ABNORMAL PUPIL REACTIONS Flashcards
Categories of abnormal pupil reactions
Marcus Gunn pupil
Parinaud’s syndrome
Agryll Robertson pupil
(T or F) Any lesion located from the retina to the pretectal nucleus is considered a relative efferent pupillary defect
F- relative afferent pupillary defect
(T or F) Any lesion located from pre-ganglionic to postganglionic fiber is considered a relative afferent pupillary defect
F- relative efferent pupillary defect
Also known as relative afferent pupillary defect
Marcus Gunn Pupil
Other name for Marcus Gunn Pupil
Pupillary escape
This indicates damage at or anterior to the LGN (afferent pathway) specifically the retinal ganglion cells to optic chiasm of one eye
MGP
Marcus Gunn Pupil is caused by a damage that is bilateral or asymmetric as seen in several retinal dse.
F- unilateral
Diseases that causes Marcus Gunn Pupil
CRAO
CRVO
BRVO
Optic Atrophy
Marked retinal detachment
Asymmetric POAG
(T or F) Loss of vision due to corneal, lenticular, vitreous, refractive or emotional causes will produce the Marcus Gunn response
F- will not produce
(T or F) In swinging flashlight test, an eye affected with MGP, the consensual response is greater than the direct response.
TRUE
Also known as Whore’s Pupil
Argyll Robertson Pupil
A parasympathetic condition that is central and bilateral in nature
Argyll Robertson Pupil
Characteristics of Argyll Robertson Pupil
- Dilates poorly in the darkness
- Responds poorly or does not respond to light
- Normal near response
(T or F) Argyll Robertson is caused by any interruption in the pattern of CN3 to CN4
F- CN2 to CN3
Common causes for Argyll Robertson pupil
Neurosyphilis
Long term diabetes
Alcoholism
Neurosyphilis is caused by
Treponema pallidum
Is a bacterial infection by the brain or spinal cord
Neurosyphilis
It occurs in people who have untreated syphilis for many years
Neurosyphilis
4 types of neurosyphilis
Primary
Secondary
Latent
Tertiary
A sexually transmitted infection that spreads through direct contact with syphilis sores
Neurosyphilis
Is a chronic disorder of carbohydrate metabolism due to relative or absolute insulin deficiency
Long term diabetes
Is a disease of the pancreas
Long term diabetes milletus
In Parinaud’s syndrome the affected part on pupillary pathway is the ____
Pretectal nucleus
In Argyll Robertson Pupil, the affected part on the pupillary pathway is the _____
Edinger Westphal
A central defect
Parinaud’s syndrome
(T or F) In Parinaud’s syndrome, there is a lesion affecting the anterior commissure and pretectal nuclei
F- Posterior commissure
(T or F) In Parinaud’s syndrome there is an interruption to the more dorsal efferent light pathway
F- afferent
Symptoms of Parinaud’s syndrome
Large pupils
Constrict briskly to an accommodative target
Constrict poorly to light
Other name for Parinaud’s Syndrome
Dorsal midbrain
Pretectal
Sylvian aqueduct
Koerbersalus-Elshnig Syndrome
Associated signs and symptoms for Parinaud’s syndrome
Vertical gaze deficit
Collier’s sign
Convergence-retraction nystagmus
triad of tabes dorsalis
gait unsteadiness
lightning pain
urinary incontenence
2 types of anisocoria
Physiological
Pathological
Due to normal difference in balance of parasympathetic and sympathetic drive to the 2 pupils
Physiological anisocoria
Due to denervation of the parasympathetic and sympathetic block
Pathological anisocoria
Type of metabolism in sympathetic NS
Catabolic
Type of metabolism for parasympathetic NS
Anabolic
Nickname for sympathetic NS
Fight or flight
