Exam 1 Flashcards by Sara Clements

what is CN I?

olfactory

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what is CN II?

optic

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what is CN III?

oculomotor

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what is CN IV?

trochlear

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what is CN V?

trigeminal

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what is CN VI?

abducens

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what is CN VII?

facial

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what is CN VIII?

acoustic

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what is CN IX?

glossopharyngeal

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what is CN X?

vagus

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what is CN XI?

spinal accessory

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what is CN XII?

hypoglossal

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CN # is olfactory?

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CN # is optic?

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CN # is oculomotor?

III

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CN # is trochlear?

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CN # is trigeminal?

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CN # is abducens?

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CN # is facial?

VII

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CN # is acoustic?

VIII

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CN # is glossopharyngeal?

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CN # is vagus?

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CN # is spinal accessory?

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CN # is hypoglossal?

XII

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which cranial nerve? Smell reception and interpretation

olfactory (I)

which cranial nerve? Visual acuity and visual fields?

optic (II)

which cranial nerve? Raise eyelids, most extraocular movements; pupillary constriction; change lens shape

oculomotor (III)

which cranial nerve? Downward, inward eye movement

trochlear (IV)

which cranial nerve? Jaw opening and clenching, chewing and mastication; sensation to cornea, iris, lacrimal glands etc

trigeminal (V)

which cranial nerve? Lateral eye movement

abducens (VI)

which cranial nerve? Movement of facial expression muscles except jaw; close eyelids; taste- anterior two thirds of tongue

facial (VII)

which cranial nerve? Hearing and equilibrium

acoustic (VIII)

which cranial nerve? Voluntary muscles for swallowing and phonation; gag reflex

glossopharyngeal (IX)

which cranial nerve? Sensation behind ear and part of external ear canal

vagus (X)

which cranial nerve? Turn head, shrug shoulder

spinal accessory (XI)

which cranial nerve? Tongue movement and swallowing

hypoglossal (XII)

term? Respecting and responding to patients' wants, needs and preferences, so that they can make choices in their care that best fit their individual circumstances

patient-centered care

what part of hand should be used to determine position, texture, size, consistency, fluid, crepitus, form of a mass, or structure?

palmar surface of the fingers and finger pads

what part of hand should be used to determine position, texture, size, consistency, fluid, crepitus, form of a mass, or structure?

what part of hand should be used to determine position?

palmar surface of the fingers and finger pads

what part of hand should be used to determine texture?

palmar surface of the fingers and finger pads

what part of hand should be used to determine size and consistency?

palmar surface of the fingers and finger pads

what part of hand should be used to determine fluid or crepitus?

palmar surface of the fingers and finger pads

what part of hand shold be used to determine form of a mass or structure?

palmar surface of the fingers and finger pads

what part of hand should be used to determine vibration?

ulnar surfaces of hand and fingers

what part of hand should be used to determine temperature?

dorsal surface of hand

what should the dorsal surface of the hand be used for?

temperature

what should the ulnar surfaces of the hand and fingers be used for?

vibration

which surface of the hand should be used when discriminatory touch is needed?

palmar surface of the fingers and finger pads

which surface of the hand is more sensitive than the fingertips?

palmar surface of the fingers and finger pads

which part of hand is most sensitive for distinguishing vibration?

ulnar surfaces of hand and fingers

what surface of hands is best for estimating temperature?

dorsal surface of hand

what are the two types of palpation?

light or deep

term? Process of observation

inspection

what is the definition of inspection?

process of observation

which percussion tone? Loud intensity, high pitch, moderate duration, drumlike quality

tympanic tone

example of where you might hear tympanic tone?

gastric bubble

which percussion tone? Very loud intensity, low pitch, long duration, boomlike quality

hyperresonant tone

example of where you may hear a hyperresonant tone?

emphysematous lungs

which percussion tone? Loud intensity, low pitch, long duration, hollow quality

resonant tone

example of where you may hear a resonant tone?

healthy lung tissue

which percussion tone? Soft/moderate intensity, moderate to high pitch, moderate duration, thudlike quality

dull tone

example of where you may hear a dull tone?

over liver

which percussion tone? Soft intensity, high pitch, short duration, very dull quality

flat tone

example of where you may hear a flat tone?

over muscle

the more dense the medium, the WHAT the percussion tone?

quieter

describe the volume of the percussion tone over air?

loud

what are the five percussion tones?

tympany (loudest), hyperresonance, resonance, dullness, flatness

what is the loudest percussion tone?

tympany

what is the quietest percussion tone?

flatness

what is another name for immediate percussion?

direct percussion

what is another name for indirect percussion?

mediate

what is another term for direct percussion?

immediate percussion

what is another name for mediate percussion?

indirect percussion

term? Involves striking the finger or hand directly against the body

immediate percussion

term? Technique in which the finger of one hand acts as the hammer (plexor) and a finger of the other hand acts as the striking surface

indirect percussion

term? listening to sounds produced by the body

auscultation

what for characteristics of sound should you listen for?

intensity, pitch, duration, quality

what is the exception for performing auscultation last?

the abdomen

which two cranial nerves are responsible for the gag reflex?

IX and X

type of question? Gives the patient discretion about the extent of an answer

open-ended question

what type of data? Information about the patient that is directly observed

objective data

what type of data? Information obtained through physical examination/assessment

objective data

what is the first assessment technique in the appropriate order?

inspection

what is the second assessment technique in the appropriate order?

palpation

what is the third assessment technique in the appropriate order?

percussion

what is the fourth assessment technique in the appropriate order?

auscultation

what are the four assessment techniques in the appropriate order?

inspection, palpation, percussion, auscultation

inspection, palpation, percussion, and auscultation produce what kind of data?

objective data

the general survey is involved in which of the four types of assessment?

inspection

what 9 things should be noted during inspection?

color, size, pattern, location, symmetry, movement, behavior, odor, sound

what are the three types of percussion?

direct, blunt, indirect

is percussion used in assessment to elicit pain?

yes

is percussion used to determine location, size, and shape?

yes

is percussion used to determine density?

yes

is percussion used to detect abnormal masses?

yes

is percussion used to elicit reflexes?

yes

what are the four characteristics used to classify sound with auscultation?

intensity, pitch, duration, quality

what are the two key elements that should be included in documentation of assessment findings?

history and physical examination

the history of present health concern is recorded in statements that begin with what?

"patient states"

which should be used in documentation- phrases or sentences?

phrases

should judgments be made in documentation?

no- write objective entries

what is the chief complaint?

a brief statement about why the patient is seeking care

what kind of data? Reflects information conveyed by the patient relative to their feelings or experiences

subjective data

type of data? Based in fact; measurable and observable

objective data

term? The motivation of the HCP to want to engage in the process of becoming culturally competent

culteral desire

term? The deliberate self-examination and in-depth exploration of one's biases, stereotypes, prejudices, assumptions, and isms that one holds about individuals and groups who are different from them

cultural awareness

term? The process of seeking and obtaining a sound educational base about culturally and ethnically diverse groups

cultural knowledge

term? The ability to collect culturally relevant data regarding the patient's presenting problem

cultural skill

term? Reflects the whole of human behavior

culture

tremors and fasciculations of the eyelids may indicate what condition?

hyperthyroidism

term? If one superior eyelid covers more of the it is than the other or extends over the pupil

term? Indicates a congenital or acquired weakness of the levator muscle or a paresis of the third cranial nerve

ptosis

what is the average upper lid position?

2 mm below the limbus

what is the limbus?

border of cornea and the sclera

term? Border of cornea and the sclera

limbus

term? When the lower lid is turned away from the eye

ectropion

what may ectropion result in?

excessive tearing

what serves as the tear-collecting system?

inferior punctum

term? The inferior punctum is pulled outward and the lower lid cannot collect lacrimal gland secretions

ectropion

term? When the lid is turned inward toward the globe

entropion

patient often reports a foreign body sensation with ectropion or entropion?

entropion

term? An acute suppurative inflamation of the follicle of an eyelash can cause an erythematous or yellow lump

hordeolum

what is another term for a hordeolum?

stye

what is the medical term for a stye?

hordeolum

what is hordeolum generally caused by?

staph infection

what might be seen with blepharitis?

crusting along the eyelashes

what are five possible causes of blepharitis?

bacterial infection, seborrhea, psoriasis, rosacea, allergic response

term? If the closed lids do not completely cover the globe

lagophthalmos

three common causes of lagophthalmos?

thyroid eye disease, seventh nerve palsy/Bell palsy; overaggressive ptosis/blepharoplasty repair

what is one of the simplest methods to determine intraocular pressure?

palpation of the eye

what is the technical term for palpating the eye to determine IOP?

digital palpation tonomoetry

what are three conditions in which pain on palpation of the eye may be present?

scleritis, orbital cellulitis, cavernous sinus thrombosis

scleritis, orbital cellulitis, cavernous sinus thrombosis can cause what?

pain on palpation of the eye

an eye that feels very firm and resists palpation may indicate what two conditions?

severe glaucoma or retrobulbar tumor

what might an erythematous or cobblestone appearance indicate? (especially on tarsal conjunctiva)

allergic or infectious conjunctivitis

term? Pupillary constriction to < 2mm

miosis

term? Pupillary dilation of more than 6 mm; failure of pupils to constrict with light

mydriasis

term? Inequality of pupillary size

anisocoria

what test can be used to evaluate the health of the optic nerve?

swinging flashlight test

what is the term for an afferent pupillary defect?

