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I. Ocular Technique > Quiz 2 > Flashcards

Quiz 2 Flashcards

1
Q

What does the first order neuron in the afferent pupillary light pathway connect?

A

connects retina to the pre-tectal nucleus in midbrain at the level of superior colliculus

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2
Q

What does the second order neuron in the afferent pupillary light pathway connect?

A

connects both pretectal to the Edinger-Westphal nuclei

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3
Q

What does the third order neuron in the afferent pupillary light pathway connect?

A

connects Edinger-Westphal nucleus to the ciliary ganglion

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4
Q

What does the fourth order neuron in the afferent pupillary light pathway connect?

A

connects ciliary ganglion to sphincter muscle of the pupil by way of short ciliary nerves

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5
Q

What should pupil sizes be around in mm in bright light? 1. Dim light? 2

A
  1. 3-6mm

2. 4-8mm

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6
Q

Is anisocoria an efferent or afferent problem?

A

efferent

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7
Q

How can you tell the difference between a physiological anisocoria and a pathological anisocoria?

A

pathological is different in bright and dim light

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8
Q

If there is no pupil constriction of either pupil when light is presented to the affected eye what pupillary defect is that?

A

absolute afferent pupillary defect

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9
Q

What are the four things that are included when documenting pupillary light responses?

A
  1. direct and consensual responses
  2. pupil shape
  3. pupil size
  4. if APD present
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10
Q

What is the purpose of the red cap desaturation test?

A

diagnosis of optic nerve disease

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11
Q

Is the red cap desaturation test done before or after pupil testing and why?

A

before to prevent bleaching out

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12
Q

When doing EOM testing with binocular conditions are versions or ductions being tested?

A

versions

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13
Q

When is an overaction of EOMs typically seen? 1. Why is this the case? 2

A
  1. patient fixating with paretic eye

2. Herings law of equal innervation

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14
Q

If an underaction of EOMs is similar in both versions and ductions what is the likely etiology? 1. Not equal? 2

A
  1. mechanical in nature

2. paresis in nature

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15
Q

What is pain on eye movements while testing EOMs suggestive of?

A

optic nerve inflammation

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16
Q

What is diplopia on eye movements while testing EOMs suggestive of?

A

overaction or underaction

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17
Q

What is differing in palpebral aperture size on eye movements while testing EOMs suggestive of?

A

Duane’s syndrome

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18
Q

What is the acronym for recording normal versions?

A

Smooth
Accurate
Full
Extensive

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19
Q

What is the inner most layer of tears? 1. What produces it? 2

A
  1. mucin layer

2. goblet cells

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20
Q

What is the middle layer of tears? 1. What produces it? 2

A
  1. aqueous layer

2. lacrimal gland and accessory glands of Kraus and Wolfring

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21
Q

What is the outer most layer of tears? 1. What produces it? 2

A
  1. lipid layer

2. meibomian glands

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22
Q

What are the standards for tear meniscus evaluation:

  1. normal value
  2. beam height and width
  3. tower position
  4. light conditions
  5. magnification
A
  1. 0.3mm
  2. 1mm tall and wide beam
  3. 60 deg
  4. medium intensity, filter out
  5. 10-16X
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23
Q

What are the two ways to measure the tear break up time?

A
  1. fluorescein

2. keratometer (tear thinning time)

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24
Q

What are the standards for tear break up time evaluation:

