Exam 3 Flashcards
what are some age-related eye changes
presbyopia, fibers thicken and yellow, cataract formation, Glaucoma, macular degeneration
Explain how to assess the pupillary light reflex and consensual light reflex
- the pupillary reflex occurs in darken room and examiner shines light from side and directly into the eye, pupil constricts 2. the consensual light reflex is the constriction of the other pupil (if it doesn’t problem with the CN III
test for accommodation
focus on distant object than shifts to close object, at near distance pupils should constrict and axes should converge
snellen test
top number- distance from chart, bottom number- normal distance an eye can see the chart line, large denominator= poorer vision refer for worse than 20/30
hand held vision screener
for near vision, 14 inches away, normal is 14/14
confrontation test
gross measure of peripheral vision, use finger to look six different ways
corneal light test
called Hirschberg test, tests parallel alignment of eye axes, same level of light shining in both eyes
cover test
used if fails corneal light reflex test, stare at nose cover one eye, both eyes should be looking in the direction of the nose
6 cardinal positions of gaze
tests EMO’s- extraoccular movements
conductive hearing loss
dysfunction because of impact of cerumen
sensorineural or perceptive loss
pathology of inner ear CN8, age related nerve damage, or ototoxic drugs called presbycusis
Vertigo
spinning twirling b/c dysfunction of labyrinth, Obj= feels room spinning Sub= feels like individual is spinning
Age related hearing changes
cilia lining of ear becoming more coarse and stiff accumulation of cerumen, cerumen gets drier b/c of atrophy of apocrine glands, frequent ear infections, presbycusis- nerve degenerations
types of cercumen
- dry gray flaky (thin masses in ear cannel) found in Asian and Native Americans
- wet honey brown to dark brown found in Caucasians and African Americans
tinnitus
ringing crackling and buzzing in ears caused by ototoxic meds(damage inner ear), ear infections, Meniere’s disease
proper way to clean the ear canal
warm mineral oil and hydrogen peroxide then irrigate using warm water (with bulb or water pick) never irrigate w/ infection
meaning of tragus or pinna being tender
otalgia (pain in the external ear) from otitis externa or swimmers ear (inflammation of outer ear and canal) and furuncle (pain, redness, infected hair follicle on tragus)
Romberg test
assesses CN8 and intactness of the cerebellum and proprioception, client stand straight with hands at sides and open and close eyes for 20 seconds normal is no swaying and keeps balance
age related changes in mouth nose and throat
nose seems more prominent, loss of taste and smell, tooth loss
Assess CN 1
only assessed with complaint of loss of smell, client close eyes and hold a cotton ball with alcohol or coffee
deviated septum
have client close one nostril and sniff in check for airflow
grading system for tonsils
1+ visible (normal) 2+halfway between tonsillar pillars and uvula 3+touching uvula 4+touching each other
cleft lip and palate
most common in Asian American and American Indians less common in Caucasians and least common in African American
torus palatinus
boney ridge in middle of hard palate, higher in Asians and women
