Health Entrance Testing 2 Flashcards
(96 cards)
1
Q
What is the aperture within the iris through which light penetrates into the eye?
A
Le Pupil
2
Q
What is the anterior section of the vascular tunic of the eye?
A
Le Iris
3
Q
What is the area in front of the crystalline lens and behind the cornea called?
A
Le Uvea
4
Q
What is Persistent Pupillary Membrane?
A
Trace of embryologic mesoderm tissue
5
Q
What is Epicapsular Stars?
A
Persistent pigment on anterior surface of lens
6
Q
What is Mittendorf dot?
A
(Bergmeinster pailla) on posterior surface of lens
7
Q
Mydriasis
A
Dilation, increase in diameter
8
Q
Miosis
A
Constriction, decrease in diameter
9
Q
Anisocoria
A
Different size pupils
10
Q
Name the functions of the pupil
A
- Control retinal illumination
- Facilitate light/dark adaptation
- Reduce optical aberrations
- Increase depth of focus (reduce blur circle in retina -> pinhole effect)
11
Q
What is Pupillary Hippus?
A
Oscillations of the pupil independent of illumination level, convergence or psychological state
12
Q
Parasympathetic effect on the pupil
A
Constriction
13
Q
Sympathetic effect on the pupil
A
Dilation
14
Q
What is an Afferent pathway?
A
From the Eyes to the CNS
15
Q
What is an Efferent pathway?
A
From the CNS to the Eyes
16
Q
What is the pupillary Sphincter?
A
Annular band of smooth muscle that encircles the pupillary border. Constriction causes miosis
17
Q
What is the Pupillary Dilator?
A
Myoepithelial cells run radially as a sheet in posterior iris. Construction causes mydriasis
18
Q
What is the sympathetic pupillary pathway mediated by?
A
Hypothalamus
19
Q
What is a direct response
A
when you observe the pupil you shine light into
20
Q
what is a consensual response
A
when you observe the pupil you don’t shine the light into
21
Q
What is grade 1 in the swinging flashlight test
A
weak initial constriction followed by earlier release
22
Q
what is grade 2 in the swinging flashlight testq
A
initially pupillary stall, no change, follwoed by dilation
23
Q
what is grade 3
A
immediate pupillary dilation
24
Q
what is grade 4
A
no rxn to light, amaurotic (blind eye)
25
in anisocorica, you must ____ and _____ pupil sizes in dim and bright light
measure and record
26
which eom are innervated by the oculomotor nerve
SR, IR, MR, IO
27
which eom is innervated by the trochlear
SO
28
which eom is innervated by the abduces
LR
29
Name the 3 important points of the Sympathetic Pupillary Pathway
1. Hypothalamus
2. Apex of Lung
3. Internal Carotid Artery
* *Does not decussate (ipsilateral)
30
what is primary action
the major moving force of a muscle
31
what is secondary action
additional forces based on muscle's orientation
32
what is duction
movement of one eye along one axis
33
what is convergence
both eyes more inward
34
what is divergencw
both eyes move outwards
35
what is version
movement of both eyes by same distance and in same direction
36
why is the IO special
the only eom with no origin in apex of orbit, but directly on the floor of the orbit
37
what are antagonists
pair pulls one eye in opposite direction
38
what are synergists
pair pulls one eye in the same direction
39
what is sherrington law of reciprocal innervation
increased contraction of an eom in is normally associated by diminished contraction of its antagonist muscle
40
what is torsion
movement of one eye along y axis
41
what is intorsion
turning upper part of your globe towards your nose
42
what is extorsion
turning upper part of your globe towards your ear
43
what is the action of the MR
adduction
44
what is the action of the LR
abduction
45
what are the primary and secondary actions of the SR
primary: elevation
secondary: intorsion and adduction
46
what are the primary and secondary actions of the IR
primary: depression
secondary: extorsion and adduction
47
what are the primary and secondary actions of the SO
prim: intorsion
sec: abduction and depression
48
If +RAPD, the doctor must include what information?
Which eye is +RAPD as well as the grade
49
what is the goal of eom testing
to isolate actions of each EOM so the function is evaluated
50
what is muscle paresis
mild/moderate muscular weakness
51
What is muscle paralysis?
severe/complete loss of motor function, inability to contract
52
What is nerve palsy?
Partial/complete defect of nerve, will affect all or some muscles
53
What EOMs are affected in CN-3 palsy? What other muscles are affected?
IR, SR, MR, IO
| as well as spincter of the iris and levator palpebrae superiosis
54
What are examples of Extensive and Asymmetric Retinal disease?
central/branch retinal artery occlusion, retinal detachment
55
what is the distance you should be to test eom?
40-60 cm from patient
56
What is the Hirshberg Test?
the ojective evaluation of binocularity using light reflected cornea
57
How would you record normal findings for the Hirshbert Test?
