
Q

PTs with conductive hearing loss exhibit decreased/improvement of symptoms in what type of environment?

A

Noisy

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13
Q

What are some S/Sx of acute/chronic otitis media?

A

Unusually soft ear wax
Debris
Rash in canal
Discharge through perforated ear drum

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14
Q

What Sx identifies true vertigo?

A

Do you feel the room is spinning

Feeling of being pulled= inner ear problem or CN8 lesion

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15
Q

What are 3 causes of rhinorrhea?

A

Viral infections
Allergic rhinitis- proven by itching
Vasomotor rhinits

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16
Q

Define Rhinits Medicamentosa

A

Excessive use of decongestants that worsens symptoms

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17
Q

What are 3 drugs that may cause stuffiness?

A

Oral contraceptives
Reserpine
Guanethidine
ETOH

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18
Q

Epistaxis can come from the nose itself or what other two areas?

A

Paranasal sinus

Nasopharynx

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19
Q

What questions can be asked to test for thyroid function?

A

Temperature intolerance

Sweating

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20
Q

What can apthhous ulcers mean?

A

Sore smooth tongue of nutritional deficiency

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21
Q

What other S/Sx often accompany pharyngitis?

A

Enlarged tender lymph nodes
No fever
Exudate

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22
Q

What are some S/Sx of Hypo/Hyperthyroidism?

A

Hypo- Intolerant to cold, dec sweating

Hyper- palpitations, hot, involuntary weight loss

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23
Q

What are some structures checked when PTs complain of changes in vision?