  1. normal value
  2. beam height and width
  3. tower position
  4. light conditions
  5. magnification
A
  1. > 10 seconds
  2. large parallel piped
  3. click stop
  4. cobalt blue filter
  5. 10x
25
What are the advantages of tear thinning time (keratometry)? 1. Disadvantages? 2
1. fluorescein not used so tear film not altered | 2. only central 70-80% cornea evaluated
26
What is one thing that Lissamine Green tests that Rose Bengal does not?
lid wiper epitheliopathy
27
What are the two ways to test how well the lacrimal gland is functioning?
1. phenol red thread | 2. schirmer strips
28
How long is the phenol red thread test? 1. What is a normal value? 2. Abnormal? 3
1. 15 seconds 2. 15mm 3.
29
What type of tearing is measured in Schirmer 1 testing? 1. How long is the test? 2. What is a normal value? 3. Abnormal? 4
1. basal and reflex tearing 2. 5 minutes 3. 10mm 4.
30
What is done differently if just basal secretion is wanting to be measured for the Schirmer test?
anesthetic is added prior
31
What type of tearing is measured in Schirmer 2 testing? 1. How long is the test? 2. What is a normal value? 3. What is done prior to the test? 4
1. reflex tearing 2. 2 minutes 3. 15mm 4. nasal mucosa irritated
32
What are the purposes of conformation visual field testing?
1. screen visual field defects | 2. good for large or deep visual field defects
33
What is noted while recording if the visual field is normal for conformation testing?
full to finger counting (FTFC)
34
What is the range of testing for an Amsler grid?
10 deg on each side of fixation
35
What are the standards for lens evaluation: 1. magnification 2. beam height and width 3. tower position 4. light conditions
1. 16x 2. parallel piped and optic section 3. 45-60 deg 4. low to medium intensity, filter out
36
What are the standards for lens retroillumination evaluation: 1. magnification 2. beam height and width 3. tower position 4. light conditions
1. 10x 2. 5mm tall and 3mm wide 3. click stop 4. low to medium intensity, filter out
37
What is the estimated VA for each of the following nuclear cataract grades? 1-4
1. 20/40 2. 20/80 3. 20/200 4. 20/400
38
What percentage of intrapupillary space does each of the grades 1-4 for cortical cataracts obscure?
1. 10% 2. 10-50% 3. 50-90% 4. 90%
39
What percentage of intrapupillary space does each of the grades 1-4 for posterior subcapsular cataracts obscure?
1. 3% 2. 30% 3. 50% 4. >50%
40
What is the vitreous tightly adhered to?
1. optic nerve 2. macula 3. ora serrata
41
What are the standards for anterior vitreous evaluation: 1. magnification 2. beam height and width 3. tower position 4. light conditions
1. 16x 2. 2-3mm wide, maximum height 3. 45-60 deg 4. medium illumination, filter out
42
What are the standards for posterior vitreous evaluation: 1. magnification 2. beam height and width 3. tower position 4. light conditions
1. 10x 2. 5mm tall by 3mm wide 3. click stop 4. low to medium illumination, filter in
43
What do white blood cells in the vitreous indicate? 1. What are these commonly seen with? 2
1. inflammation | 2. pars planitis
44
What do red blood cells in the vitreous indicate? 1. How do you confirm the type of cells? 2
1. retinal vessel damage | 2. disappear with red free filter
45
What do red blood cells in the vitreous indicate? 1. How do you confirm the type of cells? 2
1. retinal tear or detachment | 2. will not disappear with red free filter
46
What is a result of vitreous fibrils clumping together?
vitreous floaters
47
What is a remnant of the hyaloid artery?
Mittendorf dot
48
What causes a posterior vitreous detachment?
liquefaction and syneresis of vitreous
49
What are the standards for fundoscopy evaluation: 1. magnification 2. beam height and width 3. tower position 4. light conditions
1. 10x 2. 1 DD wide, 3 DD tall 3. click stop 4. low illumination, filter in
50
What are the things to evaluate while doing a retinal exam?
1. optic nerve 2. macula 3. retinal vasculature
51
What is the area between the cup and the edge of the optic nerve?
neuroretinal rim
52
What is it called when the optic nerve is more white than it should be?
pallor
53
Are arteries or veins brighter?
arteries
54
What is caused by the reflection from the interface between the blood column and the vessel wall?
arterial light reflex
55
What is a normal retinal artery to vein ratio?
2/3 to 3/4
56
When do artery/vein crossings change?
arteriolosclerosis
57
When is retinal vasculature tortuosity present?
1. hypertension 2. AV malformations 3. retinal hypoxia 4. congenital
58
What is the cilioretinal blood vessel derived from? 1. When is it important? 2
1. short posterior ciliary blood vessel or choriocapillaris | 2. central retinal artery occlusions
59
What are rhythmic variations in the retinal vein caliber as it crosses the optic disc? 1. When is it absent? 2
1. spontaneous venous pulsation | 2. cerebral spinal fluid pressure above 190 mmH2O

I. Ocular Technique (2 decks)

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