Source: Richard Glickman-Simon, MD, Assistant Professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, MA
The simplest ophthalmoscopes consist of an aperture to look through, a diopter indicator, and a disc for selecting lenses. The ophthalmoscope is primarily used to examine the fundus, or the inner wall of the posterior eye, which consists of the choroid, retina, fovea, macula, optic disc, and retinal vessels (Figure 1). The spherical eyeball collects and focuses light on the neurosensory cells of the retina. Light is refracted as it passes sequentially through the cornea, the lens, and the vitreous body.
The first landmark observed during the funduscopic exam is the optic disc, which is where the optic nerve and retinal vessels enter the back of the eye (Figure 2). The disc usually contains a central whitish physiologic cup where the vessels enter; it normally occupies less than half the diameter of the entire disc. Just lateral and slightly inferior is the fovea, a darkened circular area that demarcates the point of central vision. Around this is the macula. A blind spot approximately 15° temporal to the line of gaze results from a lack of photoreceptor cells at the optic disc.
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1Department of Biology, Indiana University of Pennsylvania
Immunology and Infection
1Department of Internal Medicine, University of Utah, 2Department of Kinesiology and Health Education, University of Texas at Austin, 3Division of Nephrology and Hypertension, University of Utah, 4Department of Biochemistry, University of Utah, 5Department of Exercise and Sport Science, University of Utah, 6Geriatric Research Education and Clinical Center, Department of Veterans Affairs
1Radiology, University of Minnesota, 2Medicine, University of Minnesota, 3School of Public Health, University of Minnesota, 4Surgery, University of Arizona
1Environmental Health Science and Research Bureau, Health Canada, Environmental Health Centre
1Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University
1Department of Neurology, Harvard Medical School, 2Department of Neurology, Beth Israel Deaconess Medical Center, 3Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, 4Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, 5Department of Neurology, Massachusetts General Hospital
1Department of Molecular and Cellular Physiology, Albany Medical College, 2Department of Neuroscience and Experimental Therapeutics, Albany Medical College
Source: Meghan Fashjian, ACNP-BC, Beth Israel Deaconess Medical Center, Boston MA
The term blood pressure (BP) describes lateral pressures produced by blood upon the vessel walls. BP is a vital sign obtained routinely in hospital and outpatient settings, and is one of the most common medical assessments performed around the world. It can be determined directly with the intra-arterial catheter or by indirect method, which is a non-invasive, safe, easily reproducible, and thus most used technique. One of the most important applications of BP measurements is the screening, diagnosis, and monitoring of hypertension, a condition that affects almost one third of the U.S. adult population and is one of the leading causes of the cardiovascular disease.
BP can be measured automatically by oscillometry or manually by auscultation utilizing a sphygmomanometer, a device with an inflatable cuff to collapse the artery and a manometer to measure the pressure. Determination of the pulse-obliterating pressure by palpation is done prior to auscultation to give a rough estimate of the target systolic pressure. Next, the examiner places a stethoscope over the brachial artery of the patient, inflates the cuff above the expected systolic pressure, and then auscultates while deflating the cuff and o…
Physical Examinations I
1Stem Cell and Regenerative Medicine Laboratory, Fondazione Istituto di Ricerca Pediatrica Citta della Speranza, 2Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 3Stem Cells and Regenerative Medicine Section, Developmental Biology and Cancer Programme, UCL Institute of Child Health and Great Ormond Street Hospital
1Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, 2Laboratory of Experimental Medicine, Department of Medicine, CHUV University Hospital, 3Department of Vascular Surgery, Pellegrin Hospital, University of Bordeaux, 4Department of Thoracic and Vascular Surgery, CHUV University Hospital
1Tissue Engineering Program and Surgical Research, Nationwide Children's Hospital, 2Cardiothoracic Surgery, Nationwide Children's Hospital, 3Pediatric Surgery, Nationwide Children's Hospital
1Molecular Genetics, Leibniz Institute on Aging - Fritz Lipmann Institute (FLI), 2Faculty of Biology and Pharmacy, Friedrich Schiller University of Jena, 3Carl Zeiss Microscopy GmbH
1Department of Neurology, Royal Melbourne Hospital, 2Department of Medicine (RMH), The University of Melbourne, 3Department of Neurology, Ulster Hospital, 4National Centre for Epidemiology and Population Health, Australian National University