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93 Cards in this Set
- Front
- Back
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What is spina bifida?
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Posterior end of neural tube does not close properly.
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What is the function of the temporal lobe?
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Auditory, speech, memory. Contains hippocampus.
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Funcion of Occipital lobe?
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Visual processing.
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How many pairs of spinal nerves are there? and whats the breakdown?
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31 pairs. C8, T12, L5, S5, C1
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Where do retinal fibers go after the optic chiasm?
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Synapse at LGN. Then to Visual Cortex.
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What is Meyers loop?
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After leaving LGN, inferior retinal fibers take this indirect path through the temporal lobe to the cortex.
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2 other names for visual cortex:
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Area 17, Striate Cortex
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Where is lesion that causes a "pie in the sky" VF defect?
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Temporal lobe. Affects inferior retinal fibers of Meyers loop.
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Where is the lesion that causes a "pie on the floor" VF defect?
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Parietal lobe.
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Parietal lobe lesions are associated with what other ocular finding?
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Asymmetric OKN responses.
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Where does the macular region of the occipital lobe recieve blood supply?
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2 sources: 1) Middle cerebral artery 2) Posterior cerebral artery.
Thus, VAs are only affected in a lesion if both sources are lost. (rare) |
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What is the main cause of macular sparing homonymous hemianopia? Macular involving?
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Sparing = Stroke. Involving = tumor...compress both blood supplies.
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Where is the lesion that produces a junctional defect?
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At junction of optic nerve and optic chiasm. (Anterior Knee of Wilbrand)
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Where is lesion if VF defect respects horizontal midline?
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Anterior to chiasm. (optic nerve)
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Where is lesion if VF defect respects vertical midline?
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Posterior to chiasm.
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Most common cause of post chiasmal lesion?
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Stroke
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Which 2 sets of arteries supply the brain?
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Internal carotids and vertebrals
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Whats in the circle of Willis?
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Basilar Artery, internal carotids, Ant. and Post. Communicating Arteries
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What is the most common VF defect seen with early glaucoma?
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Nasal steps
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Port-Wine Stains are associated with what OCULAR disease?
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Ipsilateral glaucoma (45%) (Only 5% of those have Sturge Weber Syndrome.)
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Two types of secondary open angle glaucoma:
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Psuedoexfoliation Syndrome, Pigmentary Dispersion Syndrome
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2 causes of Angle Closure Glaucoma:
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#1 = Pupillary block. #2 = Plauteau iris Syndrome
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2 sources of secondary Acute Closure Glaucoma
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Neovascular and Uveitic sources.
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Most common causes of Neovascular Glaucoma:
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#1 = CRVO, #2 = DM, others - CRAO, Carotid Dz. (anything w/ severe retinal ischemia)
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How does uveitis cause glaucoma?
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Iris gets inflamed and sticky....leads to Anterior and Posterior Synechia...leads to secondary angle closure.
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2 most common inflammatory glaucomas:
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Glaucomaticocyclitic Crisis (Posner-Schlossman Syndrome), Fuch's Heterochromic Iridocyclitis
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What causes glaucomatocyclitic crisis? Uni or bilateral?
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Acute trabeculitis, unilateral
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How do pupil size and depth of focus relate?
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Smaller pupils = increased depth of focus. (inversely)
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How do pupil size and spherical aberrations relate?
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Decreased pupil size = decreased spherical and chromatic aberrations. Spherical aberrations scale with the Square of diameter of entrance pupil.
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What part of what bone houses the pituitary gland?
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Sella turcica of sphenoid bone.
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The optic chiams lies _______to the pituitary gland.
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Superior
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Where do 4 of the EOMs originate? Which ones don't?
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Common Tendinous Ring. SO and IO.
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Where does Inf. Oblique originate?
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Maxillary bone.
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Most common benign orbital tumor in adults? in children?
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Adults - Cavernous hemangioma. Kids - Capillary hemangioma.
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3 things that pass through Sup. Orbital fissure and Common Tend. Ring:
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NOA
Nasociliary N. Oculomotor N. Abducens N. |
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Which side of orbit is thinnest? Smallest? Weakest? Strongest?
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Thinnest = medial
Smallest - medial Weakest - Floor Strongest - Lateral |
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Why is there vision loss with temporal (Giant cell) Arteritis?
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Short Post. Cil. Arteries that supply the Optic disc are damaged.
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Which CN is most likely affected by an internal carotid artery aneurysm in the cav. sinus?
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6 - Abducens
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What provides blood to the optic disc?
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Circle of Zinn. (Zinn Haller) Its a network of SPCAs.
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What causes OIS?
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Carotid or Ophthalmic Artery blockage. DM, HTN, Cardiac dz. (d/t atherosclerosis)
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Vortex veins drain the...
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choroid
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CRV drains the
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retina (inner 6 layers)
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Flow of venous blood out pathway:
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CRV + Anterior Ciliary V + Vortex V. => Sup. and Inf. Ophthalmic V. => Cav. Sinus =>Petrosal Sinus => Int. Jugular V.
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2 main threats to vision with CRVOs and BRVOs:
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Macular Edema, Neovasc. (CRVOs lead to Neo. Glaucoma)
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What goes through Cav. Sinus?
