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I. Ocular Technique > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What does the first order neuron in the afferent pupillary light pathway connect?

A

connects retina to the pre-tectal nucleus in midbrain at the level of superior colliculus

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2
Q

What does the second order neuron in the afferent pupillary light pathway connect?

A

connects both pretectal to the Edinger-Westphal nuclei

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3
Q

What does the third order neuron in the afferent pupillary light pathway connect?

A

connects Edinger-Westphal nucleus to the ciliary ganglion

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4
Q

What does the fourth order neuron in the afferent pupillary light pathway connect?

A

connects ciliary ganglion to sphincter muscle of the pupil by way of short ciliary nerves

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5
Q

What should pupil sizes be around in mm in bright light? 1. Dim light? 2

A
  1. 3-6mm

2. 4-8mm

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6
Q

Is anisocoria an efferent or afferent problem?

A

efferent

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7
Q

How can you tell the difference between a physiological anisocoria and a pathological anisocoria?

A

pathological is different in bright and dim light

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8
Q

If there is no pupil constriction of either pupil when light is presented to the affected eye what pupillary defect is that?

A

absolute afferent pupillary defect

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9
Q

What are the four things that are included when documenting pupillary light responses?

A
  1. direct and consensual responses
  2. pupil shape
  3. pupil size
  4. if APD present
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10
Q

What is the purpose of the red cap desaturation test?

A

diagnosis of optic nerve disease

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11
Q

Is the red cap desaturation test done before or after pupil testing and why?

A

before to prevent bleaching out

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12
Q

When doing EOM testing with binocular conditions are versions or ductions being tested?

A

versions

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13
Q

When is an overaction of EOMs typically seen? 1. Why is this the case? 2

A
  1. patient fixating with paretic eye

2. Herings law of equal innervation

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14
Q

If an underaction of EOMs is similar in both versions and ductions what is the likely etiology? 1. Not equal? 2

A
  1. mechanical in nature

2. paresis in nature

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15
Q

What is pain on eye movements while testing EOMs suggestive of?

A

optic nerve inflammation

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16
Q

What is diplopia on eye movements while testing EOMs suggestive of?

A

overaction or underaction

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17
Q

What is differing in palpebral aperture size on eye movements while testing EOMs suggestive of?

A

Duane’s syndrome

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18
Q

What is the acronym for recording normal versions?

A

Smooth
Accurate
Full
Extensive

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19
Q

What is the inner most layer of tears? 1. What produces it? 2

A
  1. mucin layer

2. goblet cells

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20
Q

What is the middle layer of tears? 1. What produces it? 2

A
  1. aqueous layer

2. lacrimal gland and accessory glands of Kraus and Wolfring

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21
Q

What is the outer most layer of tears? 1. What produces it? 2

A
  1. lipid layer

2. meibomian glands

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22
Q

What are the standards for tear meniscus evaluation:

  1. normal value
  2. beam height and width
  3. tower position
  4. light conditions
  5. magnification
A
  1. 0.3mm
  2. 1mm tall and wide beam
  3. 60 deg
  4. medium intensity, filter out
  5. 10-16X
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23
Q

What are the two ways to measure the tear break up time?

A
  1. fluorescein

2. keratometer (tear thinning time)

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24
Q

What are the standards for tear break up time evaluation:

  1. normal value
  2. beam height and width
  3. tower position
  4. light conditions
  5. magnification
A
  1. > 10 seconds
  2. large parallel piped
  3. click stop
  4. cobalt blue filter
  5. 10x
25
Q

What are the advantages of tear thinning time (keratometry)? 1. Disadvantages? 2

A
  1. fluorescein not used so tear film not altered

2. only central 70-80% cornea evaluated

26
Q

What is one thing that Lissamine Green tests that Rose Bengal does not?

A

lid wiper epitheliopathy

27
Q

What are the two ways to test how well the lacrimal gland is functioning?

A
  1. phenol red thread

2. schirmer strips

28
Q

How long is the phenol red thread test? 1. What is a normal value? 2. Abnormal? 3

A
  1. 15 seconds
  2. 15mm
    3.
29
Q

What type of tearing is measured in Schirmer 1 testing? 1. How long is the test? 2. What is a normal value? 3. Abnormal? 4

A
  1. basal and reflex tearing
  2. 5 minutes
  3. 10mm
    4.
30
Q

What is done differently if just basal secretion is wanting to be measured for the Schirmer test?