A

Lens
Macula
Macular degeneration
Glaucoma

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24
Q

Define Nits

A

Lice eggs

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25
What does redness and scaling under the hair/on the scalp indicate?
Seborrheic dermatitis Psoriasis Pilar cysts Pigmented nevi
26
Define Wens
Pilar cysts
27
When/why does hirsutism occur in women?
PCOS
28
Define the Palpebral Conjunctiva | Define the Bulbar Conjunctiva
Lines eyelids | Covers most of anterior eye
29
Define the Visual Field
Entire area seen by an eye when it looks at a central point
30
Define Direct Reaction | Define Consensual Reaction
Light beam shining causes pupil constriction in that eye | Light beam shining causes pupil constriction in opposite eye
31
Which CN controls iris constriction/dilation?
CN3
32
Define Accommodation
Increase in convexity of lens cause by contraction of ciliary muscles changing shape of lens to bring near object into focus
33
How are PTs older than 45y/o tested to see if reading glasses or bifocals are needed?
Near vision tested with hand held card
34
What is the definition for legally blind?
Better eye corrected by glasses is 20/200 or less | Constricted field of vision 20* or less in better eye
35
What area of vision is affected by most defects?
Temporal
36
When/what causes an enlarged blind spot?
Conditions affecting optic nerve Glaucoma Optic neuritis Pailledema
37
What causes inward/outward deviation of eyes when assessing position and alignment?
Graves Disease | Ocular tumor
38
What causes eyebrow scaliness?
Seborrheic dermatitis | Lateral sparseness= hypothyroidism
39
What causes an upstarting palpebral fissure on the tongue?
Down's Syndrome | AKA Scrotal tongue
40
Define Blephritis
Red inflammed lid margins
41
What can cause excessive tearing from increased production? | What can cause excessive tearing from inadequate drainage?
Conjunctival inflammation, corneal irritation | Ectropion, lacrimal duct obstruction
42
Define Aniosocoria
Pupil inequality of less than 0.5mm
43
Testing the eyes for the near reaction is helpful in diagnosing what disorder?
Argyll Robertson/ Tonic(Adies) pupil
44
What is the follow on test if the reaction to light is impaired or questionable?
Near reaction in normal room light
45
What does the cover-uncover test reveal issues of?
Muscle imbalances
46
Define Nystagmus
Fine rhythmic oscillation of the eyes | Few beats w/ later gaze is normal
47
How does lid lag in hyperthyroidism appear?
Rim of sclera is visible above iris with downward gazes | Normal= lid should over lap iris slightly throughout movement
48
Define Proptosis
Abnormal protrusion of eyes in hyperthyroidism
49
Normal convergence can follow the object to as close as what distance?
5 - 8 cm
50
Poor convergence is a sign of ?
Hyperthyroidism
51
What are the contraindications for using mydriatic drops?
Head injury/coma | Suspicion of narrow gaze glaucoma
52
If a PTs lens has been surgically removed from their eye, how does this change the providers view of examining their eye?
Magnifying effect is lost Retinal structures look smaller than usual Larger expanse of fundus is visible
53
What is the function of the diopter
Unit that measures the power of a lens to converge/diverge light
54
Define Hippus
Spasm of the pupil from bright, direct light
55
How is the diopter adjusted for PTs with myopic vision? Hyperopic?
My- counterclockwise, minus | Hyper- clockwise to plus
56
What are 4 characteristics to be noted of the disc during inspection?
Clarity of outline Color Size Comparative symmetry
57
Define Papilledema
Swelling of optic disc and anterior bulge of physiologic cup | Indicates serious issue with brain, meningitis, subarachnoid hemorrhage, trauma, lesion
58
How does light focus to the retina in PTs with hyper/myopia? | Which one will have retinal structures that look larger than normal?
My- anterior focus Hyper- posterior Myopic
59
What does an enlarged cup suggest an issue of?
Chronic open angle glaucoma
60
Define SVP and what they indicate
Spontaneous Venous Pulsations Normal in 75% of PTs Indicates intracranial pressure is probably normal
61
What is the sequence of inspection from the disc to macula?
``` 1- 10 oclock 2- 7 3- 5 4- 1 5- 3 ```
62
Loss of SVPs can indicate what 3 things?
Head trauma Meningitis Mass lesions
63
To inspect the anterior structures of the eye adjust the number on the diopter to ?
10 or 12
64
What is an important cause of poor central vision in the elderly?
Macular degeneration
65
What are the different types of macular degeneration?
Dry atrophic- more severe Wet exudative- neovascular Drusen- undigested cell debris
66
What are the two parts of the external ear?
Auricle | Ear canal
67
What are the two chief landmarks of the malleus when viewing the TM?
Handle | Short process
68
Define the Umbo
Where eardrum meets the tip of the malleus
69
Define the Pars Flaccida | Define Pars Tens
Above the short process of the TM | Rest of the TM not ID's