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CNs 3, 4, 5(1), 5(2), 6, Int. carotid, sympathetic plexus (postgang. fibers) CN 6 runs freely, the rest in the lateral wall.
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Infections in the ______can invade the cav. sinus.
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cheek
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4 destination for fibers after chiasm crossing:
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1) LGN => Primary Visual Cortex
2) Pretectal Nucleus for pupil innervation 3) Superior Colliculus for saccades 4) Hypothalamus for circadian rhythm |
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Edinger Westphal nucleus?
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Parasymp. innervation to ciliary and sphincter muscles. CN 3.
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What is unique about levator muscle nuclei?
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1 subnucleus controls both. (See bilateral ptosis, keep in mind possible nuclear lesion)
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How do you examine for superior oblique palsy?
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Have pt. adduct and look down. Pt. will try to tilt head away from affected side.
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Which structure do sensory nerves from eye synapse in?
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Trigeminal ganglia. (CN 5) (Final destination is thalamus)
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Pathway of sensory nerves from cornea, iris, and CB
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long ciliary nerves => Nasociliary N. => Ophthalmic N. => Trigeminal N.
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What goes through Sup. Orbital fissure?
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CN, 3, 4, 5(1), 6, Ophthalmic Veins
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Which CN is most susceptible to increased intracranial pressure?
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6 (lateral rectus palsy)
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Which CN sends parasympathetic info to lacrimal gland?
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7 (with help from 5(2)
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Two main causes of pupil-involving CN 3 lesions?
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1) Aneurysm (main artery is post. communicating) 2) tumor (anything that compresses nerve!)
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2 main causes of pupil sparing CN 3 lesions?
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DM and HTN. Affect small vessels that are nourishing inner nerve.
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Which ganglion sends parasymp info to lacrimal gland?
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Pterygopalatine
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Sympathetic Pathway to eye
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Hypothalamus => Ciliospinal Center of Budge => above lung => Superior Cervical Ganglion
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Function of orbital septum?
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Protect from infection.
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Function of tarsal plate?
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Provide rigidity (encloses Mei. glands too)
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What type of glands are Meibomian glands?
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Sebacious. (oil)
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The lacrimal sac is __________ to the orbital septum.
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Anterior
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General symptoms seen in orbital cellulitis not seen in preseptal cellulitis pts.
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Fever and malaise
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What acts as the fulcrum of the levator?
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Whitenalls Ligament
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Which contributes more to holding the eye open? Levator or Muellers?
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Levator
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Postgang. sympathetic fibers enter the skull through the...
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carotid canal. (Surround internal carotid)
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Which structure causes the eyelid furrows?
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Levator aponeurosis.
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Where and what are glands of zeis?
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Sebacious glands at eyelash follicles. Lube eyelid so it doesn't become brittle.
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Where and what are glands of moll?
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Modified sweat glands near lid margin. Apocrine.
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What type of glands are Krause?
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Accessory lacrimal. Merocrine
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What is a chalazion?
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Painless, sterile inflammation of Meibomian gland. Often caused by obstructed duct.
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What is an external hordeolum?
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Staph. infection of Zeis of Moll.
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What is an internal hordeolum?
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Staph. infection of of Meibomian gland.
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What does frontalis muscle do?
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Raises eyebrows - surprise expression.
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What is function of corrugator muscle?
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Moves eyebrows medially - concentration.
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Function of procerus muscle?
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Moves medial portion of eyebrown inferiorly for menacing look.
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Pinguecula is from what layer? What can cause?
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Submucosa. Wind, dust, UV.
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What is dacroadenitis? Symptoms?
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Inflammation of lacrimal gland. Pt. has discomfort in upper, lateral eyelid and reduced tearing on that side.
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What layer of the tear film does ocular pemphigoid and stevens johnson syndrome disrupt?
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Mucin
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Low TBUT indicates deficiency of what layer of tears.
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Lipid. (Oil, from Mei. gland) evaporation quickly
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Low Schirmer strip time indicates deficiency of what layer?
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Aqueous
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What type of gland is a goblet cell?
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Mucous.
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What type of gland is meibomian gland?
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Lipid
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What straddles lacrimal sac?
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Limbs of medial palpebral ligament.
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What is dacrocystitis? Symptoms?
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Inflammation of lacrimal sac. Pain and epiphora.
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Where does nasolacrimal duct terminate?
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Inferior meatus of nasal cavity.
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3 components of acute inflammation:
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1) Vascular size change - Quick VC, followed by VD.
2) Structural changes in microvascularization to increase arrival of leukocytes and plasma proteins 3) Immigration of leukocytes (PMNs) |
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Possible outcomes of acute inflammation:
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Scar, Chronic Infl. progression, Abscess formation (pus), Resolution ("SCAR")
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3 Components of Chronic Inflammation:
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1) Infiltration of mononuclear cells (Macrophages, lymphocytes, plasma cells)
2)Tissue destruction 3) New vessel proliferation and fibrosis. |
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True/False: All Acute Inflammation reactions are identical.
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True
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True/False: All chronic inflammation reactions are identical.
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False.
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2 common causes of binocular, granulomatous uveitis:
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TB and Sarcoidosis
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