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PA: Exam 1 > 3. SESSION 3.1: Head and Eyes > Flashcards

3. SESSION 3.1: Head and Eyes Flashcards

1
Q

Four skull bones we are supposed to know:

A
  • Frontal bone (front)
  • Parietal bone (back, side)
  • Temporal bone (under parietal)
  • Occipital bone (Behind)
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2
Q

The ________ is the bone on the upper lip, the __________ is the lower jaw and the __________ is behind the ear.

A
  • Maxilla
  • Mandible
  • Maxoid process
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3
Q

The cranium is supported by the ________

A

Vertebrae of the spine

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4
Q

Muscle on side of skull

A

Temporalis

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5
Q

Lateral edge of eye

A

Palpebral fissure

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6
Q

Line on either side of nose (smile line)

A

Nasolabial fold

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7
Q

Jaw muscle

A

Masseter

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8
Q

Muscle that goes from back of head across collar bone

A

Sternocleidomastoid

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9
Q

Wide muscle on side of neck

A

Trapezius

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10
Q

Four things to ask about f subjective data health history for the HEAD

A
  • Headache
  • Head injury
  • Dizziness (& hoe does it affect you?)
  • History of head injury or surgery
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11
Q

Migraines put a patient at a slightly higher risk of ______

A

STROKE

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12
Q

Loss of consciousness due to a head injury puts the pt at a higher risk of _________.

A

ALZHEIMER’S

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13
Q

If the pt gets dizzy when s/he tilts head back, you can suspect it is a __________ issue.

A

Circulation

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14
Q

What four steps are involved in a head exam?

A
  • Inspect and palpate skull, scalp and hair

- Inspect the face

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15
Q

What four components do you inspect the face for?

A
  • Symmetry
  • Appropriate expression
  • Abnormal structures (eg edema or swelling)
  • Abnormal movemnents (eg tick)
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16
Q

What is the difference between a stroke and Bell’s Palsy?

A
  • Stroke only affects the motor cortex, Bell’s Palsy also affects the facial nerve (can’t close affected eye, for example)
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17
Q

What are three indications of Bell’s Palsy?

A
  • Affected side of forehead not wrinkled / eyebrow not raised
  • Affected eye not closing
  • Flat nasolabial fold
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18
Q

How do you test Cranial Nerve V?

A

Sensory: Touch forehead, cheeks and chin bilaterally
Motor: Have pt clench and palpate temporal and masseter muscles bilaterally

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19
Q

How do you palpate the TMJ?

  • What does decreased ROM indicate?
  • What does a click indicate?
A
  • Press anterior to tragus, note smooth movement w/o limitation or tenderness.
  • Decreased ROM = arthritis
  • Click - meniscus tear, poor occulation or synovial swelling (Malclusion = closes poorly)
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20
Q

What is the most active joint in the body?

A

The Temporomandibular Joint

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21
Q

Name and define the six external eye structures you are looking at during an exam.

A

1) Palpebral fissure (fissure lined by eyelid)
2) Pupil (color)
3) Sclera (white part)
4) Limbus (space between transparent portion over the iris and the sclera)
5) canthus (medial, lateral corners of eye)
6) caruncle (medial pink part of eye)

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22
Q

Describe the lacrimal apparatus:

  • What is the purpose?
  • Where are tears made?
  • Where do they go? (2)
A
  • Purpose is to provide constant irrigation for the eye.
  • Lacrimal gland (below lateral eyebrow) makes tears, which flow across the eye.
  • Superior and inferior lacrimal puncta release tears
  • Tears then drain into the nasolacrimal sac and then the nose (at the inferior meatus and turbinate).
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23
Q

What is the tarsal plate?

A

Connective tissue that gives shape to the upper and lower lids.

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24
Q

What are the meibomian glands?

  • Type
  • Secretion
  • Function
A
  • Sebaceous glands that secrete an oily lubricating substance to the eye.
  • Helps give an airtight seal when eye is closed and moisture to the eye when opened.
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25
Q

Give the six components of the internal anatomy of the eye:

A
  • Three layers: Sclera, Choroid, retina
  • Ciliary body
  • Anterior compartment
  • Posterior chamber
26
Q

Discuss the sclera (3)

A
  • Outer layer of internal eye
  • Tough white coloring
  • Contiguous with the cornea to go over the lens and pupil.
27
Q

Discuss the choroid (4)

A
  • Middle layer of internal eye
  • Darkly pigmented because it’s VERY vascular.
  • Supplies blood to retina.
  • Keeps light from bouncing around too much.
28
Q

What is unique about the optic nerve?

A

It is the only nerve we can actually visualize as a clinician - through the opthalmascope.

29
Q

Describe the function and mechanism of the ciliary body.

A

Controls the thickness of the lens. Flattens to look at faraway objects and rounds to look at near objects.

30
Q

The iris serves as a _______

A

Diaphram.

31
Q

Describe the two compartnments of the internal eye, and what they contain

A 
Anterior chamber (behind cornea, in front of iris).  Contains clear liquid called aqueous humor.
Posterior chamber. Contains vitreous humor.  Floaties in eye is the gel sticking together.
32
Q

Cranial nerve VI supports the _______ movements of the eye, Cranial nerve IV supports __________________, cranial nerve III supports __________.