A

anesthetic is added prior

31
Q

What type of tearing is measured in Schirmer 2 testing? 1. How long is the test? 2. What is a normal value? 3. What is done prior to the test? 4

A
  1. reflex tearing
  2. 2 minutes
  3. 15mm
  4. nasal mucosa irritated
32
Q

What are the purposes of conformation visual field testing?

A
  1. screen visual field defects

2. good for large or deep visual field defects

33
Q

What is noted while recording if the visual field is normal for conformation testing?

A

full to finger counting (FTFC)

34
Q

What is the range of testing for an Amsler grid?

A

10 deg on each side of fixation

35
Q

What are the standards for lens evaluation:

  1. magnification
  2. beam height and width
  3. tower position
  4. light conditions
A
  1. 16x
  2. parallel piped and optic section
  3. 45-60 deg
  4. low to medium intensity, filter out
36
Q

What are the standards for lens retroillumination evaluation:

  1. magnification
  2. beam height and width
  3. tower position
  4. light conditions
A
  1. 10x
  2. 5mm tall and 3mm wide
  3. click stop
  4. low to medium intensity, filter out
37
Q

What is the estimated VA for each of the following nuclear cataract grades? 1-4

A
  1. 20/40
  2. 20/80
  3. 20/200
  4. 20/400
38
Q

What percentage of intrapupillary space does each of the grades 1-4 for cortical cataracts obscure?

A
  1. 10%
  2. 10-50%
  3. 50-90%
  4. 90%
39
Q

What percentage of intrapupillary space does each of the grades 1-4 for posterior subcapsular cataracts obscure?

A
  1. 3%
  2. 30%
  3. 50%
  4. > 50%
40
Q

What is the vitreous tightly adhered to?

A
  1. optic nerve
  2. macula
  3. ora serrata
41
Q

What are the standards for anterior vitreous evaluation:

  1. magnification
  2. beam height and width
  3. tower position
  4. light conditions
A
  1. 16x
  2. 2-3mm wide, maximum height
  3. 45-60 deg
  4. medium illumination, filter out
42
Q

What are the standards for posterior vitreous evaluation:

  1. magnification
  2. beam height and width
  3. tower position
  4. light conditions
A
  1. 10x
  2. 5mm tall by 3mm wide
  3. click stop
  4. low to medium illumination, filter in
43
Q

What do white blood cells in the vitreous indicate? 1. What are these commonly seen with? 2

A
  1. inflammation

2. pars planitis

44
Q

What do red blood cells in the vitreous indicate? 1. How do you confirm the type of cells? 2

A
  1. retinal vessel damage

2. disappear with red free filter

45
Q

What do red blood cells in the vitreous indicate? 1. How do you confirm the type of cells? 2

A
  1. retinal tear or detachment

2. will not disappear with red free filter

46
Q

What is a result of vitreous fibrils clumping together?

A

vitreous floaters

47
Q

What is a remnant of the hyaloid artery?

A

Mittendorf dot

48
Q

What causes a posterior vitreous detachment?

A

liquefaction and syneresis of vitreous

49
Q

What are the standards for fundoscopy evaluation:

  1. magnification
  2. beam height and width
  3. tower position
  4. light conditions
A
  1. 10x
  2. 1 DD wide, 3 DD tall
  3. click stop
  4. low illumination, filter in
50
Q

What are the things to evaluate while doing a retinal exam?

A
  1. optic nerve
  2. macula
  3. retinal vasculature
51
Q

What is the area between the cup and the edge of the optic nerve?

A

neuroretinal rim

52
Q

What is it called when the optic nerve is more white than it should be?

53
Q

Are arteries or veins brighter?

54
Q

What is caused by the reflection from the interface between the blood column and the vessel wall?

A

arterial light reflex

55
Q

What is a normal retinal artery to vein ratio?

A

2/3 to 3/4

56
Q

When do artery/vein crossings change?

A

arteriolosclerosis

57
Q

When is retinal vasculature tortuosity present?

A
  1. hypertension
  2. AV malformations
  3. retinal hypoxia
  4. congenital
58
Q

What is the cilioretinal blood vessel derived from? 1. When is it important? 2

A
  1. short posterior ciliary blood vessel or choriocapillaris

2. central retinal artery occlusions

59
Q

What are rhythmic variations in the retinal vein caliber as it crosses the optic disc? 1. When is it absent? 2

A
  1. spontaneous venous pulsation

2. cerebral spinal fluid pressure above 190 mmH2O

I. Ocular Technique (2 decks)

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