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EYES PowerPoint Presentation

EYES

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EYES

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  1. EYES

  2. Mrs. Smith brings her 5 y.o. daughter in for a well visit. Which of the following would assess the child for nystagmus? Assessing Visual Acuity Inspecting Movement of the Eyes to the Six Cardinal Fields of Gaze Palpating the Globe while the Child Holds Eyelids Closed Inspecting the Macula of the Eye with an Ophthalmoscope

  3. Mrs. Smith brings her 5 y.o. daughter in for a well visit. Which of the following would assess the child for nystagmus? Assessing Visual Acuity Inspecting Movement of the Eyes to the Six Cardinal Fields of Gaze Palpating the Globe while the Child Holds Eyelids Closed Inspecting the Macula of the Eye with an Ophthalmoscope

  4. nystagmus: Involuntary rhythmic movements of the eyes; the oscillations may be horizontal, vertical, rotary, or mixed. strabismus: (1) Condition in which the eyes are not directed at the same object or point. (2) Disparity in the anteroposterior axes of the eyes; the optic axes cannot be directed to the same object because of lack of muscular coordination. ptosis: (1) Prolapse of an organ or part; drooping of the upper eyelid.S (2) Drooping of the upper eyelid; can be unilateral or bilateral; usually results from innervation or lid muscle disorder.W (3) Drooping of the upper eyelid, often interfering with vision.B Testing Eye Muscles LR6 SO4 AO3

  5. Which of the following should be used to test for near vision in a 50 y.o. patient? Rosenbaum Chart Snellen “E” Chart Confrontation Test Cover-Uncover Test

  6. Which of the following should be used to test for near vision in a 50 y.o. patient? Rosenbaum Chart Snellen “E” Chart Confrontation Test Cover-Uncover Test

  7. Snellen • Far Vision • Rosenbaum • Near Vision • Card held at 14” away • Confrontation • Testing Eye Muscles • Visual Fields: Measure of Peripheral Vision • Cover-Uncover • Pt fixes gaze on an object • Examiner covers one eye with object, holding in place for several seconds • Uncover eye and observe for movement as it focuses on the same object • Outward Gaze – Exotropia • Inward Gaze - Esotropia

  8. Mrs. Smith has vision that at best is 20/210. Mrs. Smith is considered: • Mildly Myopic • Moderately Hyperopic • Unilaterally Anisocoric • Legally Blind

  9. Mrs. Smith has vision that at best is 20/210. Mrs. Smith is considered: • Mildly Myopic • Moderately Hyperopic • Unilaterally Anisocoric • Legally Blind

  10. myopia (nearsightedness): (1) A condition resulting from a refractive error in which light rays entering the eye are brought into focus in front of the retina.(2) Condition in which parallel rays of light come to focus in front of the retina. hyperopia (Farsightedness): A refractive error in which light rays entering the eye are focused behind the retina. anisocoria: Condition in which the pupils of the two eyes are of unequal size. legally blind: Vision not correctable to better than 20/200

  11. Which of the following is the correct technique for performing an ophthalomoscopic examination? • Examine the patient’s right eye w/ your left eye, and the left eye w/ your right eye. • Examine the patient’s right & left eyes w/ your dominant eye. • Examine the patient’s right eye w/ your right eye, and the left eye w/ your left eye. • Examine the patient’s right & left eye w/ your nondominant eye.

  12. Which of the following is the correct technique for performing an ophthalomoscopic examination? • Examine the patient’s right eye w/ your left eye, and the left eye w/ your right eye. • Examine the patient’s right & left eyes w/ your dominant eye. • Examine the patient’s right eye w/ your right eye, and the left eye w/ your left eye. • Examine the patient’s right & left eye w/ your nondominant eye.

  13. Ms. Smith is a 21 y.o. patient who presents to your clinic. On exam you find a cobblestone appearance of the conjunctiva. This finding is most likely related to: • Lagophthalmos • Allergic or Infectious Conjunctivitis • CMV • Subconjunctival Hemorrhage

  14. Ms. Smith is a 21 y.o. patient who presents to your clinic. On exam you find a cobblestone appearance of the conjunctiva. This finding is most likely related to: • Lagophthalmos • Allergic or Infectious Conjunctivitis • CMV • Subconjunctival Hemorrhage

  15. Mr. Smith is a 66 y.o. patient with type 2 diabetes who presents to your clinic for a routine physical exam. On exam you find that his left eye does not move temporally. The eye muscles are innervated by which of the following cranial nerves? • Optic, Abducens, Oculomotor • Trochlear, Abducens, Oculomotor • Oculomotor, Abducens, Optic • Oblique, Trochlear, Rectus

