UC Adv. Health Assessment HEENT Part 3 (KMH) Questions With Latest Solutions

Ocular Fundus - 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 - 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: - Follow a paired artery with vein to periphery Ocular Findings: Color - 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: - 2/3 or 4/5 diameter of vein, abnormal is constricted or dilated Ocular Findings: Caliber: - A/V decrease as they extend outward Ocular Findings: A-V Crossing: - Should be within 2DD of disc, Abnormal is nicking, piinching, engorged, > 2DD Ocular Findings: Tortuosity: - mild in both eyes usually congenital, Abnormal: thick and twisted vessels, extreme or asymmetry Ocular Findings: Macula: - 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: - Papilledema-bulging disc is a medical emergency, when it comes toward you it is a sign of HTN or IICP Ocular Findings: Background Abnormalities: - A-V nicking: long term HTN (narrowing), Flame Hemorrhage: little flames, HTN, Retinal Hemorrhage: "red dots" s/o bleeding-