By Bruce Muchnick OD
This up-to-date new version is a realistic advisor to the review, prognosis, and remedy of systemic problems as they relate to basic eye care. It encompasses a multidisciplinary process, from the underlying pathophysiological mechanisms, to checking out and prognosis tools, to scientific and surgical administration. medical medication in Optometric perform, 2d variation offers the reader with the knowledge had to make knowledgeable judgements approximately sufferer administration, reminiscent of deciding on indicators and their similar issues, and realizing whilst to refer sufferers to a scientific specialist.
- Shows how the big variety of health conditions and their healing thoughts effect the supply of eye care.
- Familiarizes the reader with the stipulations which are encountered in perform, those who could current with ocular manifestations, and people who have major significance to drugs in general.
- Organized in a realistic, simply available format.
- Uses case displays to illustrate medical attempt interpretation, differential analysis, remedy, and the advance of a prognosis.
- Reflects the most up-tp-date applied sciences in exam and testing.
- Features all-new illustrations in complete colour, illustrating systemic problems, the actual examination, videotaping, dermatological stipulations, and lots more and plenty more.
- Includes a brand new bankruptcy on vascular illness, specifically vital due to the fact that optometrists are often the 1st to note a majority of these changes.
- Contains new details on heart problems and carotid affliction, together with the results that stroke could have at the patient.
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Extra resources for Clinical Medicine in Optometric Practice
FIGURE 3-15 ■ Testing the glossopharyngeal nerve and vagus nerve. ” This action elevates the soft palate. The uvula should elevate without lateral deviation. A unilateral lesion that affects the vagus nerve causes a loss of laryngeal function, producing hoarseness and difficulty in swallowing. To evaluate the vagus (and the ninth cranial nerve), the examiner should perform the “ahh” test described in the preceding section on the ninth cranial nerve (see Figure 3-15). Causes of unilateral vagus lesions include trauma from surgical procedures of the neck (such as carotid endarterectomy or thyroidectomy), aortic aneurysm, and metastatic carcinoma, in which enlarged paratracheal lymph nodes can compress the vagus nerve.
Three tests are used to evaluate the trigeminal nerve: the corneal reflex test, the sensory division test, and the motor division test. The examiner evaluates the corneal reflex by gently touching the temporal side Physiologic “H” Corneal reflex Clench jaw/palpate Light touch comparison Abduction/physiologic “H” Smile, puff cheeks, wrinkle forehead, pry open closed lids Rinne test Weber test Gag reflex Gag reflex Shrug, head turn against resistance Tongue deviation of the cornea with a thin sterile braid of cotton while the patient looks down and toward his nose.
To perform skin puncture, an appropriate puncture site must be selected. In adults, this is usually the palmar surface of the last digit of the second, third, or fourth finger. The earlobe is a good alternate site. In infants, the lateral or medial plantar heel surface is most appropriate. The chosen puncture site can be warmed with a moist towel to increase blood flow through the capillaries. The site is then cleansed with 70% aqueous isopropanol solution and dried. The puncture is made with a sterile lancet in a deliberate motion perpendicular to the skin surface.
Clinical Medicine in Optometric Practice by Bruce Muchnick OD