question

What is the pathways of tears?

answer

1. Produced in lacrinal glands & accessory lacrimal glands 2. cover the cornea 3. drain out the punctum in medial eyelids 4. flow down canaliculi into lacrimal sac 5. drain down nasolacrimal duct into the nose at the inferior meatus

question

What is the structure that protects the eyes from foreign bodies?

answer

conjunctiva

question

Tears flow over the cornea and drain via the lacrimal sac into the...

answer

nasal meatus

question

Contraction of which eye structure controls the amount of light that reaches the retina?

answer

Iris

question

Contraction or relaxation of the ciliary body:

answer

changes lens thickness

question

The sensory network of the eye is the:

answer

retina

question

Term infants have a visual acuity of about:

answer

20/400

question

At what age does an infant usually develop the ability to distinguish color?

answer

6 months

question

An increased level of lysozyme in the tears will occur normally during which life stage?

answer

Pregnancy

question

A pregnant woman in her third trimester tells you that her vision has been a little blurred and she thinks she needs to get new contact lenses. You should advise her to:

answer

wait until several weeks after delivery to get new lenses.

question

Which of the following is a relatively benign condition that may occur during pregnancy or labor?

answer

Subconjunctival hemorrhage; bleeding underneath the conjunctiva

question

When does the lens usually become more rigid and the ciliary muscle of the iris become weaker?

answer

Around 45 years of age

question

A condition that typically develops by the age of 45 is:

answer

Presbyopia; eye develops a progressively diminished ability to focus on near objects

question

Whats is an ominous finding in infants?

answer

White pupils on photographs

question

What is a genetic eye disorder that should be included in the history and physical, under family history, for all members of the affected families?

answer

Retinal Cancer

question

The Rosenbaum card is used to measure:

answer

near vision

question

When measuring visual acuity, you are assessing cranial nerve:

answer

CN 2: Optic Nerve

question

Measurement of near vision should be tested:

answer

in each eye separately.

question

Mr. C.'s visual acuity is 20/50. This means that he:

answer

can read letters while standing 20 feet from the chart that the average person could read at 50 feet.

question

Peripheral vision can be estimated by means of which test?

answer

Confrontation

question

The criterion for adequacy of a patient's visual field is:

answer

correspondence with the visual field of the examiner.

question

Periorbital edema is a sign of?

answer

Abnormality

question

Xanthelasma may suggest that the patient has an abnormality of:

answer

lipid metabolism

question

Mrs. S. is a 69-year-old woman who presents for a physical examination. On inspection of her eyes, you note that the left upper eyelid droops, covering more of the iris than does the right. This is recorded as _____ on the _____.

answer

ptosis; left

question

Ptosis may be secondary to:

answer

paresis of a branch of CN III Oculomotor

question

What is the condition called when the eyelid is turned away, or everted, from the globe?

answer

Ectropion

question

Entropion implies that the lid is:

answer

turned inward

question

A condition in which the eyelids do not completely meet to cover the globe is called:

answer

lagophthalmos

question

Inspection of the tarsal conjunctiva should be performed:

answer

when a foreign body may be present

question

An allergy can cause the conjunctiva to have a:

answer

cobblestone pattern

question

An abnormal growth of conjunctiva extending over the cornea from the limbus is known as:

answer

a pterygium

question

A pterygium is more common in people heavily exposed to:

answer

ultraviolet light.

question

Mr. B. was admitted from the emergency department and you are completing his physical examination. His pupils are 2 mm bilaterally and you notice that they fail to dilate when the penlight is moved away. This is characteristic in patients who are or have been:

answer

on opioid drugs (morphine)

question

When testing corneal sensitivity controlled by cranial nerve V, you should expect the patient to respond by:

answer

brisk blinking

question

You observe pupillary response as the patient looks at a distant object and then at an object held 10 cm from the bridge of the nose. You are assessing for:

answer

accomodation

question

Mydriasis is an accompaniment of:

answer

coma

question

The inequality of pupillary size is called?

answer

anisocoria

question

When inspecting the region of the lacrimal gland, what do you palpate?

answer

in the are between the arch of the eyebrow and the upper lid

question

You note dark, rust-colored pigment just anterior to the insertion of the medial rectus muscle in an 80-year-old woman. Which action is appropriate?

answer

Record the finding in the patient's record

question

Examination to assess for extraocular muscle imbalance is conducted by?

answer

having the patient follow your finger through planes

question

When there is an imbalance found with the corneal light test, you should then perform the _____ test.