  16. Mr. Smith is a 66 y.o. patient with type 2 diabetes who presents to your clinic for a routine physical exam. On exam you find that his left eye does not move temporally. The eye muscles are innervated by which of the following cranial nerves? • Optic, Abducens, Oculomotor • Trochlear, Abducens, Oculomotor • Oculomotor, Abducens, Optic • Oblique, Trochlear, Rectus

  17. CN • CN III (oculomotor) • CN IV (trochlear) • CN VI (abducens)

  18. Mr. Smith present to your clinic with a complaint of visual disturbances. On exam you note an abnormal growth of conjunctiva from the limbus over the cornea. Which of the following best describes this condition? • ArcusLimbus • Xanthelasma • Ectropion • Pterygium

  19. Mr. Smith present to your clinic with a complaint of visual disturbances. On exam you note an abnormal growth of conjunctiva from the limbus over the cornea. Which of the following best describes this condition? • ArcusLimbus • Xanthelasma • Ectropion • Pterygium

  20. arcussenilis: (1) Gray ring composed of lipids deposited in the peripheral cornea; commonly seen in older adults; also called arcuscornealis. (2) Grayish to gray-white, opaque arc or halo surrounding the cornea; generally occurs in individuals older than 50 years. xanthelasma: (1) Xanthoma located on the eyelids. (2) Soft yellow spot or plaque that usually occurs in groups on the eyelids. ectropion: (1) Abnormal outward turning of the margin of the eyelid. (2) Turning outward of the lower lid of the eye. pterygium: Abnormal triangular thickening of the bulbar conjunctiva on the cornea, with the apex directed toward the pupil. pinguecula: Small, yellowish white subconjunctival elevation between the corneosclerallimbus and the canthus.

  21. Visual Acuity is a measurement of: • Depth perception • CN II, III, VI integrity • Lens accomodation • Central vision

  22. Visual Acuity is a measurement of: • Depth perception • CN II, III, VI integrity • Lens accomodation • Central vision

  23. Visual Acuity • First Portion of Eye Exam • Measure of Central Vision ~ CN II ~ Optic Nerve Accomodation • Ability of the pupils to constrict on object up close

  24. Mrs. Smith is a 43 y.o. patient presenting to your clinic with complaints of visual disturbances. On exam her visual acuity is recorded as 20/60. This finding can be interpreted as: • The person can read at 60 feet what an average person can read at 20 feet. • 20% of individuals tested can read 60% of the letters in this particular line. • The person can read at 20 feet what an average person can read at 60 feet. • Out of 200 individuals, 20% can read all the letters & 60% can read half of the letters in this particular line.

  25. Mrs. Smith is a 43 y.o. patient presenting to your clinic with complaints of visual disturbances. On exam her visual acuity is recorded as 20/60. This finding can be interpreted as: • The person can read at 60 feet what an average person can read at 20 feet. • 20% of individuals tested can read 60% of the letters in this particular line. • The person can read at 20 feet what an average person can read at 60 feet. • Out of 200 individuals, 20% can read all the letters & 60% can read half of the letters in this particular line.

  26. Snellenvs Rosenbaum • Snellen • Far Vision • Reporting Results: • 20/50= patient can read at 20 feet what the average person can read at 50 feet • Rosenbaum • Near Vision • Card held at 14” away

  27. Mr. Smith is a 44 y.o. patient who is referred to you with a lesion of the optic nerve at the optic chiasm. Which of the following visual field defects is a result of this lesion? • Unilateral Blindness • Homonymous Hemianopia • BitemporalHemianopia • BinasalHemianopia

  28. Mr. Smith is a 44 y.o. patient who is referred to you with a lesion of the optic nerve at the optic chiasm. Which of the following visual field defects is a result of this lesion? • Unilateral Blindness • Homonymous Hemianopia • BitemporalHemianopia • BinasalHemianopia

  29. Are you tired of this yet???? A: Optic Nerve ~ R/L Anopsia (same eye) B: Optic Chiasm ~ BitemporalHemianopsia C: Optic Tract ~ R/L Homonymous Hemianopsia (opposite eye) D: Optic Radiations ~ R/L Homonymous Hemianopsia (opposite eye) E: Cuneus ~ R/L Inferior Quadrantanopsia Cortex (opposite eye) F: Lingual Gyrus ~ R/L Superior Quandrantanopsia Cortex (opposite eye)

  30. EAR, NOSE, THROAT

  31. Mrs. Smith is a 65 y.o. patient who present to your clinic with a chief complaint of hearing loss. On physical exam you have performed the Weber Test, which of the following is considered a normal finding? • The patient hears the tone equally in both ears. • The patient hears sounds longer when conducted through the air than when conducted through the bone. • The patient hears the tone better in one ear than in the other. • The patient is able to detect tomes of varying frequencies & pitches from a tuning fork.

