Week 4

Front 1

this is the portion of the external ear that functions to funnel sound

Back 1

auricle

Front 2

the boundary between the external ear and the middle ear is...

Back 2

tympanic membrane (eardrum)

Front 3

this is the structure that travels through the temporal bone and connects the middle ear with the pharynx; functions in pressure equilibrium

Back 3

Eustacian tube

Front 4

which portion(s) of the ear are filled with air?

which portion(s) are filled with fluid?

Back 4

outer and middle

inner

Front 5

what are the two muscles contained within the middle ear?

Back 5

tensor tympani

stapidus

Front 6

the tensor tympani is innervated by the ____________ nerve while the stapidus is innervated by the ____________ nerve.

Back 6

trigeminal

facial

Front 7

the tensor tympani attaches to which ossicle?

Back 7

malleus

Front 8

the stapidus attaches to what ossicle?

Back 8

stapes

Front 9

what is the purpose of the two muscles within the middle ear?

Back 9

reflexive - to dampen loud sounds

Front 10

two portions of the inner ear

Back 10

bony labyrinth

membranous labyrinth

Front 11

the inner ear resides deep within what cranial bone?

Back 11

temporal

Front 12

Cranial nerves 7 and 8 exit the skull via the ____________.

Back 12

internal acoustic canal

Front 13

this is the portion of the ear that contains the auditory and vestibular receptors

Back 13

membranous labyrinth of inner ear

Front 14

two portions of the bony labyrinth of the inner ear:

Back 14

cochlea

vestibule

Front 15

two portions of the vestibule

Back 15

utricle

saccule

Front 16

the membranous labyrinth is filled with ____________

Back 16

endolymph

Front 17

the bony labyrinth is filled with ____________

Back 17

perilymph

Front 18

the ____________ sits on top of the cochlear duct while the ____________ sits on bottom

Back 18

scala vestibuli

scala tympani

Front 19

both the scala vestibuli and the scala tympani are filled with ____________

Back 19

perilymph

Front 20

the scala vestibule and the scala tympani are continuous and contact each other at the ____________, the apex of the cochlea

Back 20

helicotrema

Front 21

the inner core of the cochlea is also known as the ____________. contains the spiral ganglia

Back 21

modialis

Front 22

the scala tympani contacts the ____________ to allow for the dispersal of increased pressure created by inner ear vibrations back into the middle ear

Back 22

round window

Front 23

the cochlear duct sits on top of the ____________

Back 23

basilar membrane

Front 24

this is the membrane that separates the cochlear duct from the scala vestibuli

Back 24

vestibular membrane

Front 25

these are the auditory receptor cells for hearing

Back 25

hair cells

Front 26

the hair cells are found within the ____________ which rests on top of the ____________

Back 26

Spiral organ of Corti

basilar membrane

Front 27

the "hairs" of the hair cells are found within the ____________

Back 27

tectorial membrane

Front 28

what is the organization of the hair cells?

Back 28

1 row inner

3-5 rows outer

Front 29

the cell body for the nerve that receives input from the hair cells of the hear is found where?

Back 29

spiral ganglion

Front 30

describe the tonotopic localization of the spiral organ of corti

Back 30

high frequencies heard at the base

low frequencies heard at the apex

Front 31

how many neurons are involved in the auditory pathway?

Back 31

4

Front 32

this is the first order neuron of the auditory pathway

Back 32

cochlear nerve (receives innervation from SOC)

Front 33

the first order neuron of the auditory pathway synapses at the ____________ found within the medulla

Back 33

dorsal and ventral cochlear nuclei

Front 34

second order neurons in the auditory pathway form the ____________ which decussate in the caudal pons and ascend via the contralateral ____________.

Back 34

acoustic stria

lateral lemniscus

Front 35

three portions of the acoustic stria

Back 35

dorsal

intermediate

ventral

Front 36

the ventral nucleus of the acoustic stria forms the ____________ as it decussates

Back 36

ventral/trapezoid body

Front 37

in the auditory pathway, secondary neurons from the dorsal and ventral auditory nuclei synapse onto the ____________ within the caudal midbrain

Back 37

inferior colliculus

Front 38

from the inferior colliculus, third order neurons in the auditory pathway project to the ____________ via the ____________.

