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Flashcards in EENT-quiz Deck (168):
1

cornea

Each blink of the eye provides tears for what eye structure?

2

thin

Skin over the eyelid is (thick/thin)

3

orbicularis oculi

sphincter-like muscle that closes the eyelid

4

Meibomian glands

glands that secrete sebum onto the eyelid margin

5

Zeis glands, Moll's glands

2 types of glands that empty into the eyelash follicles

6

100-150

How many eyelashes are there on the upper eyelid?

7

50-75

How many eyelashes are there on the lower eyelid?

8

5 months

lifespan of an eyelash

9

10 weeks

How long does it take for an eyelash to be replaced?

10

bulbar, tarsal, fornical

3 parts of the conjunctiva

11

bulbar

part of the conjunctiva that covers the globe

12

tarsal

part of the conjunctiva that lines the eyelids

13

fornical

part of the conjunctiva in the inferior and superior cul-de-sacs

14

preauricular, submandicular

lymphatic drainage of the eyelid goes into what 2 nodes?

15

protect the eye, moisten cornea

function of the eyelid

16

CN VII, orbicularis muscle

What cranial nerve and muscle are responsible for closing the eye?

17

CN III, levator muscle

What cranial nerve and muscle are responsible for opening the eye?

18

hordeolum (sty)

small painful nodule within a gland in the upper or lower lid; acute inflammation

19

staph aureus

bacterial cause of hordeolum

20

external hordeolum (sty)

inflammation of the glands of Moll or Zeis on the lid margin; immediately adjacent to the edge of the palpebral margin

21

internal hordeolum (sty)

infection of a meibomian gland; deep from the palpebral margin; found inside eyelid

22

FALSE

Hordeolums are contagious. (T/F)

23

external hordeolum (sty)

eye condition that presents with pain and edema of the involved lid; often there is a central area of purulence and surrounding erythema; the area is palpable and may point through the skin at the lash line

24

warm compress several times a day for 48 hrs

treatment for external hordeolum

25

topical antibiotic

treatment for an external hordeolum if there is a secondary infection or if drainage is present

26

i&d

treatment for external hordeolum if it does not resolve on its own

27

cellulitis

monitor external hordeolum for _____________

28

chalazion

another name for an internal hordeolum

29

chalazion

eye condition that involves the obstruction of the meibomian gland; focal inflammation within the eyelid tarsus; firm nodule that is located away from the lid margin

30

less

An internal hordeolum is (less/more) painful than an external hordeolum

31

warm compresses

treatment for chalazion

32

steroid injection

treatment for chalazion that should be considered if the sty is not resolving

33

refer for excision

treatment for chalazion if nodule is large or lasts more than 1 month

34

biopsied (risk of cancer)

Recurrent chalazion should be ___________

35

inflammation of lid margins

blepharitis

36

men

Blepharitis is common, esp. in (men/women)

37

anterior, allergic, posterior

3 type sof blepharitis

38

blepharitis

presents with irritation, burning, with red rims and eyelash adherence; dandruff-like deposits and fibrous scales may be seen; conjunctiva is clear to slightly red

39

rosacea

blepharitis can be seen with what skin condition?

40

scrub lid margins with cotton-tip applicator and baby shampoo; topical antibiotics if infection is present or lid scrubs are ineffective

treatment for blepharitis

41

seborrhea, staph or strep, meibomian gland dysfunction

2 causes of blepharitis

42

anterior blepharitis

eye condition that presents with itching of lid margins, usually bilateral; usually staph that colonized lash bases that secrete toxins causing red eye and corneal infiltrates; can lead to sty formation

43

hygiene, antibiotics if persistent

treatment for anterior blepharitis

44

allergic blepharitis

eye condition caused by an ocular allergy; presents with itching, lid edema, mucoid discharge, conjunctival hyperemia, burning, lacrimation, and conjunctival edema

45

cool compresses, antihistamines, mast cell stabilizer, control of allergen

treatment for allergic blepharitis

46

posterior blepharitis

infection on inside of lid; infection of oil secreting meibomian glands leads to obstruction and swelling causing a chalazion

47

hygiene

treatment for posterior blepharitis

48

orbital cellulitis

eye condition that causes eyelid swelling, can lead to blindness, cranial nerve palsies, or brain abscesses; life threatening condition

49

children

orbital cellulitis is more common in (children/adults)

50

sinuses, dental, facial, globe, eyelid, lacrimal

there are several causes of orbital cellulitis including infection of what things?