70
What structures separate the pars flaccida from the pars tensa?
Anterior/posterior malleolar folds, extend obliquely upward from short process
71
Define the Conductive Phase of hearing? | Define the Sensorineural Phase
1st part External ear to middle ear Described by air conduction Cochlea and cochlear nerve
72
What does a painful "Tug Test" indicate?
Acute ottits externa- inflammation of ear canal | Ottits media- inflammation of the middle ear- presents with pain behind the ear
73
Define Exostoses
Nontender nodular swellings covered by normal skin in the ear canal
74
How does the ear canal appear/present in Acute Otitis Externa How does it appear with Chronic Otits Externa
Swollen, narrow, moist, pale/red, tender | Skin is thickened, red, itchy
75
An unusually prominent short process and handle that looks more horizontal suggest what?
Retracted ear drum
76
How is mobility of the eardrum evaluated?
Pneumatic otoscope
77
What size tuning fork is preferred for testing hearing?
512 Hz 1024 Hz Normal human speech falls in 300-3000Hz
78
Define the Weber Test
Test for lateralization of hearing
79
Define the Rinne Test
Compares air conduction with bone conduction (an alternate path that bypasses external and middle ear)
80
What can cause unilateral conductive hearing loss?
Acute otitis media Perforated TM Obstructed ear canal
81
The nasolacrimal duct drains into the ___ meatus | The paranasal sinuses drain into the ____ meatus
Inferior | Middle
82
Which sets of sinuses are accessible for clinical examination?
Frontal | Maxillary
83
Define Alae
Tenderness of the nasal tip | Suggests local infection (furuncle)
84
Viral rhinitis causes the mucosa to be ? color | Allergic rhinitis causes the mucosa to be ? color
``` Viral = Red, swollen Allergic= pale, blueish, red ```
85
Polyps seen in the nasal cavity usually come from which meatus and are associated with?
Middle | Chronic allergic rhinitis
86
When inspecting the sinuses, what combination of S/Sxs suggest acute sinusitis
Local tenderness Pain Fever Nasal discharge
87
Where are Wharton's Ducts located? | Where are the Stenson's Ducts located?
Base of the tongue for the submandibular glands | Opening in buccal mucosa near 2nd molars
88
What do bright red edematous mucosa underneath a denture suggest?
Denture sore mouth | Can present with ulcers or papillary granulation tissue
89
Redness of gingiva = ? | Black line of gingiva = ?
Gingivitis | Lead poisoning
90
Define Torus Palatinus
Benign midline lump on the tongue
91
What are the two most common cancers of the mouth?
1st- lips | 2nd- tongue (1- side, 2-base)
92
How does the soft palate/uvula respond to CN10 paralysis?
Soft palate fails to rise | Uvula deviates to opposite side
93
What are the borders of the Anterior Triangle
Mandible Sternomastoid Midline of neck
94
What are the borders of the Posterior Triangle
Sternomastoid muscle Trapezius Clavicle
95
What vessels pass under and over the sternomastoid muscles?
Carotid and Internal Jugular- deep | External jugular- over
96
What are the 5 midline structures of the neck?
``` Hyoid bone Thyroid cartilage Cricoid cartilage Tracheal rings Thyroid gland ```
97
The deep cervical chain of lymph nodes is largely obscured by the overlying sternomastoid muscle except for what two?
Tonislar node | Supraclavicular node
98
What is a visible clue to an unsuspected thyroid disease?
Scar of past thyroid surgery
99
A tonsilar node the pulsates is actually ?
Carotid artery
100
A hard/tender tonsillar node high and deep between the mandible and sternomastoid is ?
Styloid process
101
What is the sequence for feeling lymph nodes?
``` Preauricular / Posterior auricular Occipital Tonsillar Submandibular Submental Superficial cervical / Posterior cervical Deep cervical Suprclavicular ```
102
Enlarged supraclavicular nodes suggests the possibility of?
Metastasis from thoracic or abdominal malignancy | ESPECIALLY left side node
103
Tender nodes suggest ____ | Hard/fixed nodes suggest ____
Inflammation | Malignancy
104
Diffuse lymphadenopathy raises the suspicion of ?
HIV/AIDS
105
If unsure a mass is a band of muscle or artery from a lymph node, what test can be done?
Roll up and down, side to side | Artery and muscles will not pass the test
106
Thyroid isthmus is usually found covering which tracheal rings?
2-4
107
If a thyroid gland is enlarged, what follow on test can be conducted?
Listen over lateral lobes with stethoscope to detect a bruit (similar to a cardiac murmur) Localized/continuous bruit may be heard in hyperthyroidism
108
How with the thyroid adapt/change in response to different diseases?
Graves Disease- soft Hashimotos- firm Tenderness- thyroiditis
109
What is an exophthalmometer used for?
Measures distance between lateral angle of orbit and line across most anterior of cornea 20mm in whites, 22mm in blacks F/u testing with CT/US
110
Discharge of mucopurulent fluid from the puncta suggests ?
Obstructed nasolacrimal duct
111
