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HAPE Flashcards

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1
Q

Iris

A

controls the amount of light allowed to enter the eye through the pupil

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2
Q

Cornea

A

covers both the pupil and the iris and is continuous with the sclera

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3
Q

The upper eyelid

A

covers a portion of the iris but does not normally overlay the pupil

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4
Q

Palpebral fissure

A

the opening between the eyelids

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5
Q

Conjunctiva

A

Covers the surface of the eye and the inner surfaces of the eyelids

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6
Q

Two Components of Conjunctiva

A

Bulbar conjunctiva covers most of the anterior eyeball

Palpebral conjunctiva lines the eyelids

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7
Q

Tarsal Plates

A

Contains parallel rows of meibomian glands (also known as tarsal glands)
Provides oily lubrication to the ocular surface

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8
Q

Levator palpebrae superioris

A

Primary muscle that raises the upper eyelid

Innervated by the oculomotor nerve, cranial nerve (CN) III

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9
Q

Müller’s muscle (superior tarsal)

A

Innervated by the sympathetic nervous system

Also contributes to lid elevation

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10
Q

Lacrimal Gland

A 
Tears are produced at the lacrimal gland
Drain through the lacrimal puncta 
Then pass through the canaliculi 
Into the lacrimal sac 
On into the nose through the nasolacrimal (tear) duct
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11
Q

Tear Film

A

protects the conjunctiva and cornea from drying
inhibits microbial growth
gives a smooth optical surface to the cornea

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12
Q

Lens

A

Suspended by ligaments (zonule fibers) - controls thickness of lens
Allows the eye to adjust focus on near or distant objects (accommodation)
Projects clear image on retina, the sensory part of the eye

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13
Q

Presbyobia

A

farsightedness caused by loss of elasticity of the lens of the eye, aging problem.

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14
Q

Three Chambers of Fluid in Eye

A 
Anterior chamber (between the cornea and iris) 
Posterior chamber (between the iris and the lens) 
Both are filled with aqueous humor
Vitreous chamber (between the lens and the retina)
Filled with vitreous humor, maintains the shape of the eye
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15
Q

Optic Fundus

A

The posterior portion of the eye that is seen through the ophthalmoscope

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16
Q

Retina

A

a layer of tissue in the back of your eye that senses light and sends images to your brain

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17
Q

Macula

A

Part of the retina in the back of the eye. Fovea is in the middle of macula. Macula surrounds the fovea.

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18
Q

Fovea

A

Point of central vision. Tiny pit in the macula of the retina that provides the clearest vision of all

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19
Q

Optic Disc

A

entry point of optic nerve. the round spot on the retina formed by the passage of the axons of the retinal ganglion cells, which transfer signals from the photoreceptors of the eye to the optic nerve, allowing us to see

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20
Q

Choroid

A

the middle layer of tissue in the wall of the eye

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21
Q

Vitreous

A

the clear gel that fills the space between the lens and the retina of the eyeball

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22
Q

Pupillary constriction.

A

Sphincter Pupillae and is a parasympathetic response. Miosis

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23
Q

Pupillary dilation

A

Dilator pupillae. A sympathetic innervation. mydriasis and raising of upper eyelid (mullers muscle).

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24
Q

Light Test Abnormality

A

There may be a lesion in the optic tract. The eyes should move consensually. The initial sensory pathways are like those described for vision:
Retina, optic nerve (CN II), and optic tract, which diverges in the midbrain
The constrictor muscles of the iris are transmitted through oculomotor nerves (CN III)