Back 38

medial geniculate nucleus

brachium of inferior colliculus

Front 39

from the medial geniculate nucleus, fourth order neurons in the auditory pathway pass through the ____________ and project to the primary auditory cortex

Back 39

posterior limb of internal capsule (sublenticular)

Front 40

three accessory nuclei found within the auditory pathway; makes the pathway bilateral

Back 40

superior olivary nucleus

nuclei of trapezoid body

nuclei of lateral lemniscus

Front 41

what is the purpose of efferent signals back to the ear?

Back 41

to sharpen for selective attention to certain sounds

to dampen loud sounds (through Tensor Tympani and stapidius muscles)

Front 42

this is a symptom of Bell's palsy (facial nerve) caused by an inability of the stapidius to respond to loud sounds; sound is too loud in the affected ear

Back 42

hyperacoussus

Front 43

what are the circled areas?

Back 43

dorsal and ventral cochlear nucleus

Front 44

what lies just deep to the circled area?

Back 44

circled area = acoustic tubercle

just deep = dorsal cochlear nucleus

Front 45

name the circled area

Back 45

lateral lemniscus

Front 46

name the circled area

Back 46

superior olivary nucleus

Front 47

name the circled area

Back 47

brachium of the inferior colliculus

Front 48

name the circled area

Back 48

medial geniculate nucleus

Front 49

where is the primary auditory cortex found?

Back 49

transverse temporal gyrus of Heschel

Front 50

how is the primary auditory cortex organized?

Back 50

low tones lateral, high tones medial

Front 51

where must a lesion be in the auditory pathway to produce unilateral deafness?

Back 51

proximal to cochlear nuclei

(spiral organ, spiral ganglion, cochlear nerve, cochlear nuclei)

anything distal = no hearing loss

Front 52

type of deafness that results from interference with the passage of sound waves through the external or middle ear; transmission through cranial bones can still occur

Back 52

conduction deafness

eg. earwax, otitis media

Front 53

type of deafness that results from damage to receptor cells of the spiral organ or to the cochlear nerve; transmission of sound waves through air and cranial bones does not occur

Back 53

nerve (sensorineural deafness)

Front 54

this is the muscle that opens a slit in the pharynx allowing the Eustachian tube to equilibrate any pressure buildup in the middle ear

Back 54

tensor palati

Front 55

the body of hair cells sits in ____________ while the stereo cilia sit in ____________.

Back 55

perilymph

endolymph (within the tectorial membrane)

Front 56

these are special capillaries that produce endolymph

Back 56

stria vascularis

Front 57

this is the tallest stereo cilium of hair cells

Back 57

kinocilium

Front 58

if the shearing force produced by sound waves causes the stereo cilia to bend towards the kinocilium, the hair cell is...

Back 58

activated

Front 59

in the auditory system, when a hair cell is activated, it releases ____________ which binds receptors on the dendrites of CN8 and causes an action potential

Back 59

glutamate

Front 60

which portion of the cochlea is wider: the base or the apex (helicotrema)

Back 60

the apex (width = 0.5 mm)

width at base = 0.2 mm

Front 61

which hair cells constitute 95% of the afferent impulses in the auditory system?

Back 61

inner

Front 62

which hair cells receive 100% of the efferent impulses in the auditory system?

Back 62

outer

Front 63

two functions of the vestibular system

Back 63

keeps body on an even keel

keeps eyes on target when the head is in motion

Front 64

3 sources that play a role in maintaining balance via the vestibular system (need 2/3)

Back 64

vision

proprioception

vestibular

Front 65

all vestibular activity is ____________ in nature

Back 65

reflexive

Front 66

this is the phenomenon that presents when the vestibular system is abnormal

Back 66

vertigo

Front 67

where are the 4 nuclei of the ventricular system found?

Back 67

floor of the fourth ventricle in caudal pons

Front 68

ascending impulses from the vestibular nuclei are involved in ____________ while descending impulses are involved in ____________.

Back 68

vestibulo-ocular reflex

keeping body on even keel

Front 69

this disease causes degeneration of the dorsal columns of the spinal cord and can lead to a positive Romberg's sign

Back 69

pernicious anemia

Front 70

3 spots within the inner ear where the neuroepithelia for the ventricular system is found:

Back 70

utricle

saccule

ampulla of semicircular ducts

Front 71

the neuroepithelia from the utricle and saccule are chiefly involved with the ____________ system while the neuroepithelia of the semicircular ducts are associated with the ____________ system.

Back 71

vestibulospinal

vestibulo-ocular

Front 72

within the utricle and saccule, the spot where the hair cells are located is the ____________.

Back 72

macula

Front 73

within the ampulla, the spot where the hair cells are located is the ____________

Back 73

crista ampullaris

Front 74

the tectorial membrane is to the auditory system as the ____________ is to the vestibular system

Back 74

otolithic membrane

Front 75

these are little crystals that provide weight to the otolithic membrane of the vestibular system - cause inertia whenever head moves

Back 75

otoliths

Front 76

how are the utricle and saccule organized relative to each other in a standing upright position?

Back 76

at 90 degree angle

Front 77

in an upright position, which part of the vestibular system is oriented in the horizontal plane?

Back 77

macula of the Utricle

Front 78

in an upright positon, which part of the vestibular system is oriented in the vertical plane?

Back 78

macula of the saccule

Front 79

this is a condition where the otolith crystals become dislodged and can insert themselves into the crista ampularis causing excessive dizziness; usually happens at certain times of the day

Back 79

benign paroxysmal positional vertigo

Front 80

the cell bodies of first order neurons in the vestibular pathway lie in...

Back 80

vestibular (scarpa's) ganglion

Front 81

from the vestibular nuclei in the pontomedullary junction, fibers descend via the ____________ and ____________ to influence balance and posture

Back 81

medial and lateral vestibulospinal tracts

Front 82

from the vestibular nuclei in the pontomedullary junction, fibers ascend via the ____________ to influence Cranial nerves 3, 4, and 6

Back 82

medial longitudinal fasciculus

Front 83

in the crista ampullaris of the ampulla, this structure extends from one side of the duct to the other; changes in position cause deflections of this structure and create hair cell potentials

Back 83

cupula

Front 84

in the vestibular system, the utricle and saccule respond to ____________ acceleration while the ampulla of the semicircular ducts respond to ____________ acceleration

Back 84

linear

angular

Front 85

what is the circled structure?

Back 85

medial longitudinal fasciculus

Front 86

what is the circled structure?

what cranial nucleus is it located near?

Back 86

MLF near the abducens nucleus

Front 87

what is the circled structure?

what cranial nucleus is it located near?

Back 87

MLF near the trochlear nucleus

Front 88

what is the circled structure? what cranial nucleus is it located near?

Back 88

MLF near the oculomotor nucleus

Front 89

in the vestibule-occular reflex, if the head is turned to the right, what two CN nuclei are stimulated to keep the eyes on a target?

Back 89

left abducens (to lateral rectus)

right oculomotor (to medial rectus)

(left eye abducts, right eye adducts)

Front 90

with nystagmus, the slow phase is induced by the ____________ while the fast phase is induced by the ____________.

Back 90

slow phase = vestibulo-occular reflex

fast phase = cerebral cortex

Front 91

how is nystagmus named?

Back 91

based on the direction of the fast phase

Front 92

in normal individuals, what happens if you inject cool water into their ear?

Back 92

nystagmus to opposite side

COWS

Front 93

in normal individuals, what happens if you inject warm water into their ear?

Back 93

nystagmus to same side

COWS

Front 94

in comatose individuals, if their head is turned to one side or the other and the eyes turn in the opposite direction, this is referred to as the ____________ and is indicative of an intact vestibulo-ocular reflex

Back 94

doll's eye movement/oculocephalic reflex

Front 95

in comatose individuals with an intact brainstem, what happens if you inject cold water into their ear?

Back 95

eyes move slowly towards the stimulation (no fast resetting phase)

Front 96

where is the lesion?

Back 96

bilateral MLF lesion

Front 97

where is the lesion?

Back 97

low brainstem

Front 98

what ion enters the hair cell when stimulated?

Back 98

potassium

Front 99

endolymph has a high concentration of ____________ and a low concentration of ____________

Back 99

high potassium

low sodium

Front 100

perilymph has a high concentration of ____________ and a low concentration of ____________.

Back 100

sodium

potassium

Front 101

how is it hypothesized that the bending of stereo cilia causes the influx of potassium into hair cells?

Back 101

tip-lengths between cilia open a "gate"

Front 102

what is the destiny of potassium after it enters the hair cell?

Back 102

filtered to the stria vascularis (site of endolymph production) where it is pumped back into the endolymph (maintains ion gradient)

Front 103

this condition is caused by a malfunction in the pump that pumps potassium into the stria vascularis; results in endolymph that lacks potassium; deafness and vertigo

Back 103

endolymphatic hydrops

Front 104

which structure is more important when lying down: the utricle or the saccule?

Back 104

the saccule

Front 105

this is the maneuver used to treat BPPV; designed to get otoconia back into the right spot

Back 105

Epple maneuver

Front 106

why do the hair cells within the semicircular ducts (in the crista ampularis) exhibit rapid adaptation?

Back 106

because of the friction of the walls of the duct, the fluid gets to rotating the same direction as the head (once the inertia is overcome)

also why once you stop spinning, you feel as if you're still spinning in the opposite direction

Front 107

with vertigo, how can you tell where the damage is?

Back 107

side you stumble to is where the damage is located

Front 108

these CNS cells are the equivalent to peripheral monocytes and macrophages and can present Ag in the CNS

Back 108

microglia

Front 109

what types of cells infiltrate into the CNS due to CNS infection?

Back 109

neutrophils

mononuclear cells

Front 110

what are the 4 routes into the nervous system from the periphery in terms of infectious agents?

Back 110

blood

nerves

contiguous sites

trauma

Front 111

what type of CNS infection spreads via synaptic connection and follows neural routes

Back 111

virus

Front 112

this is an inflammation/infection of the meninges, ependyma, or subarachnoid space

Back 112

meningitis

Front 113

this is inflammation/infection of the brain parenchyma with clinical evidence of neurologic impairment

Back 113

encephalitis

Front 114

a patient presents with high fever, severe headache, stiff neck, nausea and vomiting; what is high on the differential

Back 114

meningitis

Front 115

____________ meningitis displays a diffuse growth pattern within the CSF while ____________ meningitis displays growth along the epithelial surface of the meninges

Back 115

bacterial

viral

Front 116

if you did a spinal tap suspecting meningitis, what would the following results indicate:

clear, colorless liquid; normal glucose; normal protein; normal cell infiltrate

Back 116

viral

Front 117

three types of viruses that commonly cause viral encephalitis

Back 117

rabies virus

poliovirus

measles

Front 118

4 types of herpesviruses that can cause encephalitis

Back 118

HSV1

HSV2

Varicella-zoster

CMV

Front 119

which is the only type of encephalitis-causing herpes virus that spreads hematogenously?

Back 119

CMV

Front 120

what is this condition associated with?

Back 120

herpesvirus (keratitis/corneal scarring)

Front 121

if a patient presented with fever, personality change, and this MRI, what is high on the list?

Back 121

herpesvirus encephalitis

Front 122

if this was seen on a peripheral blood smear, what is the diagnosis?

Back 122

CMV

(large intranuclear inclusions)

Front 123

infection with this is one of the most common causes of hearing loss in neonates

Back 123

CMV

Front 124

if you see a form of encephalitis that is present seasonally or with travel to a certain area what must be on the differential?

Back 124

arthropod-bourne encephalitis (ticks, etc.)

Front 125

this is the most important flavivirus encephalitis worldwide and is found widespread throughout Southeast Asia; 1/2 of these infections are neuroinvasive

Back 125

Japanese encephalitis

Front 126

this patient presents with a fever that began 2-3 days ago with chills and malaise as well as encephalitis; symptoms include headache, delirium, and a tremor; what is the diagnosis?

Back 126

Japanese Encephalitis

Front 127

this type of viral infection presents in two stages; the mild stage includes a fever, headache, nausea, and a characteristic rash on the back and stomach; the more severe stage includes high fever, stiff neck, convulsions, stupor, and eventually death; peak of onset is late summer

Back 127

West Nile Virus

Front 128

4 main types of inflammatory reactions to CNS infections:

Back 128

1. neutrophils
2. mononuclear cells
3. granulomatous inflammation
4. microglial nodules

Front 129

what type of inflammatory infiltrate is seen in CNS infections such as acute meningitis, cerebritis, and abcesses?

Back 129

neutrophils

Front 130

what type of inflammatory infiltrate is seen in CNS infections such as chronic meningitis and encephalitis?

Back 130

mononuclear cells

Front 131

what type of inflammatory infiltrate is seen in CNS infections such as TB, fungal, and parasitic infections?

Back 131

granulomatous

Front 132

what type of inflammatory infiltrate is seen in viral encephalitis?

Back 132

microglial nodules

Front 133

if this type of infiltrate was seen in a CNS infection, what would be the diagnosis?

Back 133

neutrophil

acute meningitis (bacterial), cerebritis, abcess

Front 134

if this type of infiltrate was seen in a CNS infection, what would be the diagnosis?

Back 134

mononuclear

chronic meningitis, encephalitis

Front 135

if this type of infiltrate was seen in a CNS infection, what would be the diagnosis?

Back 135

granulomatous

TB, fungi, parasite

Front 136

if this type of infiltrate was seen in a CNS infection, what would be the diagnosis?

Back 136

microglial nodules

viral encephalitis

Front 137

what type of CNS infection would produce this gross appearance? (cloudy meninges)

Back 137

acute bacterial meningitis

Front 138

what are 3 complications that can arise out of bacterial meningitis?

Back 138

cerebral edema

infarcts

hydrocephalus

Front 139

this is a complication that can arise specific to meningitis due to N. Meningitisl; meningococcal septicemia, hemorrhagic rash and necrosis

Back 139

Waterhouse-Friderichsen Syndrome

Front 140

this is described as an area with acute inflammation and edema which develops a necrotic center; characteristic of a brain abscess

Back 140

cerebritis

Front 141

after a few days, what forms around the necrotic center of a brain abscess in the brain?

Back 141

fibrotic capsule

Front 142

this type of focal infection usually occurs as a complication of meningitis in infants

Back 142

subdural empyema

Front 143

this type of focal CNS infection can occur secondary to bone/soft tissue infection and is rare in the brain but can spread rapidly in the spinal cord, forming abscesses that cause cord compression; seen commonly with S. aureus

Back 143

epidural empyema

Front 144

this is when you have a defect within the same location of the visual field in each eye

Back 144

homonymous defect

Front 145

this is when you have a defect within different locations of the visual field in each eye

Back 145

heteronymous defect

Front 146

this is when you have a defect in one half of the visual field

Back 146

hemianopsia

Front 147

this is when you have a defect in one quadrant of the visual field

Back 147

quadrantic anopsia

Front 148

this is a defect in the visual field

Back 148

anopsia

Front 149

this is the first order neuron in the visual pathway; receives sensory info from the rods and cones

Back 149

bipolar neurons (of the retina)

Front 150

this is the second order neuron of the visual pathway; receives input from the bipolar cells and axons form the optic nerve

Back 150

ganglion cell (of the retina)

Front 151

this is the third order neuron of the visual pathway; receives input from the optic tracts and relays that information to the primary visual cortex

Back 151

lateral geniculate nucleus

Front 152

the optic nerves converge at the ____________ and continue to the LGN as the ____________.

Back 152

optic chiasm

optic tracts

Front 153

this is found in the angle of the optic chasm; explains the visual damage caused by aneurysm

Back 153

internal carotid artery

Front 154

what is the fate of those fibers of the optic tract that don't synapse on the LGN?

Back 154

bypass, join the brachium of the superior colliculus to influence light reflexes

Front 155

what visual information is carried by the right optic tract?

Back 155

the medial visual field of the left eye

the lateral visual field of the right eye

Front 156

the LGN is composed of ____________ layers

Back 156

six

Front 157

within the LGN, the ____________ layers are the part of the visual pathway concerned with the location and movement of an object in the visual field; the "where" of the visual field

Back 157

magnocellular

Front 158

within the LGN, the ____________ are the part of the visual pathway concerned with the color and form of the object; the "what" of the visual field

Back 158

parvicellular

Front 159

from the LGN, tertiary neurons form the ____________ which enters the posterior limb of the internal capsule and forms a triangular area known as ____________

Back 159

optic radiation (geniculocalcarine tract)

Wernicke zone

Front 160

what is the circled area?

Back 160

lateral geniculate nucleus

Front 161

the fibers of the optic tract terminate in the walls of the ____________ sulcus

Back 161

calcarine

Front 162

the dorsal part of the optic radiation projects to the ____________ while the ventral part of the optic radiation (Loop of Meyer) projects to the ____________.

Back 162

cuneus gyrus

lingual gyrus

Front 163

what is the retinotopic organization of the primary visual cortex?

Back 163

Front 164

after receiving the visual stimulus in the primary visual cortex, further processing and conscious interpretation of visual information is carried out where?

Back 164

extrastriate cortical areas

Front 165

from the primary visual cortex, the magnocellul ar stream (the where) projects to the ____________ where it is combined with other outputs to form the spatial visual pathway

Back 165

posterior parietal lobe

Front 166

from the primary visual cortex, the parvicellular stream (the what) projects to the ____________ where it is combined with other senses to form the object recognition pathway (eg. looks and sounds like mom)

Back 166

inferior temporal lobe

Front 167

what would a lesion in the right optic nerve produce?

Back 167

right eye blindness

Front 168

what would a longitudinal transection of the optic chiasm produce (pituitary tumor)

Back 168

bitemporal hemianopsia (lateral visual fields are knocked out in both eyes)

Front 169

what would a lesion in the right angle of the optic chiasm produce? (aneurysm of ICA)

Back 169

right nasal hemianopsia

Front 170

what would a lesion of the right optic tract produce? (temporal lobe tumor that compresses tract against cerebral crus)

Back 170

contralateral homonymous hemianopsia (left visual field knocked out in each eye)

Front 171

what would a complete destruction of the right optic radiation produce?

Back 171

contralateral homonymous hemianopsia (left visual field knocked out in each eye)

Front 172

what would a lesion in the ventral optic radiation (loop of Meyer) produce? (temporal/occipital lobe tumor)

Back 172

contralateral, homonymous, superior quadrantic anopsia (pie in the sky)

Front 173

what would a lesion in the dorsal optic radiation produce (parietal/occipital lobe tumor)

Back 173

contralateral, homonymous, inferior quadrantic anopsia (pie on the ground)

Front 174

what would a lesion in the right visual cortex (both cuneus and lingual gyri) produce?

Back 174

left homonymous hemianopsia with macular sparing

Front 175

what are the 3 visual reflexes that govern pupil size/lens curvature?

Back 175

pupil constriction (light reflex)

pupil dilation

accommodation

Front 176

in the light reflex, impulses from the retina pass through the optic tract and bypass the lateral geniculate nucleus, traveling through the ____________ and synapsing on the ____________

Back 176

brachium of superior colliculus

pretectal nucleus

Front 177

in the light reflex, impulses from the pretectal nucleus pass to the ____________ which contains preganglionic parasympathetic neurons

Back 177

Edinger-Westfall nucleus

Front 178

in the light reflex, preganglionic parasympathetic neurons from the Edinger-Westfall nucleus pass through the ____________ to synapse onto postganglionic parasympathetic neurons in the ____________.

Back 178

occulomotor nerve

ciliary ganglion

Front 179

in the light reflex, postganglionic parasympathetic nerves from the ciliary ganglion travel through ____________ to the pupil constrictor muscles

Back 179

short ciliary nerves

Front 180

what is the circled area of the rostral midbrain?

Back 180

pretectal area

Front 181

would a lesion in the LGN or optic radiation produce a light reflex deficit?

Back 181

no - afferents are still intact (because they bypass the LGN)

Front 182

what would produce this effect? (when shined into left eye, both eyes constrict; when shine into right eye, neither eye constricts)

Back 182

lesion in right optic nerve

Front 183

what would produce this effect? (right eye doesn't constrict no matter what)

Back 183

damage to right oculomotor nerve

Front 184

where does the pupillary dilator reflex originate from?

