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Neurology

FA complete review part 3.6 Ophthalmology

QuestionAnswer
List of structures that are located in the Anterior segment of the eye: 1. Ciliary body 2. Zonular fibers 3. Cornea 4. Iris 5. Pupil 6. Lens 7. Anterior chamber 8. Posterior chamber
What structure covers the whole eye? Sclera
List of structures that are in the Posterior segment of the eye? 1. Sclera 2. Choroid 3. Retina 4. Fovea 5. Optic disc 6. Central retinal artery and vein 7. Optic nerve 8. Vitreous chamber
Anterior chamber + Posterior chamber = Anterior segment
In the posterior segment of the eye, what is the outermost structure? Sclera
In the posterior segment of the eye, what is the middle and inner structures? - Choroid (middle) - Retina (inner)
The iris, is the _______________ structure of the anterior segment of the eye. Middle
What is Conjunctivitis? Inflammation of the conjunctiva causing red eye
Clinical presentation of Allergic Conjunctivitis? Itchy eyes, and bilateral
What are the clinical features of Bacterial conjunctivitis? Pus; treatment with antibiotics
Pus in conjunctivitis most likely points to allergic, bacterial, or viral etiology? Bacterial
What are the 3 main etiologies for Conjunctivitis? Allergic, bacterial, and viral
What the most common type or etiology for Conjunctivitis? Viral conjunctivitis
What is the most common viral pathogen that causes conjunctivitis? Adenovirus
Clinical profile of viral conjunctivitis: Sparse mucous discharge, swollen preauricular node; self-resolving
Which type of conjunctivitis is often seen with preauricular node involvement? Viral conjunctivitis
List of REFRACTIVE errors: 1. Hyperopia 2. Myopia 3. Astigmatism 4. Presbyopia
What do Refractive errors mean? Means that the shape of your eye does not bend light correctly, resulting in a blurred image
What is a common cause of impaired vision, but corrected with eyeglasses? Refractive errors
What is the common name for Hyperopia? Farsightedness
What is the cause of Hyperopia? Eye too short for refractive power of cornea and lens which causes the light to focus behind the retina.
Where do light focuses in Hyperopia, in front or behind the retina? Behind retina
What type of lenses are used to correct hyperopia? Convex (converging) lenses
Convex (converging) lenses are used to correct what type of refractive error? Hyperopia
Eye to short or small for refractive power of cornea and lens. Hyperopia
Light focused behind the retina. Dx? Hyperopia
What is the common name for Myopia? Nearsightedness
Nearsightedness = Myopia
Farsightedness = Hyperopia
What is the problem with Myopia? Eye too long for refractive power of cornea and lens leading to light focused in front of retina
If the light is focused in front of retina. Dx? Myopia
In myopia, the light is focused in front or behind the retina? In front retina
Eye to long for refractive power of cornea and lens. Myopia
What type of lenses are used to correct Myopia? Concave (diverging) lens
A concave (diverging) lens is used to correct which refractive error? Myopia
Abnormal curvature of the cornea. Dx? Astigmatism
What is the result of abnormal curvature of the cornea? Different refractive power at different axes
Which refractive error (condition) is characterized by having different refractive powers at different angles? Astigmatism
What type of lens are used in Astigmatism? Cylindrical lens
Cylindrical lens correct which refractive error? Astigmatism
What is astigmatism? Abnormal curvature of cornea leading to different refractory power at different angles.
A person with Astigmatism should buy eyeglasses with what type of lens? Cylindrical lens
What is Presbyopia? Aging-related impaired accommodation, primarily due to decreased lens elasticity, changes in lens curvature, decreased strength of ciliary muscle
Which is the age related refractive error? Presbyopia
What type of glasses are used in Presbyopia patients? "Reading glasses" (magnifiers)
What refractive error is due to impaired accommodation of the eyesight? Presbyopia
77 year old man with difficulty focusing on near objects. Dx? Presbyopia
Which muscle usually looses its normal strength in Presbyopia? Ciliary muscle
Eye inspection reveal a decrease in lens elasticity, changes in curvature of lens, and a weakening ciliary muscle. What is the most likely refractive error? Presbyopia
Aging-related impaired accommodation. Dx? Presbyopia
Common vision condition in which you can see distant objects clearly, but objects nearby may be blurry Hyperopia
A "farsighted" describes his/her sight as: Can see objects far away, but see blurry objects nearby
A "nearsighted" person would say that his/her vision is: Can see objects nearby, but sees blurry or difficulty when objects are far away.