Absence of glow on one or both sinuses suggests ?
Thickened mucosa Secretions in frontal sinuses Developmental absence of one/both sinuses
112
What visual sign indicates a normal air-filled maxillary sinus
Bright light shining down from inner aspect of eye Head tilted back, mouth open Reddish glow is normal
113
What does an absence of glow with a bright light- open mouth test mean?
Thickened mucosa | Secretion in maxillary sinus
114
CN_ opens eye lid | CN_ closes it
3 | 7
115
What are the medial and lateral points of the eye called?
Medial/lateral canthus
116
Define Limbus | Why is this landmark important?
Where cornea inserts into the sclera | Peripheral border of iris and determines angle of the eye
117
What are the differences between the palpebral and bulbar conjunctiva
Palpebral- covers posterior lid | Bulbar- covers sclera. single membrane that reflects back onto itself
118
What is normally the only part of the lacrimal system that is visible?
Puncta- medial aspect of eye that drains into lacrimal duct
119
Cornea covers ___ of eye globe and is continuous with the _____
1/6 | Sclera
120
Anterior chamber of the eye is from _____ to _____ and contains______
Cornea Iris Canal of Schlemm
121
Where does acute angle glaucoma occur?
Anterior chamber
122
What separates the anterior and posterior chambers of the eye?
Iris
123
What part of what nervous system opens and closes the eye?
Sympathetic CN3 open | Parasympathetic CN3 close
124
Posterior chamber of the eye is between the _____ and _____ and contains the ____
Iris Lens Ciliary body
125
What eye structure produces aqueous humor?
Ciliary body
126
What shape is the lens?
Biconvex
127
What are the functions of the vitreous body and occupies what space?
Eyeball form Transmits signals to retina Hold retina against choroid Everything posterior to lens
128
The otpic disc is what CN and contains what landmark structure?
CN2 | Contains physiologic blind spot
129
What is the cup in the back of the eye?
Entrance/exit of nerves and vessels
130
The disc in the eye is used as a land mark for what?
Describing size of anything found internally and landmark for describing locations of abnormalities within the eye
131
Where are the rods and cones located within the eye? | How is this area identified?
Macula | No blood vessels
132
What is the function of the fovea?
Center of macula with highest density of cones, responsible for fine vision and highest sensitivity to light
133
What is the "vital signs" of the eye?
Visual acuity
134
What is the function of a Snellen Chart? | A Rosenbaum chart?
Vision | Near vision
135
What does OD OS and OU mean?
Oculus dexter Oculu sinister Oculus uterque
136
What types of eye charts should be used for children between 2-3y/o for acuity?
HOTV Tumbling E Lea Allen
137
What is a gross measure of visual acuity in young, preverbal children?
Ability to visually follow objects in front of them
138
If vision acuity of 20/20 is not achieved, what is the next step?
Pinhole testing to determine if vision is correctable to 20/20
139
When/why is pinhole testing useful?
Primary care setting | Optimizes vision
140
If child achieves a 20/20 on pinhole test, what does this mean?
Refractive error is present | If not, amblyopia is considered
141
What eye criteria means a child should be referred to a ophthalmologist for evaluation?
Visual acuity of 20/40 or worse at 3-5y/o 20/30 or worse at 6y/o or, two line difference in acuity between both eyes
142
What to do if PT can't see the large E on a snellen chart?
Walk PT to chart until visualization is possible, record as 10/400
143
What steps are taken if PT is unable to see large E on snellen chart at 3 ft?
Count fingers Hand motion Light perception
144
What is defined as legal blindness?
>20/200
145
What is the Oval Blind Spot?
Lack of retinal receptors at optic disc causes blind spot at 15* temporal to line of gaze
146
What is a method to take a gross measurement of peripheral vision?
Visual fields by confrontation
147
What are 3 patterns of visual field defects?
Homonymous hemianopsia Bitemporal hemianopsia Quadratic defects
148
How are eye peripherals reported for being equal or unequal?
``` Equal= equal by confrontation Unequal= in lateral field ```
149
What causes Bitemporal Hemianopia
Optic chiasm lesion | Pituitary tumor
150
What causes a horizontal (altidinal) defect? | What other issue can create a similar effect?
Retinal artery occlusion Ischemia of optic nerve
151
What produces unilateral monocular blindness?
Lesion on optic nerve | Lesion on eye itself
152
What causes Bitemporal Hemianopsia
Optic Chiasm lesion (pituitary gland)
153
What causes Left Homonymous Hemianopsia
Right Optic tract lesion
154
What causes Homonymous Left Superior Quadratic Defect? | What can this AKA?
Right Optic Radiation, partial lesion | AKA- pie in the sky defect
155
What causes Left Homonymous Hemianopsi
Right Optic Radiation | Complete interuption of fibers in optic radiation
156