FESA or SAFE
58
What is Nystagmus?
Bilateral, involuntary and conjugate oscillation of eyes
59
What information does the size of the pupil give you?
Photophia, Glare, Aberrations, and depth of focus.
60
What happens to the Nasal Fibers as compared to the Temporal Fibers at the Optic Chiasm?
```
Nasal Fibers (54%) decussate at Chiasm
Temporal Fibers (47%) remain on same side -> ipsilateral
```
61
After traveling through the Optic Chiasm, ganglion cell axons synapse with Interneurons where?
The Pretectal Olivary Nuclei (in the upper midbrain)
62
The crossed and uncrossed fibers in the optic tract produce what effect?
Direct and Consensual Responses
63
Where is the Edinger-Westphal structure in the optic tract?
After the Pretectal nucleus and before the Ciliary Ganglion
64
What is the Efferent Pupillary Light Reflex Pathway?
From the E-W to Oculomotor Nerve
65
What do the Short Ciliary Nerves innervate?
Iris Sphincter and Ciliary Body
66
What 3 responses happening during Synkinetic Triad?
1. Converge
2. Accommodate
3. Pupils Constrict
67
Name 2 Parasympathetic Antagonists
1. Tropicamide
| 2. Cyclopentolate
68
Name the Sympatheic Agonists
1. Phenylephrine
69
What is the Sympathetic Pupillary Pathway mediated by?
Hypothalamus
70
Name the 3 important points of the Sympathetic Pupillary Pathway
1. Hypothalamus
2. Apex of Lung
3.
71
What is Direct Response?
The eye being stimulated constricts
72
What is Consensual Response?
The eye not being stimulated constricts
73
What does the Swinging Flashlight Test measure?
How well information is carried from one eye to midbrain compared to how it is carried from other eye
74
How do you record the Swinging Flashlight Test?
(-) RAPD: Both eyes constrict normally
| +RAPD: one eye gives less (or slower) response than other eye
75
What is the Pupil Testing set up?
Patient removes correction, looks at a distance target, and the room is as Dim as possible while still being able to see both pupils
76
If a patient has anisocoria, what should the doctor do next?
1. measure pupil sizes
2. Do the Pupils Accommodative Test
3. Evaluate for ptosis
77
How far away should you shine the light into the patient's eye during pupil testing?
5cm
78
How many times do you shine the light in the patient's eye during pupil testing?
3
79
What do the numbers mean when recording Direct and Consensual Pupillary response?
```
0 = very sluggish
4 = brisk (normal)
```
80
When do you perform the Near/Accommodative Pupil test?
If there is a direct or consensual abnormal reponse
81
What is a Light-Near Dissociation?
No pupillary reaction to light but reaction to near stimuli
82
How long do you shine light into a patient's eye during the swinging flashlight test?
1. 1 second in each eye. Repeat 3x
| 2. 3 seconds in each eye. Repeat 3x
83
Where do you shine the light during the Swinging Flashlight test?
Directly into the fovea (which is slightly temporal to the eye)
84
Every patient should experience a slight ______ during the swinging flashlight test
Hippus
85
How do you record the swinging flashlight test?
1. Grade1+: weak initial constriction followed by earlier release
2. Grade 2+: initial pupillary stall, no change, followed by dilation (escape)
3. Grade 3+: Immediate pupillary dilation
4. Grade 4+: No reaction to light
86
(+)RAPD is a _______ not a ________
Sign, not a Diagnosis
87
What does PERRLA stand for?
Pupils Equal, Round, Responsive to Light and Accomodation
88
What does RAPD stand for?
Relative Afferent Pupillary Defect
89
If +RAPD, the doctor must include what information?
Which eye is +RAPD as well as the grade
90
What is Adie's Tonic Pupil?
Most common pupillary defect, usually effects women 20 - 40 years old, and near vision is decreased. No ptosis or EOM abnormalities. Parasympathetic system affected.
91
What is CN-III palsy?
Fixed Dilated Pupil, Ipsilateral abnormal EOMs, and large Ipsilateral ptosis if complete palsy. An acute, complete CN-III palsy is a medical emergency. Parasympathetic system affected.
92
What is Horner's Syndrome?
Eye does not dilate properly or quickly in dim light, mild ptosis and pain in affected eye. Sympathetic system affected.
93
How do you record Anisocoria?
Size (dim/bright) and ptosis / EOM abnormalities (if applicable) ex. OD 6/4, OS 4/3 ptosis OS
94
What are examples of Optic Nerve Disease?
Optic Neuritis, Infection (Lyme disease)
95
What are examples of Extensive and Asymmetric Retinal disease?
central/branch retinal artery occlusion, retinal detachment
96
True/False. Aniscoria is common in children.
False