A person with Myopia cannot see objects that are __________. Far away
A person with Hyperopia cannot see objects that are ____________. Nearby
What is a Cataract? Painless, often bilateral, opacification of lens, often resulting in glare and decreased vision, especially at night
Painless, bilateral, opacification of the lens leading to poor vision at night. Dx? Cataracts
What known risk factor for Cataracts? Increasing age Smoking Excessive alcohol use Excessive sunlight Prolonged corticosteroid use Diabetes mellitus
Which "blood sugar" condition is associated with development of cataracts? Diabetes mellitus
List of congenital risk factors/ conditions that increase chances of developing Cataracts: 1. Classic Galactosemia 2. Galactokinase deficiency 3. Trisomies (13, 18, 21) 4. TORCHES infections (rubella) 5. Marfan syndrome 6. Alport syndrome 7. Myotonic dystrophy 8. Neurofibromatosis 2
Which type of NF is associated with Cataracts? Neurofibromatosis 2
Which TORCHES infection is especially associated with development of cataracts? Rubella
Which saccharide metabolic conditions are associated with development fo Cataracts? Galactose metabolism
Which canal is used by the Aqueous humor in Trabecular outflow pathway? Canal of Schlemm
What type of medication is used to increase the Trabecular outflow? M3 agonist
Drainage of aqueous humor into uvea and sclera is known as: Uveoscleral outflow
What produces the Aqueous humor? Nonpigmented epithelium on ciliary body
Which type of drugs or medications are used to decrease the production of Aqueous humor? B-blockers, a2-agonists, and carbonic anhydrase inhibitors
What is the role of Muscular fibers in ciliary body? Affect lens shape for accomodation
What eyesight function can be deficient in case of damage to the muscular fibers in ciliary body? Accomodation
What is Glaucoma? Optic disc atrophy with characteristic cupping, usually with elevated intraocular pressure (IOP) and progressive peripheral visual field loss if untreated
What is the ultimate purpose of Glaucoma treatment? Lowering IOP with medications or surgically
What is "cupping" when used in association with Glaucoma? Thinning of outer rim of optic nerve head versus normal
Thinning of outer rim of optic disc and increased IOP. Dx? Glaucoma
What are the types of Glaucoma? 1. Open-angle glaucoma 2. Closed- or Narrow-angle glaucoma
What is the main associated in develop of Open-angle glaucoma? Increasing age, African-American, and family history
Which type of Glaucoma is most common in the USA? Open-angle glaucoma
What is the cause of Secondary Open-angle glaucoma? Due to blocked Trabecular meshwork from WBCs, RBCs, and/or retinal elements
What condition can lead to secondary open-angle glaucoma due to blockage of meshworkby WBCss? Uveitis
What is a possible consequence or resulting pathology of a vitreous hemorrhage? Secondary Open-angle glaucoma
Retinal detachment can led to what type of Glaucoma? Secondary Open-angle glaucoma
Blockage of trabecular meshwork General cause of Secondary Open-angle glaucoma
What is primary Closed (narrow)-angle glaucoma? Enlargement or anterior movement of lens against central iris leading to obstruction of normal aqueous flow through pupil.
What is the result of the blockage of aqueous humor flow in primary Closed angle glaucoma? Fluid builds up behind iris, pushing peripheral iris against cornea and impeding aqueous flow through trabecular meshwork
What part of the eye is either enlarged or moved anteriorly that lead to the development of Primary Closed (Narrow) angle glaucoma? Lens against central iris
What is the cause for Secondary Closed (Narrow) angle glaucoma? Hypoxia from disease induces vasoproliferative in iris that contacts angle
How does DM can cause Narrow-angle glaucoma? It causes hypoxia, which as result induces the vasoproliferation in the iris that contracts the angle.