Marcus-Gunn pupil

what is a Marcus-Gunn pupil?

afferent pupillary defect

what is a Marcus-Gunn pupil a sign of?

optic nervve disease

what should happen to the pupils when testing for accommodation?

pupils should constrict when eyes focus on the near object

testing for pupillary response to accommodation is of diagnostic importance only if there is a defect in what?

the pupillary response to light

a failure to respond to direct light but retaining constriction during accommodation is sometimes seen in patients with what two conditions?

diabetes or syphilis

opioid abuse causes bilateral WHAT to the pupils?

miosis

what is the term for pupillary constriction?

mioisis

what is the term for pupillary dilation?

mydriasis

stimulant abuse may cause what pupillary change?

mydriasis

term? Bilateral, miotic, irregularly shaped pupils that fail to constrict with light but retain constriction with conversion

Argyll Robertson pupil

term? Unequal size of pupils

anisocoria

is acute uveitis often unilateral or bilateral?

unilateral

damage to what cranial nerve causes a puil to be fixed and dilated?

CN III- oculomotor

what are three findings seen with oculomotor nerve damage?

pupil fixed and dilated; eye deviated laterally and downward; ptosis

what is another name for an Adie pupil?

tonic pupil

what is another name for a tonic pupil?

adie pupil

term? Affected pupil dilated and reacts slowly or fails to react to light; responds to convergence

adie pupil

what pupillary change is often accompanied by diminished DTRs?

adie pupil

what pupillary change is caused by impairment of postganglionic parasympathetic innervation to sphincter pupillae muscle or ciliary malfunction?

adie pupil

what should the appearance of the lens be?

transparent

what color should the sclera be?

white

when should the sclera be visible above the iris?

only if the eyes are wide open

which muscle elevates and retracts the upper eyelid?

levator palpebrae superioris

what is the only extraocular muscle that is innervated by the trochlear nerve?

superior oblique

what is the only muscle innervated by the abducens nerve?

lateral rectus muscle

what three cranial nerves control extraocular movements?

III, IV, VI

term? The exposure of the sclera above the iris when patient is asked to follow your finger as you direct the eye in a smooth movement from ceiling to floor

lid lag

what can the presence of lid lad indicate?

thyroid eye disease

term? The dense, avascular structure that appears anteriorly as the white of the eye

sclera

term? Constitutes the anterior sixth of the globe and is continuous with the sclera

cornea

is the cornea vascular or avascular?

avascular

is the sclera vascular or avascular?

avascular

the cornea is a major part of what?

the refractive power of the eye

what are the three components of the uveal tract?

iris, ciliary body, choroids

term? A circular, contractile muscular disc containing pigment cells that produce the color of the eye

iris

what is the central aperture of the iris?

pupil fixed and dilated; eye deviated laterally and downward; ptosis

term? A biconvex, transparent structure located immediately behind the iris

lens

what supports the lens circumferentially?

fibers arising from the ciliary body

what is the sensory network of the eye?

retina

where does the optic nerve originate?

optic disc

what is the site of central vision

the macula, or fovea

what kind of ophthalmoscope lens do you need to use if patient is myopic?

minus (Red) lens

what kind of ophthalmoscope lens do you need to use if the patient is hyperopic or lacks a lens?

a plus lens

term? Where the retina converges to the optic nerve

optic disc

why is the optic disc called a blind spot?

because there are no photoreceptors (rods and cones) in this part of the retina and it cannot respond to light stimulation

narrowing of vessels, increased vascular tortuosity, copper wiring/diffuse red-brown reflex; arteriovenous nicking; retinal hemorrhages are retinal changes that can be seen in patients with which condition

hypertension

what color is the opric disc?

yellow to creamy pink (varies with race)

approximately how big is the optic disc?

about 1.5 mm

what is the unit of measurement in describing lesion size and location on the fundus?

disc diameter

what should you do to be able to see the macula?

ask the patient to look directly at the ophthalmoscope

do blood vessels enter the fovea?

what does a hemorrhage at the optic disc margin indicate?

poorly controlled or undiagnosed glaucoma

flame-shaped hemorrhages occur in which retinal layers?

nerve fiber labers

where in the retina do round hemorrhages tend to occur?

in the deeper layers

does the direct ophthalmoscope permit the distinction between dot hemorrhages and microaneurysms?

term? White area with soft, ill-defined peripheral margins usually continuous with the optic disc

myelinated retinal nerve fibers

do myelinated retinal nerve fibers have physiologic significance

what characteristics differentiate myelinated retinal nerve fibers from chorioretinitis?

absence of pigment, feathery margins, and full visual fields

myelinated nerve fibers- clinical relevance?

benign condition

term? Loss of definition of the optic disc margin

papilledema

what unexpected retinal finding can be caused by increased ICP transmitted along the optic nerve?

papilledema

which abnormal retinal finding? Venous pulsations are not visible and cannot be induced by pressure applied to the globe

papilledema

which abnormal retinal finding? Physiologic disc margins are raised with a lowered central area

glaucomatous optic nerve head cupping

which abnormal retinal finding? Result of increased IOP with loss of nerve fibers and death of ganglion cells

which abnormal retinal finding? Peripheral visual fields are constricted

which abnormal retinal finding? Vascular disease secondary to HTN or DM is a common cause

cotton wool spot

what is a cotton wool spot?

ill-defined, yellow areas of retina caused by infarction of the nerve layer of the retina

term? Bulging of eye anteriorly out of the orbit

exophthalmos

what is exophthalmos?

bulging of eye anteriorly out of the orbit

which abnormal eye condition? Apparent eye protrustion, lids do not reach the pupil

exophthalmos

what is the most common cause of exophthalmos?

Graves' disease

term? Disease in which abnormal connective tissue is deposited in the orbit and extraocular muscles

graves' disease

can exophthalmos be bilateral?

yes

can exophthalmos be unilateral?

yes

when exophthalmos is unilateral, WHAT must be considered?

a retroorbital tumor

an increase in the volume of orbital contents can cause what abnormal condition of the eye?

exophthalmos

what device measures the degree of exophthalmos?

exophthalmometer

term? Inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles

episcleritis

what are the two kinds of episcleritis?

simple and nodular

what is the most common cause of episcleritis?

idiopathic

term? Deposition of calcium in the superficial cornea

band keratopathy

in what kind of patients do you most often see band keratopathy?

chronic corneal disease

which abnormal eye condition? Line below the pupil

band keratopathy

which abnormal eye condition? Horizontal grayish bands interspersed with dark areas that look like holes

band keratopathy

term? Disruption of the corneal epithelium and stroma

corneal ulcer

pain, photophobia, history of wearing contact lenses, blurry vision, feeling like something is in the eye- symptoms of what abnormal eye condition?

corneal ulcer

what abnormal eye condition? Ulcer often round or oval and the border sharply demarcated, with the base appearing ragged and gray

corneal ulcer

term? Both eyes do not focus on an object simultaneously but can focus with either eye

strabismus

what are the two classifications of strabismus?

paralytic and nonparalytic

what is the cause of paralytic strabismus?

impairment of one or more extraocular muscles

what is the major physiologic eye change that occurs with aging?

progressive weakening of accommodation

what is the term for progressive weakening of accommodation?

presbyopia

describe accommodation?

focusing power

what is presbyopia?

progressive weakening of accommodation

by what age does the lens of the eye become more rigid?

by what age do the ciliary muscles become weakner?

throughout life, lens continues to form WHAT?

fibers

WHAT forms a denser central region that may cause loss of clarit of the lens and contibute to cataract formation?

old fibers are compressed centrally

risk for what? Family history of cataracts

cataract formation

risk for what eye disorder? Steroid medication use

cataract formation

risk for what eye disorder? Exposure to UV light

cataract formation

is cigarette smoking a risk for cataract formation?

yes

is diabetes mellitus a risk for cataract formation?

yes

is steroid medication use a risk for cataract formation?

yes

is aging a risk factor for cataract formation?

yes

what happens to central vision with aging?

decrease and disortion

what happens to moisture of the eyes with aging?

dry eyes

nocturnal eye pain is a sign of what?

subacute angle closure

nocturnal eye pain is a symptom of what?

glaucoma

does difficulty with depth perception happen with aging?

yes

define visual acuity?

discrimination of small visual details

which CN function is tested with measurement of visual acuity?

CN II (optic nerve)

measurement of visual acuity is essentially a measure of what?

central vision

should I test visual acuity with glasses or without glasses first?

without

visual acuity is recorded as a WHAT?

fraction

what does the visual acuity NUMERATOR indicate?

the distance of the patient from the chart (e.g. 20 feet or 6 meters)

what does the visual acuity DENOMINATOR indicate?

distance at which the average eye can read the line

the WHAT the visual acuity fraction, the worse the vision?

smaller

what is considered legal blindness?

vision not correctable to better than 20/200

at what visual acuity measurement should you perform the pinhole test?

if the visual acuity is recorded at a fraction less than 20/20

what is the rationale for performing a pinhole test?

to see if the observed decrease in acuity was caused by a refractive error

when performing the pinhole test, expect an improvement in visual acuity by at least one line on the chart if WHAT is responsible for the diminished acuity?

refractive error

what vision chart is used to test near vision?