answer

cover-uncover

question

To see retinal details in a myopic patient, you will need to do what?

answer

turn your ophthalmoscope to a minus lens

question

The unit of measurement in describing lesion size and location on the fundus is the:

answer

disc diameter

question

Ask the patient to look directly at the light of the ophthalmoscope when you are ready to examine the:

answer

macula

question

After focusing on a blood vessel in the retina with your ophthalmoscope, you attempt to locate the optic disc. You should:

answer

follow the vessel as it converges into larger vessels

question

After completion of your ophthalmoscopic examination, you record that the AV ratio is 1:2. This indicates that the:

answer

arterioles are narrowed

question

If a patient has early papilledema, the examiner will be able to detect:

answer

dilated retinal veins

question

Cupping of the optic disc may be a result of?

answer

glaucoma

question

Drusen bodies are most commonly a consequence of?

answer

aging

question

When drusen bodies are noted to be increasing in number or in intensity of color, the patient should be further evaluated with a(n)?

answer

Amsler grib

question

Cotton wool spots are most closely associated with?

answer

Hypertension

question

The Keith-Wagner-Barker system group IV is characterized by the development of?

answer

papilledema

question

Which of the following may be suggestive of Down syndrome?

answer

Prominent epicanthal folds

question

To differentiate between infants who have strabismus and those who have pseudostrabismus, use the?

answer

corneal light reflex

question

You are attempting to examine the eyes of a newborn. To facilitate eye opening, you would first?

answer

dim the room lights

question

White specks scattered in a linear pattern around the entire circumference of the iris are called?

answer

Brushfield spots

question

Opacities of the red reflex may indicate the presence of?

answer

cataracts

question

The Snellen E chart is appropriate for initial visual acuity in what age child?

answer

3 years

question

When assessing the vision of a 4-year-old girl, you find that she has 20/50 vision in the right eye and 20/30 vision in the left eye. This child should be evaluated first for?

answer

amblyopia

question

You normally expect a child to achieve 20/20 vision by age ____ years.

answer

6

question

What maneuver can be done to reduce systemic absorption of cycloplegic and mydriatic agents when examining a pregnant woman if the examination is mandatory?

answer

Use nasolacrimal occlusion after instillation

question

Episcleritis may indicate?

answer

an autoimmune disorder

question

The most common cause of exophthalmos is?

answer

Graves disease

question

Horner syndrome is manifested by?

answer

ipsilateral miosis and mild ptosis

question

Dot hemorrhages, or microaneurysms, and the presence of hard and soft exudates are most commonly seen in?

answer

diabetic retinopathy

question

Changes seen in proliferative diabetic retinopathy are the result of?

answer

anoxic stimulation

question

Bone spicule pigmentation is a hallmark of?

answer

retinitis pigmentosa

question

An initial sign of retinoblastoma in an infant is?

answer

cat's eye reflex

question

Retinal hemorrhages in an infant require investigation for?

answer

child abuse

question

In adults, the length of the external auditory canal is _____ cm.

answer

2.5

question

The middle ear contains the?

answer

umbo and malleus

question

The middle ear is normally filled with?

answer

air

question

The hair cells of Corti and membrane of Corti?

answer

stimulate the eighth cranial nerve

question

The organ of Corti is a coiled structure located inside the?

answer

cochlea in the inner ear

question

Which ear structure is responsible for equalizing atmospheric pressure when swallowing, sneezing, or yawning?

answer

Eustachian tube

question

The structures that lie along the lateral wall of the nasal cavity near the facial cheek are the _____ sinuses.

answer

Maxillary

question

A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness you should palpate over the?

answer

Maxillary sinuses only

question

A 30-year-old woman presents with rapid swelling beneath her jaw that suddenly appears while she is eating. The swelling is mildly painful but is not hot or red. You suspect Wharton salivary duct stones and proceed to palpate?

answer

under the tongue along each side of the frenulum

question

An infant's auditory canal, when compared with an adult's, is?

answer

short and curved upward

question

When examining an infant's middle ear, the practitioner should use one hand to stabilize the otoscope against the head while using the other hand to?

answer

pull the auricle down and back

question

The eruption of permanent teeth most commonly begins with?

answer

lower central incisors

question

The pregnant woman can expect to experience?

answer

more nasal stuffiness

question

During what developmental stage are hoarseness, voice-cracking, and a persistent cough a common finding?

answer

Pregnancy

question

Hearing tends to deteriorate after 50 years of age because of?