  32. Mrs. Smith is a 65 y.o. patient who present to your clinic with a chief complaint of hearing loss. On physical exam you have performed the Weber Test, which of the following is considered a normal finding? • The patient hears the tone equally in both ears. • The patient hears sounds longer when conducted through the air than when conducted through the bone. • The patient hears the tone better in one ear than in the other. • The patient is able to detect tomes of varying frequencies & pitches from a tuning fork.

  33. Weber test: Test of bone conduction through the use of a tuning fork placed on the top of the skull or middle forehead. A normal result occurs when the client reports that the sound is heard equally in both ears. The sound lateralizes when hearing loss is present. Rinne test: Test comparing air conduction and bone conduction through the use of a tuning fork. In normal hearing, air conduction sounds are heard longer than bone conduction sounds (positive / normal Rinne).

  34. Mrs. Smith present to your clinic with her 5 y.o. son. On physical exam you note a tympanostomy tube in the right ear. Which of the following is an expected finding for the TM of this ear? • Amber colored appearance • Chalky white in appearance • Bulging w/o mobility • Retracted with limited mobility

  35. Mrs. Smith present to your clinic with her 5 y.o. son. On physical exam you note a tympanostomy tube in the right ear. Which of the following is an expected finding for the TM of this ear? • Amber colored appearance • Chalky white in appearance • Bulging w/o mobility • Retracted with limited mobility

  36. Mrs. Smith present to your clinic with her 5 y.o. son. On physical exam you note a tympanostomy tube in the right ear. Which of the following is an expected finding for the TM of this ear? • Amber colored appearance • Chalky white in appearance • Bulging w/o mobility • Retracted with limited mobility

  37. TM ~ Normal • Concave, pulled in at the center by the malleus • Translucent - permits visualization of middle ear • Most of membrane is tense - pars tensa • Superior portion is more flaccid- pars flaccida

  38. Mr. Smith brings his 7 y.o. son in with a chief complaint of sore throat. On physical exam you find that the patient’s tonsils are enlarged & touch the uvula. This finding would be documented as: • 1+ • 2+ • 3+ • 4+

  39. Mr. Smith brings his 7 y.o. son in with a chief complaint of sore throat. On physical exam you find that the patient’s tonsils are enlarged & touch the uvula. This finding would be documented as: • 1+ • 2+ • 3+ • 4+

  40. Enlarged tonsils are graded to describe their size: A 1+ visible B 2+ halfway between tonsillar pillars & the uvula C 3+ nearly touching the uvula D 4+ touching each other

  41. The function of cerumen in the EAC is: • Provide vibration • Provide lubrication • Provide adhesiveness • Attract insects

  42. The function of cerumen in the EAC is: • Provide vibration • Provide lubrication • Provide adhesiveness • Attract insects

  43. The set of the ears is determined by an imaginary line that originates at the: • Bridge of the nose • Orbital ridge • Tip of the nose • Inner canthus

  44. The set of the ears is determined by an imaginary line that originates at the: • Bridge of the nose • Orbital ridge • Tip of the nose • Inner canthus

  45. To determine the position of the auricle, draw an imaginary line between the inner canthusof the eye and the most prominent protuberance of the occiput. • The top of the auricle should touch or be above this line. • Then draw another imaginary line perpendicular to the previous line just anterior to the auricle. The auricle's position should be almost vertical, with no more than a 10-degree lateral posterior angle. • An auricle with a low-set or unusual angle may indicate chromosomal aberrations or renal disorders.

  46. Mr. Smith is a 40 y.o. patient who during the Weber Test, indicates that sound is heard better in one ear. This is described as: • Predilection • Redirection • Lateralization • Reinforcement

  47. Mr. Smith is a 40 y.o. patient who during the Weber Test, indicates that sound is heard better in one ear. This is described as: • Predilection • Redirection • Lateralization • Reinforcement

  48. A sensorineural hearing loss is the result of: • Impaired transmission of sound through the TM • A defect in the inner ear that leads to distortion of sound & misrepresentation of speech • Impaired transmission of sound through the Eustachian Tube • Impaired conduction through the Middle / External Ear

  49. A sensorineural hearing loss is the result of: • Impaired transmission of sound through the TM • A defect in the inner ear that leads to distortion of sound & misrepresentation of speech • Impaired transmission of sound through the Eustachian Tube • Impaired conduction through the Middle / External Ear