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2nd Year - Ophthalmology > Anatomy 6 - Raised ICP > Flashcards

Anatomy 6 - Raised ICP Flashcards

1
Q

What is raised intracranial pressure?

A

Increase in pressure within the cranial cavity (chronic or acute)e

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2
Q

What causes raised ICP?

A

An increased pressure in fluid surrounding the brain or an increase in pressure within the brain itself e.g. brain tumour, head injury, hydrocephalus, meningitis, stroke

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3
Q

What is hydrocephalus?

A

Increased fluid around the brain

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4
Q

Why is ICP such a serious problem?

A

It can cause damage to the brain and the spinal cord

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5
Q

How does the intracranial volume normally fluctuate?

A

It is normally constant

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6
Q

What is the main idea of the Monro-Kellie Hypothesis?

A

3 things exist within the fixed minions of the skull: blood, CSF and the brain - an increase in any one component must lead to a decrease in one (or both) of the other components, otherwise intracranial pressure will increase

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7
Q

In what way can raised ICP damage the brain and spinal cord?

A

Causes damage to tissues, shifts in tissues, herniation and constriction of blood vessels

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8
Q

What kind of visual/ eye problems can increased ICP cause?

A 
Transient blurred vision
Double vision
Loss of vision
Transient flickering
Decreased colour perception
Pupillary changes
Papilloedema (swelling of optic disc due to increased ICP)
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9
Q

What is the name of the membranes that line the skull and vertebral canal and enclose the brain and spinal cord?

A

meninges

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10
Q

What are the 3 layers of meninges?

A

Dura
Arachnoid
Pia

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11
Q

Name of the space between the arachnoid and pia?

A

Sub-arachnoid space

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12
Q

What is the toughest layer of the meninges?

A

Dura mater

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13
Q

What provides the sensory supply to dura mater?

A

CN V

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14
Q

What does the dura mater enclose?

A

The dural venous sinuses

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15
Q

What is the name for the projections of arachnoid membrane into the dural sinuses?
What is the purpose of this?

A

Arachnoid granulations

To allow CSF entrance from the subarachnoid space into the venous system

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16
Q

What is contained within the subarachnoid space?

A

Circulating CSF and blood vessels

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17
Q

Describe the appearance of the pia?

A

Adherent to the brain with vessels and nerves entering or leaving

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18
Q

What is the purpose of the subarachnoid space?

A

Completely surrounds both brain and spinal cord and contains circulating CSF = cushions and protects

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19
Q

Where is CSF produced?

A

In the choroid plexus of the ventricles

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20
Q

Where is CSF reabsorbed?

A

Into the dural venous sinuses via arachnoid granulations

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21
Q

At what levels can CSF be drawn during a lumbar puncture?

A

L3/4 or L4/5 IV disc level

22
Q

At what level does the subarachnoid space end/ close?

A

S2

23
Q

Name of the sinus within the cranium that can be seen surrounding the brain when it is cut longitudinally in half?

A

Superior sagittal sinus

24
Q

What ventricle is located within the right cerebral hemisphere?

A

Right lateral ventricle

25
Q

What ventricle is located in the midline within the diencephalon?

A

The 3rd ventricle

26
Q

What part of the spinal cord is continuous with the 4th ventricle?

A

The central canal

27
Q

Where is the 4th ventricle located?

A

Between the cerebellum and pons

28
Q

What connects the third and 4th ventricles in the midline?

A

The cerebral aqueduct

29
Q

Where is the choroid plexus located?

A

Within the lateral and third ventricle

30
Q

How does raised ICP affect the optic nerve?

A

Raised ICP will be transmitted along the subarachnoid space in the optic nerve sheath compressing the optic nerve and can lead to bulging or swollen optic discs

31
Q

How does raised ICP affect the other structures of the retina (apart from the optic nerve)?

A

Will also compress the central artery and vein

32
Q

What type of damage is the oculomotor nerve susceptible to?

A

Compression

Tentorial herniation

33
Q

What effect can damage to the oculomotor nerve have on the eye? (3)

A

Paralysis of somatic motor innervation
Paralysis of parasympathetic innervation of the sphincter of the pupil
Ptosis

34
Q

What is the name of the triangular opening in the tentorium cerebelli through which the brainstem extends?

A

Tentorial notch

35
Q

Name of the 4 folds of dural mater that divides up the cranial cavity?

A

Falx cerebri
Tentorium cerebelli
Falx cerebelli
Diaphragm sellae

36
Q

What nerve can be damaged if raised ICP causes medial temporal love to herniate through tentorial notch?

A

Oculomotor nerve

37
Q

What type of damage is the trochlear nerve susceptible to?

A

Stretching, compression

38
Q

What symptom can damage to the trochlear nerve cause?

Why?

A

Paralysis of superior oblique muscle = inferior oblique is unopposed -> eye cannot move inferomedially = diplopia when looking down

39
Q

What type of damage is the abducent nerve susceptible to?

A

Damage by stretching

40
Q

What eye movements cannot occur if the abducent nerve is damage?

A

Eye cannot move laterally in horizontal plane (due to paralysis of lateral rectus muscle)

41
Q

What is the name of the sign in infants/ children where the eyes appear driven downward, the sclera may be seen between the upper eyelid and iris and part of the pupil may be covered by the lower eyelid?
What is this a sign of?

A

Sunset sign

Hydrocephalus

42
Q

What dural fold is located right down the centre between the 2 hemispheres?

A

Falx cerebri

43
Q

What dural fold separates the cerebellum from the rest of the brain?

A

Tentorium cerebelli

44
Q

What dural fold separates the 2 hemispheres of the cerebellum?

A

Falx cerebelli

45
Q

How many grades of papilloedema are there?

A

5

46
Q

What does grade I papilloedema look like?

A

C-shaped halo around the disc

47
Q

What does grade II papilloedema look like?

A

Circumferential halo with blurred edges

48
Q

What does grade III papilloedema look like?

A

Vessels on edge of disc disappear

49
Q

What does grade IV papilloedema look like?

A

loss of major vessels on disc

50
Q

What does grade V papilloedema look like?

A

Extremely blurry edges of disc with total or partial obscuring of vessels on disc

2nd Year - Ophthalmology (7 decks)

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