Rosenbaum

what does the Rosenbaum eye chart test?

near vision

what is used to estimate peripheral vision?

confrontation test

is the confrontation vision test precise?

when is the confrontation test considered significant?

only when it is abnormal

these conditions can cause abnormalities in which vision assessment? Stroke, retinal detachment, optic neuropathy, pituitary tumor compression at the optic chiasm, central retinal vascular occlusion

confrontation test

can stroke cause abnormality with confrontation test?

yes

can retinal detachment cause abnormality with confrontation test?

yes

can optic neuropathy cause abnormality with confrontation test?

yes

can pituitary tumor compression at optic chiasm cause abnormality with confrontation test?

yes

can central retinal vascular occlusion cause abnormality with confrontation test?

yes

the eyelid, conjunctiva, lacrimal gland, eye muscles, and bony orbit comprise what?

the external eye

can blepharitis be caused by bacterial infection?

yes

can blepharitis be caused by seborrhea?

yes

can blepharitis be caused by psoriasis?

yes

can blepharitis be a manifestation of rosacea?

yes

can blepharitis be a manifestation of an allergic response?

yes

can pain on palpation of the eye be caused by scleritis?

yes

can pain on palpation of the eye be caused by orbital cellulitis?

yes

can pain on palpation of the eye be caused by cavernous sinus thrombosis?

yes

where is the palpebral conjunctiva?

inside of the eyelids

where is the bulbar/ocular conjunctiva?

anterior surface of the eye with the exception of the cornea and the surface of the eyelid in contact with the flobe

how should the conjunctivae appear?

translucent and free of erythema

what two features should you assess on the palpebral conjunctivae?

translucency and vascular pattern

when would you inspect the upper tarsal conjunctivae?

if suggestion that a foreign body may be present

do you have to evert the eyelid to inspect the upper tarsal conjunctivae?

yes

an erythematous or cobblestone appearance, especially on the tarsal conjunctiva, may indicate what?

allergic or infectious conjunctivitis

term? Bright red blood in a sharply defined area surrounded by healthy-appearing conjunctivae

subconjunctival hemorrhage

describe a subconjunctival hemorrhage?

bright red blood in a sharply defined area surrounded by healthy-appearing conjunctiva

why does blood of subconjunctival hemorrhage stay red?

because of direct diffusion of oxygen through the conjunctiva

causes of what?: violent coughing, sneezing; straining (constipation); intractable vomiting; spontaneously during pregnancy or during labor

subconjunctival hemorrhage

do subconjunctival hemorrhages resolve spontaneously?

yes

term? An abnormal growth of conjunctiva that extends over the cornea from the limbus

pterygium

what is a pterygium?

an abnormal growth of conjunctiva that extends over the cornea from the limbus

a pterygium is an abnormal growth of what?

conjunctiva

where does a pterygium extend?

over the cornea from the limbus

where are pterygium more commonly located?

on the nasal side

pterygiums are more common on the nasal side, but can also be located WHERE as well?

temporally

when can pterygium interfere with vision?

if it advances over the pupil

people heavily exposed to WHAT more often experience pterygium?

UV light

how do you examine the cornea for clarity?

by shining a light tangentially on it

why would you shine a light tangentially on the cornea?

to examine for clarity

is the cornea vascular or avascular?

avascular

should you see vessels on the cornea?

which cranial nerve controls corneal sensitivity?

CN V (trigeminal)

how do you test corneal sensitivity?

touching a wisp of cotton to the cornea

what is the expected response to corneal sensitivity testing?

a blink

a blink with corneal sensitivity testing indicates what?

intact sensory fibers of CN V and motor fibers of CN VII (facial nerve)

does diabetes decrease corneal sensation?

yes

does herpes simplex decrease corneal sensation?

yes

does herpes zoster decrease corneal sensation?

yes

is decreased corneal sensation a sequelae of trigeminal neuralgia?

yes

is decreased corneal sensation a sequelae of ocular surgery?

yes

term? Composed of lipids deposited in the periphery of the cornea

corneal arcus

what is another name for corneal arcus?

arcus senilis

what is another name for arcus senilis?

corneal arcus

what is deposited in the periphery of the cornea with arcus senilis?

lipids

what is it called when arcus senilis causes a complete circle?

circus senilis

what age group may have circus senilis?

older than 60

if circus senilis is present before age 40, patient may have what kind of disorder?

lipid disorder

can you have a pterygium and circus senilis?

yes

should the pattern of the iris be clearly visible?

yes

should the irises be the same color?

yes

should the pupils be round?

yes

should the pupils be regular?

yes

should the pupils be equal in size?

yes

miotic pupils fail to do WHAT in the dark?

dilate

miotic pupils are commonly caused by ingestion of what?

narcotics

other than narcotics, miotic pupils can be caused by what type of medications?

glaucoma medications

term? Failure of the pupils to constrict with light

mydriasis

term? Pupillary dilation of more than 6 mm

mydriasis

mydriasis is an accompaniment of WHAT condition?

coma

can atropine eyedrops cause mydriasis?

yes

can glaucoma medications also cause mydriasis?

yes

can glaucoma medications cause miosis?

yes

can strabismus management drops cause mydriasis?

yes

strabismus management meds are associated with miosis or mydriasis?

mydriasis

coma is associated with miosis or mydriasis?

mydriasis

what two types of response to light should pupils demonstrate?

direct and consensual

what are you testing for with the swinging flashlight test?

afferent pupillary defect

the swinging flashlight test is checking the health of which cranial nerve?

CN II (optic nerve)

what should the pupils do when testing for accommodation?

constriction

when is the accommodation test of diagnostic importance?

only if there is a defect in the pupillary response to light

in what two conditions might you see a failure to respond to direct light but retention of constriction during accommodation?

diabetes or syphilis

can pilocarpine cause miosis?

yes

can atropine cause mydriasis?

yes

lesions located where in the brain can cause mydriasis?

midbrain (Reflex arc)

hypoxia- mydriasis or miosis?

mydriasis

damage to which cranial nerve can cause mydriasis?

CN III (oculomotor)

what happens to the pupils with brain herniation?

fixed dilated pupils

what effect does retinal degeneration have on response to light stimulus?

failure to respond (constrict)

shape of Argyll Robertson pupils?

irregular

miosis or mydriasis with Argyll Robertson pupils?

miotic

do Argyll Robertson pupils occur in one or both eyes?

both

are Argyll Robertson pupils equal in size?

may or may not be

neurosyphilis is a common cause of what pupillary abnormality?

Argyll Robertson pupil

lesions in what part of the brain can cause Argyll Robertson pupils?

midbrain

term? Unequal size of pupils

anisocoria

can anisocoria be congenital?

yes

what % of healthy people have minor or noticeable difference in pupil size?

0.2

can anisocoria be caused by local eye medications?

yes

can constrictors cause anisocoria?

yes

can dilators cause anisocoria?

yes

what pupillary abnormality can be caused by unilateral sympathetic or parasympathetic pupillary pathway destruction?

anisocoria

does acute uveitis commonly present bilaterally or unilaterally?

unilaterally

what condition? Constriction of pupil accompanied by pain and reddened eye, especially adjacent to the iris

iritis (anterior uveitis)

pupil fixed and dilated indicates damage to which CN?

CN III (oculomotor)

eye deviated laterally and downward- indicates damage to which CN?

CN III (oculomotor)

ptosis can indicate damage to which CN?

CN III (oculomotor)

which abnormal pupil condition can be caused by impairment of postganglionic parasympathetic innervation to sphincter pupillae muscle?

adie pupil

which abnormal pupil condition can be caused by ciliary malfunction?

adie pupil

which abnormal pupil condition is often accompanied by diminished tendon reflexes?

adie pupil

in what two conditions might you see diminished tendon reflexes with adie pupil?

diabetic neuropathy or alcoholism

what is the expected appearance of the lens?

transparent

what is the expected appearance of the sclera?

white

what two kinds of conditions can cause the sclera to be yellow or green?

liver or hemolytic disease

liver or hemolytic disease can cause the sclera to look what colors?

yellow or green

how does senile hyaline plaque appear?

dark, slate gray pigment just anterior to the insertion of the medial rectus muscle

does senile hyaline plaque imply disease?

no, but note it

term? Dark slate gray pigment just anterior to the insertion of the medial rectus muscle

senile hyaline plaque

where is the lacrimal gland located?

temporal region of the superior eyelid

what structure produces tears that moisten the eye?

lacrimal gland

WHAT should be seen as slight elevations with a central depression on both the upper and lower lid margins nasally

puncta

are the lacrimal grands often enlarged?

rarely

what do you have to do to the eyelid to inspect the lacrimal glands?

evert

can tumors cause enlarged lacrimal glands?

yes

can lymphoid infiltration cause enlarged larcrimal glands?

yes

can sarcoid disease cause enlarged lacrimal glands?

yes

can Sjogren syndrome cause enlarged lacrimal glands?

yes

why might a patient with enlarged lacrimal glands report dry or gritty feeling in the eyes?

the lacrimal glands are not producing adequate tears

what extraocular muscular finding may indicate thyroid disease?

lid lag

the corneal light reflex tests the balance of what?

the extraocular muscles

if you find an imbalance with the corneal light reflex test, you should perform what test?

the cover-uncover test

I should perform ophthalmoscopic exam of patients left eye with which of my eyes?

left eye

I should perform ophthalmoscopic exam of patient's right eye with which of my eyes?

right eye

term? Internal eye- inner layer of nerve fibers

retina

term? Dense, avascular structure that appears anteriorly as the white of the eye

sclera

structure? Physically supports the internal structure of the eye

sclera

structure? Constitutes the anterior sixth of the globe and is continuous with the sclera

cornea

structure? Is optically clear, has rich sensory innervation, and is avascular

cornea

structure? Major part of the refractive power of the eye

cornea

what are the three structural components of the uveal tract?

iris, ciliary body, choroids

the iris, ciliary body, and choroids comprise what?

uveal tract

structure? A circular, contractile muscular disc containing pigment cells that produce the color of the eye

iris

what structure does light travel through to the retina?

pupil

structure? Produces the aqueous humor

ciliary body

what structure produces the aqueous humor?

ciliary body

term? Fluid that circulates between the lens and the cornea

aqueous humor

structure? Contains the muscles controlling acommodation

ciliary body

term? A pigmented, richly vascular layer that supplies oxygen to the outer layer of the retina

choroid

where does the choroid supply oxygen to?

outer layer of the retina

where is the lens located?

immediately behind the iris

what is located immediately behind the iris?

