Final Exam Seidel Physical Assessment Questions and answers. Rated A+

AV nicking is key in the world of hypertension. These are the only capillaries you can see in the body. Nicking is a classic sign of vessel disease. ** looks like vein stops on either side of the artery. - Ans-AV Nicking Small, odd shaped, yellow colored plaques are lipid deposits and indicate lipid metabolism problem. - Ans-Xanthelasma lower lid turned away from eye - Ans-Ectropion lid turned inward - Ans-Entropion drooping/sagging upper eyelid. Over the globe of the eye caused by problem in cranial nerve 3. - AnsPtosis: crusting along eyelashes - Ans-Blepharitis: infected - Ans-Acute purulent conjunctive: abnormal growth of conjunctiva that extends over the cornea from the limbus. Overexposure to ultraviolet rays - Ans-Pterygium: lipids deposited in the periphery of the cornea - Ans-Arcus senilis: those lipids in a complete circle - Ans-Cornal arcus senilis: bright red blood in a sharply defined area. Sometimes present PG and labor resolve on own. - AnsSubconjuctival hemorrhage red, cobblestone caused by allergic reaction - Ans-Erythema small discrete spots that are slightly more yellow than the retina. With time they enlarge, aging but can be precursor for senile macular degeneration. If they are increasing in number and color intensity use an Amsler grid to eval central vision. - Ans-Drusen bodies glaucoma - Ans-Cupping of optic disc hypertension. Infarcts of retina - Ans-cotton wool spots diabetes - Ans-cotton wool spots and hemorrhage cataracts- risk factors family hx, steroid med use, UV light, smoking cigs, DM, aging. - Ans-Opacities blocking red reflex like a curtain or shadow has come down on part of my visual field. - Ans-partial retinal detachment Pupils equal reactive to light not the same size - Ans-anisocoria Flame- nerve layer fibers blood spreads parallel to fibers Round- in deeper layers darker color Dot- microaneurysm- diabetic retinopathy At disc margin- poorly controlled/undiagnosed glaucoma - Ans-Hemorrhages crossed eye. exotropic is outward toward midline. Esotropic is inward toward the nose. - Ans-Strabismus 20/200 - Ans-legal blindness cranial nerve II Blurry- problem with visual acuity or dbl vision/diplopia? Monocular diplopia is a optical prob. Binocular is alignment. - Ans-VISUAL ACUITY- Snellen chart cover one eye smallest line for fraction. Cover other eye. - Ans-Distance visionhold card 35cm from eye smallest line. Cover one eye at a time. - Ans-Near visionconfrontation test. Cover each eye in turn. You wiggle fingers into the center . pt says I see. - AnsPeripheral visionrefer to eye specialist if there is a two line difference in the visual acuity of different eyes. - Ans-Pediatric pt size, hair texture, extension beyond eye. - Ans-Inspect eyebrows for: : : : : . : edema, puffiness, sagging tissue - Ans-Inspect orbital area for spasms=hyperthyroid, ability open wide and close. Redness, swelling, flakes. Do eyelashes curve in? Ptosis? Eversion-ectropion ot Inversion-entropion - Ans-Inspect eyelids for nodules - Ans-Palpate eyelids for very firm: glaucoma, hyperthyroid, retrobulbar tumor - Ans-Palpate eye clear? Red? Swelling? Exudate? Hemorrhage? pterygium ? Only peel up and down if foreign body present. - Ans-Inspect conjunctivae shine light tangentially to assess clarity. Should be clear. Corneal arc, circle may be hyperlipidemia - AnsExamine Cornea: *** - cranial nerve 5/V. touch cotton to eye they need to blink. - Ans-Corneal sensitivity if the cornea is clear and even in contour - Ans-Look at the eye from the far sideways position to see 1. inspect iris for being clearly visible and same color 2. Observe pupil shape and size 3. ***Test pupil response to light- direct and consensually- simultaneous constriction. Shine in one eyeconstrict in both. 4. Perform swinging flashlight test. Shine one a=eye and then go rapidly to the next. If second eye doesn't constrict afferent pupil defect/optic nerve disease. 5. ***Accommodation- nerve IV. look distant object then focus object 10 cm from nose. Pupil should constrict. 6. Nystagmus in book - Ans-Assess iris and pupil- 5 characteristics Tear duct in the nasal corner of the eye - Ans-medial canthus. plaque dark slate gray pigment. Not disease, just note. - Ans-Senile hyaline A. CN 3-III-oculomotor, 4-IV-trochlear, 6-VI-abducens (lateral eye muscle moves) B. Cardinal gaze Up and down Corneal light reflex-pt look nearby object, shine light nasal bridge, eyes should converge and reflect light symmetrically if this reflex unbalanced, perform cover-uncover test - Ans-A. Extraocular muscles there are 6 work with B. 4 techniques: Inspect interior eye: Red reflex-look for opacities that look like black densities Fundus- an easy way to find your way around the fundus is to Follow the branching of the blood vessels that always branch away from the optic disc. Pigment-yellow or reddish pink, varies and can be darker with skin color. Retinal vessels- note pulsations abnormalities where arty and veins cross. ***AV nicking- looks like vein stops on either side of an artery. ***Optic disc located by following a vessel centrally toward the midline of the head. Vessels nearer the disc are directionally towards the nose, larger, less branching. Nasal region of the globe. Macula- lighter dot surrounded by avascular area. 2 disc diameters temporal to disc. - AnsOpthalmoscopic exam smell reception and interpretation You have one nose on your face - Ans-Olfactory visual acuity and visual fields You have 2 eyes the optometrists uses the the Snellen chart to see if you need new opticals - Ans-(II): Optic raise eyelids, most extraocular movements, pupillary constriction, change lens shape - Ans-(III): Oculomotor