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6- Neuro Diag > Ch13 Brainstem II > Flashcards

Ch13 Brainstem II Flashcards

1
Q

Eye Movements and Pupillary Control pathways

A
  1. nuclear

2. supranuclear

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2
Q

nuclear pathway includes

A

nuclei of CN III, IV, VI

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3
Q

supranuclear pathway includes

A

comes from frontal lobe as one chooses to visually track object

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4
Q

Action of Superior Rectus

A

upward gaze

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5
Q

Action of Inferior Rectus

A

downward gaze

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6
Q

Action of Medial Rectus

A

medial gaze

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7
Q

Action of the Lateral Rectus

A

lateral gaze

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8
Q

Action of Inferior Oblique

A

up and in, primary action is rotation

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9
Q

Action of Superior Oblique

A

down and in, primary action is rotation

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10
Q

a condition where one eye is not tracking the same as the other is called
(Patient sees 2 images)

A

Dysconjugate gaze (Diplopia)

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11
Q

Diplopia is caused by

A

Mechanical problems- orbital fracture
Disorders of the extraocular muscles- orbital myositis
Disorders of neuromuscular junction- myasthenia gravis (attacks muscle receptors)
Disorders of- III, IV, and VI.

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12
Q

Question to ask Pt about deplopia

A
  • Does it go away when covering one eye?
    (Suggestive of eye movement abnormality)
  • ask about near vs far vision, and when looking up, down, left, or right
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13
Q

Strabismus includes

A

Esotropia
Exotropia
Hypertropia
Hypotropia

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14
Q

Esotropia is

A

eye deviate medially (internally)

Lateral rectus weakness

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15
Q

Exotropia is

A

eye goes outside

medial rectus weakness

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16
Q

Hypertropia is

A

eye up

superior oblique weakness

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17
Q

Hypotropia is

A

eye down

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18
Q

Strabismus is caused by

A
  • Muscle weakness
  • Serious in children
  • Suppression amblyopia
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19
Q

In Suppression amblyopia the input from ____ is ignored

A

the bad eye

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20
Q

Suppression amblyopia can be treated by

A

patchin the good eye

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21
Q

Diplopia Tests:

Cover test is when Pt is asked to

A

cover one eye (bad) look straight ahead

Then the covered eye is quickly uncovered

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22
Q

Red glass is held over

A

the right eye

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23
Q

When an eye muscle fails the images splits into

A

red and white light

should fuse and see pink

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24
Q

which muscles are not affected in Oculomotor Palsy

A

SO

LR

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25
Q

Oculomotor Palsy eye position

A

down and out

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26
Q

Oculomotor Palsy signs include

A

ptosis

mydriassis

27
Q

Oculomotor Diplopia is least looking

A

down and out

28
Q

Oculomotor Diplopia is greatest looking

29
Q

Oculomotor Palsy is caused by

A
  • Diabetes (complete palsy sparing pupil)
  • Head trauma
  • Compression from aneurysm (painful and partial palsy sparing pupil)
  • Midbrain ischemia
  • Ophthalmoplegic migraine (reversible)
30
Q

Trochlear IV Palsy signs

A

vertical diplopia
hypertropia
head tilt toward unaffected side

31
Q

The most common traumatically injured cranial nerve is:

A

Trochlear IV Palsy

32
Q

Trochlear Diplopia is least looking

A

up and out

33
Q

Trochlear Diplopia is worst looking

A

down and in

34
Q

Abducens VI Palsy is ____ diplopia

A

horizontal

35
Q

Abducens VI Palsy Eye position:

36
Q

in Abducens VI Palsy, Eye will not

37
Q

in Abducens VI Palsy, diplopia is worsen when trying to look toward

A

affected side

38
Q

Abducens VI Diplopia is least looking

A

away from the leasion

39
Q

Abducens VI Palsy is caused by

A

increase intracranial pressure (early sign)

40
Q

Internuclear Opthalmoplegia is a sign of

41
Q

Internuclear Opthalmoplegia

when looking right, the right eye moves fine, while the left eye _____

A

stops

no medial rectus action III

42
Q

Internuclear Opthalmoplegia accommodation

A

Both eyes converge

43
Q

Anisocoria

Oculomotor nerve lesion can cause ____ pupil

44
Q

Anisocoria is ore obvious in

A

Lit environment

45
Q

Horner syndrome signs:

A

Ptosis

smaller pupil meiosis

46
Q

Horner syndrome is more obvious in

A

dim lightning

47
Q

Horner syndrome causes _____ chain problem

A

sympathetic

48
Q

Marcus Gunn Pupil direct response is

A

diminished

49
Q

Marcus Gunn Pupil indirect response is

50
Q

Anisocoria Tested via

A

swinging light

51
Q

Anisocoria is caused by

A

MS

bullbar and retrobulbar

52
Q

Light near dissociation aka

A

Argyll Robertson Pupil

53
Q

Light near dissociation

Eyes will react to accommodation on

A

near vision

54
Q

Light near dissociation; Eyes will not react to

55
Q

Light near dissociation is caused by

A

Argyll Robertson pupil 3* syphilis

56
Q

Cavernous Sinus Syndrome involves which cranial nerves?

A

III, IV, VI, V1

57
Q

Cavernous Sinus Syndrome caused by

58
Q

Cavernous Sinus Syndrome signs and symptoms

A

space occupying lesions (venous thrombosis)
Total ophthalmoplegia
fixed dilated pupil

59
Q

Orbital Apex Syndrome involves which cranial nerves?

A

III, IV, VI, V1, and II

60
Q

Orbital Apex Syndrome is caused by

A

aspergillis infection

61
Q

Orbital Apex Syndrome Signs and Symptoms

A

Loss of vision
proptosis
bulging of the eye

62
Q

Both Cavernous Sinus Syndrome and Orbital Apex Syndrome are considered

A

medical emergencies

63
Q

Parinaud Syndrome Signs and symptoms

A

impaired vertical upgaze
Light near dissociation
Impaired convergence

64
Q

Parinaud Syndrome is caused by

A

Hydrocephalus or pineal tumor

6- Neuro Diag (10 decks)

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