Cornea:
clear layer covering the front of the eye. works with the lens to focus images on the retina.
Retina
internal layer receives and transmits focused images. normally red due to its rich blood supply.
Retina
Can be seen with an ophthalmoscope Allows the examiner to see through the pupil and lens to the retina Called a funduscopic exam
Retina
Turn on and adjust to round beam of white light Place scope light on dim setting Set lens disc to 0 diopters (neutral) Keep index finger on lens disc to adjust during examination
Right hand and right eye to pt. Right eye Left hand and left eye to pt. Left eye Hold opthalmoscope firmly against your bony orbit Glasses off (both examiner and patient) Contacts are OK
The examination
Have patient look over your shoulder and across the room at a specific point on the wall From about 15 inches and 15 degrees lateral to the patients line of vision, shine the light beam on the pupil
Should see an orange glow (the red reflex reflection of light off retina) Move in on the 15 degree line toward the pupil , almost touching the patients lashes
On NASAL side of each retina Yellowish orange to creamy pink oval or round Follow a blood vessel centrally until you see it
external, middle, and inner structures. eardrum and the three tiny bones conduct sound from the eardrum to the cochlea: malleus, incus, stapes
Symmetry, size, shape Position: pinna level with corner of eye Lesions Drainage
Whisper two syllable word (out of view) Weber Test: lateralization of sound.. Rinne test: bone vs air conduction of sound
ossicles : can see the short process of the malleous, handle of the malleous, and the incus There is a cone of light that is a reflection of the otoscope light
Otoscopic Examination
An otoscope
Otoscopic Examination
Dim lights in room Patient in sitting position Pull ear up and back (down for kids) SLOWLY insert otoscope into ear canal while looking into viewer
Otoscopic Landmarks
Tympanic membrane: should be intact, pearly gray, translucent, shiny Cone of light: right side 4/5 oclock; left side 7/8 oclock Malleus short process -- knob
Abnormal Findings:
Otoscopic Examination
The speculum is angled slightly toward the person's nose to follow the canal. A light beam extends beyond the viewing tip of the speculum. The otoscope is gently moved to different angles to view the canal walls and eardrum.
The End