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PE midterm > Eye (UPDATED!) > Flashcards

Eye (UPDATED!) Flashcards

1
Q

What should PAs never prescribe for pts to put int heir eyes withour direction from an opthamologist?

A

steroids

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2
Q

what are the side effects of steroids in the eye?

A

weakened, perforated cornea

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3
Q

True or false: you should always answer “refer to opthamologist” if it is an option

A

TRUE

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4
Q

what are the corners of the eyes called?

A

lateral and medial canthus

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5
Q

what gland is just above the eye?

A

lacrimal gland

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6
Q

what is the part of the eylid that is found under the eyelashes?

A

palpebral fissure

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7
Q

what are the holes on the superior and inferior palpebral fissures near the medial canthus?

A

superior/inferior lacrimal punctum

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8
Q

where is the caruncle located?

A

the red spot in the nasal corner of the eye

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9
Q

what duct empties into the inferior nasal turbinate?

A

the nasolacrimal duct

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10
Q

what is the funciton of tears?

A

protect conjunctiva/cornea from drying, inhibit microbial growth, make surface of cornea smooth

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11
Q

What disease is associated with a lack of tears?

A

Sjogrens

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12
Q

what CN is associated with closing the eye?

A

VII

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13
Q

what CN is associated with opening the eye?

A

III

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14
Q

what are the major CN associated with the eye?

A

3, 4, 6, 7

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15
Q

what CN is associated with changing the shape of the ciliary muscle to focus the lens?

A

III

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16
Q

What is the canal of schlem?

A

drains the vitreous humor of the eye

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17
Q

What can form if the canal of schlem is blocked? How is it treated?

A

glaucoma, vitrectomy to laster through and form the canal again

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18
Q

what parts of the eye are associated with the anterior chamber?

A

cornea, pupil, iris, lens

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19
Q

What parts of the eye are associated with the posterior chamber?

A

retina, vitreous humor, macula, choroid

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20
Q

distinguish the bulbar conjunctiva from the palpebral conjunctiva

A

the bulbar conjunctiva is associated with the eye and the palpebral conjunctiva is associated with the eyelid

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21
Q

what makes up the optic nerve?

A

choroid + retina

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22
Q

what size is the optic cup relative to the optic disc?

A

cup = 1/2 the disc diameter

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23
Q

on eye exam, what is the dark middle region of the eye?

A

macula with the fovea in the middle

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24
Q

what CN are associated with eye muscles?

