Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Clinical Assessment > Eyes and Visual Pathways > Flashcards

Eyes and Visual Pathways Flashcards

1
Q

What is in the eyes ROS when there is a positive response?

A
  • sudden or gradual onset or pattern of change, type of change
  • Associated symptoms: discharge/tearing, pain, redness, photophobia
  • H/O prior eye issues
  • Date and result of last eye exam
  • Medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Components of an Eye Exam

A

Visual Acuity
External
Internal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is included in the visual acuity component of an eye exam?

A

Central/distant (CN II): Snellen or Rosenbaum

Peripheral: Visual fields (CN II)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is included in the external component of an eye exam?

A
  • Brows, lids, lashes, orbit, gaze (EOMs, nystagmus)

- Conjunctiva & sclera, cornea & lens, pupils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Nystagmus

A
  • fine rhythmic oscillation of the eyes

- normal during extreme lateral gaze

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is included in the internal component of the eye exam?

A

retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Horizontal Visual Field Defect

A

Occlusion of branch of central retinal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Monocular Visual Field Defect

A

Also called blind right eye

-lesion of the optic nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bitemporal hemianopsia Visual Field Defect

A
  • lesion at the optic chiasm and may involve only fibers crossing over to the opposite side
  • visual loss involves the temporal half of each field
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Homonymous hemianopsia Visual Field Defect

A
  • same part of visual field is affected in both eyes
  • lesion at optic tract
  • multiple types
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are you looking for on the brows?

A

quantity, distribution, scales

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are you looking for on the lids?

A
  • Palpebral conjunctiva
  • Edema, color, position, lesions
  • Orbicularis occuli closure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dacryocystitis

A
  • inflammation of the lacrimal sac
  • swelling between the lower eyelid and nose
  • acute: painful, red, tender
  • chronic: obstruction of the nasolacrimal duct
  • tearing is prominent and pressure on sac produces regurgitation of material
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ptosis

A
  • drooping of the upper lid

- caused by myasthenia gravis, damage to CN III, damage to SNS supply (Horner’s disease), congenital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Exophthalmos

A

-protrusion of the eyeball triggered by autoreactive T lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Entropion

A
  • inward turning of the lid margin
  • lower lashes irritate the conjunctiva and lower cornea
  • common in elderly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Ectropion

A
  • lower lid turned outward, exposing palpebral conjunctiva
  • eye no longer drains well and tearing occurs
  • common in elderly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sty

A

Painful, tender, red infection in a gland at the margin of the eyelid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Chalazion

A

subacute nontender, usually painless nodule involving a blocked meibomian gland

  • usually points inside the lid rather than on the lid margin
  • not painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Xanthelasma

A

slightly raised yellowish, well-circumscribed plaques that appear along the nasal portions of one or both eyelids
-may accompany lipid disorder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Retraction

A
  • wide eyed stare suggests retracted eyelids

- symptom of hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are you looking for in the lashes?

A

Presence/absence of lashes, crusting and irritation combination with sty/chalzion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Blepharitis

A

swelling or inflammation of the eyelids, usually where the eyelash hair follicles are located