lens

the lens is highly WHAT?

elastic

what changes the thickness of the lens?

contraction or relaxation of the ciliary body

contraction or relaxation of WHAT changes the thickness of the lens?

ciliary body

images are focused on what structure?

retina

term? Sensory network of the eye

retina

what is the sensory network of the eye?

retina

photoreceptors and neurons transform light impulses into what?

electrical impulses

the optic nerve communicates with what anatomical structure?

brain

how is accurate binocular vision achieved?

when an image is fused on the retina by the cornea and the lens

accurate binocular vision requires the synchronous functioning of what?

the extraocular muscles

structure? Where does the optic nerve originate

optic disc

what causes the red reflex?

light illuminating the retina

light illuminating the retina causes what assessment finding?

red reflex

what is the most likely cause of absent red reflex?

improperly positioned ophthalmoscope

can a cataract cause an absent red reflex?

yes

can hemorrhage into the vitreous humor cause an absent red reflex?

yes

what should you do if you lose the red reflex?

move back and start again

should you see discrete areas of lighter or darker pigmentation when viewing the fundus?

where might you see crescents or dots at the disc margin when viewing the fundus?

along the temporal edge

what is the first structure you may see when you are 3-5 cm from the patient?

blood vessel

blood vessels always branch in what direction?

away from the optic disc

structure? Where the retina converges to the optic nerve

optic disc

are there photoreceptors in the optic disc?

can the optic disc respond to light stimulation?

copper wiring (diffuse red-brown reflex) is associated with what condition?

hypertension

are narrowing of retinal vessels seen with HTN?

yes

is increased vascular tortuosity seen with HTN?

yes

is copper wiring (retinal) seen with HTN?

yes

is arteriovenous nicking (Retinal) seen with HTN?

yes

are retinal hemorrhages seen with HTN?

yes

how should the margins of the optic disc appear?

sharp and well defined

where should the margins of the optic disc be especially well defined?

in the temporal region

what is the usual color of the optic disc?

yellow to creamy pink (varies with race)

how big is the optic disc?

1.5 mm diameter

what is the site of central vision?

macula

where should the patient look if you want to see the macula?

directly at the ophthalmoscope

structure? Appears as a lighter dot surrounded by an avascular area

abnormal finding? White area with soft, ill-defined peripheral margins usually continuous with the optic disc

myelinated retinal nerve fibers

abnormal finding? Absence of pigment, feathery margins, and full visual fields

myelinated retinal nerve fibers

how do you differentiate myelinated retinal nerve fibers from chorioretinitis?

absence of pigment, feathery margins, and full visual fields

benign or not? Myelinated retinal nerve fibers

benign condition

what is the innermost retinal surface?

nerve fiber layer

myelinated nerve fibers obscure areas of WHAT, particularly inferiorly?

retinal blood vessels

abnormal finding? Loss of definition of optic disc margin

papilledema

where does papilledema initially cause loss of definition of optic disc margin?

superiorly and inferiorly

abnormal retinal finding? Veins are markedly dilated

papilledema

do you expect to see venous pulsations with papilledema?

do you expect to be able to induce venous pulsations by applying pressure to the globe with papilledema?

can you induce venous pulsations in papilledema?

what kind of hemorrhages may occur with papilledema?

venous

is vision initially altered with papilledema?

abnormal retinal finding? Physiologic disc margins are raised with a lowered central area

glaucomatous optic nerve head cupping

abnormal retinal finding? Blood vessels may disappear over the edge of the physiologic disc and may be seen again deep within the disc

glaucomatous optic nerve head cupping

what causes the disc to appear much whiter than usual with glaucomatous optic nerve head cupping?

impairment of blood supply may lead to optic atrophy

with glaucomatous optic nerve head cupping, what causes the optic disc to appear much whiter than usual?

impairment of blood supply may lead to optic atrophy

what is the difference between glaucomatous optic nerve head cupping and glaucomatous atrophy?

the cup is usually not particularly enlarged in glaucomatous optic nerve head cupping

what causes glaucomatous optic nerve head cupping?

increased IOP with loss of nerve fibers and death of ganglion cells

effect of glaucomatous optic nerve head cupping on peripheral visual fields?

constricted

abnormal retinal finding? Ill-defined, yellow areas caused by infarction of nerve layer of retina

cotton wool spot

what causes a cotton wool spot?

infarction of nerve layer of retina

what is the underlying problem/cause of cotton wool spot?

vascular disease

external eye abnormality? Bulging of eye anteriorly out of orbit

exophthalmos

what is exophthalmos?

bulging of eye anteriorly out of the orbit

increase/decrease volume of orbital contents can cause exophthalmos?

increased

what is the most common cause of exophthalmos?

graves' disease

how does Graves' disease cause exophthalmos?

abnormal connective tissue is deposited in the orbit and extraocular muscles

external eye abnormality? Abnormal connective tissue is deposited in the orbit and extraocular muscles

exophthalmos

can exophthalmos be unilateral?

yes

can exophthalmos be bilateral?

yes

can exophthalmos be unilateral and bilateral?

yes

what should you consider with unilateral exophthalmos?

retroorbital tumor

external eye abnormality? Inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles

episcleritis

which type of episcleritis is more painful?

nodular

what is the most common cause of episcleritis?

idiopathic

external eye abnormality? Associated with acute onset of mild-to-moderate discomfort or photophobia

episcleritis

external eye abnormality? Associated with painless injection (redness) and/or watery discharge without crusting

episcleritis

external eye abnormality? Diffuse or localized injection of the bulbar conjunctiva

episcleritis

which conjunctiva is affected with episcleritis?

bulbar conjunctiva

which external eye abnormality is associated with purplish elevation of a few millimeters?

episcleritis

what kind of eye discharge is associated with episcleritis?

watery discharge

external eye abnormality? Most commonly in patients with chronic corneal disease

band keratopathy

external eye abnormality associated with hypercalcemia?

band keratopathy

external eye abnormality associated with hyperparathyroidism?

band keratopathy

external eye abnormality associated with renal failure sarcoidosis?

band keratopathy

can band keratopathy be seen with syphilis?

yes

external eye abnormality? Line just below the pupil

band keratopathy

external eye abnormality? Horizontal grayish bands interspersed with dark areas that look like holes

band keratopathy

where does line pass with band keratopathy?

over the cornea

external eye abnormality? Disruption of the corneal epithelium and stroma

corneal ulcer

external eye abnormality? Incomplete lid closure or poor lacrimal gland function

corneal ulcer

what kind of exudate would be seen with a corneal ulcer?

purulent

abnormal condition? Both eyes do not focus on an object simultaneously but can focus with either eye

strabismus

what are the two types of strabismus?

paralytic and nonparalytic

what causes paralytic strabismus?

impairment of one or more extraocular muscles

nonparalytic strabismus does not have what?

primary muscle weakness

strabismus may be a sign of increased what?

ICP

which CN is particularly vulnerable to damage from brain swelling?

CN III (oculomotor)

what abnormal eye condition may have sudden onset of double vision?

strabismus

abnormal eye condition? Report of eye deviation

strabismus

if an extraocular muscle has become impaired, the eye will not move in what direction?

the direction controlled by that muscle

what test can detect strabismus?

cover-uncover test

abnormal internal eye condition? Interruption of sympathetic nerve innervation to the eye

horner syndrome

what is horner syndrome?

interruption of sympathetic nerve innervation to the eye

what three things comprise the horner syndrome triad?

ipsilateral miosis; mild ptosis; loss of hemifacial sweating

loss of hemifacial sweating is associated with what eye disorder?

horner syndrome

ipsilateral miosis is part of the triad of what eye disorder?

horner syndrome

what kind of ptosis is part of the triad of horner syndrome?

mild

symptoms of horner syndrome depend on what?

underlying cause

can horner syndrome be congenital?

yes

can horner syndrome be acquired?

yes

can horner syndrome be hereditary?

yes

what is the hereditary pattern/transmission of horner syndrome?

autosomal dominant

how might the pupil appear on the affected side with horner syndrome?

round and constricted

which abnormal eye condition may cause anisocoria that is greater in darkness?

horner syndrome

which abnormal eye condition may cause dilation lag?

horner syndrome

what is dilation lag?

affected pupil dilates more slowly than the normal pupil

on which side of the face does dry skin occur with horner syndrome relative to the affected pupil?

dry skin is on the same side of the face as the affected pupil

abnormal eye condition? Opacity in lens

cataracts

what is the most common cause of cataract?

denaturation of lens protein d/t aging

cataracts from aging are generally what?

central

hypoparathyroidism can cause what kind of cataracts?

peripheral

which abnormal eye condition is associated with halo around lights?

cataracts

which abnormal eye condition is associated with faded colors?

cataracts

can steroid medications cause cataracts?

yes

what class of medication can cause cataracts?

steroids

can cataracts be congenital?

yes

maternal infection with what can cause cataract?

rubella

during which trimester of pregnancy can congenital cataracts develop?