A

all are asscoiated with CN III except SO4 and LR6

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25
how shoud the pupil respond to light exam with direct light?
pupil should become myotic, the other eye should respond consensually
26
what is accomodation?
how the eye focuses on objects coming towards or moving away from them
27
what CN are associated with accommodation?
II and III
28
how is a normal eye exam documented?
PERRLA
29
Distinguish the Jaeger from the Snellen chart
Jeager: hand-held near vision chart; Snellen: distance chart
30
How close should the snellen and jaeger charts be away from the pt?
snellen: 20ft; Jaeger: 14ft
31
what does 20/200 vision mean?
you see at 20ft what someone with normal vision sees at 200ft
32
what vision is considered legally blind?
20/200
33
what tool is used to determine color blindness?
ishihara cards
34
What constitutes most color blindness?
dichromacy (red and green color lost)
35
What causes color blindness?
genetic issues with retinal cones
36
what population is a higher incidence of color blindness?
males (1% of males)
37
what are the most common types of dichromacy?
protanope and dueteranope vision (loss of red, green or yellow combo)
38
how is the palpebral conjunctiva inspected on exam?
have pt look down, using a Qtip place it on the eyelid and evert the eyelids
39
what is the normal pupil size?
3-5mm
40
what drugs can cause miosis and miodriasis?
miosis: opiates, miodriasis: sympathomimetic drugs
41
what are 3 common APD?
marcus gunn, argyll robertson, CNIII palsy
42
what is the MCC and features of marcus gunn?
MCC: optic nerve disease/lesion, eyes react with no accommodation
43
What is the MCC and features of argyll roberston?
MCC: syphilis, accommodation with no reaction
44
What is the MCC of CN III palsy and features?
MCC: DM II, lid lag, big pupils
45
what are causes of absent light relfex of the eye?
cataracts, retinoblastoma, retinal detachment
46
when is retinoblastoma usually seen?
newborn exam
47
what does an asymmetric light reflex mean?
disconjugate gaze (one eye is looking straight in a gaze and the other is looking off)
48
how can you evaluate disconjugate gaze?
cover-uncover test, when the normal eye is covered, the one in the gaze with straighten out
49
what is a nasal/temporal disconjugate gaze called?
esotropia (adducted) exotropia (abducted)
50
what CN is responsible for the corneal reflex?
Sensory: V; Motor: VII (opthalmic branch)
51
how is the cornea reflex performed?
touch a Qtip to the pts eye, they should blink
52
what disease causes worsening of visual fields?
glaucoma
53
what is nystagmus?
beating of the eyes when looking up and down or side to side
54
What does up and down nystagmus indicate?
lesion to the brain, MS, doesn't stop
55
What does nystagmus side to side indicate?
vertigo, vetibulocochlear problems, stops
56
when is nystagmus normal?
just a few beats side to side
57
what is the uvea of the eye made up of?
iris, choroid, ciliary body
58
anisocoria
pupils are unequal size - slight variation is normal in 35% of people who have it
59
What can cause exopthalmos
bilateral: Grave's, unilateral: tumor, orbital cellulitis
60
Xanthelasma
lipid deposits on the outside of the eye due to severe hyperlipidemia
61
pterygium
Visual disturbance caused by bulbar conjunctive invading the pupil
62
Kayser-fleischer rings
wilson's disease, Copper deposits
63
corneal (Senile) arcus
grey hue around cornea - in young people it is due to hyperlipidemia
64
Key points of funduscopic exam
Dilate pupils, use lowest brightness, start at 0 diopters, start 12 inches away at 15 degrees and move in
65
What is a cataract?
thickening of the cornea
66
General order of funduscopic exam
red reflex first, cornea, lens, background, arteries and veins, optic disc, macula
67
what is the fovea?
high concentration of cones, found in the macula
68
True or false: arteries are more transparent than veins
TRUE
69
choroid crescent
hyperpigmentation around the optic disc
70
What can cause AV nicking?
HTN
71
What can cause hemorrhages on fundus exam?
HTN, swelling, occlusion of retinal veins, DM
72
differentiate deep from superficial hemorrhages
superficial: obscure margins, deep: redder, rounder
73
what can cause preretinal hemorrhage?
increased ICP
74
What does neovascularity look like on fundus exam?
tortuous, fragile
75
What can cause neovascularity?
DM retinopathy
76
What can cause soft exudates? What do they look like?
soft edges; HTN, DM
77
What can cause hard exudates and what do they look like?
sharp edges; HTN, DM
78
What is drusen and what is it a sign of?
tiny yellow or white accumulations of extracellular material, sign of macular degeneration
79
What are signs of DM retiopathy?
neovascularity, AV nicking, hard exudates
80
how can hypertensive retinopathy be diagnosed on fundus exam?
hemorrhages, soft/hard exudates
81
What is papilledema?
swelling of the optic disc due to increased ICP causing hemorrhages
82
where is the lesion in right homonymous hemianopsia?
L optic tract: missing vision on right side of both eyes
83
where is the lesion for bitemporal hemianopsia?
optic chiasm, can only see nasal side of both eyes
84
where is the lesion for homonyous right quadrantic defect?
L optic radiation, missing vision in right upper quadrant of both eyes
85
where is the lesion responsible for Horner's syndrome?
stellate ganglion in neck caused by carotid dissection or pancoast tumor
86
characteristics of horner's syndrome?
myosis, ptosis, anhidrosis
87
Causes of ectropion?
older pts, excessive tearing
88
causes of entropion?
older pts, tearing issues
89
What is Blepharitis
inflammation of the eyelid caused by staph or seborrheic blepharitis - increase in cebum blocks glands leading to itchiness, can alos be fungal
90
What is periorbital cellulitis?
due to URI, fever, staph/strep - pain with EOM and proptosis
91
how is blepharitis treated?
cleansing, topical abx
92
how is periorbital cellulitis treated?
augmentin, 3rd gen cephalosporin
93
What can cause periorbital edema?
allergies, hypothyroidism, nephrotic syndrome
94
What causes herpes zoster opthalmicus?
varicella infection of the trigeminal nerve (V, opthalmic branch)
95
Signs of herpes zoster opthalmicus?
deutritic lesions, hutchinson's sign (lesion on top of nose causing occular involvement, keratosis, and blindness)
96
What causes hordeolum (stys)?
staph infection of meibomian gland in tarsal plates
97
how are stys treated?
warm compress, abx
98
What is a chelazion?
chronic inflammation of meibomian gland following hordeolum, not infectious (tx: steroids)
99
What is dacrocystitis?
bacterial superinfection of lactrimal tract due to strep/staph - treated with cephalosporin
100
What causes conjunctivitis?
srep, adenovirus, chlamydia
101
Signs of bacterial conjunctivitis?
unilateral, discharge, purulent, adenopathy - treat with abx
102
signs of viral conjunctivitis?
bilateral, not as red, less discharge, periocular adenopathy - treat with abx
103
signs of allergic conjunctivitis?
stringy discharge, less red
104
what is a subconjunctival hemorrhage?
rupture of small vessels of sclera due to valsalva, HTN, coagulopathy - BENIGN, well-demarcated, no tx
105
what is iritis?
medical emergency, autoimmune disease (SLE, sarcoid, ankylosing sponydlitis
106
Signs of iritis?
pain with EOM, ciliary injection, cells in flare, photophobia, blurred vision, myotic pupil
107
What is acute glaucoma?
painful red eye, vision loss, emergency, steamy cornea, ciliary injection, N/V, HA - Tx: BB, carbonic anhydrase inhibitors, psychoplegics contraindicated
108
What is a hyphema
blood in the anterior chamber due to a blow to the eye - pain, red, vision loss - tx: drain, tPa, F/u in 5 days
109
what is pinguecula?
overgrowth of sclera in the bulbar conjunctiva due to age, sun, wind - yellow spot on sclera

PE midterm (10 decks)

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