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Visual Acuity: Clarity or sharpness of Ocular vision or the ability of the eye to see fine details. Visual acuity depends on the functions of Retina, neuronal transmission, and the interpretative ability of the brain. Normal visual acuity is expressed as 20/20 indicating that one can see at 20 feet what should normally be seen at that distance. Visual acuity can also be influenced by brightness, color, and contrast.
 JoVE Medicine

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool

1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, 2Center for Brain Health, Cleveland Clinic Foundation, 3Quantitative Health Sciences, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation


JoVE 51318

 Science Education: Essentials of Physical Examinations II

Eye Exam

JoVE Science Education

Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA

Proper evaluation of the eyes in a general practice setting involves vision testing, orbit inspection, and ophthalmoscopic examination. Before beginning the exam, it is crucial to be familiar with the anatomy and physiology of the eye. The upper eyelid should be slightly over the iris, but it shouldn't cover the pupil when open; the lower lid lies below the iris. The sclera normally appears white or slightly buff in color. The appearance of conjunctiva, a transparent membrane covering the anterior sclera and the inner eyelids, is a sensitive indicator of ocular disorders, such as infections and inflammation. The tear-producing lacrimal gland lies above and lateral to the eyeball. Tears spread down and across the eye to drain medially into two lacrimal puncta before passing into the lacrimal sac and nasolacrimal duct to the nose. The iris divides the anterior from the posterior chamber. Muscles of the iris control the size of the pupil, and muscles of the ciliary body behind it control the focal length of the lens. The ciliary body also produces aqueous humor, which largely determines intraocular pressure (Figure 1). Cranial nerve

 Science Education: Essentials of Physical Examinations III

Cranial Nerves Exam I (I-VI)

JoVE Science Education

Source: Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

During each section of the neurological testing the examiner uses the powers of observation to assess the patient. In some cases cranial nerve dysfunction is readily apparent: a patient might mention a characteristic chief complaint (such as loss of smell or diplopia), or a visually evident physical sign of cranial nerve involvement, such as in facial nerve palsy. However, in many cases a patient's history doesn't directly suggest cranial nerve pathologies, as some of them (such as sixth nerve palsy) may have subtle manifestations and can only be uncovered by a careful neurological exam. Importantly, a variety of pathological conditions that are associated with alterations in mental status (such as some neurodegenerative disorders or brain lesions) can also cause cranial nerve dysfunction, therefore any abnormal findings during a mental status exam should prompt a careful and complete neurological exam. The cranial nerve examination is applied neuroanatomy. The cranial nerves are symmetrical, therefore while performing the examination each side should be compared to the other. A physician should approach the examination in a systematic fashion an

 JoVE Behavior

Vision Training Methods for Sports Concussion Mitigation and Management

1Neurology and Rehabilitative Medicine, University of Cincinnati, 2Division of Sports Medicine, Department of Orthopaedic Surgery, University of Cincinnati, 3Department of Athletics, University of Cincinnati, 4Department of Neurosurgery, University of Cincinnati, 5College of Education, Criminal Justice, and Human Services, University of Cincinnati, 6Division of Sports Medicine, Cincinnati Children's Hospital Medical Center


JoVE 52648

 JoVE Neuroscience

Vibratome Sectioning Mouse Retina to Prepare Photoreceptor Cultures

1Department of Genetics, UMR_S 968, Institut de la Vision, 2Department of Visual Information, UMR_S 968, Institut de la Vision, 3Exploratory Team, UMR_S 968, Institut de la Vision, 4Sorbonne Universités, Paris 06, UMR_S 968, Institut de la Vision, 5INSERM, U968, Institut de la Vision, 6CNRS, UMR_7210, Institut de la Vision


JoVE 51954

 Science Education: Essentials of Physical Examinations I

Proper Adjustment of Patient Attire during the Physical Exam

JoVE Science Education

Source: Jaideep S. Talwalkar, MD, and Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

