Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
89 Cards in this Set
- Front
- Back
How many bones are there in the face?
|
14
|
|
How many cervical vertebrae support the skull?
|
7
|
|
Which cervical vertebrae helps flex your head?
|
C7
*to locate, find the vertebra that sticks out the most during neck flexion |
|
What are fontanelles?
|
Areas on the infantile skull that feel like "soft spots"
There should be NO protrusion |
|
What are possible findings in fontanelle assessment
|
1. normal: soft & flat
2. full, bulging: brain injury? 3. sunken: dehydration |
|
Describe the shape of the ANTERIOR fontanelle and when it closes.
|
Anterior fontanelle:
1. diamond 2. 4mo - 26 months |
|
Describe the shape of the POSTERIOR fontanelle and when it closes.
|
Posterior fontanelle:
1. triangle 2. 2 months |
|
Which questions about the head should you ask during the health history?
|
1. headache?
2. head injury? 3. dizziness? 4. history of head injury or surgery? *pay attention to a severe headache |
|
What are additional questions that you should ask when taking the history of an aging adult?
|
1. If dizziness is a problem, how does it affect your ADLs?
2. Are you able to drive safely? 3. Are you able to maneuver around the house safely? |
|
What are 4 aspects of the head that you should inspect and palpate?
|
1. skull
2. scalp 3. hair 4. face |
|
What are 4 facial features that you should pay attention to during the physical exam?
|
1. Symmetry of features
2. CN VII, V 3. TMJ 4. Temporal arteries |
|
What are 3 descriptions of head size?
|
1. Macrocephaly
2. Normocephalic 3. Microcephaly |
|
What is macrocephaly? Potential cause?
|
>90th percentile for gestational age
hydrocephaly |
|
What is microcephaly? Potential causes?
|
<10th percentile for gestational age
chromosomal abnormalities intrauterine infection maternal alcohol/drug abuse |
|
What are 4 reasons why you should inspect the face?
|
1. symmetry (eyebrows, palpebral fissures lined up with top of ear, nasoliabial folds)
2. facial expression 3. abnormal structures 4. abnormal movements |
|
What is acromegaly?
|
A disease in which the pituitary gland produces too much GH...causes excessive frontal bone and soft tissue growth
|
|
What are some features that appear in a person with fetal alcohol syndrome?
|
1. epicanthal folds
2. think upper lip |
|
What is CN VII and what does it innervate?
|
Facial
mediates facial muscles |
|
How can you assess CN VII?
|
1. expressions should be symmetrical
2. palpebral fissures should be equal bilaterally 3. nasolabial folds should be symmetric |
|
What is a condition that occurs from paralysis of one side of CN VII?
|
Bell's Palsy
|
|
What is CN V and what does it innervate?
|
trigeminal nerve
forehead, cheeks, and chin bilaterally |
|
What are the 3 distributions of CN V?
|
1. ophthalmic
2. maxillary 3. mandibular |
|
How can you assess the SENSORY function of CN V?
|
gently rub a cotton ball over the innervated area (ie cheeks, forehead, chin) and ask if patient feels it
|
|
How can you assess the MOTOR function of CN V?
|
Ask the patient to clench teeth and open mouth while you palpate temporal and masseter muscles bilaterally
|
|
What is the most active joint in the body?
|
TMJ: temporomandibular joint
|
|
Where is the TMJ located?
|
below the temporal artery and anterior to the tragus
|
|
What should you assess while palpating the TMJ?
|
Palpate while the person opens his/her mouth.
-check for normal smooth movement with no limitation or tenderness -check for ROM (range of motion) |
|
What are problems that could occur in the TMJ?
|
-decreased ROM (arthritis)
-Click: meniscus tear, poor occlusion, synovial swelling |
|
What should the temporal artery NOT feel like?
|
-indurated (hard)
-torturous (twisty) |
|
Inflammation of the temporal artery may cause...
|
blindness
|
|
When eyes are approximate, what does that mean?
|
they're closed
|
|
What is a caruncle?
|
the fleshy part in the medial canthus that has sebaceous glands
|
|
What is a palpebral fissure?
|
opening between the 2 eyelids
|
|
What are tarsal plates of the eye?
|
plates of dense connective tissue that gives the eyelid form and support
|
|
What are meibomian glands?
|
Sebaceous glands that secrete oil to lubricate the eye
|
|
What are 2 types of conjunctiva and what do they line?
|
1. bulbar (lies over cornea)
2. palpebral (lines the lids) |
|
What color should the conjunctiva normally be?
|
pink
|
|
How can you diagnose conjunctivitis?
|
Since the conjunctiva are swollen, you can see the mucus membrane of the BULBAR conjunctiva sticking away from the eye
|
|
What does the lacrimal apparatus do?
|
Provides constant irrigation by secreting tears
|
|
What is the pathway of tear flow?
|
lacrimal gland secretes-->
flows across eye--> drains into puncta--> drain to nasolacrimal sac--> nose |
|
Which two parts of the eye are continuous with each other
|
sclera and cornea
|
|
What does the choroid do?
|
gives blood to the retina
|
|
Why is the retina significant?