51

h, influenza, s. pneumoniae

causative organisms of orbital cellulitis in children <4 y/o

52

staph

causative organism of orbital cellulitis in older people

53

molluscum contagiosum, warts, herpes

common viral infections of the eye

54

crabs, mites, fly larvae

3 parasitic infections of the eye that causes inflammation

55

entropion

condition of the eyelid being flipped in; irritates structures of eye (risk of corneal abrasion)

56

ectroption

condition of the eyelid being flipped out; conjunctiva is exposed

57

blepharoptosis

droopy eyelid syndrome of upper lid

58

assess status of cornea to determine urgency, lubricate the eye, antibiotics for inflammation, warm compresses, surgery

treatment for eyelid/lash malpositions

59

more

Outer eye (cornea and sclera) and supporting structures are (more/less) sensitive than the inner eye (retina)

60

assessing severity and referring sight-threatening injuries

first priority when evaluating a traumatized eye

61

globe

high velocity injury to the eye may lead to penetration of the ________

62

blowout fracture

a blunt trauma injury may cause a ________ __________

63

rim

an injury from a larger sized object will affect the _____ of the eye

64

globe

an injury from a smaller sized object will affect the _______ of the eye

65

zygomatic arch

forms the lateral and inferior portion of the orbit

66

TRUE

patients with a zygomatic fracture may have pain opening their mouth (T/F)

67

water;s view and jug-handle view x-rays, CT if suspected more than zygomatic fracture

diagnostic tests to determine a zygomatic fracture

68

entrapment of eye muscles

why may a patient with a zygotmatic fracture have gaze impairment?

69

immediate referral

treatment of zygomatic fracture

70

maxillary, palatine, zygomatic

what bones compose the orbital floor?

71

blow-out fracture

fracture that presents with misalignment and swelling; movement of globe is restricted; often inability to look upward; diplopia and exophthalmos

72

referral to ophthalmologist, avoid pressure increase, nasal decongestant, ice pack, antibiotics

treatment for blow-out fracture

73

subconjunctival hemorrhage

eye condition caused spontaneously or by blunt trauma; bright red blood under conjunctiva; iris and pupil not involved

74

12 mm

How long it the cornea across?

75

<1mm

How thick is the cornea?

76

Bowman's, stroma, epithelium, Descemet's membrane, endothelium

5 layers of the cornea

77

FALSE

The cornea has a blood supply (T/F)

78

check visual acuity, anesthetize, every lids, fluorescein, antibiotic drops/ointment, check daily

treatment for corneal abrasion

79

cornea

If a patient has a foreign body in their eye and they are experiencing blurred vision, it suggests what structure is involved?

80

FALSE

If a patient has a foreign body in their eye and there is a penetrating injury, you should refer immediately and attempt to remove the body (T/F)

81

visual acuity

When a patient has a foreign body in their eye, you always need to test what?

82

slit lamp or hand held lamp

What should you use to look at foreign bodies in patients' eyes?

83

use irrigation or cotton tip applicator to remove, follow daily until resolved, patching (controversial)

treatment for foreign body in the eye

84

rust ring on cornea

indication of a metallic foreign body

85

removal with rotating burr or referral

treatment for a metallic foreign body in eye

86

welding without eyewear, snow blindness, indoor sunlamp

3 typical causes of acute UV radiation injury

87

acute UV radiation injury

eye condition characterized by pain, photophobia, excessive tearing, blurred vision; occurs 6-12 hours after exposure

88

acetamenophin (for pain), consider antibiotic 2-3 times a day, patching for 24 hours, re-evaluate next day

treatment for acute UV radiation injury

89

refer

What should you do if a patient with an acute UV radiation injury does not improve after you re-evaluate the next day?