What part of the EOMI test is the finger paused to test for nystagmus? What type of PT may need to have their distance/spacing altered during test?
Upward and lateral Middle age/older
157
How do you test for suspected lid lag/hyperthyroidism?
Follow finger up and down at midline Lid should overlap iris W/ hyperT- Sclera rim is visible above iris w/ down gaze
158
Define Nystagmus | When is it considered normal?
Fine rhythmic oscillation of eyes | Extreme lateral gaze
159
What is the next step if a nystagmus is observed?
Bring finger into filed of binocular vision and try again | Sustained nystagmus= neurological defect
160
New onset dysconjugate gaze in adult life is usually the result of ?
CN injury/lesion MS Syphilis
161
EOMs are tested for what 3 things?
Normal conjugate movement Nystagmus Lid lag
162
CN 6 paralysis will be seen in what ways?
``` Right= conjugate Straight= esotropia Left= no lateral movement of L eye ```
163
CN 4 paralysis will be noted how?
Looking down and to right, L eye can't look down during inward gaze
164
How will CN3 paralysis be noted?
Straight gaze= eye pulled outward | Up/down/in= impaired/lost
165
Other than affected gaze, what othe issues can be demonstrated by paralysis of CN3?
Ptosis | Pupil dilation
166
Normal convergence within how close to the face? | Poor convergence = ?
5-8cm | Hyperthyroidism
167
Define Strabismus | How is it revealed?
Binocular fixation is not present | Cover test/light reflex test
168
Define Amblyopia
Reduced VA not correctable by refractive means
169
Amblyopia can be caused by what 3 things?
Strabismus Uremia Toxins
170
Layman term for strabismus and amblyopia
Stra- cross eyed | Ambly- lazy eye
171
Define Tropia and Phoria
Tropia- misalignment that is always there, detected with cover-uncover test Phoria- only occurs some times, when synchronization of eyes is broken/occluded Break fusion w/ cross-cover test
172
``` Define: Esotropia Exotropia Hypertropia Hypotropia ```
``` In Out Up Down Dominant eye does not correct itself ```
173
If retina reflection is not symmetric during the Hirschberg's test what does the PT have?
Tropia
174
PT complaining of diplopia but has not tropia means what?
No movement with Cover/Uncover test
175
Define Anisocoria
Inequality of pupil size | <0.5mm is visible in 20% of normal PTs
176
Define Direct Reaction | Define Consensual Reaction
Direct- constriction of same eye | Consensual- constriction in opposite eye
177
Normal size of pupils? | How far can you vary in size and still be within a normal variant?
Norm= 4-6mm | +/- 1
178
When evaluating pupils don't let the PT focus on the light in order to avoid ? reaction
Accommodation
179
Define Argyll Robertson Pupils
Bilateral small pupils that constrict w/ focus on near objects but NOT when exposed to bright lights
180
Define Edinger Wesphal Nu
Light near dissociation- dorsal mid-brain selectivity | Sign of neurosyphilis and rarely diabetes
181
What is the near response in Argyll Robertson pupils?
Brisk and Immediate
182
Define Tonic Pupil
Dilated pupil and anisocoria
183
Define Adie's Tonic Pupil
Idiopathic tonic pupil | Minimal/no reaction to light, slow reaction to convergence from damaged parasympathetic innervation to eye
184
Most cases of tonic puil is ?
Idiopathic (Adie's Pupil) Trauma Local: tumor, inflammation, surgery, infection of orbit Systemic neuropathies: DM, Guillain-Barre
185
What extra precaution is taken in PTs +60y/o with acute tonic pupil?
ESR to rule out giant cell arteritis
186
How is a Marcus Gunn pupil detected during exam?
RAPD test
187
What is the most common cause of Marcus Gunn pupil?
Lesion of optic nerve, proximal to optic chiasm Optic Neuritis Retina detachment Central retinal vein/artery occlusion
188
What does a RAPD test on a Marcus Gunn pupil look like?
Unaffected w/ light- normal constriction Affected w/ light- mild constriction of both pupils Light on affected eye causes less pupillary constriction than light on unaffected eye
189
Where would you see Hordeolum or Chalazion lesions?
External Eye/lids
190
What can cause a PT to lose the outer 1/3 of their eye brow?
Thyroid Dz Normal aging Syphilis
191
What are the eye brows inspected for?
Quantity, Distribution- lateral sparseness in hypothyroidism | Scales- seborrheic dermatitis, AKA scurf
192
Eyelids ares inpsected for what 6 things?
``` Position Width Edema/color Lesions Condition/direction Adequacy ```
193
Define Blepharitis
Red inflammed eye
194
Define Sty
Painful red tender infection in gland at lid margin | AKA Hordeolum
195
Define Chalazion
Nontender usually painless nodule of meibomian gland | Differs from stye by pointing inside the lid
196
Define Xanthelasma
Yellow raised plaques filled with cholesterol along nasal portion of eyelids Hyperlipidemia Primary biliary cirrhosis
197
What are the measurements of the palpebral fissure?
10mm vertically | 30mm horizontal
198
What are the causes of stys on the outter or inner lids?
Staph A Inner- obstructed meibomian gland Outter- obstructed eyelash follicle or tear gland
