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PD Block I > The Ophthalmologic Exam > Flashcards

The Ophthalmologic Exam Flashcards

1
Q

myopia

A

nearsightedness

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2
Q

hyperopia

A

farsightedness

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3
Q

describe the directionality of the macula and optic disk

A

macula is temporal (lateral), optic disk is nasal (medial)

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4
Q

how do you test peripheral vision?

A

confrontation test (finger wiggle test)

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5
Q

what is the cutoff for legal blindness?

A

20/200

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6
Q

what is complete blindness?

A

NLP, no light perception

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7
Q

emmetropia

A

normal vision

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8
Q

why does presbyopia occur?

A

lens becomes less fluid muscles of lens become rigid.

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9
Q

where is an image focused if a pt. has hyperopia?

A

behind the retina

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10
Q

where is an image focused if a pt. has myopia?

A

in front of the retina

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11
Q

KNOW ANATOMY OF THE EYE!

A

slide 12 of ophthalmologic exam lecture

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12
Q

what is the diopter on the ophthalmoscope?

A

illuminating lens indicator shows varying power (diopter) of magnification.

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13
Q

what color lens numbers on ophthalmoscope should you use if you have myopia? hyperopia?

A

myopia: red
hyperopia: green/black

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14
Q

why would you use the slit aperture setting?

A

exam of anterior eye; determine elevation of lesions

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15
Q

why would you use the cobalt blue filter?

A

used w/ fluoroscein dye to view small lesions

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16
Q

what is the purpose of the snellen eye chart?

A

to assess distance vision

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17
Q

explain the test for peripheral vision

A

confrontation (finger wiggle test) test eyes separately

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18
Q

limbus

A

area around iris

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19
Q

bulbar conjunctiva

A

conjunctiva that covers the eye and lies deep to the eyelid

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20
Q

tarsal plate

A

area that lies next to conjunctiva under the eyelid

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21
Q

meibomian gland

A

sebaceous gland at rim of eyelid inside the tarsal plate

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22
Q

what test to you use to evaluate anterior chamber depth?

A

penlight from the side, don’t need to cover other eye, looking for shadow over the iris

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23
Q

discuss the process of examining the adnexa of the eye

A

use both ambient and pen light to inspect

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24
Q

what structures do you palpate during the physical exam of the eye?

A

lacrimal gland, orbit

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25
Q

how do you assess pupillary reaction?

A

place you hand between the patient’s eyes, bring your light into the field of vision and watch response in direct eye, do the same and look for the same response in indirect eye. repeat with opposite eyes. dark room

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26
Q

how do you test accommodation?

A

pupil reaction to looking at far objects vs. near objects. look at door, look at penlight.

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27
Q

name the muscles of the eye (from 12 oclock to 12 oclock clockwise)

A

inferior oblique, medial rectus, superior oblique, inferior rectus, lateral rectus, superior rectus. (all the RECTUS ones make sense, the OBLIQUES don’t)

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28
Q

which ocular muscles are controlled by which CNs?

A

lateral rectus (CN6), superior oblique (CN4), all the rest CN3

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29
Q

during EOMS what are you looking for?

A

conjugate gaze
nystagmus
lid lag

30
Q

esotropia

A

most common type in children, inward crossed eyes

31
Q

exotropia

A

AKA wall eye, outward turned eyes

32
Q

hypertropia

A

vertical misalignment up

33
Q

hypotropia

A

vertical misalignment down

34
Q

what is the corneal light reflex test used for?

A

to test for strabismus

35
Q

pseudostrabismus

A

seen in patient’s with large epicanthal folds (common in asian backgrounds, also seen in pt’s with down syndrome)

36
Q

red reflex

A

seen light reflecting off retina

37
Q

what does a cup ratio of 0.3 mean?

A

cup is 1/3 diameter of optic disk

38
Q

what is the average AV ratio?

39
Q

what is the AV ratio?

A

ratio of arteries to veins when viewing the retina via ophthalmoscope

40
Q

uvea

A

iris, ciliary body, choroids

41
Q

iris

A

circular, muscle, containing pigment

42
Q

choroid body

A

pigmented, richly vascular layer, oxygenates the outer layer of retina

43
Q

visual impairment/loss

A

vision that cannot be corrected

44
Q

proptosis

A

AKA exophthalmos, protrusion of the eyeball, associated with Graves disease

45
Q

exopthalmos

A

AKA proptosis, protrusion of the eyball, associated with Graves disease

46
Q

ptosis

A

drooping eyelids

47
Q

nystagmus

A

involuntary eye movement, or twitching

48
Q

strabismus

A

eye misalignment, can be continuous or temporary

49
Q

dipopia

A

double vision, simultaneous perception of two images of a single object

50
Q

astigmatism

A

blurred vision due to irregular corneal shape or curve of lense

51
Q

mydriasis

A

dilation of the pupil usually caused by disease, drugs, or trauma

52
Q

miosis

A

constriction of pupil

53
Q

anisocordia

A

pupils of different diameter

54
Q

list possible eye exam findings in someone with thyroid diease

A
  1. exopthalmos
  2. band keratopathy (hyperparathyroidism)
  3. cataracts (hyperparathyroidism)
55
Q

list possible eye exam findings in someone with diabetes

A
  1. snowflake cataract
  2. cotton wool spots
  3. blurred vision, distortion or visual acuity loss
  4. microaneurysms on ophthalmoscopic exam (dilated vessels)
  5. yellow patches of hard exudates
  6. bleeding from vessels of retina
  7. vessels grow out of retina toward vitreous humor
56
Q

cotton wool spots

A

soft exudates caused by infarction of the nerve layer, often seen in patients with diabetes on ophthalmoscopic exam (appear yellow on retina)

57
Q

band keratopathy

A

deposition of calcium in the superficial cornea, seen in patients with hyperparathyroidsm, hypercalcemia, trauma, renal failure, syphilis, sarcoidosis

58
Q

list possible eye exam findings in someone with hypertension

A
  1. as hypertension progresses, arteries become narrower (smooth muscle contraction, hyperplasia, or fibrosis), thickening of arteriole coat occurs, creating AV nicking
  2. hemorrhage (in moderate cases)
  3. cotton wool spots (in moderate cases)
  4. optic disk edema (in malignant cases)
59
Q

AV nicking

A

arterioles and venules in the eye crossing, associated with hypertension

60
Q

which is brighter on ophthalmoscope exam arterioles or venules?

A

arterioles

61
Q

which are smaller arterioles or venules?

A

arterioles

62
Q

list possible eye exam findings in someone with hypercholesterolemia

A

fundus appears white, reverse as serum triglycerides return to normal

63
Q

what should you palpate for on the temples? what might be a medical emergency?

A

inflamed temporal artery, medical emergency, giant cell arteritis

64
Q

what sinuses are above the eyebrows?

65
Q

what sinuses are deep to the cheeks?

66
Q

which are the small sinuses in between the eyeballs?

67
Q

which are the deep sinuses that are on either side of the face?

68
Q

where are the glands on the inside of you cheeks? think of lemons

A

parotid glands

69
Q

what ducts empty near the second molar? what gland does it drain?

A

stenson duct, parotid gland

70
Q

what duct empties the submandibular glands?

A

wharton duct

71
Q

name the top teeth from anterior to posterior

A

central incisor, lateral incision, canine, pre-molar 1, molar 2, molar to the wisdom teeth

72
Q

how many teeth do you have if you have wisdom teeth? if you do not have wisdom teeth?

PD Block I (6 decks)

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