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PDX Midterm NWHSU
| Question | Answer |
|---|---|
| The cone of light in the ear is oriented from the ______ (or tip of malleus) to the ________ __________ quadrant. | Umbo Anterior inferior |
| Handle of the malleus runs ___ and ________ toward the _____. It ends are the "______ ______" of the malleus | up and forward towards the eyes short process |
| Ear wax or _______ is produced by sebaceous and apocrine sweat glands. ________ in color when fresh and ___________ with age. | Cerumen Yellow fresh brown/black with age |
| Ear pain is known as __________. Primary _______ is pain originating in the ear. Secondary ________ is referred pain from sinuses or teeth. | Otalgia (otalgia, otalgia) |
| Ear discharge or drainage is called _________. Most common causes of this include acute _____ _______ wiht perforation, chonic _______ ________ with perforation, ________ _______, and cholesteatoma. | Otorrhea Acute otitis media Chronic otitis media otitis externa |
| Ruptured middle ear is known as _____ _____. | Otitis Media |
| Buzzing, Clicking, or ringing of the ears is known as __________. This sound is only heard by the patient. _ in _ people experience this. It causes sleepless nights, anxiety, mood swings, depression, exhaustion, stress in your life. | Tinnitus 1 in 5 |
| Dizziness or sensation of movement is called _______. Labyrinth or CN _ disorder. | Vertigo CN 8 |
| Malformations of the Ear and _______ often occur together. Congenital deafness and _________ is a well recognized entity. Uric acid deposits occur in the helix of the ear and in the ______ in gout. | Kidney nephritis kidney in gout |
| White discreet nodules along the upper halix of the ear are _______ deposits of ______ _______ or (_________). | gouty deposits of uric acid (tophi) |
| _______ ear is due to former trauma or infection of the helix. Usually boxers and wrestlers get this. If drained immediately the likelyhood of deformity decreases. If not it can turn into a _________ hearing problem. | Cauliflower ear Conductive hearing problem |
| Basilar skull fracture may cause ____ to come out of the ear. Often described as clear/yellow and sparkling/shiney fluid. It contains ______. | CSF Glucose |
| _______ _______ (___________ _______) is a classic triad of vertigo, tinnitus, and hearing loss. It is episodic and progressive. Unknown cause but may be lack of reabsorption of endolymph which distends the endolymphatic compartment. | Meniere Disease (Endolymphatic Hydrops) |
| __________ is inflammation of the inner ear. Acute onset of ______ that is _______ and lasts up to a week. May also cause balance disorders, hearing loss, and tinnitus. | Labyrinthitis Vertigo that is continuous |
| Labyrinthitis is most commonly caused by a _________ infection. OTher potential causes are ________ infection, head injury, stress, or allergy. | Viral Bacterial |
| ________ is inflammation and infection of the mastoid. Usually caused by a _________ ear infection that spreads to the mastoid. Symptoms include fever, hearing loss, headache, ear pain, drainage from the ear, redness and swelling behind the ear. | Mastoiditis Middle ear |
| Sever pain and swelling _______ the ear may signify infection of the __________. A common finding of otitis media is more intense and projects farther in mastoiditis. | behind the ear mastoiditis |
| _________ ________ is inflammation or infection of the external auditory canal. This can be ________ or ________. This may occur after swimming. Symptoms include otalgia, hearing loss, fullness/pressure, itching, or discharge. | Otitis Externa Bacterial or fungal |
| Manipulation of the _______ which reproduces pain suggests ________ ear canal involvement. | tragus external |
| ______ ________ is inflammation of the middle ear due to eustachian tube dysfunction. This can be ____________ or ________. Symptoms include deep seated pain aggravated by ________ ______, otorrhea, headace, cough, congestion, pain behind the ear/mastoid | Otitis Media Bacterial or viral Bending over |
| Acute _________ _________ is redness of the ear drum, calor (heat), dolor (pain), and tumor (swelling) behind the tympanic membrane. | Acute Tympanic inflammation (Look at Bates textbook) |
| ________ _________ __________ causes inflammation of the ear drum. Accumulation of opaque pus in the _______ ear cavity. Bulging occurs obscuring the normal landmarks. | Suppurative Otitis Media Middle ear cavity |
| _______ _________ __________ is clear or yellow fluid in the ear and creates a "vacuum" because of eustachian tube disfunction. Fluid is sucked into the ______ ear cavity. Bubbles of air are seen in the fluid behind the ear drum. | Serous Otitis Media Middle ear |
