Assignment: Ophthalmoscope or Otoscope

NOW F OR AN ORIGINAL PAPER ASSIGNMENT:Assignment: Ophthalmoscope or Otoscope

Test accommodation of pupils by shifting gaze from far to near (normally, pupils constrict).

Internal Eye Structure

17.Inspect the red reflex by using an ophthalmoscope or otoscope to shine the light beam toward the client’s pupil (normally, a red reflex is easily seen and should appear round with regular borders). (This is the “red- eye” seen in some home photographs.)

Optional (all blue areas)–may do the following eye assessments if you can, though it is not always possible to do well without dilating the eyes–give it a try and see if you can identify any of the following.

Your score will not be affected by either your success or inability in this optional section in blue– it is a skill that takes quite a lot of practice! I recommend that you at least try so that if you take advanced practice classes you will have an idea how it feels.)

2. Inspect the optic disc by using the ophthalmoscope focused on the pupil and moving very close to the eye. Rotate the diopter setting until the retinal structures are in sharp focus (observe disc for shape, color, size, and physiologic cup).

3. Inspect the retinal vessels using the above technique (observe vessels for numbers of sets, color, diameter, arteriovenous ratio, and arteriovenous crossings).

4. Inspect retinal background for color and the presence of lesions.

5. Inspect the fovea and macula

for lesions.

Current Symptoms: Ears

External Ear Structures

1. Inspect the auricle, tragus, and lobule for size and shape, position, lesions/discoloration, and discharge.

2. Palpate the auricle and mastoid process for tenderness.

Otoscopic Examination

3. Inspect the external auditory canal with the otoscope for discharge, color and consistency of cerumen, color and consistency of canal walls, and nodules.

4. Inspect the tympanic membrane, using the otoscope, for color and shape, consistency, and landmarks.

5. Have the client perform the Valsalva maneuver, and observe the center of the tympanic membrane for a flutter. (Do not do this procedure on an older client, as it may interfere with equilibrium and cause dizziness.)

Hearing and Equilibrium Tests