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Abnormalities of EOM

A
  • Imbalance muscle tone- congenital or CN disorder (lesions, trauma, MS, syphilis)
  • Nystagmus (normal = extreme lateral gaze)
  • Lid lag
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the three layers of the eye?
- Fibrous (outer): sclera & cornea - Vascular (middle): choroid, ciliary body & iris - Inner: retina, optic & non-visual parts
26
What is bulbar fascia?
covers anterior part of cornea
27
How do you assess the conjunctiva and sclera?
- For: Color, injection, hemorrhage, foreign bodies - Spread lids: sclera & bulbar conjunctiva - Lid eversion (PRN): for palpebral conjunctiva
28
What ROS should you do if sclera is yellow?
GI ROS
29
What does blue sclera refer to?
Osteogenesis imperfecta, a congenital bone condition causing extremely fragile bones
30
What are you looking for when examining the cornea?
-Arcus, scar, pinguecula/pterygium, Kayser-fleischer ring (Wilson’s dz), shadows
31
Corneal arcus
- thin grayish whiet arc or circle not quite at the edge of the cornea - accompanies normal aging - usually benign - in young people, suggests possible hyperlipoproteinemia
32
pinguecula
- harmless yellowish triangular nodule in the bulbar conjunctiva on either side of the iris - appears frequently with aging, 1st on nasal and then on temporal side
33
pterygium
- triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side - reddening may occur - may interfere with vision as it encroaches on pupil
34
Kayser-Fleischer ring
- golden to red brown ring, sometimes shading to green or blue - from copper deposition in periphery of the cornea found in Wilson's dz - due to mutation in gene on chromosome 13
35
Corneal Scar
- superficial grayish white opacity in the cornea - secondary to an injury or inflammation - variable size and shape - do not confuse with cataracts, which can only be seen through pupil
36
Cataracts
-opacities of the lenses visible through the pupil
37
Assessment of Pupils (CN II & III)
- Size (3-5mm), shape, symmetry (Miosis, mydriasis, Anisocoria) - pupillary reaction
38
Miosis
constriction of pupils
39
Mydriasis
dilation of pupils
40
anisocoria
- pupils not the same size - benign if normal pupillary reaction - Tonic Pupil (Adie’s Pupil), CN III paralysis, Horner’s, Argyll Robertson
41
Tonic Pupil (Adie's Pupil)
- impaired PSNS to iris - pupil is U/L, large, regular - reaction to light severely reduced and slowed, or absent - near reaction is slow, but present - deep tendon reflexes decreased - slow accommodation = blurry vision
42
Oculomotor Nerve (CN III) Paralysis
-dilated pupil is fixed to light and near effect -ptosis of upper eyelid lateral deviation
43
Horner's Syndrome
- affected pupil is small, but reacts briskly to light and near effort - ptosis is present, with possibly loss of sweating in forehead - when congenital Horner's: iris is lighter in color than its fellow
44
Argyll Robertson Pupils
- small, irregular pupils - accomodate but do not react to light - seen in CNS syphillis
45
Parts of the fundus
- Optic disc - Macula lutea - Fovea - Blood vessels
46
Normal Optic Disc
- Yellow-orange to creamy pink - Well defined margins - Physiologic cup (Usually ½ size of disc; may or may not be visible)
47
papilledema
- Pink, hyperemic - optic disc appears swollen & blurred margins - Physiologic cup is not seen - may have history of trauma, pain in back of eyes
48
What is important to look for in the blood vessels of the fundus?
- AV crossing, AV nicking, tapering - Copper wiring, silver wiring - Hemorrhages (deep, superficial & preretinal) - Neovascularization - Microaneurysms
49
AV nicking
-vein appears to stop abruptly on either side of the artery
50
AV crossing
- vein crossing beneath the artery | - can be seen right up to the column of blood on either side
51
Tapering
the vein appears to taper down on either side of the artery
52
Cooper Wiring
- arteries become full and somewhat tortuous | - develop an increased light reflex with bright coppery luster
53
Silver Wiring
-portion of narrowed artery develops such an opaque wall that no blood is visible within it
54
Deep Retinal Hemorrhaging
- small, rounded, slightly irregular red spots that are sometimes called dot or blot hemorrhages - occur in deeper layer of retina than flame shaped hemorrhages - commonly caused by diabetes
55
Superficial Retinal Hemorrhaging
- small linear flame-shapped red streaks in the fundi - shaped by superficial bundles of nerve fibers that radiate from the optic disc - see in hypertension, papilledema, occlusion of the retinal vein
56
Preretinal Hemorrhaging
- develops when blood escapes into potential space between retina and vitreous - larger than retinal hemorrhages - obscures any underlying retinal vessels - red cells settle when patient is erect
57
Neovascularization
- formation of new blood vessels - they are more numerous, more tortuous, and narrower than other blood vessels in the area - common in diabetics - may obstruct vision
58
Microaneurysms
- tiny, round, red spots seen in and around macular area - minute dilations of very small retinal vessels - associated with diabetes
59
When looking at the fundus with the opthalmoscope, what are you looking for?
- “cotton wool” patch (soft exudates) - hard exudates - Drusen - Macular Degeneration (wet and dry)
60
Cotton-Wool Patches
- white or grayish cotton like patches - moderate in size but usually smaller than disc - result from infarcted nerve fibers - associated with HTN, DM
61
Hard Exudates
- creamy or yellowish bright lesions with well defined "hard" boxers - small and round and occur in clusters or circular/linear/star-shaped patterns - caused by HTN, DM
62
Drusen
- yellowish round spots that vary from tiny to small - edges may be soft or hard and are haphazardly distributed - appear in normal aging, but accompany other conditions (i.e. age-related macular degeneration) - seen through peripheral fields
63
Macular Degeneration
- cause of poor central vision in older adults - Wet (Exudative):neovascular macular degeneration; common in diabetics - Dry (atrophic): more common and less severe
64
Examples of Age-Related Changes in the Eyes
- VA: glare sensitivity, presbyopia, macular degeneration - Lids: entropion - Growths: xanthalasma, pingecula & pterygium - Cornea/lens: arcus, cataracts, glaucoma - Precancerous/cancerous skin changes
65
What are the four types for anisocoria?
Tonic, CN III paralysis, Horner's, Argyll Robertson
66
What are hard and soft exudates associated with?
HTN and diabetes
67
In younger people what is a corneal arcus associated with?
hyperlipoproteinemia
68
Risk Factors of Cataracts
-risk factors: old age, smoking, diabetes, corticosteroid use
69
What does hypertension, papilledema, occlusion of the retinal vein have in common?
seen in superficial retinal hemorrhaging
70
What type of macular degeneration is associated with diabetics?
Wet or Exudative
71
Fortifications
zig-zag arcs of light in vision

Clinical Assessment (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions