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93 Cards in this Set

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