|
It is the place where light rays become nerve impulses
|
|
What are 3 layers of the eye?
|
1. Sclera
2. Choroid 3. Retina |
|
What is the anterior compartment and what fluid does it contain?
|
Located between the cornea and iris; filled with aqueous humor
|
|
What eye part makes the aqueous humor?
|
ciliary body
*aqueous humor meant to drain waste |
|
What disease occurs when problems in the anterior compartment occur?
|
glaucoma
|
|
What fluid does the posterior chamber contain?
|
vitreous humor
*watch for floaters |
|
Describe the 6 extraocular muscles.
|
straight (4): rectus muscles
oblique (2): rotation of eye |
|
What are 2 possible causes of problems with eye movement?
|
1. problem with nerve
2. problem with muscle |
|
Name the cranial nerves that innervate the extraocular muscles.
|
1. CN VI (abducens)
2. CN IV (trochlear) 3. CN III (oculomotor) |
|
Which muscles does CN VI innervate?
|
the LATERAL rectus muscles
|
|
Which muscles does CN IV innervate?
|
superior oblique muscles
|
|
Which muscles does CN III innervate?
|
Superior, inferior, medial rectus
Inferior oblique |
|
What eye movement does CN VI enable?
|
looking at the sides
|
|
What eye movement does CN IV enable?
|
down and in
|
|
What is the "red reflex"?
|
When the opthalmoscope light reflects off the retina
|
|
What eye parts can you see through the opthalmoscope?
|
1. retinal vessels
2. retinal field or background 3. optic disc 4. macula |
|
What should the optic disc look like through the opthalmoscope?
|
creamy color; round or oval; blurred edge on nasal side, demarcated edge on temporal side
|
|
How many sets of retinal vessels should you look for?
|
4, each set consists of a vein + artery, 2 sets are superior, 2 sets are inferior
|
|
How are visual pathways projected?
|
upside down and reversed right to left
|
|
What is the visual pathway of nerve impulses?
|
nerve impulses are conducted through the..
retina--> optic nerve--> optic chiasm--> optic tract on each side--> through a curving tract called the optic radiation |
|
What are 2 types of pupillary light reflexes?
|
1. direct
2. consensual |
|
How do you test the direct pupillary light reflex?
|
shine the light into the left eye, the left pupil constricts
|
|
How do you test the consensual pupillary light reflex?
|
shine the light into the left eye, the right pupil constricts
|
|
Accomodation: At far vision, pupils..
|
dilate
|
|
Accomodation: At near vision, pupils...
|
constrict and converge
|
|
How do you use the Snellen chart?
|
Place the chart 20 ft from the patient.
Shield 1 eye and instruct the patient to read the line that they can see best. *leave glasses on if needed! |
|
What does the Snellen chart test
|
distance visual acuity
|
|
Interpret 20/50 vision.
|
What that person read at 20 ft could be read by a person with perfect vision (20/20) at 50 ft.
|
|
What occurs in myopia?
|
near vision; the anterior-posterior measurement is too long
|
|
What occurs in hyperopia?
|
far vision; the anterior-posterior measurement is too short
|
|
What is presbyopia?
|
when the ability of the lens to accommodate decreases
|
|
What disease would you expect if the outer 1/3 of the eyebrow is missing?
|
thyroid disease
|
|
What is ptosis?
|
drooping of the upper eyelid; may be congenital or caused by a disease
|
|
What is anisocoria?
|
When people are born with 1 pupil bigger than the other
|
|
How can you decide if aniscocoria is benign?
|
if the pupils respond to light
|
|
What is a normal pupil size?
|
3mm-5mm
|
|
What are the 5 tests for eye function that you should perform during the physical?
|
1. Corneal light reflex
2. Direct and consensual (pupillary light reflex) 3. Accomodation 4. Extraocular muscles 5. Visual fields |
|
Which pathway does light travel in order to instruct the pupil to constrict?
|
light-->
CN II--> cortex--> CN III--> constrict |
|
How far away do you need to be in order to test the 6 cardinal positions of a gaze?
|
~1 foot away from the patient
|
|
How do you test the range of peripheral visual fields?
|
Fishbowl
*do one eye at a time if you expect an eye problem |
|
What are the normal peripheral visual field limits?
|
nasally: 60 degrees
temporally: 90 degrees superiorly: 50 degrees inferiorly: 70 degrees |
|
What is bitemporal hemianopsia?
|
involves the fibers crossing over tot he opposite side.
since the fibers originate in the NASAL half of each retina, visual loss involves the temporal half of each field |
|
What is left homonymous hemianopsia?
|
lesion in the RIGHT optic tract inturrupts fibers originating on the same side of both eyes
Visual loss in the eyes is therefore similar and involves half of each eye; in this case left temporal and right nasal |
|
What is A-V nicking?
|
when the artery crosses over in the vein
|
|
When is A-V nicking often seen?
|
-diabetics
-hypertension |
|
What is papilledema?
|
Choking of the disc from increased ICP pressing on the optic nerve
It looks puffed up; normally veins pulsate, but not in this case If you must change your focus to visualize the optic disc, you may have edema |
|
What are causes of papilledema?
|
1. headache
2. injury |