307 (Exam 2) Ch 15: Eyes

_____ ______ _____ surround by cushion of fat protects eye

Bony orbital cavity

Lower lid margin, at limbus, borders between _____ and _______

cornea

sclera

_______: corner of eye, angle where lids meet

Canthus

the tarsal plates contain _______ glands, which are modified sebaceous glands that secrete an oily lubricating material onto lids

meibomian glands

is the transparent protective covering of the eye

Conjunctiva

Covers and protects the iris and pupil

Cornea

provides irrigation to the eye (tear film)

Lacrimal apparatus

how many muscles attached to the eyeball to its orbit and direct eye to point of a person's interest?

six

Each muscle is coordinated, or yoked, with one in other eye ensuring that when the two eyes move, their axes always remain parallel, is called _________

Conjugate movement

Parallel axes are important because the human brain has a ______ and ______-_______ visual system

- binocular

- single-image

movement of the extra ocular muscles stimulated by which three cranial nerves?

CN VI (abducens nere)

CN IV (trochlear nerve)

CN III (Ocularmotor nerve)

CN III, oculomotor nerve, INNERVATES

superior, inferior, medial rectus, and oblique muscles

CN IV, trochlear nerve, innervates

superior oblique muscles

CN VI, Abducens nerve, innervates ________ which abducts the eye

lateral rectus muscle which abducts the eye

pupil size determine by a balance between _______ and ________ chains of autonomic nervous system

parasympathetic and sympathetic

Stimulatioin of parasympathetic branch (of the pupil) is through CN ____ which causes ______ of the pupil

CN III

Constriction

pupil size reacts to amount of _____ ____ and to ________ or focusing an object on retina

ambient light

accommodation

intraocular pressure is determined by balance between amount of ________ produced and ________ to outflow

aqueous

resistance

_______: the visual receptive layer of eye where light waves change into nerve impulses

Retina

_______: area in which fibers from retina converge to form ______nerve

Optic disc

optic

_____ normally include a pair of artery and vein extending to each quadrant

Retinal vessels

______: located on temporal side of fundus

Macula

Receives and transduces light from center of visual field

Macula

images formed on retina is _____ and _____

upside down

reversed

right side of brain looks at ______ side of the world via the ____ ______

left

optic chiasm

pupillary Light reflex: normal ______ of pupils

constriction

adaptation of eye for near vision

accommodation

pupil size _____ as age increases

decreases

impaired vision as a result of aging

presbyopia

by age _____, normally transparent fibers of the lens begin to_____ and ____, the beginning of ______

70

thicken

yellow

cataracts

Visual acuity may diminish gradually after age _____ and more so after age____

50

70

Most common causes of decreased visual functioning

-

-

-

-

- Cataract formation

- Glaucoma

- Age-related macular degeneration (AMD)

- Diabetic retinopathy

this degreased visual functioning results from clumping of proteins in lens

Cataract formation

This decrease visual functioning increases intraocular pressure; chronic open-angle AND IS THE MOST COMMON TYPE

Glaucoma

this decreased visual functioning is the LEADING cause of BLINDNESS in adults 25 to 74 years of age

Diabetic retinopathy

this decreased visual function is a break down of cells in macula of retina; loss of central vision

Age-related macular degeneration (AMD)

Leading cause of blindness: estimated that 80% are preventable or curable with sx

Cataracts

African Americans are 3 to 6 times more likely to develop _______ than Caucasian Americans

Glaucoma

Test visual acuity

Snellen eye chart

Snellen chart poorer than 20/30.....

refer to optometrist

what can you substitute for near vison test?

magazine

newspaper

Test visual fields, testing your peripheral vision

Confrontation test

This examination assess parallel alignment of eye axes by shining a light toward the person's eyes.

Corneal light test (Hirschberg)

Assess for potential EOM muscle weakness, nystagmus, or lid lag.

six cardinal positions of gaze

strabismus

eyes don't look in exactly same direction (cross eyed)

Diplopia

seeing two images of an object

if the person wears glasses during the Snellen chart test, they should....

leave them on, remove ONLY reading glasses

What should you do if the person is unable to see the largest letters during a shelled test?

shorten distance i.e 10/20, and record distance

if visual acuity is lower than shortening distance, assess if the patient can ______

count your fingers

near vision, you should test each eye _______ with ,with glasses ____

separately

on

Confrontation test compares person's _______ ________ with yours

peripheral vision

during the confrontation test, instruct the person to say _______ as the target is first seen

"now"

Corneal light reflex test (Hirschberg test) assess ________ ________ of the eye axis

parallel alignment

During light reflex test (Hirschberg test) reflection of the light should be _____

exactly in the same spot on each eye

deviation of the Hirschberg test indicates muscular ____ and _____

weakness or paralysis

During 6 Cardinal position of gaze move pen light or object in a _______

clockwise

During 6 Cardinal position, weak EOM muscles indicate ____ and ____ _____

NYSTAGMUS

lid lag

Palpebral fissure are ______ in non-Asians

horizontal

Palpebral fissures are ______ in asians, normally

slant upward

when inspecting the lacrimal apparatus, ask the person to look_____

down

When inspecting the sclera or conjunctiva, as the person to look ____

up

Presence of excessive tearing in the lacrimal duct may indicate

blockage of nasolacrimal duct

When inspecting the cornea, it should be ____ and ______there should be no _____

- smooth and clear

- opacities (cloudiness)

to test Puppllary light reflex, you want the room to be _______

dark

when testing pupillary light reflex, what will dilate pupils?

looking into the distance

When testing pupillary light reflex, advance light in from _____ and note response

from side

normal PERRL reaction of the first pupil will _____ and is called _______ light reflex

constrict

direct light reflex

during PERRL, simultaneous constriction of other pupil is called

consensual light reflex

Test for accommodation

ask person to focus on distant object

then have the person shift gaze near object, your finger or pen, about 7 to 8 cm from nose

how far should you place object when testing for accommodation

7 to 8 cm (3 inches) from nose

darker pigmented region surrounding the fovea centralis

Macula

which area of the eye is sharpest and keenest vision

Fovea centralis

in aging adults do not confuse ______ ______with an _______ (cloudiness)

ARCUS SENILIS

opacity

________ is a normal finding with aging adults (grey - white circle with no effect on vision)

Arcus senilis

______ is a yellowish raised growth of the conjunctiva on the sclera close to the edge of cornea (sun wind dust exposure)

Pinguecula

periorbital edema

abnormality of eye lid

Exophthalmos

abnormal protrusion of the eyeball

Ptosis

drooping upper lid

this abnormal finding is lesion on the eyelids. it has tiny oil glands of inner eyelid become inflamed

BLEPHARITIS

Anisocoria of the pupil

unequal pupil size

Miosis of the pupil

constricted and fixed pupils

Mydriasis (of pupil)

Dilated and fixed pupils

pink eye, red, beefy looking vessels.

viral or bac infection

purulent discharge

preauricular lymph node and swelling

Conjunctivitis

upper like, conjunctiva and cornea re inflamed from seasonal allergen

allergic conjunctivitis

red patch on sclera, not serious

from increased intraocular pressure from coughing, vomiting , weight lifting, labor / child birth, straining at stool or trauma

subconjunctival hemorrage

myopia

nearsightedness

hyperopia

farsightedness

Asking the person to focus on a distant object, then have the person shift gaze to near object, such as your finger held about 7-8 cm (3 in) from nose is testing for what,

Accomadation

gray-white arc or circle around the limbus of the iris that is common with aging

arcus senilis