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PMCOL 343 > 5-autonomic-eyeball! > Flashcards

5-autonomic-eyeball! Flashcards

1
Q

what is accomodation

A

focusing of the eye

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2
Q

what does morphine do to pupil

A

miosis

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3
Q

what does organophostate poisoning do to pupil

A

miosis

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4
Q

what does cocaine do to pupil

A

mydriasis

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5
Q

what does amphetamine do to pupil

A

mydriases

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6
Q

what is mydriasis

A

dilation of pupil

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7
Q

what is miosis

A

constriction of pupil

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8
Q

what causes mydriases

A

increase in sympathetic outflow

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9
Q

what is the role of the pupillary dilator muscle

A

cause mydriasis with alpha adrenoceptor stimulation

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10
Q

what is another name for the pupillary dilator muscle

A

iris radial muscle

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11
Q

what is another name for the iris radial muscle

A

pupillary dilator muscle

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12
Q

what does alpha stimulation do to the pupillary dilator muscle

A

mydriases

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13
Q

what does alpha stimulation do to the iris radial muscle

A

mydriases

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14
Q

what is another name for the circular pupillary constrictor muscle

A

iris sphincter

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15
Q

what is another name for the iris sphincter

A

circular pupillary constrictor muscle

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16
Q

what kind of receptor stimulation happens with the iris sphincter

A

muscarinic

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17
Q

what kind of receptor stimulation happens with the circular pupillary constrictor muscle

A

muscarinic

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18
Q

what kind of receptor stimulation happens with the circular pupillary dilator muscle

A

alpha

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19
Q

what kind of receptor stimulation happens with the iris radial muscle

A

alpha

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20
Q

what kind of activation do ciliary muscles require

A

muscarinic

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21
Q

what does muscarinic activation do to ciliary muscles

A

contraction

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22
Q

what kind of vision does ciliary muscles help with

A

myopia (near vision)

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23
Q

what does the trabecular meshwork do

A

moves do that fluid can leave through the canal of schlemm

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24
Q

what does the canal of schlemm do

A

let fluid leave the eye

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25
Q

what causes the trabecular meshwork to move

A

ciliary muscle activation

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26
Q

how do ciliary muscles help with removing aqueous humor

A

puts tension on trabecular meshwork which opens pores to let outflow of aqueous humor in canal of schlemm

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27
Q

what does the ciliary epithelium do

A

produces the aqueous humor

28
Q

what kind of receptors stimulate the ciliary epithelium

A

beta

29
Q

how do beta blockers reduce IOP

A

reduces aqueous humor release from the ciliary epithelium (ciliary epithelium has beta adrenergic receptors)

30
Q

how do muscarinic agonists reduce IOP

A

because it activates ciliary muscles which activates trabecular meshwork to open pores and let aqueous humor out into the canal of schlemm

31
Q

what is galucoma and what can it cause

A

elevated IOP and it can cause optic nerve damage and blindness

32
Q

what are the two types of glaucoma

A

open angle and angle closure glaucoma

33
Q

what is open angle glaucoma

A

high pressure between cornea and iris

34
Q

how common is open angle glaucoma and how easily is it treated

A

common and easily treated

35
Q

what is angle closure glaucoma

A

high pressure between ciliary body and iris

36
Q

how common is angle closure glaucoma and how easily is it treated

A

not as common and doesnt respond as well to drugs :(

37
Q

what is the course of treatment for open angle glaucoma (4)

A
  • beta blocker (stop ciliary body secretion)
  • cholinergic agonist/cholinesterase inhibitor (preserve sympathetic tone)
  • add adrenaline or apraclonidine (with b blocker still)(reduces blood flow to ciliary body)
  • carbonic anhydrase inhibitor (affects ciliary body secretion)
38
Q

why is it safe to take glaucoma meds if you have systemic circulation issues

A

the eye drops have very poor access to systemic circulation

39
Q

what is Timolol (drug class)

A

betablocker

40
Q

what is the difference with timolol and propranolol

A

timolol has no anesthetic effects (dont want that in the eye)

41
Q

what does Timolol do

A

reduces secretion of aqueous humor from ciliary body and lower IOP

42
Q

what is pilocarpine (drug class)

A

muscarinic agonist

43
Q

what does pilocarpine do

A

cause ciliary muscle contraction

increase outflow of aqueous humor into circulation, reduce IOP

44
Q

what are the untoward effects of pilocarpine

A

miosis (by iris sphincter)

myopia (by ciliary muscle)

45
Q

what is physostigmine

A

anticholinesterase

46
Q

what does physostigmine do to eye

A

ciliary muscle contraction, increase outflow of aqueous humor, reduce IOP

47
Q

what does apraclonidine do

A

vasoconstrict, reduce blood flow to ciliary body, less aqueous humor secreted, IOP decreased

48
Q

what do cannabinoids do to eye

A

lower IOP likely by relaxing the trabecular network

49
Q

what is anandamide

A

endogenous ligand of the CB1 and CB2 receptors

50
Q

what do CB1 receptors do (g protein)

A

Gi which reduces NT release by activating Ca2+ and GIRK channels

51
Q

what direction does GIRK channels go

A

releases K+ from nerve terminal!

52
Q

what does atropine do to the eye

A

dilate pupil for ocular examination

53
Q

what kind of drug is atropine

A

muscarinic antagonist

54
Q

why does atropine cause mydriasis

A

muscarinic antagonist, meaning it removes the parasympathetic tone to cause dilation (mydriasis)

55
Q

what causes Horner’s syndrome

A

head trauma or stroke in brainstem

even if the damage is unilateral

56
Q

can damage to sympathetic nerves cause horners syndrome

A

yes thats what it is about

57
Q

can damage to parasympathetic nerves cause horners syndrome

A

no

58
Q

what characterizes horners syndrome

A

interruption of oculosympathetic pathway somewhere between hypothalamus and eye

59
Q

what are the 3 neurons that could be damaged to cause horners syndrome

A

1-hypothalamus to spinal cord
2-sympathetic preganglionic neuron
3-sympathetic ganglion neuron

60
Q

what would you expect cocaine to do to the pupil

A

cause dilation

61
Q

if cocaine doesn’t cause pupil dilation, where would the lesion be

A

neurons 1 2 or 3

62
Q

how can you use amphetamines to test for horners syndrome

A

test neuron 3
-if it is intact, the pupil will dilate (it releases NA REGARDLESS of the condition of neuron 1 and 2 or sympathetic outflow to neuron 3)

63
Q

in summary, what do alpha adreoceptor agonists do to eye

A 
lowers IOP (decrease flow to ciliary body)
mydriases (increase pupil size from pupillary dilator/iris radial muscle)
64
Q

in summary, what do muscarinic agonists do to eye

A 
miosis (pupillary constrictor/iris sphincter)
myopia (ciliary muscle contraction, accomodation for near vision)
lower IOP (contract ciliary muscle - tension on trabecular meshwork - aqueous humor squeezed out into circulation)
65
Q

in summary, what do beta adreoceptor antagonists do to eye

A

lower IOP (blocks humor production by ciliary body)

66
Q

why can atropine be bad for glaucoma

A

antimuscarinic (stops parasympathetic tone)

it can relax the ciliary muscle

PMCOL 343 (31 decks)

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