What is "Chronic closure" in Closed-angle glaucoma referred to? Often asymptomatic with damage to optic nerve and peripheral vision
Which is a true ophthalmic emergency, acute or chronic closure, in Closed-angle glaucoma? Acute closure
What are the symptoms seen in Acute closure in Closed angle glaucoma? Very painful, red eye, sudden vision loss, ahos around lights, frontal headache, fixed and mid-dilated pupil.
What type of agents are contraindicated in Acute closure? Mydriatic agents
What causes Acute closure in Closed angle Glaucoma? Elevated IOP pushes iris foard leading to angle to close up abruptly.
What condition is suspected in diabetic mellitus patient, that has suddenly lost vision in right eye, complains of a headache, and indicates alot of pain in the right eye? Acute closure in Closed angle glaucoma
What is Uveitis? Inflammation of the uvea
What determines the specific name for uveitis type? Location within affected eye
What are the types of uveitis? Anterior uveitis, iritis, and posterior uveitis.
What is hypopyon? Accumulation of pus in anterior chamber
What ocular condition is associated with Hypopyon? Uveitis
What are associated symptoms along with Uveitis? Hypopyon and conjunctival redness
What are common systemic inflammatory disorders associated with Uveitis? Sarcoidosis, rheumatoid arthritis, juvenile idiopathic arthritis, HLA-B27-associated conditions.
What is and causes Age-related macular degeneration? Degeneration of macula (central ara of retina), and causes distortion and eventual loss of central vision.
What causes loss of central vision in Age-related macular degeneration? Scotomas
What are the two types of age-related macular degeneration? Dry and Wet
Description of Dry macular degeneration due to age. Deposition of yellowish extracellular material in between Bruch membrane and retinal pigment epithelium with gradual decreaes in vision
Non-exudative macular degeneration is another way to refer to: Dry macular degeneration
What the simpler form to refer to Exudative age-related macular degeneration? Wet macular degeneration
Rapid loss of vision due to bleeding secondary to choroidal neovascularization. Wet macular degeneration
What is the treatment to prevent progression of age-related dry macular degeneration? Multivitamins and antioxidant supplements
What is used to treat Age-related wet macular degeneration? Anti-VEGF injections
What are some examples of anti-VEGF injections? Bevacizumab and Ranibizumab
What is retinal damage due to chronic hyperglycemia? Diabetic retinopathy
Diabetic retinopathy has two forms: 1. Nonproliferative 2. Proliferative
How does Nonproliferative Diabetic retinopathy develops? Due to damaged capillaries leak blood leading to lipids and fluid seep into retina causing hemorrhages and macular edema
What is the best treatment and/or management for Nonproliferative Diabetic retinopathy? Blood sugar control
What is the result of the damaged capillaries in nonproliferative diabetic retinopathy? Leak blood which lead to lipids and fluids to reach the retina causing hemorrhages and macular edema
What causes Proliferative Diabetic retinopathy? Chronic hypoxia
Chronic hypoxia is the major cause for which type of Diabetic retinopathy? Proliferative Diabetic retinopathy
What is the result of chronic hypoxia causing proliferative diabetic retinopathy? New blood vessel formation with resultant traction on retina
What is the treatment for proliferative diabetic retinopathy? Peripheral retinal photocoagulation, surgery, and anti-VEGF.