A
  • Lateral
  • The ability to look down and in toward your nose
  • The rest of the eye movements.
33
Q

Describe the function of CN VI.

A

ABDUCENS

- Innervates the lateral rectus muscles.

34
Q

Describe the function of CN IV

A

TROCHLEAR

- Innervates the superior oblique muscles.

35
Q

Describe the function of CN III

A

OCULOMOTOR
- Innervates the rest of the external eye muscles:
Superior, inferior, medial rectus, inferior oblique.

36
Q

What additional things might you see in a diabetic’s eye? (3)

A
  • Little dots over the back parts of their eyes
  • Little hemorrhages
  • Extra vessels
37
Q
  • Describe the shape of the optic disc.

- What is the name / function of the inner part?

A
  • Round, a little oval with a crisp edge on the lateral side and a fuzzy edge on the medial side.
  • The inner part is brighter yellow. Called the PHYSIOLOGIC CUP. This is where vessels enter the eye.
38
Q

Name the four sets of vessels in the eye.

A
  • Superior lateral vein / artery
  • Inferior lateral vein / artery
  • Superior medial vein / artery
  • Inferior medial vein / artery
39
Q

Name the visual pathways / visual fields of the eye function. (2)

A
  • Refraction of light rays

- Crossing of fibers at the optic chiasm.

40
Q

Name the 3 visual reflexes

A
  • Pupillary light reflex (Direct, consensual)
  • Fixation
  • Accommodation
41
Q

What is diplopia?

A

Double vision.

42
Q

Moving from the lateral left to the lateral right, what are the four visual fields?

A

Left temporal, left nasal, right temporal, right nasal

43
Q

Nerve impulses are conducted through the (1), (2), (3) and (4) on each side, and then through a curving tract called the (5)

A

1) Retina
2) Optic nerve
3) Optic chiasm
4) Optic tract
5) Optic radiation

44
Q

What 9 health history questions should you ask regarding the eye?

A

1) Vision difficulty
3) Pain
3) Strabismus / diplopia
4) Watering, discharge
6) Past history of ocular problems
7) Glaucoma
8) Use of glasses / contact lenses
9) Self- care behaviors

45
Q

What 9 components go into a visual physical exam

A
  • Assess visual acuity
  • Inspect outer portion of eye
    (lashes, conjunctiva, sclerae, iris, cornea)
  • Shape and size of pupils
  • Accommodation & Convergence
  • Extraocular movements
  • Visual field
  • Corneal light reflex
  • Direct and consensual light reflex
  • Funduscopic
46
Q
  • What is used to test visual acuity?
A

SNELLIN CHART

47
Q

___/___ is legal blindness in your ____ eye.

A

20/200, best

48
Q

_____ is the word for nearsightedness. It means you can’t see ______, and the eye is too _____.

A

Myopia
can’t see far away
the eye is too long

49
Q

______ is the word for farsightedness. It means you can’t see _______, and the eye is too ______.

A

Hyperopia, can’t see close up, the eye is too short.

50
Q 
Range of Peripheral Visual fields
\_\_\_\_ degrees superiorly
\_\_\_\_ degrees temporally
\_\_\_\_ degrees nasally
\_\_\_\_ degrees inferiorly
A

50 degrees superior
90 degrees temporally
60 degrees nasally
70 degrees inferior

51
Q

What causes papilledema?

A
  • Choking or inflammation of the optic disc - can be caused by too much pressure in the brain. Border of optic disc becomes fuzzy all around.
52
Q

______ conjunctiva lines the eyeball itself and the

______ conjunctiva lines the inner eyelid

A

Bulbar conjunctiva

Palpebral conjunctiva

53
Q

What is the name / function of the inner part of the optic disc? What does it look like?

A
  • Called the PHYSIOLOGIC CUP.
  • This is where the vessels enter the eye
  • Inner part is bright yellow.
54
Q

Vessles in the eye:

  • Arteries appear (2)
  • Veins appear (2)
A

Arteries:

  • Lighter
  • Light reflex (gray)

Veins:

  • Darker
  • Redder
55
Q

What are visual fields?

A

The entire area that is seen by the eye when it’s looking at a central point.
- Can’t see behind, lateral, etc

56
Q

Visual pathways. How and where is an image projected?

A
  • For an image to be seen, image is projected on the retinae upside-down and are reversed right to left.
57
Q

Visual pathways:

1) What is the pathway for the left temporal field of view?
2) What is the pathway for the left nasal field of view?
3) What is the pathway for the right nasal field of view?
4) What is the pathway for the left nasal field of view?

A

1) Crosses the optic chiasm to the right optic tract.
2) Goes to the left optic tract.
3) Crosses the optic chiasm to the left optic tract.
4) Goes to the right optic tract.

LEFT = TEMPORAL
RIGHT = NASAL
58
Q

_____ refers to unequal pupils.

A

Aniscoria

59
Q

Vision is missing on outside part of both eyes.

  • What is this called?
  • Why does this occur?
A
  • Bitemporal Hemianopsia
  • Occurs when optic nerve communication is cut between the two eyes. (Brain can still relay info from nasal fields of vision.)
60
Q

Air bubble at the tympanic membrane occurs when…

A

…the eustachian tube is blocked.

PA: Exam 1 (10 decks)

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