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40 Cards in this Set

  • Front
  • Back
eye mm in near vision?
ciliary mm contracts --> relaxation of zonular fibers --> lens relaxation --> more CONVEX
eye mm in distant vision?
ciliar mm relaxes --> zonular fibers pull on lens --> lens FLATTENS
vision change w/aging?
presbyopia; loss of near vision due to change in lens shape
sclerosis & decreased elasticity
acute, painless monocular loss of vision?
retinal artery occlusion
pale retina & cherry-red macula?
retinal artery occlusion

macula is thinner than surrounding retina; see choroid more easily thru it (cherry red)
optic disc atrophy with cupping?
glaucoma; increased intraocular pressure
myopia?
near-sightedness
(far objects appear blurry)

MYOpia - think mm; ciliary mm active - contracting so lens is not flattened
closed angle glaucoma?
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
open angle glaucoma?
obstructed outflow (canal of Schlemm) as primary process
glaucoma in:
-myopia
-age
-African American
open/wide angle, painless
eye pain, decreased vision, frontal headache, "rock hard eye"
closed/narrow angle glaucoma

do NOT give sympathomimetics
cholinergics may help
opacification of the lens?
cataract

Risk factors: age, smoking, EtOH, sun, galactosemia, galactokinase deficiency, diabetes, trauma, infection
optic disc elevated, blurred margins?
Papilledemea; increased ICP

bigger blind spot (can be seen in hydrocephalus)
eye looks down & out, ptosis, dilated?
CN III damage (also has loss of accommodation)
eye drifts up, vertical diplopia?
CN IV damage
problems reading newspaper, going down stairs? (CN lesion)
CN IV damage
eye deviates medially?
CN VI damage
how to test superior oblique?
have pt look down from adducted position
CN IV
parasympathetic innervation of the eye arises from?
Edinger-Westphal nucleus --> ciliary ganglion
pupillary dilation? constriction?
dilation = mydriasis; sympathetic (wide open = dried out)

constriction = miosis; parasympathetic
why is there a consensual pupillary reflex?
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
light is shone in 1 eye, decreased pupillary constriction bilaterally?
Marcus Gunn pupil
-afferent defect
(optic nerve damage, or retinal detachment)
what is the first sx noticed w/CN III compression?
blown pupil - parasympathetics carried in outer part of CN III

inner part of CN III carries output to ocular mm
cause of blown pupil?
CN III compression
-posterior communicating artery berry aneurysm
-uncal herniation
cause of neurologic deficit of motor actions of CN III? (down & out gaze; also get ptosis)
vascular dz
-diabetes; glucose --> sorbitol
-"decreased diffusion to interior"
retinal detachment?
neurosensory layer of retina separates from pigment epithelium
-degeneration of photoreceptors
-vision loss

2nd to trauma, diabetes
age-related macular degeneration (ARMD)?
central scotomas

"dry"/atrophic - fat deposits; SLOW/gradual
"wet" - neovascularization, FAST
central scotoma?
macular degeneration
left hemianopia w/macular sparing?
lesion very posterior (macula projects to different area)
Posterior Cerebral Artery
right anopia?
lesion of rt optic nerve distal to chiasm
bitemporal hemianopsia?
compression of medial aspect of optic chiasm
sellar tumors
binasal hemianopsia?
compression of lateral aspects of optic chiasm
carotid calcification
right homonymous heminanopia?
lesion of left optic tract; proximal to optic chiasm
where does the optic nerve begin?
distal to the optic chiasm; proximally it is called the optic tract
where does the optic tract split? into what?
Lateral geniculate body
-Meyer's loop (inferior, inferior retina; superior visual field)
-Dorsal optic radiation (superior, superior retina; inferior visual field)
what does superior visual field correspond to? inferior field?
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
left upper quadrantic anopia?
lesion right in Meyer's loop (inferior to calcarine sulcus)
-right temporal lesion
-Middle Cerebral Artery
right lower quadrantic anopia?
lesion in left dorsal optic radiation (superior to calcarine sulcus)
-left parietal lesion
-Middle Cerebral artery
on lateral gaze adduction is impaired, adduction intact w/nystagmus; convergence intact?
Internuclear ophthalmoplegia (MLF syndrome)
-multiple sclerosis

On lateral gaze
-CN VI nucleus innervates ipsilateral LR; sends fibers to contralateral MR thru MLF
multiple sclerosis eye movement deficits?
interophthalmoplegia
MLF deficit

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