90

irrigate

key in treatment for a chemical injury to the eye

91

water or normal saline, at least 30 min

What should you flush a chemical injury out with? for how long?

92

chemical injury

eye injury presenting with pain, blurred vision, and blepharospasm; ranges from mild to severe; cornea can be hazy to edematous and opaque, conjunctiva may be injected to white with a loss of vasculature

93

TRUE

A patient with a chemical eye injury should be transported to the ER and referred to an ophthalmologist. (T/F)

94

FALSE

Acid chemically injuries are generally worse than alkali. (T/F)

95

acid

(acid/alkali) is precipitated and inactivated by tissue protein it destroys (for chemical injury)

96

alkali

(acid/alkali) soponifies collagen and damages underlying tissue (for chemical injury)

97

irrigation, test pH of tears, fluorescein stain to assess damage, daily exam to assess damage and follow healing, topical antibiotics or antibiotic/steroid combo considered

treatment for chemical injury

98

TRUE

A chemical eye injury is an ophthalmic emergency. (T/F)

99

thermal injury

caused by exposure to heat; presents with pain, foreign body sensation, excessive tearing, decreased vision and visual acuity; conjunctiva is injected, cornea whitened

100

antibiotic drops, patching, referral

treatment for thermal injury

101

glue injury

presents as eyelids shut with injected conjunctiva; foreign body sensation

102

warm compress, warm topical antibiotic ointment, artificial tears, gentle massage

treatment for glue injury

103

3-4 days

How long should you wait to refer to an ophthalmologist for a glue eye injury if it has not resolved?

104

eyelids

has the thinnest skin of the body

105

if changes occur, bothersome

under what 2 conditions can you remove nevi on the eyelids?

106

lentigo senilis

eyelid neoplasm that resembles seborrheic keratosis

107

seborrheic keratosis

benign epithelial neoplasm that can occur on the eyelid

108

actinic keratosis

precancerous epithelial neoplasm that can occur on the eyelid

109

basal cell carcinoma

most common type of skin cancer; slow growing; noduloulcerative, pigmented, sclerosing, superficial

110

biopsy, excise, Moh's, radiation

treatment for BCC

111

squamous cell carcinoma

2nd most common type of skin cancer; fast growing; elevated, firm plaque or nodule, ulcerates, irregular borders; local spread and may metastasize to lymph nodes

112

biopsy, wide excision

treatment for SCC

113

sebaceous neoplasms

carcinomas arising from meibomian gland

114

sebaceous neoplasms

third most common malignancy of the eye

115

sebaceous neoplasm

eyelid neoplasm whose presentation varies-appears like a chalazion as a small firm nodule, diffuse plaque-like tarsal thickening or papillomatous growth

116

excision, biopsy

treatment for sebaceous neoplasm

117

capillary hemangioma, nevus flammeus, pyogenic granuloma

3 vascular skin lesions of the eye

118

hidrocystoma, pilosebaceous cyst

2 cystic skin lesions of the eye

119

hidrocystoma

retention cyst of the apocrine or eccrine sweat glands

120

FALSE

The lacrimal system secretes tears all of the time, including during sleep. (T/F)

121

FALSE

Eyelids close lateral to medial. (T/F)

122

medial canthus

Eyelids close and milk tears toward what structure?

123

nasolacrimal duct

The lacrimal sac empties under the inferior turbinate into the nose through what structure?

124

TRUE

The nasolacrimal duct's inferior end is not open at birth. (T/F)

125

tears

supply nutrients, antibacterial substances, flushing microorganisms, and lubricates the eyes

126

meibomian sebaceous glands, lacrimal gland, conjunctival goblets

The lacrimal system has 3 layers: ___________ ___________ _________ in the outer layer, ___________ ________ in the middle layer, and _______________ _____________ in the inner layer.

127

trigeminal

tearing is stimulated by the first division of what cranial nerve?

