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Physical Exam > Exam I > Flashcards

Exam I Flashcards

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1
Q

Pulse and Respiration Evaluation

A

Count for 30 multipply by 2
Tachycardia count to 60sec.

Resp. 60 sec. or 15 Sec. X4

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2
Q

Orthostatic Hypotension Evaluation

A

Drop in Systolic BP of >= 20mmHg (Wait 3min.)

Drop in Diastolic BP of >=10mmHg

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3
Q

Examination skills from least invasive to most invasive

A

Inspection
Auscultation
Percussion
Palpation

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4
Q

Stethoscope bell-side lightly applied detects______sounds

A

Low -Pitched sounds

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5
Q

Stethoscope diaphragm detects________sounds

A

High-pitched sounds

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6
Q

Sphygmomanometer BP evaluation width should be

A

40% of upper arm circumference

Length- Should almost encircle upper arm

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7
Q

Blood Pressure evaluation

A
  1. Avoid smoking/coffee for 30 min.
  2. Sit x5 min. quietly arm supported at heart level
  3. Arm free of clothing, injury or I.V
  4. Inflate Cuff 30 mmHg
  5. BP both arms X1 Ea.
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8
Q

Tuning Fork Large

A

128 C (Hz) Used for vibratory sensation

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9
Q

Tuning Fork Small

A

512 C (Hz) Weber and Rinne Test

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10
Q

Joint Range of Motion evaluation tool

A

Goniometer

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11
Q

Eye Chart evaluation tool______ held ___” from PT

A

Snellen; 14 Inches

Snellen Chart= 20 feet

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12
Q

Prior to Examining Eye obtain

A
  1. Last eye exam
  2. Wear Glasses or contacts
  3. Hx of Ocular Disease
    (Do not Press on the Globe)
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13
Q

Eye chart notation N: indicates?

A

Distance from chart

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14
Q

Eye Chart notation D: indicates?

A

Distance a normal eye can read the line

20/15= You can read at 20’ what a normal reads at 15’

20/40= you can read at 20’ what a normal reads at 40’

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15
Q

What if patient cannot see largest letter?

A

Walk the PT toward chart until they see the E

Record: 10/400 if seen at 10 ‘

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16
Q

What if patient is unable to see big E at 3’?

A

Count fingers, hand motion, light perception

>20-200= Legally blind

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17
Q

A visual field is the entire area seen by an eye when it looks at a central point

A

Visual Fields by confrontation

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18
Q

A lack of retinal receptors at the optic disc produces an oval blind spot in the

A

normal field of each eye 15 Degrees Temporal to the line of Gaze

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19
Q

Looking down and to the right: the left eye cannot look down when turned inward

A

L CN IV Paralysis

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20
Q

is a form of strabismus in which one or both eyes turns inward.

A

Esotropia

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21
Q

Looking straight: esotropia appears.

Looking to left: left eye does not move laterally.

A

L CN VI

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22
Q

Drooping of an upper eyelid

A

Ptosis

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23
Q
  • Looking straight: the eye is pulled outward by action of CN VI.
  • Upward, downward, and inward movements are impaired or lost.
  • Ptosis and pupillary dilation may be associated
A

L CN III Paralysis

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24
Q

Ask pt to follow your finger or pencil as you move it in toward the bridge of the nose. Poor= Hyperthyroidism