199
Define Dacryocystitis
Swelling of lacrimal swelling Acute- pain, red, tender Chronic- obstructed duct, regurgitation occurs
200
What are two causes of excessive tearing?
Inc production- conjunctival inflammation or corneal irritation Impaired drainage- extropion or duct obstruction
201
When palpating PTs lacrimal ducts, press on the face between what two structures?
Close to medial canthus | Inside rim of bony orbit
202
Discharge from lacrimal gland suggests ?
Obstructed nasolacrimal duct
203
Define Conjunctiva/Sclera injection
Dilatation of conjunctival vessels Two types: Diffuse- conjunctivitis Local- episcleritis
204
Define Hyposphagma | Can be harmless but also associated w/ ?
Bleeding under conjunctiva and between conjunctiva/sclera HTN/Trauma
205
What are four traumatic causes of hyposphagma
Choking Coughing Straining Vomiting
206
Define Pinguecula
Collection of fat that is medial/lateral to iris but does not extend onto cornea Starts on nasal
207
Define Pterygium
Triangular thickening of bulbuar conjunctiva that slowly grows across outer surface of cornea usually from nasal side (may interfere with vision)
208
Define Chemosis
Edema of conjunctiva | Nonspecific sign of eye irritation
209
What are three causes of chemosis?
Allergies Viral infections Aggressive eye rubbing
210
What is the triad of blue/cyanotic sclera?
Fragile bones Blue sclera Early deafness
211
Define Corneal Arucs
Thing gray arc/circle near edge of cornea, comes with normal aging
212
Define Nuclear Cataract
Looks gray when seen by a flashlight | If dilated, the gray opacity surrounded by black rim
213
Define Peripheral Cataract
Produces spokelike shadows that point—gray against black, as seen with a flashlight, or black against red with an ophthalmoscope
214
Define Hyphema
Blood in anterior chamber of eye from severe trauma
215
Define Narrow Angle Glaucoma and how it appears on exam
Iris bows forward forming narrow angle with cornea and creating crescent shadow
216
Define Open-Angle Glaucoma and how it appears on exam
Normal spatial relation between iris and cornea
217
What are the S/Sx of Acute Iritis
Eye pain Photophobia Blurry vision Redness
218
What is used to dilate pupils for better viewing of structures in the back of the eye?
Mydriatic agent- Tropicamide
219
What part of the optic disc margin is often slightly blurry?
Nasal portion
220
Pale color or white/pigemented crescents on optic disc mean ?
Pale- not well perfused, atrophy | While/crescent- normal
221
What cup to disc ratio is indicative of glaucoma?
> 0.6 - 0.7 | Norm= 0.4-0.5
222
What is suspected if the eye disc is red?
Papilledema
223
How does optic disc atrophy present? | What conditions can cause this?
White, tiny disc vessels are absent | Optic neuritis, MS, temporal arteritis
224
Define Papilledema
Swelling of optic disc w/ bulge in physiologic cup Blurred margins Cupt not visible
225
What can cause Papilledema
``` Increased ICP Meningitis Subarachnoid hemorrhage Tramua Mass lesion ```
226
How do retinal vessels look?
Dark red, larger, inconspicuous/absent
227
Define AV nicking | When is it commonly seen?
Arteriole crosses venule causing impaction of vein w/ bulging Most commonly seen in HTN retinopathy
228
How are lesions in the fovea/macula measured?
Disc diameters from optic disc
229
Tiny bright reflection at the center of a fovea can help with orientation except w/ ? PT?
Older
230
Shimmering light refleciton in macular area is common in ? PT?
Younger
231
What can cause retinal lesions?
``` HTN Retinal vein occlusion DM Shaking Severe blows to back of head ```
232
Define "Cotton-Wool" Spots and what causes them
White/yellow/gray lesions with irregular soft borders Infarcted nerves on retina surface Most common cause- HTN, DM
233
Define Hard Exudates
White/yellow lesions with well defined borders Accumulation of lipids/protein, show inc permeability and risk of retinal edema. Occurrence in macula=blindness. Occur in circle/linear or star shaped, caused by HTN, DM
234
Define Drusen Bodies
Yellow pigmentations located over macula | Asymptomatic/non-pathogenic
235
What type of vision is lost with macular degeneration?
Loss of central, peripheral is preserved
236
Define the use of a Amsler Grid
Graph/grid sheet showing loss of vision from macular degeneration
237
Defines neovascularization and what does it represent?
Prliferative retinopathy | New vessels of poor quality and leak/rupture causing blindness
238
Routine eye exams are performed on what three types of PTs?
Diabetes HTN Systemic Dz F/u
239
What are routine eye complaints that need to be evaluated?
Blurry vision Eye drainage Lid swelling
240
Eye exams are needed for what three types/scenarios of urgent eye complaints?
Trauma Periorbital cellulitis Blindness
241
What is the primary function of CN 1
Smell
242
What is the primary function of CN 2
Acuity Fields Ocular Fundi
243
What is the primary function of CN 3
Pupil constriction Open eye lid Most extraocular movement
