Assessment
HEENT Part 3
(KMH)(solved &
updated)
Ocular Fundus - answer Done with room darkened,
"Look at my shoulder not the light.", Elicit Red
Reflex 8-10" away with lens at Zero, Come in really
close with hand on pts forehead, Close in with lens
in the black (+) & focus on the optic disc at the
nasal side of the retina, Change lens to Red (-) to
view posterior structures, follow vessels centrally.
Optic Disc - answer On NASAL Side of retina,
creamy yellow orange in color, round or oval
shape, distinct sharply demarcated margins, Cup-
disc ratio: Horizontal diameter not > 1/2 disc
,diameter, Normal cup looks recessed, Papiledema
looks like cup is coming toward you, Fovea
Centralis is where vision occurs
Ocular Findings: Eye vessels: - answer Follow a
paired artery with vein to periphery
Ocular Findings: Color - answer Arteries bright light
red with a central white reflex stripe, veins are 1/4
larger and darker and have NO white reflex stripe
Ocular Findings: A:V width ratio: - answer 2/3 or
4/5 diameter of vein, abnormal is constricted or
dilated
Ocular Findings: Caliber: - answer A/V decrease as
they extend outward
Ocular Findings: A-V Crossing: - answer Should be
within 2DD of disc, Abnormal is nicking, piinching,
engorged, > 2DD
, Ocular Findings: Tortuosity: - answer mild in both
eyes usually congenital, Abnormal: thick and
twisted vessels, extreme or asymmetry
Ocular Findings: Macula: - answer 1 DD in size 2DD
TEMPORAL side to the disc, do this last b/c may
cause discomfort, Fova Centralis site of sharpest
and keenest vision, the macula looks slightly
darker than rest of the fundus
Ocular Findings: Background Abnormalities: -
answer Papilledema-bulging disc is a medical
emergency, when it comes toward you it is a sign
of HTN or IICP
Ocular Findings: Background Abnormalities: -
answer A-V nicking: long term HTN (narrowing),
Flame Hemorrhage: little flames, HTN, Retinal
Hemorrhage: "red dots" s/o bleeding-seen in DM,
Microaneurysms: "red dots" s/o bleeding-seen in
DM and HTN, Neovascularization: small collateral
tortuous vessels-s/o longstanding DM
Cotton Wool Patches in eye - answer "white fluffy
spots" s/o HTN and DM