| ________ of the ____ ______ is usually accompanied dramatic sudden relief of pain in the ear. | Perforation of the ear drum |
| ________ is abnormal progressive bone remodeling of the middle ear when the stapes becomes adhered and decreases vibration | Otosclerosis |
| Otosclerosis is caused by immune compromise, stress fractures, and previous infection. Symptoms include __________ ______, ________ and _______. Scars are white and may take on a trabeculated appearance. Drum may be thick and retracted. | Hearing loss, dizziness, tinnitus |
| ___________ is accumulation of debris in the ear drum(squamous epithelium) in a cystlike pocket. | Cholesteatoma |
| Cholesteatoma looks like a white granulated nodule anywhere along the rim of the drum. Most commonly caused by _____ _______ or may be congenital. It will cause pain below the ________ of the _____. | Chronic infections Angle of the Jaw |
| _________ is calcification of tissues in the eardrum and middle ear. This is due to _____ ________. Described as chalky, opaque, and white patches in horseshoe shapes. This can lead to _______ hearing loss and tinnitus. | Tympanosclerosis Chronic infection conductive hearing loss |
| _____ _____ is lost with scarring. Tympanograms measure movility objectively but are expensive. It is lost with bloked eustachian tube. | Drum Mobility |
| _______ hearing loss is loss of air conducted sound sensitivity. Any disorder obstructing sound waves from stimulating at the _____ window. (Ear wax, foreign body, otosclerosis, and fussion of ear ossicles) | Conductive hearing loss oval window |
| _______ hearing loss is disease or dysfunction of the organ of corti and cocolea. This is caused by some viral infections or medications. Neural transmission of CN __. | Sensorineural Hearing Loss CN8 |
| Auditory acuity testing will test if a patient can hear ______ ______ ______ ___ ________. Use a high pitched low intensity reproducible sounds such as _______ _____ or ________. | equally from side to side finger rustle or whisper |
| ________ test is when you use a vibrationg 512 tuning fork placed on the skull apex. Sound should be heard equally in both ears. Sound will lateralize to the ______ ear in conductive loss. Sound will lateralize to the ______ ear in sensorineural loss. | Weber Bad- conductive Good- Sensorineural |
| ________ test is placing a vibrating tuning fork on the mastoid and moved to the outside of the EAM wen sound is no longer heard. Inability to hear the fork in the ear position suggests _______ hearing loss. | Rinne Test Conductive |
| Normally humans hear better through ______ than _______. | air than bone |
| ________ test is comparing the patients air conduction ability to the normal examiners conduction ability. First hold in front of the patients ear and when it is no longer heard quickly transfer to the doctors ear. | Schwabach test |
| Medial and lateral angles of the eye formed by the junction of the upper and lower lids is the _______. | canthus |
| ________ ______ is the layer of extra skin draped over the medial angle of the eyes. More apparent in asians and down's syndrome | epicanthal fold |
| _______ ________ is a gland located in the superior lateral portion of the eyes. Secretions drain into the puncta located on the ____ ______ and lower lid margins. | Lacimal apparatus medial upper |
| Normal pupils are round, symmetrical and the size is influenced by _________ _______. | autonomic nerves |
| Muscle that moves the eye laterally. | lateral rectus |
| muscle that moves the eye medial | medial rectus |
| muscle that elevates the eye and turns medially | superior recturs |
| muscle that depresses eye and turns medially | inferior rectus |
| muscle that depresses eye and turns laterally | superior oblique |
| Muscle that elevates the eye and turns laterally | inferior oblique |
| CN 2 is | optic vision |
| CN 3 is | Oculomotor (sup/mid/inf rectus, inf oblique and levator palpebrae muslces) |
| CN 4 is | trochlear (Sup oblique muslce |
| CN 5 is | Trigeminal (Corneal sensation) Swab test |
| CN 6 is | abducens (Lateral rectus muscle) |
| CN 7 is | facial muscles of the eyelids and lacrimal gland |
| Parasympathetic from cranial nerve 3 is pupillary ______. | constriction |
| Sympathetic T1, T2 is pupillary _________. | dialation |
| ________ is unequal pupils. Defined as a difference of .__mm or less. This is caused by autonomic problems, medication, increased intracranial pressure, CN 3 disorders. | Anisocoria .4mm |
| ________ is a collection of symptoms including eye fatique, weakness, pain, headache (Eyestrain headache), dim vision, lacrimation. Causes are prolonged focusing, binocular vision disorders, refractive errors. | Asthenopia |