Which condition is known to be treated with Peripheral Retinal Photocoagulation? Proliferative Diabetic retinopathy
Retinal damage due to chronic uncontrolled HTN Hypertensive retinopathy
What ophthalmologic condition is associated with Flame-shaped retinal hemorrhages? Hypertensive retinopathy
Clinical features of Hypertensive Retinopathy 1. Flame-shaped retinal hemorrhages 2. Arteriovenous nicking 3. Microaneurysms 4. Macular star 5. Cotton-wool spots
Cotton-wool spots + Macular star + Flamed-shaped retinal hemorrhages. Dx? Hypertensive retinopathy
What associated symptom if present in Hypertensive retinopathy, requires immediate lowering of the blood pressure? Papilledema
What conditions are often associated with Hypertensive retinopathy? 1. Increase risk of stroke 2. CAD 3. Kidney disease
A person with BP 190/112, that has not visited a physician in 20 years, and indicates some problems with sight. Dx? Hypertensive retinopathy
Blockage of central or branch retinal vein due to compression from nearby arterial atherosclerosis. Retinal vein occlusion
"blood and thunder appearance" in fundoscopy is often used in describing what ophthalmologic pathology? Retinal vein occlusion
What is a more common way to refer to the retinal hemorrhage and venous engorgement seen in retinal vein occlusion? "blood and thunder appearance"
What are the clinical features of Retinal vein occlusion? 1. Retinal hemorrhage and vein engorgement 2. Edema in affected area
What is Retinal vein occlusion? The blockage of central or branch of the Retinal vein due to the compression from nearby arterial atherosclerosis.
What is the most common cause of blocking the central retinal vein or a branch of such vein? Compression by nearby arterial atherosclerosis
What is Retinal detachment? Separation of neurosensory layer of retina from outermost pigmented epithelium leading to degeneration of photoreceptors and eventually vision loss
Which parts of the eye anatomy are "detached" in Retinal detachment? The neurosensory layer of the retina, form the outermost pigmented epithelium
What is degenerated by the detachment of the retina layer and the outermost pigmented epithelium, in Reitan detachment? Photoreceptors
What is the results or degeneration of photoreceptors in Retinal detachment? Vision loss
What are some secondary etiologies for Retinal detachment? - Retinal breaks - Diabetic tration - Inflammatory effusions
What are the fundoscopic findings in Retinal detachment? Crinkling of retinal tissue and changes in vessel direction
Retinal breaks, which cause retinal detachment are more common in: Patients with high myopia and/or history of head trauma
What are common used words to describe the Posterior vitreous detachment which often precedes Retinal detachment? "Flashes" and "floaters"
What are key features or symptoms seen in Retinal detachment? 1. Posterior vitreous detachment 2. Monocular loss of vision
How is the loss in vision in Retinal detachment described? - Monocular loss - Like "curtain drawn down"
A patient complains of unable to see from right eye, and describes it as a "curtain been drawn down" and indicate prior to losing vision, he could "feel and see" floaters in the right eye. Dx? Right eye Retinal detachment
How is the progress and vision loss in Central Retinal artery occlusion? Acute, painless monocular vision loss
Retinal cloudy with attenuated vessels and "cherry-red" spot at fovea. Dx? Central Retinal artery occlusion
Which is most common, Central Retinal artery or Central Retinal vein, occlusion? Central Retinal vein occlusion
Which is more severe, Central Retinal artery or Central Retinal vein, occlusion? Central Retinal artery occlusion
Which most likely to occur, an occlusion of the Central Retinal vein or Branch Retinal vein? Branch Retinal vein occlusion
In which Central Retinal vessel occlusion, is a "cherry-red" spot at the fovea seen? Central Retinal artery occlusion
What is the first thing to evaluate in cases of suspected Central Retinal artery occlusion? Embolic source
What are common conditions that predispose for Central Retinal artery occlusion? Embolic-inducing conditions such as: Carotid Artery atherosclerosis, Cardiac vegetations, and PFO.
Clinical presentation of Central Retinal artery occlusion (CRAO)? - Sudden, profound vision loss - Painless - Monocular
Clinical presentation of Central Retinal vein occlusion (CRVO)? - Blurred vision to sudden vision loss - Painless - Monocular
Is vision loss in CRAO and CRVO, painful or painless? Painless
Common etiologies for CRAO: 1. Embolism 2. Vasculitis 3. Vasospasm 4. Sickle cell 5. Trauma 6. Glaucoma
Common etiologies for CRVO: Hypercoagulable states, stokes, glaucoma, and compression of vein by thyroid or ocular tumors
Optic disc edema + Diffuse retinal hemorrhages. Dx? Central Retinal vein occlusion
Retinal pallor, Macular "cherry-red" spot + Afferent pupillary defect. Dx? Central Retinal artery occlusion
What is inherited retinal degeneration disorder? Retinitis pigmentosa
What is Retinitis pigmentosa? Inherited retinal degeneration. - Painless, progressive vision loss beginning with night blindness.