244
What is the primary function of CN 4
Down, internal eye rotation
245
What is the primary function of CN 5
Motor- temporal/masseter muscles, lateral jaw movement | Sensory- facial dermatome, corneal reflex
246
What is the primary function of CN 6
Lateral deviation of eye
247
What is the primary function of CN 7
Motor- facial expression, closing eye/mouth | Sensory- taste anterior 2/3 of tongue
248
What is the primary function of CN 8
Hearing | Balance
249
What is the primary function of CN 9
Motor- pharynx | Sensory- posterior ear drum/canal, pharynx, posterior 1/3 tongue
250
What is the primary function of CN 10
Motor- palate, pharynx, larynx | Sensory- pharynx and larynx
251
What is the primary function of CN 11
Sternomastoid and trapezius muscles
252
What is the primary function of CN 12
Tongue
253
What is the common site for epistaxis to occur?
Kiesselbach plexus- superficially located on anterior superior septum
254
How is the nasal vestibule different than the rest of the nasal cavity?
Unlike rest of cavity, vestibule is lined with hair-bearing skin and not mucosa
255
Define Philtrum
Area/groove below nose and in between vermilion border
256
What is the sequence of connections from the labial frenulum to the lip?
Frenulum Gingiva Alveolar mucose Labial mucosa
257
Where do nerves/vessels enter a tooth?
Apex, pass into pulp canal and chamber
258
Tonsils lie in between what two oral structures?
Protrude from tonsillar fossa | Between anterior/posterior pillars
259
What is the medical term for dandrug?
Suborrheic dermatitis
260
What can cause mastoiditis
Complications of middle ear infections
261
What directions is the ear pulled to view the ear canal?
Up Back Away
262
What two issues can decrease TM mobility?
Fluid in middle ear | Thickened TM
263
What is a general screening for gross estimation of hearing?
Auditory acuity
264
Weber or Rinie, what is more accurate for PTs with hearing loss?
Weber
265
What are the differences between Conductive Hearing Loss and Sensoneural Hearing Loss?
CHL- weber to impaired ear, BC>AC SNHL- weber lateralizes to good ear, AC>BC
266
What structures should be viewed during the nasal exam?
Inferior/middle turbinate Septum Passages in between
267
What are the S/Sx of Acute Bacterial Rhonosinusitis? | What structures are affected?
``` Tenderness Facial pain Discharge Nasal obstruction Smell disorders All greater than 7 days ``` Frontal or Maxillary sinuses
268
AHHHH uses ? CN Gag refex uses ? CN Tongue protrusion
10 9 and 10 12
269
What are the criteria for tonsils occupancy?
``` 0- entirely in fossa 1- less than 25% 2- less than 50% 3- less than 75% 4- more than 75% ```
270
Tongue cancer is most common in ? PT population?
+50y/o Smoker Alcohol consumers
271
Define Shotty
Normal nodes- small, mobile, discrete, nontender
272
Causes of Diffuse Thyroid enlargement
Isthmus and lobe involvement | Graves, Hashimoto, Thyroiditis, goiter
273
Causes of single thyroid nodules
Cyst Benign tumor Malignancy
274
Multinodular goiter is indicative of ?
Enlarged w/ two or more nodules means metabolic issue
275
Define Keloid
Firm hypertrophic mass of scar tissue
276
Define Chondrodermatitis Helicis
Chronic inflammation lesion starts as painful on helix/antihelix, ulcerates, crusts
277
Define Tophi
Uric acid crystal on anti/helix from Chronic Tophaceous gout
278
Define BCC/SCC Carinomas
Raised nodule w/ irregular border
279
What PT population is more likely to present with BCC/SCC carcinoma?
BCC- Fair skin overexposed to sunlight
280
What grows slower, BCC or SCC?
BCC
281
Define Angular Cheilitis
Softening/fissure of corner of mouth | Nutrition deficiency or over closure of mouth (no teeth) or ill fitting dentures
282
What is a secondary infection of Angular Cheilitis?
Candida
283
Define Actinic Cheilitis
Precancerous condition from over exposure to sun, especially on lower lip Fair skin, men, outdoor worker
284
How does Actinic Cheilitis look
Loss of color Scaly Thick and everted
285
Solar damage causes damage to lips and make them prone to what type of cancer?
Squamous cell carnicnoma
286
Define Peutz-Jeghers Syndrome
Small brown spots on dermal layer of lips/buccal and hands/feet
287
What kind of disease is Peutz-jeghers Syndrome? | What issue accompanies this disease?
Autosomal dominant | Intestinal polyps
288
How does carcinomas of the lip appear?
Scaly plaque Ulcerated W or w/out crust or, Nodular lesion
289
What does pharyngitis look like?
Intense redness w/out exudate
290
Define Fordyce Spots
Normal sebaceous glands that appear as yellow spots in buccal mucosa
291
How does Oral Candidiasis appear?
Thrush | Thick white plaques on mucosa from prolong ABX, corticosteroid use or AIDS
292
How does Leukoplakia appear?
Thickened white patch on oral mucosa that CAN'T be scarped off from chewing tobacco and leads to cancer Hairy is seen in HIV/AIDS
293
How do exudative tonsilitis look?
Red w/ white exudate Fever Enlarged cervical nodes Ifection from GABHS or Mono
