Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Neurology
FA complete review part 3.6 Ophthalmology
| Question | Answer |
|---|---|
| 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 activités 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
Popular USMLE sets