Bates Physical Exam of the Head and Neck (Questions & Answers) Rated 100% Correct!!

2 components of conjuctiva - Bulbar conjuctiva (covers the anterior eyeball) Palpebral conjuctiva (lines the eyelids) 20/30, what does this mean? - First number indicates the distance of the patient from the chart. The second indicates the distance at which a normal eye can read the line of letters. So 20/30 means the pt can read at 20 ft. what a normal eye can read at 30 ft. Acommodation - Increased convexity of lenses. Brings near objects into focus. Anisocoria - inequality in the diameter of the pupils Anterior triangle - Mandible, sternomastoid laterally, and midline of the neck. Autonomic nerve that produces constriction? - Parasympathetic. Autonomic nerve that produces dialation? - Sympathetic. Bilateral visual loss? - Painless= medications that change refraction such as cholinergics, anticholinergics, and steroids. Painful= chemical or radiation. Bone conduction - Bypasses external & middle ear and directly stimulates cochlea. Causes of epistaxis - Trauma, inflammatory disorders, structure abnormalities, or bleeding disorders Conductive hearing loss - Results from problems in the external or middle ear. Ask pt "do you have trouble understanding people speak?"conductive hearing loss - sound is heard as long or longer through bone than air. Difficulty with close work suggests? - Hyperopia (Farsightedness), or presbyopia (aging vision) Diplopia - Double Vision epistaxis - Bleeding from the nose Exophthalmometer - Objective measuring tool to measure protruding eyes. Upper limits of normal are 20 mm in whites and 22 mm in blacks. Goiter - enlarged thyroid gland Goiter - Enlarged thyroid gland. Hard or fixed lymph nodes suggest? - Malignancy How do you correctly ID a lymph node? - You should be able to roll a node in 2 directions: up and down, & side to side. Neither a muscle or an artery will pass this test. How do you descibe lesions position in the eye? - Give clock directions from optic disc & relative distances. EG: 3 O'clock from optic disc, at a distance of 12 optic discs. How do you easily evaluate thyroid gland? - Ask patient about temperature intolerance and sweating. "Do you prefer hot or cold weather?" "Any new palpitations or changes in weight?" Hyperopia - FarsightednessIf sudden unilateral visual loss is painfull consider? - Causes are usually in the cornea and anterior chamber such as a coneal ulcer, uveiteis, traumatic hyphema, acute glaucoma, and optic neuritis. If sudden unilateral visual loss is painless consider? - Vitreous hemorrhage, macular degenartion, retinal detachment, retinal artery occlusion. Important areas to examine in the eyes? - Visual acuity, visual field, conjunctiva and sclera, cornea, lens, pupils, extraocular movements, fundi (opitic disc & cup, retina, retina vessels) Important areas to examine on the head? - Hair, scalp, skull, face, and skin. Left cranial nerve disorders of eye movement. - Paralysis of CN VI, IV, III Miosis - constriction of the pupils Most common symptom in clinical practice? - Headache Muscle most responsible for left eye movement? - Left Superior oblique (CN IV) Muscle most responsible for right eye movement? - Right inferior rectus (CN III) Mydriasis - dilation of the pupils Myopia - nearsightedness Nystagmus - Fine oscillations in the eye. Pay att. to which way the nystagmus occurs and record this. nystagmus - fine rhythmic oscillation of the eyesotitis externa - inflammation of the ear canal papilledema - swelling of the optic disc and anterior bulging of physiological cup Posterior triangle - Sternomastoid, trapezius, and clavicle.