Progressive, painless vision loss that starts by losing vision at night. Dx? Retinitis pigmentosa
What are the features findings in Macular of Retinitis pigmentosa? Bone spicule-shaped deposits around macula
Finding; Bone spicule-shaped deposits around macula. Dx? Retinitis pigmentosa
Which cells are affected first in Retinitis pigmentosa? Rods
Early in Retinitis pigmentosa, are the rods or cones affected first? Rods
What is the definition for Retinitis? Retinal edema and necrosis leading to scar
What are the common viral pathogens that cause Retinitis? CMV, HSV, VZV
What condition is often associated or seen with Retinitis? Immunosuppression
What is Papilledema? Optic disc swelling (usually bilateral) due increased ICP
Enlarged blind spot and elevated optic disc with blurred margins. Dx? Papilledema
What is the most characteristic fundoscopic finding in Papilledema? Elevated Optic disc with blurred margins
What ocular condition is often seen with enlarged blind spot, and optic disc swelling? Papilledema
What are the three actions or functions of the eye that compose Pupillary control? 1. Miosis 2. Pupillary light reflex 3. Mydriasis
Pupillary constriction is referred as __________________. Miosis
Miosis is it controlled by the Parasympathetic or sympathetic system? Parasympathetic
How many neurons make up the process of Miosis? 2 neurons
What is connected by the 1st Neuron in Miosis? Edinger-Westphal nucleus to ciliary ganglion via CN III
What is the role or connection of the 2nd Neuron in Miosis? Short ciliary nerves to sphincter pupillae muscles
Medical term to "make pupil small" Miosis
In testing the Pupillary light reflex, the light shone at either eye, sends signal to Pretectal nuclei via which cranial nerve? CN II
Light going INTO the eye is transmitted to the LGN and Edinger-Westphal nucleus via the : CN II
Once the light signal transmitted by CN II reaches the Pretectal nuclei in the midbrain it: Activates bilateral Edinger-Westphal nuclei
The bilateral activation of the Edinger-Westphal nuclei causes: Pupils constrict bilaterally
If the Light reflex on either eye, cause pupil contsticiton in boeth eyes, it is: Positive (non affected) Direct and consensual reflex
A positive Direct and Consensual reflex in Pupillary light reflex means: Both pupils constrict when light is shone to one eye
What is the expected (healthy) result for Pupillary light reflex? Illumination of 1 eye result in blagearl pupillary constriction
Mydriasis is: Sympathetic dilation of the pupil
How many neurons are involved in Mydriasis? 3 neurons
What is "connected" by the 1st neuron of Mydriasis? Hypothalamus to Ciliospinal center of Budge (C8-T2)
Where is the Pretectal nuclei? Midbrain
In which pupillary function is the Ciliospinal center of Budge involved with? Mydriasis 1st neuron
Where in the spinal cord is the ciliospinal center of Budge usually located? C8-T2
Where does the 2nd neuron of Mydriasis exits the spinal cord? At T1
Exit at T1 and travels to superior cervical ganglion 2nd neuron of Mydriasis
What is the course followed by the 2nd neuron of Mydriasis? Travels along cervical sympathetic chain near lung apex, and subclavian vessels
What is the course or path of the 3rd neuron involved in Mydriasis? Plexus along internal carotid, through cavernous sinus; enter orbit as long ciliary nerve to pupillary dilator muscles
What do the sympathetic fibers of the 3rd neuron in mydriasis innervate? Smooth muscle of eyelids and sweat glands of forehead and face
What is Marcus Gunn pupil? When light shine into a normal eye, the pupillary reflex is intact, but when shown to the affected eye, both pupils dilate instead of constrict.