1st

what is the primary objective finding with a cataract?

cloudiness of the lens

abnormal eye condition? Dot hemorrhages or microaneurysms and the presence of hard and soft exudates

nonproliferative diabetic retinopathy

what are the two types of diabetic retinopathy?

nonproliferative and proliferative

what causes hard exudates with nonproliferative diabetic retinopathy?

lipid transudation through incompetent capillaries

what causes soft exudates with nonproliferative diabetic retinopathy?

infarction of the nerve layer

cotton wool spots are associated with nonproliferative or proliferative diabetic retinopathy?

nonproliferative diabetic retinopathy

in initial stages of nonproliferative diabetic retinopathy, patient is what?

asymptomatic

which abnormal eye condition is associated with blood vessels with balloon-like sacs?

nonproliferative diabetic retinopathy

which abnormal eye condition is associated with tiny yellow patches of hard exudates?

nonproliferative diabetic retinopathy

abnormal eye condition? Development of new vessels as result of anoxic stimulate

proliferative diabetic retinopathy

where do vessels grow in proliferative diabetic retinopathy?

out of the retina toward the vitreous humor

laser therapy in proliferative diabetic retinopathy can do what?

control neovascularization and prevent blindness

what may obstruct the view of the retina in proliferative diabetic retinopathy?

vitreous hemorrhage

what is a major cause of blindness in patients with diabetes?

vessel bleeding (proliferative diabetic retinopathy)

abnormal eye condition? Creamy white appearance of retinal vessels

lipema retinalis

what causes lipema retinalisis?

excessively high serum triglyceride levels

excessively high serum triglyceride levels causes what eye condition?

lipema retinalis

what is the triglyceride threshold for lipema retinalis?

triglyceride levels > 2,000

does lipema retinalis cause vision symptoms?

which stage of lipema retinalis? White and creamy aspect of peripheral retinal vessels

grade I (Early)

which stage of lipema retinalis? Creamy color of vessels extends toward optic disc

grade II (moderate)

which stage of lipema retinalis? Retina appears salmon color and all vessels have a milky appearance

grade III (marked)

do retinal abnormalities with lipema retinalis resolve as the triglyceride levels return to normal?

yes

abnormal eye condition? Genetic defects cause cell death, mainly in the rod photoreceptors

retinitis pigmentosa

what is the genetic transmission pattern of retinitis pigmentosa?

autosomal recessive disorder

abnormal eye condition? Genetic defect causes apoptosis in the photoreceptors

retinitis pigmentosa

deafness (Usher syndrome) is associated with which abnormal eye disorder?

retinitis pigmentosa

term? Paralysis of one or more extraocular muscles

ophthalmoplegia

ophthalmoplegia is associated with which abnormal eye condition?

retinitis pigmentosa

Kearns-Sayre syndrome is associated with which abnormal eye condition?

retinitis pigmentosa

intellectual delay is associated with which abnormal eye condition?

retinitis pigmentosa

what is the earliest symptom of retinitis pigmentosa?

night blindness

tunnel vision or reports of bumping into furniture are associated with which abnormal eye disorder?

retinitis pigmentosa

is vision loss painful with retinitis pigmentosa?

which abnormal eye condition? Optic atrophy with a waxy pallor

retinitis pigmentosa

what is a hallmark of advanced disease with retinitis pigmentosa?

peripheral bone spicule pigmentation

peripheral bone spicule pigmentation is associated with which abnormal eye condition?

retinitis pigmentosa

abnormal eye condition? Disease of optic nerve wherein the nerve cells die

glaucoma

excessively high WHAT is usually the cause of glaucoma?

IOP

abnormal eye condition? May occur acutely with dramatically elevated IOP if the iris blocks the exit of aqueous humor from the anterior chamber

acute angle glaucoma

abnormal eye condition? Caused by decreasing aqueous humor absorption

open angle glaucoma

abnormal eye condition? Increased resistance and painless buildup of pressure in the eye

open angle glaucoma

can glaucoma be congenital?

yes

what is the mechanism of congenital glaucoma?

improper development of the eye's aqueous outflow system

which is more common- acute angle or open angle glaucoma?

open angle glaucoma

which glaucoma? Symptoms are absent except for gradual loss of peripheral vision over a period of years

open angle glaucoma

which glaucoma? Accompanied by intense ocular pain

acute angle glaucoma

which glaucoma? Intense ocular pain, blurred vision, halos around lights, a red eye, and a dilated pupil

acute angle glaucoma

abnormal eye condition? Intense ocular pain, blurred vision, halos around lights, red eye, dilated pupil

acute angle glaucoma

which eye condition can be associated with stomach pain, N/V?

glaucoma

abnormal eye condition? Optic nerve damage can be clearly seen during dilated eye exam and has characteristic appearanc eof the optic nerve (increased cupping)

glaucoma

with glaucoma, visual field tests may show loss of what?

peripheral vision

abnormal eye condition? Inflamamtion in the anterior vitreous, ciliary body, and peripheral retina

intermediate uveitis

when should the term intermediate uveitis be used?

where vitreous is major site of inflammation and there is an associated infection or systemic disease

what abnormal eye condition may be the presenting feature of an autoimmune disease?

intermediate uveitis

is pain common with intermediate uveitis?

no- rare

what age group is generally affected by intermediate uveitis?

15-40 years

vitreous snowballs are associated with what abnormal eye condition?

intermediate uveitis

snowbanks are associated with what abnormal eye condition?

intermediate uveitis

term? Yellow-white inflammatory aggregates found in the midvitreous and inferior periphery

vitreous snowballs

term? Gray-white fibrovascular and/or exudative plaque on the pars plana

snowbanks

what is the most common cause of chorioretinitis?

laser therapy for diabetic retinopathy

laser therapy for diabetic retinopathy can cause what abnormal eye condition?

chorioretinitis

abnormal eye condition? Inflammatory process involving both the choroid and the retina

chorioretinitis

what is another name for chorioretinal inflammation?

chorioretinitis

what is another name for posterior uveitis?

chorioretinitis

what two structures are involved in chorioretinitis?

choroid and retina

toxoplasmosis is associated with which abnormal eye condition?

chorioretinitis

abnormal eye condition? Sharply-defined lesion; generally whitish yellow and becomes stippled with dark pigment in later stages

chorioretinitis

what kind of scar is seen with chorioretinitis?

chorioretinal scar

what is the appearance of a chorioretinal scar?

whitish lesions with well-demarcated borders

can chorioretinal scar have feathery margins?

yes

what is the most common cause of visual field deficit or blindness?

interruption of vascular supply to the optic nerve

what causes bitemporal hemaniopia?

lesion

what kind of lesion most commonly causes bitemporal hemaniopia?

pituitary tumor

how does a pituitary tumor cause bitemporal hemaniopia?

interrupting the optic chiasm

what are the two types of macular degeneration?

dry and wet

what is another name for dry macular degeneration?

atrophic

what is another name for wet macular degeneration?

exudative or neovascular

what is another name for atrophic macular degeneration?

dry

what is another name for exudative or neovascular macular degenration?

term? Blind spots

scotomas

term? Straight lines looking irregular or bent

metamorphopsia

what is metamorphopsie?

straight lines looking irregular or bent

abnormal eye condition? Objects appearing a different color or shape in each eye

macular degeneration

term? Objects appearing smaller in one eye

micropsia

what is micropsia?

objects appearing smaller in one eye

what part of vision is decreased in macular degeneration?

central vision

what is the leading cause of legal blindness in pts older than 55 in the US?

macular degeneration

is dry macular degeneration gradual or rapid?

gradual

which type of macular degeneration may have rapid vision loss?

wet macular degeneration

abnormal eye condition? New abnormal blood vessels grow under the center of the retina

wet macular degeneration

abnormal eye condition? Gradual breakdown of cells in the macula that results in a gradual blurring of central vision

dry macular degeneration

what scars the retina in wet macular degeneration?

blood vessels leak and bleed

drusen is associated with which macular degeneration?

dry macular degeneration

which macular degeneration? Thinning and loss of the retina and choroid

dry macular degeneration

which macular degeneration? Exudates, blood, scarring, and new blood vessel membranes below the retina

wet macular degeneration

abnormal pediatric eye condition? Embryonic malignant tumor arising from the retina

retinoblastoma

when does retinoblastoma usually develop?

during the first 2 years of life

what are the two modes of genetic transmission of retinoblastoma?

autosomal dominant trait or chromosomal mutation

what chromosomal mutation can cause retinoblastoma?

RB1 gene on chromosome 13

what is the most common retinal tumor in children?

retinoblastoma

which abnormal eye condition can cause white pupil on photographs?

retinoblastoma

what is the initial sign of retinoblastoma?

leukocoria

term? White reflex

leukocoria

what is the term for cat's eye reflex?

leukocoria

cat's eye reflex associated with which abnormal eye condition?

retinoblastoma

which abnormal eye condition? Ill-defined mass arising from retina; chalky white areas of calcification

retinoblastoma

abnormal eye condition? Disruption of normal progression of retinal vascular development in preterm infant

retinopathy of prematurity

what gestational age can see retinopathy of prematurity?

less than or equal to 30 weeks

what weight poses a risk for retinopathy of prematurity?

less than or equal to 1500 grams

what infants have the highest risk for retinopathy of prematurity?

low birth weight preterm infants

is anemia a risk factor for retinopathy of prematurity?

yes

is poor weight gain a risk factor for retinopathy of prematurity?

yes

is blood transfusion a risk factor for retinopathy of prematurity?

yes

are respiratory distress and breathing problems risk factors for retinopathy of prematurity?

yes

abnormal eye condition? Straight, temporally divered blood vessels

retinopathy of prematurity

abnormal eye condition- pediatric? Abnormal bleeding of the blood vessels in the retina

retinal hemorrhages in infance

pediatric abnormal eye condition? Results from acceleration-deceleration impact head injury in abusive head trauma

retinal hemorrhages in infance

what abnormal eye condition is associated with shaken baby syndrome?

retinal hemorrhages in infance

is retinal hemorrhages of infancy usually unilateral or bilateral?

bilateral

how should the auricle be positioned?

nearly vertical

how long is the external auditory canal in adults?