294
What causes Hairy Tongue
Elongated papillae | ABX therapy or unknown
295
When does fissure tongue tend to appear?
Increased age | Down's Syndrome
296
Define Atrophic Glossitis
Smooth tongue and sore from lost papillae from nutritional deficiency or Chemo treatment
297
What will CN10 paralysis look like? | What will CN12 paralysis look like?
Uvula and Soft palate don't rise, uvula points away from side w/ lesion Tongue points to side w/ lesion
298
What is the triad of Horner's Syndrome and when is compared?
Ptosis Meiosis Anhidrosis
299
Tonic Pupil/Adies Pupil
``` Unilateral large pupil Reduced/slowed light reaction Near reaction slow but present Slow accomodation DTRs decreased ```
300
CN 3 paralysis presentation
Dilated pupil is fixed to light and near vision Ptosis of upper lid Lateral deviation of eye
301
Argyll Robertson pupils
Small irregular pupil that accomodate but DON"T react to light CNS syphilis
302
Equal pupils and one blind eye
Unilateral blindness does not cause anisocoria as long as SNS and PNS are intact Blind eye does not respond to light
303
Koplick spots
Salt specks on dark background appearing near 2nd molars
304
What nerve combinations control pupillary reactions?
2 and 3
305
What nerve combinations control extraocular movements
3 4 6
306
What nerve combinations control swallowing and rise of soft palate?
9 10
307
What nerve combinations control voice and speech
5 7 10 12
308
Why are obnoxious odors like ammonia avoided when testing CN 1?
Triggers CN5
309
What circumstances is the sense of smell lost?
``` Head trauma Smoking Aging Cocaine Parkinsons ```
310
Define Prechiasmal defect of the eye and what are 3 examples
Anterior defect Glaucoma Retinal emboli Optic neuritits
311
Homoonymous hemianopsias or quadrantanopsia usually occure in what area of the brain? How do they present?
Parietal | Associated findings of stroke but VA is normal
312
Define Ophthalmoplegia
Eyes not aligned | Eyes constrict but don't dilate
313
How are nystagmus' named?
In direction of quick component
314
Isolated facial sensory loss occurs in peripheral nerve disorders like? How is this finding confirmed?
Trigeminal neuralgia | Test tubes with different temp liquids
315
Absent blinking can occur from lesions on ? CNs?
5 or 7
316
Absent blinking and sensorineural hearing occurs in ?
Acoustic neuroma
317
Bell's Palsy affects ? CN?
7
318
Where is presbyocusis seen?
Aging hearing loos | Sensorineural type
319
Hoarse voice = ? CN | Nasal voice = ? CN
Vocal cord paralysis | Palate paralysis
320
When assessing CN 11, what is looked for on the trap muscles?
Fssciculations- small flickering groups of muscles | PNS disorder
321
Define dysarthria
Poor articulation of mouth
322
Tongue atrophy and fasciculations are seen in ? Dzs
Amyotrophic Lateral sclerosis | Polio
323
What Dzs can cause ptosis?
Myasthenia gravis CN 3 damage SNS damage (Horners)
324
Define Entropion | Define Ectropion
Lids turn in | Lids turn out
325
Bilateral exophthalmosis is indicative of ? | Unilateral is caused by ?
Graves hyperthyroidism | Graves Dz, tumor, inflammation
326
Corneal arcus in young PTs suggests ?
Hyperlipoproteinemia
327
Anisocoria in bright light = | In dim light =
Larger pupil can't constrict Trauma, open glaucoma, PNS damage Small pupil can't dilate Horners, SNS damage
328
How is hereditary Horner's Syndrome visually ID'd?
Heterchromia- one iris is lighter
329
Define Glaucomatous Cupping
Bacward depression of cup and atrophy w/ pale base
330
How do superficial retinal hemorrhages appear? | How do deep ones appear?
Flame shaped- HTN, papilledema, occlusion | Small/round dots from DM
331
An occassional superficial hemorrhage is ID'd how?
White center of fibrin
332
Define Preretinal Hemorrhage
Blood escapes from retina and vitreous from sudden ICP | Upright PT allows blood to settle in demarcation line
333
Copper wiring appearance of arterioles in the eye is indicative of ?
HTN retinopathy
334
Define Bullous Myringitis
Viral infection | Earache, blood color discharge, conductive hearing loss
335
Define Hereditary Hemorrhagic Telangiectasia
Dilated capillaries on face and hands, red in color
336
How does exudative tonsillitis present?
White exudate Fever Enlarged cervical nodes
337
How does diphtheria present?
Dull red | Gray exudate on uvula, pharynx, tongue
338
What is Kaposi Sarcoma common in?
AIDS | Deep purple color
339
What conditions cause Gingival Hyperplasia?
Dilantin therapy Puberty Pregnancy Leukemia
340
How does attrition of teeth look?
Long tooth appearance due to gum recession
341
When is teeth erosion commonly seen?
Bulemia
342
What causes teeth abrasions with notching?
Biting nails or bobby pins
343
Hutchinson's teeth is a sign of what congenital disease?
Syphilis
344
Define Tori Mandibulraes
Bony growths on inner mandible | Asymptomaic and harmless
345
Define erythroplakia
Reddened area of mucosa suggesting malignancy

IPAP (212 decks)

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