Unit 3 HEENT, neuro system Flashcards
Children reach 20/20 by age
- If not at least 20/30 by 6, refer to ophthalmologist
Snellen test
Measures central distance vision. have the patient stand 20 feet from the chart, cover one eye, and read the chart, starting with the largest letters and working down to the smallest they can clearly see, repeating for the other eye. Visual acuity is record as a fraction, 20/20, 20/40. Top number is distance the patient is from the chair. Bottom number is distance at which a person with normal vision can read the same line. 20/20 means patient can see at 20 feet what a person with normal vision can see at 20 feet.
colorblindness
Ishihara chart, a color vision test used to detect red-green color blindness
Testing vision in illiterate person
Tumbling E chart. Uses only E’s in various rotated forms of the E. Patient covers one eye, indicates direction of the E (up, down, left, right) by pointing or gesturing. Visual acuity is based on the smallest line of Es they can identify
most common eye pathologies
cataracts, glaucoma, age-related macular degeneration (AMD), hypertensive and diabetic retinopathy, dry eye, conjunctivitis, floaters, retinal detachment
ICP associated conditions
Swollen optic disc with blurred edges- papilledema, brain tumors, bleeding in the brain, hydrocephalus, infections, head injuries, abscess, pseudotumor cerebri
eye conditions that are medical emergencies
herpes keratitis-acute eye pain, photophobia, tearing, blurred vision. Refer to ED.
acute angle-closure glaucoma-acute eye pain accompanied by headache, n/v, halos around lights, decreased vision. Exam reveals mid-dilated pupil that is oval-shaped, cloudy cornea, cupping of optic nerve. Refer to ED.
Orbital cellulitis-acute onset of erythematous swollen eyelid with proptosis (eyeball bulging) and eye pain on affected eye. Unable to perform full ROM with pain on eye movement. Look for hx of recent URI or sinusitis, Refer to ED.
Retinal detachment-sudden onset of shower of floaters, ‘looking thru a curtain’, sudden flashes of light, refer to ED
degenerative changes of aging in eyes
presbyopia, decreased ability of eye to accommodate stiffening of lenses, usually starts at 40, near vision is affected with decreased ability to read small print at close range
cataracts
glaucoma
age-related macular degeneration
dry eye
hyperopia and myopia
hyperopia is farsightedness
Myopia is nearsightedness (l M N o p)
autoimmune disorders that cause eye problems
Sjogren’s Syndrome-decreased function of lacrimal and salivary glands-persistent dry eyes and dry mouth longer than 3 months, c/o gritty or sandy eyes, increase in dental caries, exam shows swollen and inflamed salivary glands
Graves disease-thyroid eye disease
lupus
MS
Uveitis-inflammation of uveal tract, middle layer of eye
different kinds of hearing loss
conductive-outer and middle ear, obstruction of sound waves
Sensorineural hearing loss-inner ear, damage or aging of cochlea/vestibule, or to nerve pathways, ototoxic drugs, stroke
descriptions of eye findings pinguecula
harmless, yellowish, raised growth on eyeball, chronic sun exposure
pterygium
surfers eye, yellow, triangular thickening of conjunctiva extending across cornea on nasal side, chronic sun exposure
Weber and Rinne test
Weber - place tuning fork midline on forehead, normal finding is no lateralization. If lateralization (hearing sound in only one ear)
abnormal finding
Rinne - place tuning fork first on mastoid process, then at front of each ear. Time each area. Normal finding is AC (air conduction ) lasts longer than BC (bone conduction) so can hear longer in front of ear than on mastoid bone
chalazion
small, painless bump on eyelid formed when meibomian (oil) glad becomes blocked
post nasal drip
when mucus from nasal passages drips down back of throat. Causes are allergies, irritants, acid reflux, structural problems with nasal passages, medications, viral infections, sinus infections, hay fever. Sore throat, cough, throat clearing, bad breath, hoarseness
allergic rhinitis
inflammatory changes of throat due to allergy, increases risk of sinusitis. Nose has blue-tinged or pale boggy nasal turbinates, clear mucus, posterior pharynx can show cobblestoning, has thick mucus, with colors ranging from white, clear, yellow, or green. Circles under eye
rhinitis medicamentosa
prolonged use of topical nasal decongestants causes rebound effects that result in severe and chronic nasal congestion. Daily severe nasal congestion and nasal discharge
anatomical structures of mouth and throat
pink to dark pink moist mucous membranes. Three salivary glands, parotid, submandibular, sublingual.
Tonsils-made of lymphoid tissue (specialized tissue with various cells for immunity, including lymphocytes, front line defense), butterfly shaped glands.
Posterior pharynx - collection of lymphoid tissue spread over the surface of back and sides of throat
tongue
mouth and throat structures
congenital abnormalities of hard and soft palate
cleft palate-roof of mouth doesnt fully close during fetal development, leaves an opening that extends into nasal cavity
cleft lip and palate-both lip and palate are not fused
submucous cleft palate-muscles of soft palate don’t fully fuse
cheilosis
inflammation, dryness of lips, cracks, fissues, scaling.
caused by vitamin deficiencies-riboflavin and iron
sun exposure
dry mouth
lip licking
infections
allergic reactions
oversalivation
poorly fitting dentures
lupus
autoimmune disease
treat underlying cause
criteria to dx strep throat
throat culture for strep A, fever, tonsillar exudate, anterior cervical lymphadenopathy, absence of cough, pain in throat that develops quickly and lasts thru the day, swallowing may be uncomfortable, headache
manifestations of peritonsillar abscess
caused by infection in tissue around tonsils, sometimes strep A, other bacteria, or complication on tonsillitis, can form an abscess
legal blindness is
best corrected vision of 20/200