1 inch

term? Waxy substance secreted by the apocrine glands in the distal third of the canal

cerumen

what is the purpose of cerumen?

provides an acidic environment that inhibits the growth of microorganisms

structure? An air-filled cavity in the temporal bone

middle ear

what are the three ossicles?

malleus, incus, stapes

what do the ossicles do?

transmit sound from the TM to the oval window of the inner ear

structure? Dense fibrous ring that surrounds the TM

annulus

what separates the external ear from the middle ear?

tympanic membrane

shape of tympanic membrane?

concave

what is the center of the tympanic membrane?

umbo

what pulls the TM in at the center (umbo)?

malleus

what is the clarity of the TM?

translucent

what is the tension of most of the TM?

tens

what is the term for the tense portion of the TM?

pars tensa

which part of the TM is more flaccid?

superior portion (pars flaccida)

structure? Membranous curvy cavity inside a bony labyrinth

inner ear

what are the three structures of the inner ear?

vestibule, semicircular canals, cochlea

structure? A coiled structure containing the organ of Corti

cochlea

the cochlea transmits sound impulses to which cranial nerve?

VIII

what does the cochlea do?

transmits sound impulses to CN VIII

what ear structure contain the end organs for vestibular function?

semicircular canals

term? Interpretation of sound waves by the brain

hearing

what cells detect sound vibrations?

hair cells

where are hair cells located?

organ of corti

where are the adenoids located?

posterior wall of the nasopharynx

structure? Parallel, curved bony structures covered by vascular mucous membrane

turbinates

structure? Form the lateral walls of the nose and protrude into the nasal cavity

turbinates

structure? Air-filled, paired extensions of the nasal cavities within the bones of the skull

paranasal sinuses

what two sinuses can be examined?

maxillary and frontal

where are the maxillary sinuses located?

along the lateral wall of the nasal cavity in the maxillary bone

structure? Lie along the lateral wall of the nasal cavity in the maxillary bone

maxillary sinuses

where are the frontal sinuses located?

frontal bone superior to the nasal cavities

where are the ethmoid sinuses located?

behind the frontal sinuses and near the superior portion of the nasal cavity

which sinuses lie behind the frontal sinuses?

ethmoid sinuses

which sinuses are near the superior portion of the nasal cavity?

ethmoid sinuses

which sinuses are deep in the skull behind the ethmoid sinuses?

sphenoid sinuses

where are the sphenoid sinuses located?

deep in the skull behind the ethmoid sinuses

what color should the auricles be?

same color as the facial skin

is a Darwin tubercule an expected variation?

yes

finding? A thickening along the upper ridge of the helix

darwin tubercule

a darwin tubercule may be seen when assessing what general structure?

ear

if the auricle is blue, what might this indicate?

some degree of cyanosis

pallor or excessive redness of auricles may indicate what?

vasomotor instability

extreme pallor of the auricles may be caused by what?

frostbite

finding? Results from blunt trauma and necrosis of the underlying cartilage

cauliflower ear

finding? Small, whitish uric acid crystals along the peripheral margins of the auricles

tophi

tophi may indicate what?

gout

finding? Elevations in the skin with a punctum indicating a blocked sebaceous gland

sebaceous cysts

auricle position- a low set or unusual angle may indicate what?

genetic syndrome or renal anomalies

external auditory canal with purulent foul smelling discharge is associated with what conditions?

otitis externa, perforated acute otitis media, foreign body

otitis externa, perforated acute otitis media, foreign body- may produce what kind of discharge in the external auditory canal?

purulent, foul-smelling discharge

in cases of head trauma, a bloody or serous discharge is suggestive of what?

skull fracture

what kind of external audity discharge may be seen in skull fracture?

bloody or serous discharge

procedure? Used to inspect the external auditory canal, TM, and middle ear

otoscopy

what size of otoscopic speculum should be used?

largest speculum that will comfortably fit in the patient's ear

how should you position the auricle for otoscopic exam?

upward and back

why should you pull the auricle upward and back?

to straighten the auditory canal for the best view

where should hairs and cerumen be located in the ear canal?

outer third

should cerumen have an odor?

what determines cerumen consistency?

variation of a single gene

what is the shape of a bulging TM?

more conical

contour of TM- more conical, usually with a loss of bony landmarks and a distorted light reflex?

bulging TM

contour of TM- more concave, usually with accentuated bony landmarks and a distorted light reflex?

retracted TM

bulging TM with no mobility may indicate what abnormal condition?

middle ear effusion due to acute otitis media

how might the TM appear with middle ear effusion due to acute otitis media?

bulging with no mobility

obstructuion of eustachian tube w/ or w/o middle ear effusion may cause what TM signs?

retracted with no mobility or mobility with negative pressure only

healed perforation or atrophic TM may cause what TM sign?

excess mobility in small areas

when might you see excess TM mobility in small areas?

healed perforation, atrophic TM

yellow or amber TM indicates what condition?

serous fluid in the middle ear (otitis media with effusion)

color of TM if serous fluid in middle ear (otitis media with effusion)?

amber or yellow

color of TM if blood in middle ear?

blue or deep red

when might the TM be blue or deep red?

blood in middle ear

term? Blood in middle ear

hemotympanum

what is a hemotympanum?

blood in middle ear

TM might be chalky white with what condition?

acute otitis media

prolonged crying can cause what TM color?

redness

fibrosis can cause TM to appear how?

dullness

on TM white flecks indicate what?

healed inflammation

on TM, dense white plaques indicate what?

healed inflammation

on TM, air bubbles indicate what?

serous fluid in middle ear

on TM, bullae or vesicles indicate what?

bullous myringitis

bullous myringitis is a form of what?

acute otitis media

when does otitis media typically occur?

after swimming

what is the initial symptom of otitis externa?

itching in ear canal

what are two aggravating factors of otitis externa pain?

movement of pinna and chewing

what is the initial ear discharge seen with otitis externa?

watery discharge

thick, musty, foul-smelling ear discharge seen with what abnormal condition?

otitis externa

what kind of hearing loss is seen with otitis externa?

conductive loss

what causes conductive hearing loss with otitis externa?

exudate and swelling of ear canal

how does the ear canal look with otitis externa?

red, edematous

is the TM obscured with otitis externa?

yes

what is the initial sx of otitis media w/ effusion?

sticking or cracking sound on yawning or swallowing

which abnormal ear condition? Sticking or cracking sound on yawning or swalling

otitis media with effusion

pain with otitis media with effusion?

discomfort, feeling of fullness

is there discharge with otitis media with effusion?

what kind of hearing loss is seen with otitis media with effusion?

conductive loss

why is there conductive hearing loss with otitis media with effusion?

middle ear fills with fluid

what color is the TM with otitis media with effusion?

yellowish

contour of TM with otitis media with effusion?

retracted or full

bubbles on TM with otitis media with effusion?

yes

fever is associated with which ear condition?

acute otitis media

pain with AOM?

deep-seated earache

pulling at ear is associated with what abnormal ear condition?

acute otitis media

is there discharge with AOM?

only if TM ruptures

if there is discharge with AOM, describe it?

foul-smelling

what kind of hearing loss with AOM?

conductive loss

why is there conductive hearing loss with AOM?

middle ear fills with purulent material

abnormal ear condition? TM with distinct erythema, thickened or clouding; bulging

acute otitis media

abnormal ear condition? Limited or absent movement from positive or negative pressure; vesicles or bullae may be seen

acute otitis media

how should infant be positioned for otoscopic exam?

supine or prone position so head can be turned side to side

how is the TM usually positioned in the newborn?

extremely oblique position

why might the light reflex appear diffuse in a newborn?

the TM does not become concical for several months

how should you position an older toddler for an otoscopic exam?

face the child sideways with one arm placed around the parent's waist

if the child has been/is crying, what can cause the TM to appear pinkish-red?

dilation of blood vessels in the TM

why would the otoscopic and oral exams be performed last on young children?

young children often resist

how is cranial nerve VIII tested?

by evaluating hearing

when does hearing screening begin?

when the patient responds to your questions and directions

speech with a monotonous tone and erratic volume may indicate what?

hearing loss

what test has been found to have good specificity and sensitivity for detecting hearing loss in what age group?

adults aged 50 to 70

what is the purpose of the tuning fork?

to compare hearing by bone versus air condition

what does the Weber test assess for?

unilateral hearing loss

what test assesses for unilateral hearing loss?

Weber test

with the Weber test, is lateralization of sound normal?

how should patient hear sound with the Weber test?

equally in both ears

what is the purpose of the Rinne test?

helps distinguish whether the patient hears better by air or bone conduction

what test assesses whether the patient hears better by air or bone conduction?

Rinne test

how long should air conduction be relative to bone conduction?

air conducted sound should be heard twice as long as bone-conducted sound

Weber test- with conductive hearing loss, where is sound heard better?

affected ear

Weber test- with sensorineural loss, which ear does sound lateralize to?

better ear

what is a positive Rinne test?

air conduction heard longer than bone conduction by 2:1 ratio

what is a negative Rinne test?

bone conduction heard longer than air conduction in affected ear

what happens with Rinne test if sensorineural hearing loss?

air conduction heard longer than bone conduction in affected ear, but less than 2:1 ratio

structure? Bridge of tissue separating the nares

columella

what is the columella?

bridge of tissue separating the nares

what is the expected position of the columella?

directly midline

what can cause a depression of the nasal bridge or saddle nose deformity?

fractured nasasl bone or previous nasal cartilage inflammation

fractured nasal bone or previous nasal cartilage inflammation can cause what findings?

depression of the nasal bridge or saddle nose deformity

what is nasal flaring associated with?

respiratory distress

what can narrowing of the nares on inspiration indicate?

chronic nasal obstruction and mouth breathing

what finding can occur with chronic nasal obstruction and mouth breathing?

narrowing of the nares on inspiration

what may a transverse crease at the junction between the cartilage and bone of the nose indicate?

allergic salute

what is allergic salute?

frequent upward rubbing of the nose d/t chronic nasal itching and allergies

term? Frequent upward rubbing of the nose d/t chronic nasal itching and allergies

allergic salute

what kind of nasal discharge is seen with allergy?

bilateral watery discharge

what kind of nasal discharge is seen with epistaxis or trauma?

bloody discharge

what kind of nasal discharge is seen with rhinitis or upper respiratory infection?

bilateral mucoid or purulent discharge

what kind of nasal discharge is seen with foreign body?

unilateral, purulent, thick, greenish, malodorous discharge

nasal discharge- unilateral purulent, thick, greenish, malodorous- what can cause?

foreign body

is nasal discharge from foreign body unilateral or bilateral?

unilateral

is nasal discharge from allergy unilateral or bilateral?

bilateral

what kind of nasal discharge is seen with CSF leakage?

unlateral watery discharge

is nasal discharge from CSF leakage unilateral or bilateral?

unilateral

expected appearance of the nasal mucosa?

glisten and deep pink

purulent discharge in nasal cavity may be associated with what three conditions?