In order to optimize the predictive value of the physical examination, the provider must perform maneuvers correctly. The proper use of drapes is an important component of correctly performing physical examination maneuvers. Skin lesions are missed when "inspection" occurs through clothing, crackles are erroneously reported when the lungs are examined through a t-shirt, and subtle findings on the heart exam go undetected when auscultation is performed over clothing. Accordingly, the best practice standards call for examining with one's hands or equipment in direct contact with the patient's skin (i.e., do not examine through a gown, drape, or clothing). In addition to its clinical value, the correct draping technique is important for improving the patient's comfort level during the encounter. Like all other aspects of the physical exam, it takes deliberate thought and practice to find the right balance between draping, which is done to preserve patient modesty, and exposure, which is necessary to optimize access to the parts that need examination. Individual provider styles in the use of gowns and drapes vary consider

 Science Education: Essentials of Emergency Medicine and Critical Care

Lateral Canthotomy and Inferior Cantholysis

JoVE Science Education

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

Lateral canthotomy is a potentially eyesight saving procedure when performed emergently for an orbital compartment syndrome. An orbital compartment syndrome results from a buildup of pressure behind the eye; as pressure mounts both the optic nerve and its vascular supply are compressed, rapidly leading to nerve damage and blindness if the pressure is not quickly relieved. The medial and lateral canthal tendons hold the eyelids firmly in place forming an anatomical compartment with limited space for the globe. In an orbital compartment syndrome pressure rapidly increases as the globe is forced against the eyelids. Lateral canthotomy is the procedure by which the lateral canthal tendon is severed, thereby releasing the globe from its fixed position. Often, severing of the lateral canthal tendon alone is not enough to release the globe and the inferior portion (inferior crus) of the lateral canthal tendon also needs to be severed (inferior cantholysis). This increases precious space behind the eye by allowing the globe to become more proptotic and resulting in decompression. Most frequently, orbital compartment syndrome is the result of acute facial trauma with the subsequent development of a retrobulba

 Science Education: Essentials of Physical Examinations III

Cranial Nerves Exam II (VII-XII)

JoVE Science Education

Source: Tracey A. Milligan, MD; Tamara B. Kaplan, MD; Neurology, Brigham and Women's/Massachusetts General Hospital, Boston, Massachusetts, USA

The cranial nerve (CN) examination follows the mental status evaluation in a neurological exam. However, the examination of the cranial nerves begins with observations made upon greeting the patient. For example, weakness of the facial muscles that are innervated by the cranial nerve VII can be readily apparent during the first encounter with the patient. Cranial nerve VII, the Facial nerve, also has sensory branches, which innervate the taste buds on the anterior two-thirds of the tongue and the medial aspect of the external auditory canal. Therefore, finding ipsilateral taste dysfunction in the patient with facial weakness confirms the involvement of CN VII. In addition, knowledge of the neuroanatomy helps the clinician to localize level of the lesion: unilateral weakness of the lower facial muscles suggests a supranuclear lesion on the opposite side, while lesions involving the nuclear or infranuclear portion of the facial nerve, manifest with an ipsilateral paralysis of all the facial muscles on the involved side. Cranial nerve VIII, the Acoustic nerve, has two divisions: the hearing (cochlear) division, and the vestibular division, which innervates

 Science Education: Essentials of Cognitive Psychology

Approximate Number Sense Test

JoVE Science Education

Source: Laboratory of Jonathan Flombaum—Johns Hopkins University

A common carnival game is to ask people to guess the number of jellybeans packed into a jar. The chances that anyone will get the exact number right are low. But what about the chances that someone will guess 17 or 147,000? Probably even less than the chances of guessing the correct answer; 17 and 147,000 just seem irrational. Why? After all, if the beans cannot be taken out and counted one-at-a-time, how can someone tell that an estimate is too high or too low? It turns out that in addition to verbal counting (something clearly learned), people appear to possess hardwired mental and neural mechanisms for estimating numbers. To put it colloquially, it is what might be called an ability to guesstimate, or “ballpark.” Experimental psychologists call it the “Approximate Number Sense,” and recent research with an experimental paradigm of the same name has begun to uncover the underlying computations and neural mechanisms that support the ability to guesstimate. This video demonstrates standard procedures for investigating nonverbal numerical estimation with the Approximate Number Sense Test.

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