Back 184

pupillodilator nucleus in posterior hypothalamus

Front 185

from the pupillodilator nucleus, neurons descend through the pupillodilator tract to synapse on the ____________ which contains preganglionic sympathetic neuron

Back 185

ciliospinal center of C8-T1 (in lateral horn)

Front 186

from the ciliospinal center, pregangionic sympathetic fibers from the pupillodilator reflex pass out of the spinal cord and ascend to synapse on the ____________ which contains postganglionic sympathetic neurons

Back 186

superior cervical ganglion

Front 187

from the superior cervical ganglion, postganglionic sympathetics fibers travel through ____________ nerves to reach the pupil dilator muscle

Back 187

nasociliary and long ciliary nerves

Front 188

what is the classic triad of Horner's syndrome?

Back 188

miosis (pupil constriction)

ptosis

anhydrosis

Front 189

what are the three components of the accommodation reflex?

Back 189

convergence of eyes

pupillary constriction

thickening of lens

Front 190

this is the process of maintaining a clear visual image as gaze shifts from distant to a near object

Back 190

accomodation

Front 191

in the accommodation reflex, ____________ afferent fibers from the striate cortex project to the ____________ of the midbrain

Back 191

corticotectal

accommodation center

Front 192

from the accommodation center, fibers pass to the ____________ and the ____________ to constrict the pupil and converge the eyes.

Back 192

Edinger-westfall nucleus

occulomotor nucleus (to medial rectus)

Front 193

this is a condition where the pupil doesn't constrict the pupil in reaction to increased light but does constrict the pupil in the accommodation reflex; can result from neurosyphilis, MS, or encephalitis

Back 193

Argyll Robertson pupil

Front 194

this is the ring around the cornea that connects the cornea and the sclera

Back 194

limbus

Front 195

this is the point where the optic nerve contacts the retina; can be visualized in the back of the eye

Back 195

optic disk/papilla

Front 196

this condition occurs when the lens calcifies and becomes opaque, can no longer refract light

Back 196

cataracts

Front 197

this the structure that produces aqueous humor; also contains the muscles that determine the tension of the suspensory ligaments of the lens (important in accommodation)

Back 197

ciliary body

Front 198

this is a condition that results from an imbalance in the ratio of production:drainage of aqueous humor that bathes the eye causing a pressure buildup; on e of most common causes of blindness in the world

Back 198

glaucoma

Front 199

lens accommodation and miosis is controlled by ____________ input (sympathetic or parasympathetic?)

Back 199

parasympathetic (from the E-W nucleus)

Front 200

pupil dilation (mydriasis) is controlled by ____________ input. (sympathetic or parasympathetic)

Back 200

sympathetic (from the superior cervical ganglion)

Front 201

this is the area within the retina that contains the highest density of receptors to ganglion cells (1:2); contains only cones

Back 201

fovea

Front 202

this is the photopigment with rods that does the signal transduction; changes shape when it absorbs energy resulting in signal cascade

Back 202

rhodopsin

Front 203

two types of retinal processing that take place after the excitation of photoreceptors

Back 203

spectral (determines color)

spatial (location of stimulus)

Front 204

these supporting cells within the retina gather information between neighboring photoreceptors and functions in center surround antagonism

Back 204

horizontal cell

Front 205

this a condition where the eye focuses information within the eye; as a result, near objects appear clearly but far objects don't; nearsightedness

Back 205

myopia

Front 206

this is a condition where the eye focuses light behind the retina; as a result, near objects appear blurry but far objects don't; farsightedness

Back 206

hyperopia

Front 207

there are two general types of eye movements; ____________ movements is when eyes move together in the same direction, whereas ____________ is where eyes move inward or outward

Back 207

conjugate

vergence

Front 208

what are the 4 different types of conjugate movements

Back 208

saccades

smooth pursuit

optokinetic

vestibulo-ocular

Front 209

this conjugate eye movement is voluntary and involves rapid movement of vision to search for a target

Back 209

saccades

Front 210

this conjugate eye movement is reflexive and functions to keep an image of a moving target fixed on the retina

Back 210

smooth pursuit

Front 211

this conjugate eye movement is reflexive and functions during continuous movement of the target (when you're stationary but objects are moving by quickly)

Back 211

optokinetic

Front 212

this conjugate eye movement is reflexive and keeps targets fixed on the retina during head movement

Back 212

vestibulo-ocular

Front 213

these eye muscles move the eye horizontally and vertically

Back 213

rectus muscles

Front 214

these eye muscles provide torsional eye movements

Back 214

oblique muscles

Front 215

how do you test the superior rectus muscle?