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25
Near Reaction
Pupils constrict When gaze shifts from far to near object Mediated by the oculomotor nerve (CN III) Eyes converge Bilateral medial rectus movement Accommodation Increased convexity of the lenses caused by contraction of the ciliary muscles
26
Pupillary dilation abnormality.
A lesion anywhere along this pathway may impair sympathetic effects that dilate the pupil and will cause miosis
27
Dilation Pathway
Starts in the hypothalamus Passes down through the brainstem and cervical cord into the neck The neurons travel with the brachial plexus at the lung apex Returns to the superior cervical ganglion near the mandible Follows the carotid artery or its branches into the orbit
28
Hyperobia
Farsightedness
29
Myopia
nearsightedness
30
diplopia
double vision
31
What may cause painless unilateral vision loss
``` Vitreous hemorrhage from diabetes or trauma Macular degeneration Retinal detachment Retinal vein occlusion Central retinal artery occlusion ```
32
What may cause PAINFUL unilateral vision loss
Usually in cornea or anterior chamber. Corneal ulcer Uveitis Traumatic hyphema Acute angle closure glaucoma Optic neuritis from multiple sclerosis If associated with headache, a thorough neurologic examination is warranted Immediate referral is warranted
33
What may cause bilateral and painless vision changes?
Vascular etiologies, stroke, or non-physiologic causes.
34
What may cause bilateral and PAINFUL vision changes?
Intoxication, trauma, chemical or radiation exposures
35
What may cause gradual vision loss?
Cataracts, glaucoma, or macular degeneration
36
What are moving specks or strands
Vitreous floaters.
37
What do blind spots (scotoma) suggest
lesions in the retina, visual pathway, or brain
38
Red Painless Eye
Subconjunctival hemorrhage and episcleritis
39
Red Eye with gritty sensation
Viral conjunctivitis and dry eye
40
Red painful eye
Corneal abrasions, foreign bodies, corneal ulcers, acute angle closure glaucoma, herpes keratitis, fungal keratitis, hyphema, and uveitis
41
What may cause diplopia?
Lesions in the brainstem or cerebellum Weakness or paralysis of one or more extraocular muscles horizontal diplopia from palsy of CN III or VI vertical diplopia from palsy of CN III or IV
42
what may cause diplopia in one eye
ocular surface, cornea, lens, or macula
43
what may cause diplopia in one eyes
ocular surface, cornea, lens, or macula
44
Astigmatism
imperfection of the cornea or lens causing distortion while looking at near and far objects
45
Visual Acuity Test
Done with a snell test. Cover one eye. Read the lowest row possible. First # is how far in feet the person is standing. second # is distance at which a normal eye can read.
46
Visual Field Test
Static Finger Wiggle Test. Causes of anterior pathway defects Glaucoma, optic neuropathy, optic neuritis, and compressive lesions Posterior pathway Stroke and chiasmal tumors
47
Bitemporal Hemianopsia
Lesion at the optic chiasm Pituitary tumor May involve only fibers crossing over to the opposite side Fibers originate in the nasal half of each retina Visual loss in temporal half of each field
48
Homonymous Hemianopsia
Left Homonymous Hemianopsia (Right Optic Radiation) A complete interruption of fibers in the optic radiation A visual defect like that produced by a lesion of the optic tract
49
Color Vision issues
Damage to optic nerve
50
Eye position and alignment
Esotropia (inward deviation) one eye inward other normal Exotropia (outward deviation) Hypertropia (upward deviation) one eye up other normal Hypotropia (downward deviation)
51
Hyper/hypo-globus
Deviation in the globe position Congenital abnormalities, lacrimal gland enlargement, mucocele, or ocular tumors. It's like one eye socket up, another down.
52
Abnormal protrusion or proptosis
Thyroid eye disease, congenital abnormalities, orbital infections, or ocular tumors
53
Lagophthalmos
Failure of the eyelids to close Neuromuscular palsy, trauma, and thyroid eye disease Exposes the corneas to serious damage Refer to ophthalmology
54
Ptosis
Drooping of the upper lid Causes include senescence, myasthenia gravis, damage to the oculomotor nerve (CN III), and damage to the sympathetic nerve supply (Horner syndrome) A weakened muscle, relaxed tissues, and the weight of herniated fat may cause senile ptosis May be congenital
55
Entropcion
More common in the elderly Inward turning of the lid margin Ask the patient to squeeze the lids together and then open them
56
Ectropion
More common in the elderly Outward turning of the lid margin Exposes palpebral conjunctiva
57
Lid Retraction and Exophthalmos
A wide-eyed stare suggests retracted eyelids Note the rim of sclera between the upper lid and the iris Exophthalmos describes protrusion of the eyeball In unilateral exophthalmos, consider thyroid eye disease (though usually bilateral), trauma, orbital tumor, and granulomatous disorders
58
Lacrimal Apparatus
``` Inspect for swelling or tearing Excessive tearing May be due to conjunctival inflammation, corneal irritation, impaired drainage, ectropion and/or nasolacrimal duct obstruction Dryness from impaired secretion Seen in Sjögren syndrome ```
59
Nasolacrimal Duct Obstruction
Ask the patient to look up Press on the lower lid close to the medial canthus to compress the lacrimal sac Look for fluid regurgitated out of the puncta into the eye Avoid if area is inflamed and tender
60
Jaundice
A yellowish discoloration of the sclera or skin Due to excess of the pigment bilirubin Typically caused by obstruction of the bile duct, liver disease, or excessive breakdown of red blood cells
61
Hyphema
Blood in anterior chamber from trauma
62
Swinging Flashlight Test
Clinical test for functional impairment of the optic nerves In dim light, note the size of the pupils. After asking the patient to gaze into the distance, swing the beam of a penlight for 1 to 2 seconds first into one pupil, then into the other Normally, each illuminated eye constricts promptly The opposite eye also constricts consensually
63
Anisocoria
One pupil bigger than the other
64
Argyll Robertson Pupils
The pupils are small, irregular and usually bilateral Do not react to light They constrict with near vision and dilate with far vision (a normal near reaction) Seen in neurosyphilis and rarely in diabetes
65
Strabismus
Eyes don't look the same way at the same time. Cover uncover test.
66
Which Cranial Nerves are the extraocular muscles innervated by.
3,4,6. LR 6. SO 4. Rest are 3.
67
What does an absent red reflex mean
``` Opacity of the lens (cataract) Opacity of the vitreous Detached retina Mass Retinoblastoma ```
68
Papilledema
Swelling of the optic disc and blurred margins Anterior bulging of physiologic cup Elevated intracranial pressure (ICP) Meningitis, intracranial mass or lesion, hemorrhage
69
AV Nicking
When the arterial walls lose their transparency, changes appear in the arteriovenous crossings. Decreased transparency of the retina The vein appears to stop abruptly on either side of the artery
70
Macular Degeneration
Important cause of poor central vision in older adults Types include dry atrophic (more common but less severe) and wet exudative, or neovascular. Cellular debris called drusen “Hard” and sharply defined “Soft” and confluent with altered pigmentation
71
Cotton-Wool Spots
Not getting enough blood supply, that's why it appears more whiteish.
72
OD OS OU
OD (oculus dexter) right eye OS (oculus sinister) left eye OU (oculus uterque) both eyes

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