A "reverse" result in Pupillary light reflex? Marcus Gunn pupil
What causes the abnormal Pupillary reflex that leads to Marcus Gunn pupil? Impaired conduction of light signal along the injured optic nerve
What is the Direct reflex part of the Pupillary light reflex? Constriction of the Ipsilateral eye
What is the Consensual reflex part of the Pupillary light reflex? Constriction of the contralateral eye
What are the main symptoms of Horner syndrome? 1. Ptosis 2. Anhidrosis 3. Miosis
What is Ptosis? Slight drooping of eyelid
What muscle is associated with Ptosis? Superior tarsal muscle
Horner syndrome is: Sympathetic denervation of the face
Medical term for absence of sweating? Anhidrosis
Horner syndrome is associated with a sympathetic chain composed of how many neurons? 3 neurons
What are the lesions associated with 1st neuron associated with Horner syndrome? - Pontine hemorrhage - Lateral medullary syndrome - Spinal cord lesion above T1
What is the condition that is known to cause Horner syndrome at the level of the 2nd neuron? Pancoast tumor
What condition may lead to Horner syndrome due to 3rd neuron lesion? Carotid dissection
What are common spinal cord lesion above T1 that cause Horner syndrome? Brown-Sequard syndrome and Late-stage syringomyelia
Which condition is seen with Ptosis, Anhidrosis, and Miosis? Horner syndrome
Where is the synapse of the first and second neuron in Horner syndrome sympathetic chain? Lateral horn
Where or which structure locates the synapse between the second and third neuron in Horner syndrome? Superior cervical ganglion
At what point of spinal cord is the Superior Cervical ganglion? C2
What what level of the spinal cord is the second synapse in Horner syndrome sympathetic chain? T1
Which arterial bodies are in proximity to the 3rd neuron of Horner syndrome? Internal and External Carotid artery
List of Ocular motility muscles: 1. Superior Rectus muscle 2. Lateral Rectus muscle 3. Inferior Oblique muscle 4. Superior Oblique muscle 5. Medial Rectus muscle 6. Inferior Rectus muscle
Which ocular motility muscle is innervated by cranial nerve VI? Lateral rectus muscle
Which ocular motility muscle ins innervated by CN IV? Superior oblique muscle
What is the mnemonic to depict the all the ocular motility cranial nerve innervation? LR6 SO4 R3
What is the strongest action of the Superior Oblique muscle? Depression when the eye is adducted
In ocular muscles, the "obliques" go: Opposite side
If patient is looking to the right, which ocular muscles are been tested? Left SO and Left IO
How is the patient asked to look in order to test the Inferior Oblique muscle? Up
What are common causes of CN III damage? 1. Ischemia --> pupil sparring 2. Uncal herniation --> coma 3. PCA aneurysm --> sudden-onset headache 4. Cavernous sinus thrombosis --> proptosis, involvement of CNs IV, V1/V2, VI 5. Midbrain stroke --> contralateral hemiplegia
What type of pathology affects in CN III damage, affects most the motor output to extraocular muscles? Vascular disease due to decreased diffusion of oxygen and nutrients to the inferior fibers form compromised vasculature that reside on outside of nerve.