Back 215

abduct and elevate

Front 216

how do you test the inferior rectus muscle

Back 216

abduct and depress

Front 217

how do you test the superior oblique muscle?

Back 217

adduct and depress

Front 218

how do you test the inferior oblique?

Back 218

adduct and elevate

Front 219

if the limitation of eye movement isn't restricted to one muscle but rather groups of muscles, what should be on your differential?

Back 219

myasthenia gravis

Front 220

the horizontal gaze center is located in the ____________ while the vertical and vergence gaze centers are located in the ____________

Back 220

pons

midbrain

Front 221

this is the horizontal gaze center that is found in the pons adjacent to the abducens nucleus

Back 221

paramedian pontine reticular formation (PPRF)

Front 222

to gaze to the left, which PPRF is activated?

what nuclei does it project to?

what muscles does it activate?

Back 222

left PPRF

projects to left abducens nucleus, right oculomotor nucleus

activates left lateral rectus, right medial rectus

Front 223

what would be the outcome of a unilateral lesion in the right PPRF?

Back 223

no gaze to the right in either eye

Front 224

in the horizontal gaze pathway, fibers from the abducens nucleus project to the contralateral oculomotor nucleus via the ____________.

Back 224

medial longitudinal fasciculus

Front 225

what is this condition? where is the lesion?

Back 225

right internuclear opthalmoplegia

right eye can't abduct during horizontal gaze to the left, but still functions during convergence

Front 226

what is this condition? commonly seen in what disease?

Back 226

bilateral internuclear opthalmoplegia

seen in MS

Front 227

what is this condition? on what side?

Back 227

one and a half syndrome

lesion on the left side

Front 228

where is the lesion located in one and a half syndrome?

Back 228

unilateral lesion of MLF that also includes adjacent abducens nucleus/PPRF

Front 229

this is the nucleus of the vertical gaze center

Back 229

rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF)

Front 230

2 clinical conditions that can cause vertical gaze paralysis

Back 230

pineal tumors that compress dorsal midbrain (Parinaud Syndrome)

hydrocephalus

Front 231

these are the two nuclei that constitute the vergence gaze center

Back 231

nucleus raphe interpositus

nucleus reticularis tegmenti pontus

Front 232

the mergence gaze center is controlled by the ____________ eye field

Back 232

occipital

Front 233

4 eye fields that constitute the cortical gaze centers

Back 233

occipital

parietal

temporal

frontal

Front 234

this eye field, when activated, results in saccades to the contralateral side; projects to the contralateral PPRF

Back 234

frontal

Front 235

what would be the result of an irritative lesion (epilepsy) to the right frontal eye field?

Back 235

deviation of right towards left

Front 236

this eye field constitutes the visual attention center

Back 236

parietal eye field

Front 237

a lesion in what eye field results in a patient neglecting objects in the contralateral side, difficulty making eye movements towards affected side

Back 237

parietal eye field

Front 238

what would be the result of an acute lesion (stroke) to the right frontal eye field?

Back 238

deviation of eyes towards affected side

Front 239

this eye field is involved in smooth pursuit of the eyes towards the ipsilateral side; also involved in opt-kinetic movements

Back 239

temporal eye field

Front 240

what is thought to trigger "attacks" seen in MS

Back 240

activation of auto reactive CD4 T cells in PNS

(possibly due to EBV or HHV6)

Front 241

these can be seen radiographically and pathologically in patients with MS; represents focal areas of inflammation and injury

Back 241

MS plaque

Front 242

T/F: MS only affects white matter

Back 242

False - becoming more clear that grey matter is affected