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clinical skills > Normal fundus 2 > Flashcards

Normal fundus 2 Flashcards

1
Q

When do nerve fibres get myelinated?

A

Level of lamina cribrosa

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2
Q

Where do nerve fibres sometimes retain their myelin?

A

On the disc or the retina

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3
Q

What are myelinated nerve fibres?

A

Non progressive

non pathogenic condition

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4
Q

What are the two layers of capillaries of the fundus?

A

A superficial network in nerve fibre layer

A deep network at junction of INL and the OPL

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5
Q

What do you find in the central macula?

A

No capillaries

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6
Q

What is the outer layer of the retina supplied with?

A

By underlying choroidal circulation

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7
Q

What do the Blood vessels walls look like

A

Transparent

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8
Q

How is the light reflex formed by>?

A

Reflection at convex cylinder blood column
Reflection from the convex vessel walls
Both surfaces act as convex mirrors

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9
Q

What is the purpose of retinal vessels?

A

Supply oxygen and other nutrients from the blood to first six layers of the retina

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10
Q

What can you detect by assessing the blood vessels of retina?

A

Systemic diseases such as hypertension, diabetes, arteriosclerosis

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11
Q

What is the general rule for A/V and V/A crossing?

A

Arterioles dont cross arterioles

Venules dont cross venules

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12
Q

Where does the artery remain?

A

Arteriole remains at normal level of the nerve fibre layer and the venule dips to avoid the arteriole

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13
Q

What happens to A/V crossing in hypertension?

A

A/V crossing changes as venule is compresses by sclerosed arteriole may cause deflection of venule

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14
Q

What is the name for changes in course of the vessels?

A

Tortuosity

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15
Q

What are tortuosity of arterioles?

A

May be congenital - should be uniform across the fundus

isolated regions of arteriole tortuosity suggests sclerosis

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16
Q

What can pathology show?

A

Narrowing of arteries

increase in width of vein

17
Q

What do arteries do ?

A

Arteries get narrower

18
Q

What do veins do?

A

Veins get wider

19
Q

What is the normal A/V ratio?

A

2/3

20
Q

When do you find generalised narrowing of the arteries?

A

Healthy elderly px

21
Q

How is severe narrowing of arteries caused?

A

Systemic hypertension

22
Q

What does focal narrowing indicate?

A

Hypertension

23
Q

what other signs can you see ?

A

Leakage of blood vessels

24
Q

What does leakage of blood vessels show?

A

Haemorrhages (blood)
hard Exudates (lipids)
oedema (fluid)

25
Q

How are vessels obscured?

A

Myelinated Nerve fibres

Pre retinal haemorrhages

26
Q

What is type of Hyperplasia of fundus are there?

A

Choroidal neavus
Malignant Choroidal melanoma
Congenital hypertrophy of RPE (CHRPE)
Coloboma of retino choroid

27
Q

What is a Choroidal neavus?

A
  • round or oval shaped
  • uniform slate grey or brown colour
  • less than 3 disc diameter
  • flat or min elevated
  • underlying drusen
  • benign
28
Q

How are Choridal neavus caused?

A

Accumulation of melanocytes in choroid

29
Q

What is a malignant choroidal melanoma?

A
  • -Often mottled
  • -Range in colour from white to greenish grey
  • -larger than neavi
  • -may present with serious retinal detachment
  • -significantly elevated
  • -overlying orange pigmentation (lipofuscin)
  • -asymptomatic but may present with metamorphopsia, photopsia, visual field defect, hypermetropic shift
30
Q

What is a congenital Hypertophy of RPE (CHRPE)?

A
  • —-Congenital flat black lesion with sharp dramatic outline
  • —-Ring of hypo pigmentation is frequently seen
  • —-benign
31
Q

What is a coloboma of retino (choroid)?

A 
>Large white oval lesion in fundus
>usually inferior nasal region 
>effect iris and lens as well as fundus 
>unilateral and bilateral 
>visual field defect 
>amblyopic px 
>non progressive
32
Q

How is coloboma caused?

A

Failure of embryonic fissure to close

33
Q

what does the macula look like?

A

Centre of macula is 1.5 to 2 DD temporal to disc and usually just below the centre of the disc

Shape usually oval with long axis horizontal

bit bigger than optic disc

centred on the fovea

34
Q

What is the foveal reflex ?

A

Bright spot of light at the centre of the macula

Image of ophthalmoscope beam formed by the concave surface of the fovea acting as a concave mirror

35
Q

What is the major cause of blindness and partial sight?

A

Diabetic retinopathy
ARMD
Taxoplasmosis

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