What are the CN III palsy deficits due to vascular disease? Ptosis, "down and out" gaze
What are the two main components of CN III? Motor (central) and Parasympathetic (peripheral)
What affects the parasympathetic component in CN III damage? Compression by PCom aneurysm or Uncal herniation
What are the signs seen by Parasympathetic (peripheral ) CN III damage? 1. Diminished or absent Pupillary light reflexes 2. "blown pupil" often with "down-and-out" gaze
What type of gaze is seen in CN III palsy? Down and Out
Eyes move upward, particularly with contralateral gaze. Dx? CN IV palsy
How does one can easily distinguish CN IV palsy in a person by non-ocular signs? Going down stairs, head may tilf in the opposite direction to compensate
Cranial Nerve VI damage (palsy) is defined as: Affected eye unable to abduct and is displaced medially in primary position of gaze
Which ocular palsy is characterized by inability to abduct affected eye? CN VI palsy
What condition is suspected if a person can abduct eye, and instead it is "maintained" at primary position (medial) of gaze? CN VI palsy
Ask patient "look to the left" and the patient immediately has upward eye deviation. Dx? Right sided CN IV palsy
List of Visual field defects: 1. Right/Left anopia 2. Bitemporal hemianopia 3. R/L homonymous hemianopia 4. R/L Upper quadrantanopia 5. R/L lower quadrantanopia 6. R/L hemianopia with macular sparing 7. Central Scotoma
Which conditions can cause Bitemporal hemianopia? Pituitary lesion and compression of Pituitary chiasm
A left upper quadrantanopia is most likely due to: Left temporal lesion or MCA lesion
A right parietal lesion may me responsible for which visual field defect? Left lower quadrantanopia
Visual field defect caused by a Left PCA infarct? Left hemianopia with macular sparing
The Meyer loop course: Lower retina; Loops around inferior horn of Lateral ventricle
Dorsal optic radiation: Superior retina; takes shortest path via internal capsule
Which brain area is traversed or caused by the Dorsal Optic radiation? Internal capsule
An infarct to the internal capsule will most likely cause defects to the superior or lower retina? Superior retina
Meyer Looop damage or lesion will cause problems with the lower or superior retina? Lower retina
What areas of the brain are involved or anatomically approximate to with the Meyer Loop? Inferior horn of lateral ventricle
When an image hits the Primary visual cortex, it is ===> Upside down and left-right reversed
Where is the light of an image if it is upside down, and Left-right reverse? Primary visual cortex
What is the Cavernous sinus? Collection of venous sinuses on either side of pituitary.
Where does the blood from eye and superficial cortex drains into? Cavernous sinuses
Collection of venous sinuses on either side of the pituitary. Cavernous sinuses
The contents oft he Cavernous sinuses drain into ----> Internal jugular vein
The internal jugular vein receives content (blood) from which structure? Cavernous sinuses
Which Cranial nerves and other nervous system structures pass through the Cavernous sinus? - CNs: III, IV, V1, and V2 - Postganglionic sympathetic pupillary fibers en route to orbit
What are signs and features of Cavernous sinus syndrome? 1. Ophthalmoplegia, 2. Decreased corneal sensation 3. Horner syndrome 4. Occasional decreased maxillary sensation
What are secondary causes for Cavernous sinus syndrome? Pituitary tumor mass effect, Carotid-cavernous fistula, or Cavernous sinus thrombosis related to infection
Which cranial nerve that goes through the cavernous sinus is most susceptible to injury in Cavernous sinus syndrome? CN VI
What is Internuclear Ophthalmoplegia? A disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction.
What is the Medial Longitudinal fasciculus? Pair of tracts that allows for crosstalk between CN VI and CN III nuclei.
What it the role of the MLF? Coordinates both eyes to move in same horizontal direction
Which structure is in charge to move eyes to same horizontal side, together? Medial longitudinal fasciculus (MLF)
Bilateral lesions to the MLF are common in: Multiple sclerosis
Why is the MLF highly myelinated? Must communicate quickly so eyes move at the same time
What is the most common conditions due to MLF damage? Internuclear Ophthalmoplegia (INO)
Conjugate horizontal gaze palsy. Internuclear Ophthalmoplegia (INO)
Lack of communication such that when CN 6 nucleus activit├ęs ipsilateral lateral rectus, contralateral CN 3 does not stimulate medial rectures to contract Internuclear Ophthalmoplegia (INO)
What action causes eye to get nystagmus in INO? Abducting the eye
What causes the nystagmus in INO by abducting the affected eye? CN VI overfires to stimulate CN III
In Right INO, which eye is paralyzed, right or left? Right
How is convergence in INO? Normal
What is Leukocoria? Loss (whitening) of the red reflex
What are some causes for Leukocoria in children? Retinoblastoma, congenital cataract, and toxocariasis
Created by: rakomi
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