| ________ is double vision. It occrus with loss of eye muscle balance. Diabetic neuropath, Myasthenia gravis, and thyroid disorders. | Diplopia |
| __________ (Proptosis) is an abnormal protrusion of the eye from the orbit. Main concern is __________, tumors of the orbit, and arteriovenous fistulas. | Exopthalmos hyperthyroidism |
| _______ is abnormal elevation of the eyelid. White slcera shows above the iris, _________ is a common case. | Stare Hyperthyroidism |
| _______ are foating debris or ________ that may drift in and out of the field of vision. Usually harmless. When recent or severe it may indicate ________ __________. | Floaters Protein (retinal traction/detachment) |
| ___ ________ is when the superior tarsal muscle of the eye becomes hypertonic. This may occur in ___________. As the patient looks down from an upward gaze the white sclera is seen above the iris. | Lid lag hyperthyroidism |
| ___________ is aversion to light. Systemic infections may cause this. Often occurs from _________. | Photophobia migraines |
| ________ is drooping of the eyelid. This is caused by interruption of the ________ nerve, _________ nerve, and ________ nerves. | ptosis facial oculomotor sympathetic |
| ________ (Tropia) is misalignment of the eye. This can be described by the direction the weak eye presents or by the CN involved. Muscle weakness, CN, brain injury. 4% of the US population has this. | Strabismus |
| ________ is similar to strabismus but is not overtly apparent. This can be unmasked by the cover/uncover test. Signs and symptoms can vary from nothing to headache or eyestrain. | Phoria |
| Eye turns in is _______. | Esophoria |
| Eye turns out is ______. | Exophoria |
| Eye turns up is ______. | hyperphoria |
| Eye turns down is _______. | hypophoria |
| ___________ is lipid deposition about the eye. It may be associated with ______ _________ or triglycerides. | Xanthalasthma high cholestrol |
| Jaundice is ______. Usually a _______ accumulation in the conjunctiva. | Yellow bilirubin |
| Pale conjunctiva is due to _______ ______. Compress the lacrimal sac to milk it. | Severe anemia |
| PERRLA stands for | P=pupils E=equal R=round R=React to L=Light A=Accommodation |
| Direct pupillary reaction is when you shine the light directly in the eye and watch the _______ eyes pupil. It should ________. | same constrict |
| Indirect or (_________) pupillary reaction is when you shine the light directly in the eye and watch the ________ eyes pupil. It should _________. | Consensual oppopsite constrict |
| Accommodation to distance. When the patient focuses on something near their pupil _______. When they focus on something far the pupil _______. | Constricts Dilates |
| H-Pattern lid leg extraocular motor function test. Inability to move in a given direction suggests a ________ or ________ problem. | nerve or muscle |
| Set up for eye exam with opthalmoscope. Light turned on to about _/_ full light intensity. Thumb on ______ _______. Move to ___ degrees, locate red reflex or optic disk. | 2/3 focus wheel 15 degrees |
| ________ ________ _______ are accumulation of cellular debris most often caused by microinfarcts. They are white/grey and have very defined borders. The main concern is __________, along with diabetes, viruses, anemia, thrombocytopenia. | Cotton Wool Patches Hypertension |
| ____ ______ are areas of leukocytes and cellular debris found near retinal vessels. They are yellow-white and have indistinct margins. Concerns are herpes zoster, simplex, leukemia, and parasites. | Retinal infiltrates |
| ________ _________ are accumlations of normal cellular byproducts and debris. Small yellow or white deposits on the retina around the macula. These are age related or early signs of _______ _________. | Drusen Bodies Macular Degeneration |
| _______ ________ is a lipid residue in the eye. It looks like little yellow flecks. The most common cause is ___________. Other causes are radiation exposure or hypertension. | Hard Exudate Diabetes |
| If we are concerned about hypertension, unilateral headaches and exopthalmic eyes we should use auscultation over the orbit. This may reveal continuous murmur of an ________ _________. | arteriovenous fistula |
| Snellen Eye chart is the distance of a patient from the chart (20)/ (distance at which a person ___________ defect could identify the letter). | without |
| ________ cards are used to test color vision. Genetic color blindness occurs when a patient does not have all 3 types of ________ (red, green, or blue) | Ishihara cards cones |
| _________ problems are when the eye is working fine but the light is not hitting the back of the retina so its distorted. | Refractive problems |
| ________ is nearsightedness. It is the inability to focus on objects in the distance. The eye is ______. Can use divergent lenses or lasik to correct. | Myopia long |
