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UC Adv. Health Assessment HEENT Part 3 with complete solution 2024_2025.
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UC Adv. Health Assessment HEENT Part 3 with complete solution 2024_2025.
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UC Adv. Health Assessment HEENT Part 3with complete solution 2024/2025
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,
Papilledema 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, Fovea 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 long
standing DM
Cotton Wool Patches in eye - ANSWER-"white fluffy spots" s/o HTN and DM
Hard Exudates in eye - ANSWER-"hard white spots" s/o HTN and DM
Drusen bodies - ANSWER-random white bodies normally seen increase with age
earliest feature of age related macular degeneration
Retinal Detachment - ANSWER-Looks like a "sandy beach"
Macular Plaques - ANSWER-White hard bodies
macular degeneration - ANSWER-loss of central vision, may see a macula hole
Eye Emergencies - ANSWER-FB: use fluorescein stan & slit lamp: rust ring--get to
opthamology ASAP, Red eye- hyperemic & congested may be vision-threatening,
always evaluate thoroughly, Pain, Blurred Vision, Red eye= send to
Ophthalmology
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