answer

degeneration of the hair cells of the organ of Corti

question

You are performing hearing screening tests. Difficulty in hearing the highest frequencies would be expected in the ___ year old.

answer

50 (or the oldest age available)

question

Mr. S. presents with the complaint of hearing loss. You specifically inquire about current medications. Which medications, if listed, are likely to contribute to his hearing loss?

answer

Salicylates

question

Mr. W., age 25, has recovered recently from an upper and lower respiratory infection. He describes a long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has not gone away. Information concerning his chronic postnasal drip should be documented within which section of his history?

answer

Past medical data

question

A newborn whose serum bilirubin is greater than 20 mg/100 mL risks later...

answer

Hearing loss

question

Which ethnicity has the highest rate of oral cancers?

answer

African American ancestry

question

To approximate vocal frequencies, which tuning fork should be used to assess hearing?

answer

500 to 1000 Hz

question

You are using a pneumonic attachment on the otoscope while assessing tympanic membrane movement. You gently squeeze the bulb but see no movement of the membrane. Your next action should be to do what?

answer

change to a rubber speculum.

question

An ear auricle with a low-set or unusual angle may indicate chromosomal aberration or?

answer

renal disorders

question

When conducting an adult otoscopic examination, you should?

answer

select the largest speculum that will fit in the canal

question

Normal tympanic membrane color is?

answer

pearly gray

question

Bulging of an amber tympanic membrane without mobility is most often associated with?

answer

middle ear effusion

question

In the presence of otitis externa, tympanic membrane perforation, or myringotomy tubes you should?

answer

avoid instilling fluids

question

When hearing is evaluated, which cranial nerve is being tested?

answer

VIII ~ Vestibulochlear

question

Speech with a monotonous tone and erratic volume may indicate?

answer

hearing loss

question

Placing the base of a vibrating tuning fork on the midline vertex of the patient's head is a test for?

answer

lateralization of sound

question

To perform the Rinne test, place the tuning fork on the?

answer

mastoid bone

question

You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to the unaffected ear; for the Rinne test, air conduction to bone conduction ratio was less than 2:1. You interpret these findings as suggestive of:

answer

a defect in the inner ear

question

Nasal symptoms that imply an allergic response include?

answer

bluish gray turbinates

question

When you ask the patient to identify smells, you are assessing which cranial nerve?

answer

I Olfactory

question

Pallor of the lips and mucous membranes is one sign of?

answer

anemia

question

A smooth red tongue with a slick appearance may indicate?

answer

niacin or vitamin B12 deficiency

question

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are?

answer

aphthous ulcers (canker sores)

question

A hairy tongue with yellowish brown to black elongated papillae on the dorsum?

answer

is sometimes seen following antibiotic therapy

question

To inspect the lateral borders of the tongue, you should?

answer

pull the gauze-wrapped tongue to each side

question

A 6-month-old who can hear well can be expected to?

answer

turn his or her head toward the source of sound

question

Which variation may be an expected finding in the ear examination of a newborn?

answer

Diffuse light reflex

question

For best results, an otoscopic and oral examination in a child should be?

answer

performed at the end of the examination

question

What pediatric patient complaint would you refer immediately to the emergency department?

answer

The drooling patient with muffled voice and stridor

question

Which abnormality is common during pregnancy?

answer

Hypertrophy of the gums

question

Expected physical changes associated with older adults include?

answer

bristly hairs in the vestibule

question

Intense pain with movement of the pinna is most closely associated with?

answer

otitis externa

question

Severe vertigo, tinnitus, and progressive hearing loss are characteristic of?

answer

Ménière disease

question

Which of the following recreational drugs is commonly associated with nasal septum perforation?

answer

Cocaine

question

Evidence-based practice suggests that the strongest predictor of sinusitis is?

answer

any combination of: 1. Maxillary toothache 2. dull or opaque sinus transilluminations 3. ineffective decongestants and colored nasal drainage 4. purulent nasal secretions

question

You are interviewing a parent whose child has fever, is batting at her right ear, and is irritable. You ask the parent about the child's appetite and find that the child has a decreased appetite. This additional finding is more suggestive of?

answer

acute otitis media

question

The term hyperopic means?

answer

far sighted

question

The term myopic means?

answer

near sighted

question

When in life does myopia occur?

answer

at any age

question

When in life does a stigmatism develop?

answer

at any age

question

Which cranial nerve is involved in accommodation?

answer

CN IV Trochlear Nerve

question

Legal blindness is considered what visual acuity?

answer

20/200

Mosby’s Ch.11 & 12 H&PExam2 – Flashcards

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