| _________ is farsightedness or the inability to focus on near objects. The eye is ______ or fatter _ to _. | Hyperopia short I to S |
| __________ is variations of corneal curvature. IT is not sphere shaped but more like a spoon. All postions of the visual field are not in focus at one time. | Astigmatism |
| __________ is a decrease in elasticity of lens due to aging. Difficulting seeing in ____ light. Cannot focus on fine print. | Presbyopia dim |
| ______ ______ are when a person are looking straight ahead but a certain area of the vision is missing or blurry. | field cuts |
| _________ is partial loss of vision. A field cut or island of loss is known as a ____ ________. The loss may go unnoticed by the patient. | Scotoma Blind Spot |
| Causes of visiual field defects are transient _______ ________ (may cause brief remittent attacks) _________ (may cause permanent loss), ______ (may cause progressive loss), _______ ( may cause progressive loss or tunnel vision_) | ischemia attacks Strokes tumors glaucoma |
| ________ is a constricted pupil compared to the opposite side. | Miosis |
| ________ is lack of sweating with very dry skin around the eye. It also may be slightly red. | Anhidrosis |
| ______ ________ results from sympathetic nerve interruption to the head (ptosis, miosis, anhydrosis). Causes may include stroke, spinal cord injury, apical lung tumor. | Horner Syndrome |
| ________ is when the eyelashes turn out. Tarsal plate everts due to laxity. | Ectropian |
| ________ is when eyelashes turn in. Tarsal plate invert due to spasticity. | Entropian |
| _________ is eye pain due to increased extraocular pressure. The uveal tract (middle layer of the eye) is inflamed. This can lead to ______ nerve damage and blindness. | Glaucoma optic |
| ______ _______ (__________) is inflamation of the iris and cilliary body. Causes include trauma, RA, AS, psoriasis, IBD, lymes disease, TB. | Anterior Uveitis (Iritis) |
| Symptoms of anterior uveitis are red, sore, ________ eye. ______ vision, _____ sensitivity. Small or ________ pupil. Vision may be threatened if left untreated. | inflamed eye Blurred vision, light sensitivity. Asymmetric pupil |
| _________ ________ (Choroiditis) is inflamation of the choroid, retina, optic disc. This is rare but causes include infection HSV2, Syphillis, parasite. Symptoms are sore, red eye, _______ vision, ______ vision loss, _________ and ______ sensitivity. | Posterior Uveitis blurred vision, progressive vision loss, floaters, light sensitivity |
| _______ ________ is a scratch on the clear protective cornea. Signs are a _______ feeling, eye pain with opening and closing the eye. Tearing redness, light sensitivity, blurred vision and may lack other signs of inflammation due to _____ ______ _______. | Corneal Abrasion Gritty Minimal blood supply |
| ______ impregnated strip of filter paper aids in the diagnosis of corneal abrasion. Forescein die accumulates in the scratch. You use the _____ ________ light setting on the ophthalmoscope. | Fluorescein cobalt blue |
| Open angle and closed angle are two types of _______. Signs and symptoms are pain free to eventually severe pain, _______ vision, Hazy/steamy vision. Seeing ________ around lights. | Glaucoma tunnel halos |
| In _________ angle glaucoma the iris bulges forward to narrow or block the canal of schlemm. The fluid cant adequately flow through and exit your eye. This can be genetic, caused by eye injury, or infection. This is rare (less than __% of Glacoma) | Closed angle 10% |
| ______ angle glqucoma is when the entrance to the canal of schlemm is patent and working correctly. Blockage or degenration occurs deep in the canals. As a result, fluid can't adequately flow through and exit your eye. Affects _____ Americans. | open angle 3,000,000 Americans |
| The _______ of ______ drains aqueous humor from the eye. | Canal of schlemm |
| _________ is measuring interocular pressure. It is a small ______ ___ ___. High pressure is associated with ______. | Tonometry. Puff of air Glaucoma |
| _________ is a lazy eye. This starts in childhood in which vision has not developed properly in one eye or the other. Th most common cause is _______. If left untreated a childs vision will not develop correctly. One eye will remain with _____ _____. | Amblyopia strabismus poor vision |
| _______ ________ is the destruction of the retina. Causes are injury, advanced diabetes, eye inflammation, aging. Signs are sudden appearance of _________, ______ of light, followe by ____ ___ ________ (curtain of darkenss). Loss of red reflex. | Retinal detachment floaters, bright light, loss of vision |
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