URI, sinusitis, foreign body

increased redness of nasal mucosa may occur with what?

infection

localized redness and swelling in the nasal vestibule may indicate what?

furuncle

how should the turbinates feel?

firm

how might turbinates of patient with allergies apepear?

bluish gray or pale pink

what might the texture of the turbinates be in patient with allergies?

swollen, boggy consistency

how might a nasal polyp appear?

rounded, elongated mass in nasal cavity from boggy mucosa

should the anterior septum or posterior septum be thicker?

anterior septum

how might a deviated septum present?

asymmetric size of posterior nasal cavities

what might be the cause of asymmetric size of the posterior nasasl cavities?

deviated septum

structure? Anterior portion of the nasal septum

Kiesselbach plexus

what is the Kiesselbach plexus?

anterior portion of the nasal septum

crusting of the Kiesselbach plexus may occur where?

at the site of epistaxis

what is the sensory function of CN I?

smell reception and interpretation

when would you test the olfactory nerve?

a concern exists with the patient's ability to discriminate odors

when testing the olfactory nerve, which scent should be used first?

least irritating

can allergic rhinitis interfere with the ability to discriminate odors?

yes

can inflammation fo the mucous membranes interfere with the ability to discriminate odors?

yes

can excessive smoking interfere with the ability to discriminate odors?

yes

what happens to the sense of smell with age?

may diminish

term? Loss of sense of smell or inability to discriminate odors

anosmia

what is anosmia?

loss of sense of smell or inability to discriminate odors

what are three causes of anosmia?

trauma to cribiform plate, olfactory tract lesion, infection

can infection cause anosmia?

yes

can an olfactory tract lesion cause anosmia?

yes

trauma to what structure can cause anosmia?

cribiform plate

swelling, tenderness, and pain over sinuses may indicate what?

infection or obstruction

sinus infection or obstruction may present how?

swelling, tenderness, pain over sinuses

term? Dry, cracked lips

cheilitis

what is cheilitis?

dry, cracked lips

term? Deep fissures at the corners of the mouth

angular chelitis

what is angular chelitis?

deep fissures at the corners of the mouth

deficiencies of what two minerals/vitamins can cause angular chelitis?

iron and B vitamins

term? Swelling of the lips

angioedema

what is angioedema?

swelling of the lips

can angioedema be caused by infection?

yes

can angioedema be caused by allergy?

yes

what lip change is associated with anemia?

lip pallor

what is circumoral pallor associated with?

scarlet fever due to group A strep infection

scarlet fever due to group A strep infection can cause what lip color change?

circumoral pallor

term? Bluish-purple lips

cyanosis

what is cyanosis?

bluish-purple lips

what causes cyanosis?

hypoxia

what lip/buccal mucosa finding is associated with Peutz-leghers syndrome?

round, oval, or irregular bluish-gray macules

round, oval or irregular bluish-gray macules on the lips and buccal mucosa are associated with what?

Peutz-leghers syndrome

what may cause the landmarks of the TM to appear slightly more pronounced in older adults?

sclerotic changes

with older adults, there is often some degree of what hearing change?

sensorineural hearing loss with advancing age (presbycusis)

what kind of hearing loss is caused by otosclerosis in older adults?

conductive loss

what kind of hearing loss is caused by cerumen impaction?

conductive loss

term? Dryer oral tissues

xerostomia

why might older adults have dental malocclusion?

due to migration of remaining teeth after extractions

what is CN VII?

facial nerve

symmetry of facial features with various expressions tests which cranial nerve?

CN VII (facial nerve)

which two cranial nerves are involved in taste?

VII and IX

where is the Stensen duct located?

approximate alignment with the second upper molar

what color is the Stensen duct?

whitish-yellow or whitish-pink

structure? Whitish-yellow or whitish-pink protrusion in approximate alignment with the second upper molar

should you see small stones or exudate from the Stensen duct?

are Fordyce spots an expected variant?

yes

structure? Ectopic sebaceous glands that appear on the buccal mucosa and lips as numerous small, yellow-white raised lesions

Fordyce spots

a red spot on the buccal muscosa at the opening of the Stensen duct is associated with what?

parotitis

parotitis is associated with what kind of infection?

mumps

abnormal finding? On the buccal mucosa appear as white, round, or oval ulcerative lesions with a red halo

aphthous ulcers

describe the appearance of aphthous ulcers on the buccal mucosa?

white, round, or oval ulcerative lesions with a red halo

abnormal finding? A thickened white patch lesion that cannot be wiped away

leukoplakia

what kind of lesion is leukoplakia?

premalignant oral lesion

when is leukoplakia most commonly seen?

patients smoking or chewing tobacco

is leukoedema a normal variant?

yes

leukoedema is a normal variant in what perccentage of black adults?

0.9

finding? Diffuse, filmy, grayish surface with white streaks, wrinkles, or milky alteration (buccal mucosa)

leukoedema

how should gingivae appear?

slightly stippled or dotted pink appearance

how should gingivae feel?

firm and tightly bound to underlying bone

term? A localized gingival enlargement or granuloma

epulis

what is epulis?

a localized gingival enlargement or granuloma

is an epulis inflammatory or neoplastic?

usually inflammatory

does pregnancy cause gingival enlargement?

yes

does puberty cause gingival enlargement?

yes

does vitamin C deficiency cause gingival enlargement?

yes

does phenytoin cause gingival enlargement?

yes

does cyclosporine cause gingival enlargement?

yes

do CCBs cause gingival enlargement?

yes

does leukemia cause gingival enlargement?

yes

what two things can cause looth teeth?

periodontal disease or traums

what should you suspect when discolorations are seen on the crown of a tooth?

caries

asking the patient to extend the tongue tests which cranial nerve?

CN XII (hypoglossal)

if the tongue deviates to one side while extended it means what?

tongue atrophy and hypoglossal nerve impairment?

is the geographic tongue an expected variant?

yes

finding? Superficial denuded circles or irregular areas exposing the tips of papillae

geographic tongue

what may a smooth red tongue with a slick appearance indicate?

vitamin B12 deficiency

term? Smooth red tongue with a slick appearance

glossitis

glossitis may indicate what?

vitamin B12 deficiency

hairy tongue with yellow-brown to black elongated papillae on the dorsum sometimes follows what?

antibiotic therapy

structure? Apparent on each side of the frenulum

Wharton duct

what is another word for ranula?

mucocele

what is another word for mucocele?

ranula

where might a ranula be seen?

on the floor of the mouth when the duct of a sublingual salivary gland is obstructed

what can cause a ranula/mucocele?

duct of a sublingual salivary gland is obstructed

what can cause lesions on the tongue?

infectious process

finding indicates what? Ulcer, nodule, or thickened white patch on the lateral or ventral surface of the tongue

malignancy

how should the hard palate appear?

whitish, dome-shaped, with transverse rugae

the pinker soft palate is contiguous with what?

hard palate

structure? A midline continuation of the soft palate

uvula

structure? Bony protuberance of the midline of the hard palate

torus palatinus

is torus palatinus a normal variant?

yes

is torus palatinus more common in men or women?

women

what is the torus palatinus?

hard palate with a bony protuberance at the midline

what might a nodule on the palate that is not midline indicate?

a tumor

is mandibular torus an expected variant?

yes

structure? A bony protuberance that occurs bilaterally on the lingual surface of the mandible, near the canine and premolar teeth

mandibular torus

how do you evaluate movement of the soft palate?

asking the patient to say "ah"

asking the patient to say "ah" also tests the function of which two cranial nerves?

CN IX (glossopharyngeal) and CN X (vagus)

deviation of the uvula to one side may indicate what two conditions?

vagus nerve paralysis or peritonsillar abscess

with vagal nerve paralysis, in which direction does the uvula deviate?

toward unaffected side

in peritonsillar abscess, in which direction does the uvula deviate?

toward unaffected side

is a bifid uvula a benign condition?

yes

a bifid uvula may be a normal variant in what population?

native americans

if a bifid uvula indicates a pathology, what condition may it indicate?

submucous cleft palate or Loeys-Dietz syndrome

how might the uvula appear in Loeys-dietz syndrome?

bifid uvula

how might the uvula appear with a submucous cleft palate?

bifid uvula

what is Loeys-Dietz syndrome?

a disorder in which aortic root dilation and aortic dissection may occur

disorder? A disorder in which aortic root dilation and aortic dissection may occur

loeys-dietz syndrome

a red bulge adjacent to the tonsil and extending beyond the midline may indicate what?

peritonsillar abscess

a yellowish mucoid film in the pharynx indicates what?

postnasal drip

eliciting a gag reflex tests what cranial nerves?

