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Assessment HEENT

HEENT

QuestionAnswer
head - child key points head circumfrence---symmetry/shape---facial expression---abn facies
when do fontanels close aterior at 10-18 months, posterior at 2 months (book says within first year of life)
which sinuses are fully developed at birth? only ethmoid and maxillary . . .others by age 7
how many deciduous and adult teeth 20 baby teeth---32 permanent
gross hearing tests normal voice ---whisper test---Weber and Rinne
myopia nearsightedness, rays focus in front of retina
hyperpopia farsightedness - rays focus behind lens
astigmatism irregular curvature or cornea causing light scattering, blurred images to retina
where is only place where blood vessels can be directly observed the optic fundus (vessels emerge from optic disc)
damage to CN III limited actions of sup/inf.medial rectus--> limited ROM up/down/nasal/upper diagonal
damage to CN VI innervate lateral rectus for lateral impairment
damages to CNIV innervates superior oblique
hemianopia visual loss which can be ipsilateral, contralateral
infant s/b able to fixate by 2-4 weeks, ---visual following 5-6 weeks---by 1 month follow an object.. .180 degree tracking at 4 months acuity of 20/200 goes to 20/20 by school age
infant presence of red reflex, which is normal finding absense may indicate congenital cataracts or retinal detachment
amblyopia - lazy eye corneal light reflex, binocular vision cover/uncover test
strabismus (eyes not properly aligned) alignment of eye important due to correlation with brain development. may need to correct surgically
elderly - ectropion lower lid sags away from globe, punctum no longer in contact to collect tears --> constant tearing
landmarks for eye assessment superior, inferior ---left/right temporal
ptosis (drooping eyelid) s/d assessed as well as exophthalmos---edema---redness
children assessed for this btw 4-8 yo colorblindness
20/20 values mean numerator is distance from chart/denominatory is distance for normal person to read chart----the higher the denominator, the WORSE THE FAR VISION
peripheral vision measured on 2 planes - horizontal/vertical and in 4 directions superior/inferior---medial/nasal--lateral/temporal
retina assessment - optic disk diam 1.5cm with cup-to-disk ratio 0.1 - 0.5 and these macula avascular/darker---vessels (arteries thinner/brighter than veins)---inspect all 4 directions
corneal light reflex tests extraocular membrane and determines if eyes being maintained in conjugate position, light should reflect back as sparkle as it reflects off cornea
cover/uncover test - disconjugate eye movement gaze should be steady, no drifting
corneal reflex test tests for CNs V and VII---pt should blink, some tearing
consensual reaction is when we do something to one eye (shine light/constriction) and other eye does the same thing cuz they are working in conjugate
Created by: lorrelaws