A

Convergence

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25
Ask pt to focus on a distant object, then a new object. | pupil normally constricts when focusing on near objects
Accomodation
26
A condition in which binocular fixation is not present. | Misalignment of the eyes
Strabismus
27
also called lazy eye; Reduced Visual acuity not correctable by refractive means
Amblyopia
28
misalignment that is always there, even when both eyes are open and attempting to work together
Tropia
29
misalignment that only occurs some of the time, such as when the synchronization between the eyes is broken by covering one eye
Phoria
30
Types of Tropia
``` Exotropia= Eye vears lateral Esotropia= Eye Vears medial Hypertrophia= Eye vears Superior Hypotrophia = Eye vears Inferior ```
31
Stand in front of the patient and shine a penlight in front of their nose directed toward a center point (between the eyebrows). Observe reflection of light on cornea with respect to pupil
Hirschberg's Test (Pos. = Tropia)
32
For every 1mm of asymmetry, there is approx____degrees of misalignment
7 Degrees (3mm= 21 Degrees)
33
In a positive Hirschberg's The dominant eye
Does not correct itself (Does not move)
34
is the subjective complaint of seeing 2 images instead of one and is often referred to as double-vision
Diplopia
35
Nearsightedness
Myopia
36
Farsightedness
Hyperopia
37
an abnormal curvature of the cornea can cause two focal points to fall in two different locations, making objects up close and at a distance appear blurry.
Astigmatism
38
How to break through a phoria
Cover one eye then cross over immediatley to cover the other.(Both eyes will move subtle, when uncovered)
39
Normal size of a pupil
4-6mm
40
Constriction of a pupil
Miosis
41
Dilation of a pupil
Mydriasis
42
Inequality of the pupils
Anisocoria
43
Pupillary constriction of the opposite eye
Consensual Reaction
44
Pupillary constriction of same eye
Direct Reaction
45
Bilateral small pupils that constrict when the patient focuses on a near object, but do not constrict when exposed to bright light
Argyll Robertson Pupils
46
Positive Argyll Robertson Pupils indicates
Neurosyphilis Dorsal midbrain damage-Light-near dissociation
47
dilated right pupil (above) constricts slowly and progressively until it becomes slightly smaller (below) than the simultaneously constricted left pupil
Tonic Pupil
48
can be caused by local disorders such as tumor, inflammation, surgery or infection within the orbit
Tonic Pupil
49
RAPD stands for
Relative Afferent Pupillary Defect
50
In RAPD Less constriction to both eyes with light into affected eye. Light light into unaffected eye=Bilat constriction
Marcus Gunn Pupil
51
The most common cause of Marcus Gunn pupil is a
Lesion of the Eye
52
Other causes of Marcus Gunn pupil
- Optic neuritis - Retinal Detachment - -Central Artery or Vein occlusion
53
lateral sparseness of eyebrow can be related to
Hypothyroidism
54
Scales on the eyebrows "Scurf"
Seborrheic Dermatitis
55
red inflamed lid margins.
Blepharitis
56
painful, tender red infection in a gland at the lid margin.
Stye
57
nontender, usually painless nodule of the meibomian gland
Chalazion
58
Xanthelasma
yellowish, slightly raised, plaques.
59
eyeball protrudes forward (Graves’ hyperthyroidism).
Exopthalmus
60
inward turning of the lid margin
Entropion
61
Outward turning of the lid margin
Ectropion
62
lacrimal gland and lacrimal sac swelling | Suggests Blockage of lacrimal duct
Dacryocystitis
63
yellow sclera
Icterus
64
dilatation of the conjunctival vessels; Local or diffuse
Injection (Diffuse) Conjunctivitis (Localized) Episcleritis
65
Bleeding underneath of conjunctiva; Hypertension or trauma
Hyposphagma
66
Edema of the conjunctiva
Chemosis
67
Blue or cyanotic sclera is seen in children with
Osteogenis Imperfecta
68
thin grayish white arc or circle not quite at the edge of the cornea (accompanies normal aging).
Corneal Arcus (Arcus Senilis)
69
opacities of the lens, most common in old age.
Cataract
70
Pooling of blood inside the anterior chamber; results form severe trauma
Hyphema
71
collection of fat, medial or lateral to the iris, which DOES NOT extend onto the cor
Pinguecula
72
triangular thickening of the bulbar conjunctiva that grows (insidious) across the outer surface of the cornea May interfere with if on pupil LOS; Usually nasal side.
Pterygium
73
iris bows forward (forming a narrow angle with the cornea) or crescent shadow; Usually flat= no shadow
Narrow-Angle Glaucoma
74
Eye pain, photophobia, blurry vision, redness.
Iritis
75
numbers are used for people who have longer globe.
Red=Nearsighted (Myopic)
76
numbers correct a shorter globe.
Farsighted (Hyperopic): ((black)) or ((green))
77
Opthalmoscope Technique
about 15 inches away from the patient and 15 degree angle lateral to their line of vision, shine the light beam on the pupil and check the red reflex
78
If Red Reflex is absent, could indicate
- Tumor in infants - congenital catarct - Central artery occlusion - retinal detachment
79
Inspect the optic disc for
- Margins; Slightly Blury - Color; Yellowish-orange - Size of cup; Cup-to Disk 1:2 1/2
80
If Disk is red suspect
Papilladema
81
Id the disk is pale suspect
Atrophy
82
If cup to dsik ratio is greater than 1/2 (.5) indicates
Glaucoma
83
Papilladema-Swelling of the optic disc with bulging of the physiologic cup indicates______ Signals D/O of brain such as
ICP Meningitis, SubArachnoid hemorrhage, Trauma
84
arteriole crosses a venule resulting in impaction of the vein with bulging on either side of the crossing Seen in hypertensive retinopathy
Nicking
85
can be caused by hypertension or retinal vein occlusion (a blockage of a retinal vein), or Diabetes M. (Shaken Baby Syndrome)
Retinal Hemorrhage
86
(cotton-wool spots): white, yellowish or grayish, ovoid lesions with irregular “soft” borders Diabetes or hypertension
Retinal Lesions (Soft Exudates)
87
White, creamy or yellowish, often bright lesions with well-defined “hard” borders. Retinal Edema Protein and lipid accumulation; Vision may be lost if on macula
Retinal Lesions (Hard Exudates)
88
yellowish round spots with soft or hard borders; occurs w/ age but also macular degeneration (Central Blind)
Drusen (Retinal Lesion)
89
Represent proliferative retinopathy. These are new vessels that grow tend to be poor quality and leak or rupture, thus causing blindness. 
Neovascularization
90
Covers most f the Ant. eyeball adhering loosely to the underlying tissue.
Bulbar conjunctiva
91
Lines the eyelids
Palpebral cojunctiva
92
Lie within the eyelids as firm strips that containi a parallel ro of Meibomian Glands
Tarsal Plates
93
Lid elevation is raised by the_____ muscle innervated by CN______
Levator Palpebrae; CN III
94
When a person shifts gaze from a far object to a near one pupils constrict; this is mediated by the____ Nerve
Oculomotor Nerve CNIII
95
COnvergence and accommodation is controlled by the
Ciliary Msucles
96
Poor central vision suggests
Macular degeneration
97
Constricted field of vision 20 degrees or less in the better eye is suggests
Legal Blindness

Physical Exam (2 decks)

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