128

keratoconjunctivitis sicca

dry eye

129

alacrima

dry eye syndrome; absence of tears

130

keratoconjunctivitis sicca (dry eye)

eye condition that is seen often from systemic disease (frequently connective tissue disease) or medications

131

keratoconjunctivitis sicca

eye condition that presents as complaints of gritty, foreign body sensation, burning, photophobia, and a decreased visual acuity

132

avoid irritants, artificial tears, lubricating ointment, steroid drops

initial treatment for keratoconjunctivitis sicca

133

cyclosporine

2nd or 3rd line treatment for keratoconjunctivitis sicca

134

primary Sjogren's syndrome

keratoconjunctivitis sicca plus xerostomia is classified as what condition?

135

secondary Sjogren's syndrome

keratoconjunctivitis sicca pluse xerostomia and connective tissue disease is classified as what condition?

136

epiphoria

excessive tearing; overflow of tears onto the cheeks; "crocodile tears"

137

salivary and lacrimal

epiphoria is caused by an abnormal linkage of what 2 kinds of glands?

138

salivation

In epiphoria, _________ produces lacrimation

139

dacryocystorhinostomy or outpatient with local anesthetic

treatment for epiphoria

140

dacryocystorhinostomy

drainage hole in the lacrimal duct; a treatment for epiphoria

141

dacroystenosis

eye condition common in newborn after the first month of life; occurs when the lacrimal duct does not open

142

TRUE

Dacryostenosis usually resolve within 9 months. (T/F)

143

warm compresses, surgical probe if no resolution

treatment for dacryostenosis

144

dacryocystitis

inflammation of the lacrimal gland caused by obstruction

145

staph aureus, hemolytic strep, staph epidermis, candida

4 common pathogens in dacryocystitis

146

dacryocystitis

eye condition that presents with revealing pain, swelling, tenderness, redness, and purulent discharge

147

warm compresses, antibiotics

treatment for dacroycystitis

148

TRUE

Orbital structural defects, atrophies, degenerations, deposits, and tumors are uncommon and should be referred to an ophthalmologist. (T/F)

149

orbit

bony socket containing globe, EOM muscles (sensory, motor, autonomic nerves), blood vessels, and lacrimal gland, all packed in fat

150

later

orbital neoplasms typically occur (early/later) in life

151

increases

Structural and degenerative disease prevalence of the orbit (increases/decreases) with age

152

orbital cellulitis

condition that usually comes from the sinuses; threatens vision and life; can also come from face, teeth, meninges, ear, or eye; can spread causing cavernous sinus thrombosis, intracranial abscess, or temporal is fossa abscess; emergent

153

preseptal

tissue of eyelids and periocular region anterior to the orbital septum

154

preseptal cellulitis

condition common in children; presents with pain, lid swelling, chemosis, and fever

155

strep, h, influenzae, s, aureus

causitive organisms in preseptal cellulitis

156

leukocytosis in preseptal, consider imaging if concern for orbital cellulitis

diagnostics for preseptal cellulitis

157

oral antibiotic, compresses

treatment for preseptal cellulitis

158

thyroid

exophthalmos, decreased eye movement, lid swelling, and conjunctival injection is a presentation of ophthalmopathy associated with _______

159

thyroid associated ophthalmopathy

common cause of unilateral or bilateral proptosis; muscles of eye swell and push globe forward; possible tether of the levitator and rectus muscles and squeezing the optic nerve

160

support, treat thyroid condition, lubricants, surgery

treatment for thyroid associated ophthalmopathy

161

neuroblastoma

condition of metastatic orbital tumor in children (90% <5 y/o); often with bilateral proptosis, raccoon eye, lid ecchymosis; may have associated abdominal or thoracic mass

162

breast carcinoma

most common orbital metastasis in adults

163

anophthalmic socket

condition of no globe-absent from birth or removed

164

symmetry with remaining eye, matching shape, color, and movement

goal of socket rehabilitation

165

ophthalmologist and ocularist

you should refer an anophthalmic socket to what 2 specialists?

166

FALSE

There is usually a place for an artificial eye if a patient has congenital anophthalmic socket, because lid and socket are large. (T/F)

167

annually

How often should a prosthetic eye be removed, irrigated, and cleaned by an ocualrist?

168

8-Jul

An ocularist should consider a new prosthetic eye how often?