First Aid - Neurology - Eye

Front 1

eye mm in near vision?

Back 1

ciliary mm contracts --> relaxation of zonular fibers --> lens relaxation --> more CONVEX

Front 2

eye mm in distant vision?

Back 2

ciliar mm relaxes --> zonular fibers pull on lens --> lens FLATTENS

Front 3

vision change w/aging?

Back 3

presbyopia; loss of near vision due to change in lens shape
sclerosis & decreased elasticity

Front 4

acute, painless monocular loss of vision?

Back 4

retinal artery occlusion

Front 5

pale retina & cherry-red macula?

Back 5

retinal artery occlusion

macula is thinner than surrounding retina; see choroid more easily thru it (cherry red)

Front 6

optic disc atrophy with cupping?

Back 6

glaucoma; increased intraocular pressure

Front 7

myopia?

Back 7

near-sightedness
(far objects appear blurry)

MYOpia - think mm; ciliary mm active - contracting so lens is not flattened

Front 8

closed angle glaucoma?

Back 8

the flow of aqueus humor from posterior to anterior chamber through the pupil is blocked b/c lens is in contact with iris

pressure in the posterior chamber builds, dislocating the lens anteriorly, this closes the angle between iris & cornea, obstructing the canal of Schlemm

Front 9

open angle glaucoma?

Back 9

obstructed outflow (canal of Schlemm) as primary process

Front 10

glaucoma in:
-myopia
-age
-African American

Back 10

open/wide angle, painless

Front 11

eye pain, decreased vision, frontal headache, "rock hard eye"

Back 11

closed/narrow angle glaucoma

do NOT give sympathomimetics
cholinergics may help

Front 12

opacification of the lens?

Back 12

cataract

Risk factors: age, smoking, EtOH, sun, galactosemia, galactokinase deficiency, diabetes, trauma, infection

Front 13

optic disc elevated, blurred margins?

Back 13

Papilledemea; increased ICP

bigger blind spot (can be seen in hydrocephalus)

Front 14

eye looks down & out, ptosis, dilated?

Back 14

CN III damage (also has loss of accommodation)

Front 15

eye drifts up, vertical diplopia?

Back 15

CN IV damage

Front 16

problems reading newspaper, going down stairs? (CN lesion)

Back 16

CN IV damage

Front 17

eye deviates medially?

Back 17

CN VI damage

Front 18

how to test superior oblique?

Back 18

have pt look down from adducted position
CN IV

Front 19

parasympathetic innervation of the eye arises from?

Back 19

Edinger-Westphal nucleus --> ciliary ganglion

Front 20

pupillary dilation? constriction?

Back 20

dilation = mydriasis; sympathetic (wide open = dried out)

constriction = miosis; parasympathetic

Front 21

why is there a consensual pupillary reflex?

Back 21

afferent arm (CN II) synapses on pretectal nucleus; from there EFFERENT arm synapses BILATERALLY on Edinger Westphal nucleus

from edinger-westphal nucleus 2nd neuron of efferent arm synapses on ipsilateral ciliary ganglion --> pupillary constrictor

Front 22

light is shone in 1 eye, decreased pupillary constriction bilaterally?

Back 22

Marcus Gunn pupil
-afferent defect
(optic nerve damage, or retinal detachment)

Front 23

what is the first sx noticed w/CN III compression?

Back 23

blown pupil - parasympathetics carried in outer part of CN III

inner part of CN III carries output to ocular mm

Front 24

cause of blown pupil?

Back 24

CN III compression
-posterior communicating artery berry aneurysm
-uncal herniation

Front 25

cause of neurologic deficit of motor actions of CN III? (down & out gaze; also get ptosis)

Back 25

vascular dz
-diabetes; glucose --> sorbitol
-"decreased diffusion to interior"

Front 26

retinal detachment?

Back 26

neurosensory layer of retina separates from pigment epithelium
-degeneration of photoreceptors
-vision loss

2nd to trauma, diabetes

Front 27

age-related macular degeneration (ARMD)?

Back 27

central scotomas

"dry"/atrophic - fat deposits; SLOW/gradual
"wet" - neovascularization, FAST

Front 28

central scotoma?

Back 28

macular degeneration

Front 29

left hemianopia w/macular sparing?

Back 29

lesion very posterior (macula projects to different area)
Posterior Cerebral Artery

Front 30

right anopia?

Back 30

lesion of rt optic nerve distal to chiasm

Front 31

bitemporal hemianopsia?

Back 31

compression of medial aspect of optic chiasm
sellar tumors

Front 32

binasal hemianopsia?

Back 32

compression of lateral aspects of optic chiasm
carotid calcification

Front 33

right homonymous heminanopia?

Back 33

lesion of left optic tract; proximal to optic chiasm

Front 34

where does the optic nerve begin?

Back 34

distal to the optic chiasm; proximally it is called the optic tract

Front 35

where does the optic tract split? into what?

Back 35

Lateral geniculate body
-Meyer's loop (inferior, inferior retina; superior visual field)
-Dorsal optic radiation (superior, superior retina; inferior visual field)

Front 36

what does superior visual field correspond to? inferior field?

Back 36

superior visual field --> inferior retina; Meyer's loop (inferior to calcarine sulcus) TEMPORAL LOBE

inferior visual field --> superior retina; Dorsal optic radiation (superior to calcarine sulcus) PARIETAL LOBE

Front 37

left upper quadrantic anopia?

Back 37

lesion right in Meyer's loop (inferior to calcarine sulcus)
-right temporal lesion
-Middle Cerebral Artery

Front 38

right lower quadrantic anopia?

Back 38

lesion in left dorsal optic radiation (superior to calcarine sulcus)
-left parietal lesion
-Middle Cerebral artery

Front 39

on lateral gaze adduction is impaired, adduction intact w/nystagmus; convergence intact?

Back 39

Internuclear ophthalmoplegia (MLF syndrome)
-multiple sclerosis

On lateral gaze
-CN VI nucleus innervates ipsilateral LR; sends fibers to contralateral MR thru MLF

Front 40

multiple sclerosis eye movement deficits?

Back 40

interophthalmoplegia
MLF deficit

on lateral gaze, adduction (medial) is absent & abduction has nystagmus; convergence is normal