CN IX (glossopharyngeal) and CN X (vagus)

should a gag response be unilateral or bilateral?

bilateral

oral lesion? White, irregular lesions on the lateral side of the tongue or buccal mucosa; may have prominent folds or "hairy" projections

oral hairy leukoplakia

oral lesion of HIV? Red, unilateral or bilateral fissures at corners of mouth

angular chelitis

oral lesion of HIV? Creamy white plaques on oral mucosa that bleed when scraped

candidiasis

oral lesion of HIV? Recurrent vesicular crusting lesions on the vermillion border of the lip

herpes simplex

oral lesion of HIV? Vesicular and ulcerative oral lesions in the distribution of the trigeminal nerve; may also be on gingiva

herpes zoster

oral lesion of HIV? Single or multiple sessile or pedunculated nodules in the oral cavity

HPV

oral lesion of HIV? Recurrent circumscribed ulcers with an erythematous margin

aphthous ulcers

oral lesion of HIV? In a mouth with little plaques or calculus, gingivitis with bone and soft tissue degeneration accompanied by severe pain

periodontal disease

oral lesion of HIV? In the mouth, incompletely formed blood vessels proliferate, forming lesions of various shades and size as blood extravasates in response to the malignant tumor of the epithelium

kaposi sarcoma

ear abnormality? Abnormal squamous epithelial tissue behind the tympanic membrane

cholesteatoma

what can happen as the epithelial tissue enlarges with cholesteatoma?

it can perforate the TM

unilateral or bilateral hearing loss with cholesteatoma?

unilateral

what kind of hearing loss occurs with cholesteatoma?

conductive hearing loss

abnormality? Reduced transmission of sound to the middle ear

conductive hearing loss

cerumen impaction causes what kind of hearing loss?

conductive hearing loss

otitis media with effusion causes what kind of hearing loss?

conductive hearing loss

a patient that turns the volume louder on the TV may be experiencing what kind of hearing loss?

conductive hearing loss

a patient that hears better in a noisy environment may have what kind of hearing loss?

conductive hearing loss

what kind of hearing loss is caused by otosclerosis?

conductive hearing loss

condition? Bone deposition immobilizing the stapes

conductive hearing loss

lateralization to affected ear with Weber test- what kind of hearing loss?

conductive hearing loss

loss of low-frequency sounds- what kind of hearing loss?

conductive hearing loss

bone conduction heard longer than air conduction- what kind of hearing loss?

conductive hearing loss

why do patients with conductive hearing loss speak softly?

hears own voice by bone conduction

patient speaks softly- what kind of hearing loss?

conductive hearing loss

condition? Reduced transmission of sound in the inner ear

sensorineural hearing loss

damage to which cranial nerve causes sensorineural hearing loss?

CN VIII

cochlear disorder- causes which kind of hearing loss?

sensorineural hearing loss

which hearing loss- complains that people mumble?

sensorineural hearing loss

which hearing loss- difficulty understanding speech?

sensorineural hearing loss

which hearing loss? Speaks more loudly

sensorineural hearing loss

which hearing loss? Unable to hear in a crowded room?

sensorineural hearing loss

which hearing loss- air conduction heard longer than bone conduction with Rinne test?

sensorineural hearing loss

which hearing loss? Weber test- lateralizes to unaffected ear

sensorineural hearing loss

which hearing loss? Loss of high-frequency sounds (consonants)

sensorineural hearing loss

which hearing loss can be caused by prolonged exposure to loud occupational/recreational noise?

sensorineural hearing loss

condition? In older adults, results from degenerative changes in the inner ear or vestibular nerve

presbycusis

what kind of hearing loss is presbycusis?

sensorineural hearing loss

condition? An inner ear disorder characterized by episodes of hearing loss, vertigo, tinnitus, ear fullness

Meniere disease

condition? May be caused by excess secretion of endolymph or failure of reabsorption in the subarachnoid space

Meniere disease

condition? Sudden onset of severe vertigo (r/t moving the head) typically lasts for 20 minutes to several hours

Meniere disease

can Meniere disease cause hearing loss?

yes

condition? Whistling or roaring sounds in the affected ear- may be continuous or intermittent

Meniere disease

condition? Hearing loss to low tones initially with fluctuating progression to profound sensorineural hearing loss

Meniere disease

which hearing condition is associated with sensitivity to sound, imbalance, and nystagmus?

Meniere disease

Meniere disease can cause what secondary condition?

vertigo

condition? The illusion of rotational movement by a patient, most often d/t disorder of the inner ear

vertigo

condition? Inflammation of the vestibular nerve after an acute viral URI

acute vestibular neuronitis

acute vestibular neuronitis is associated with what condition?

vertigo

condition? Otolith fragments gravitate into the semicircular canal, and nerve sensors in the canal cause vertigo with head movements

benign paroxysmal positional vertigo

which cause of vertigo? Spontaneous episode of vertigo that is severe initially and lessens over a few days

acute vestibular neuronitis

which cause of vertigo? Episode of vertigo with head or body movements; lasts less than a minute

benign paroxysmal positional vertigo

which cause of vertigo? Spontaneous horizontal nystagmus with/without rotary nystagmus

acute vestibular neuronitis

associated with which cause of vertigo? Staggering gait

acute vestibular neuronitis

associated with which cause of vertigo? May have no physical findings

benign paroxysmal positional vertigo

associated with which cause of vertigo? Rotary nystagmus with Dix-hallpike maneuver

benign paroxysmal positional vertigo

condition? A bacterial infection of one or more of the paranasal sinuses

sinusitis

condition? Inflammation, allergies, or structural defect of the nose may block the sinus meatus and prevent the sinus cavity from draining

sinusitis

condition? Overproduction of mucus may result from inflammation and increase susceptibility to infection

sinusitis

preadolescent children with what condition may have daytime and nighttime cough, halitosis, and fever?

sinusitis

condition? Infection of tonsils or posterior pharynx by microorganisms

acute bacterial pharyngitis

what oropharyngeal condition can be caused by group A beta hemolytic strep?

acute bacterial pharyngitis

what oropharyngeal condition can be caused by N gonorrhoaea and mycoplasma pneumoniae?

acute bacterial pharyngitis

scarlatiniform rash is associated with what oropharyngeal condition?

acute bacterial pharyngitis

palatal petechiae are associated with what oropharyngeal condition?

acute bacterial pharyngitis

what lymph nodes are enlarged with acute bacterial pharyngitis?

anterior cervical

condition? A deep infection in the space between the palatine tonsil capsule and pharyngeal muscles

peritonsillar abscess

what condition is thought to develop as a complication from adenotonsilitis?

peritonsillar abscess

when is the peak indicence of peritonsillar abscess?

adolescence

associated with what condition? Dysphagia, odynophagia, drooping

peritonsillar abscess

associated with what condition? Severe sore throat pain with pain radiating to ear; pain is worse on one side

peritonsillar abscess

associated with what condition? Unilateral red and swollen tonsil and adjacent soft palate

peritonsillar abscess

describe organisms involved with peritonsillar abscess?

typically polymicrobial

term? Spasm of masticator muscles

trismus

what kind of lymphadenopathy is seen with peritonsillar abscess?

cervical and/or submandibular

what is trismus?

spasm of masticator muscles

in what two conditions might you see trismus?

peritonsillar abscess and retropharyngeal abscess

condition? A life-threatening deep neck space infection that may occlude the airway

retropharyngeal abscess

condition? Occurs in the potential space extending from the base of the skull to the posterior mediastinum between the posterior pharyngeal wall and prevertebral fascia

retropharyngeal abscess

when does retropharyngeal abscess most often occur?

in pediatric patients after URI

is retropharyngeal abscess more common in boys or girls?

boys

predisposing factors to what condition? Pharyngitis, tonsillitis, sinusitis, dental infection

retropharyngeal abscess

condition? Recent URI, acutely ill/fever, drooling, anorexia, pain in neck and jaw referred to ear; chest pain if extends to mediastinum

retropharyngeal abscess

condition? Lateral neck movement increases pain; torticollis

retropharyngeal abscess

how is the lateral pharyngeal wall disorted with retropharyngeal abscess?

medially

condition? A cancer involving the oral cavity or related structures

oral cancer

what is the most often original type of oral cancer?

squamous cell carcinoma

where does squamous cell carcinoma originate in oral cancer?

basal layer of the oral mucosa

what percentage of squamous cell carcinomas are HPV positive?

0.56

condition? Painless sore in mouth that does not heal

oral cancer

condition? Ulcerative lesion (Red or white) appearing as piled up edges around a core on the lateral border or floor of the mouth

oral cancer

condition? A red or white patch on the gums, tongue, tonsil, hard or soft palate, or buccal mucosa

oral cancer

condition? Firm, nonmobile oral mass; tooth mobility in absence of peridontal disease; cervical lymphadenopathy

oral cancer

condition? Chronic infection of the gums, bones, and other tissues that surround and support the teeth

periodontal disease

what is another name for periodontitis?

periodontal disease

what is another name for periodontal disease?

periodontitis

what is often the cause of periodontal disease?

poor dental hygiene

condition? Calculus and hard plaque not removed below the gum line

periodontal disease

condition? Underlying bone is reabsorbed and teeth loosen

periodontal disease

condition? Red and swollen gums that bleed easily with brushing

periodontal disease

condition? Teeth appear long; deep pockets between the teeth and gingiva; halitosis; loose/missing teeth

periodontal disease

condition? Most common craniofacial congenital malformation

oropharyngeal clefts

condition? Result of the lip or palate failing to fuse during embryonic development before the 12th week of gestation

oropharyngeal clefts

oropharyngeal clefts are thought to be caused by what?

interactions between genetic and environmental factors

condition? Difficulty sucking and failure to gain weight

oropharyngeal clefts

can clefts be unilateral?

yes

can clefts be bilateral?

yes

what evolves from honesty, candor, demonstrating dignity and respect?

trust

Exam 1 Flashcards

(1052 cards)