CH13: Ocular Movement and Pupillary Function Flashcards
Quick eye movements whose peak velocity may exceed 700 degrees per second (p. 273)
saccades
Interval between the appearance of a target and the initiation of a saccade (p. 273)
200ms
slower and smoother pursuit movements stabilizing the image of an object that is mocing (p. 274)
pursuit
saccades initiation localization (p. 273)
Area 8 of the forntal lobe
pursuit localization (p. 274)
ipsilateral parietooccipital cortex
bundle of saccades fibers (p. 274)
capsular peduncular bundle and transthalamic bundle
three integrated structures for vertical gaze (p. 276)
riMLF, INC, nucleus and fibers of PC
ocular apraxia of childhood (p. 277)
Cogan syndrome
T/F pontine gaze palsies tend to be longer lasting than those of cerebral origin (p. 278)
TRUE
Percent of adult not demosntrating Bell’s phenomenon (p. 279)
15%
eye is lower or higher: lateral medullary infarction (p. 280)
LOWER
eye is lower or higher: MLF or INC (p. 280)
HIGHER
Vergence movements are under the control of medial rectus neurons, unpaired. (p. 280)
Nucleus of Perlia
muscle imbalance that results in misalignment of the visual axes (p. 282)
Strabismus
Normal slight exotropia of neonates are corrected by what age (p. 283)
3 months of age
Compensatory head tilting to the opposite shoulder brought by a CNIV lesion (p. 284)
Bielschowsky sign
Sixth nerve palsy from DM is ususally painful at the onset (p. 287)
TRUE
mitochondrial defect in mendelian inheritance pattern occurs with POLG1 and twinke gene mutations (p. 289)
Progressive External Ophthalmoplegia
Law stating vestibular nystagmus of peripheral origin beats in most cases away from the side of the lsion and increases as the eyes are turned in the direction of the quick phase (p. 292)
Alexander Law
T/F in brainstem and cerebellar origin, nystagmus changes according to the direction of the gaze (p. 292)
TRUE
A type of nystagmus described as course and bilateral horizontal with an amplitude higher to the side of the lesion (p. 293)
Brun’s nystagmus
A type of pendular nystagmus accompanied by head nodding, and occasionaly by wry positions of the neck (p. 293)
Spasmus mutans
Eye movements that are continuous and chaotic, without an intersaccadic pause (p. 294)
Opsoclonus
Intermittent bursts of very rapid horizontal oscillations around the point of fixation (p. 294)
Ocular flutter
normal number of blinking per minute (p. 295)
12- 20 times per minute
Blepharospasm with dystonic grimacing movements of the lower face (p. 295)
Meige syndrome
Patient continues to blink with each tap on the forehead or glabella (p. 295)
Myerson sign
Aberrant regeneration of the third nerve after an injury wherein the upper lid retracts on lateral or downward gaze (p. 295)
pseudo von Graefe sign
Retraction of the upper lids with a staring expression (p. 296)
Collier sign
Delayed relaxation of the eyelid on attempted downgaze (p. 296)
von Graefe sign
rapid flactuation in pupillary size common in metabolic encephalopathy (p. 297)
Hippus
MGP vs hippus
In MGP, initial movements are in dilation (p. 297)
How to localize the lesion of the sympathetic chain based on sweat (p. 297)
CCA: loss of sweating entire side of face
How to localize the lesion of the sympathetic chain based on sweat (p. 297)
Distal: no or just in the medial
Afferent arm of the ciliospinal pupillary reflex (p. 298)
C2, C3
Characteristic of Adie- Tonic Pupil (p. 299)
Once constricted, tends to remain tonically constricted and redilates very slowly
Adie- tonic pupil is unusally sensitive tothis drug (p. 299)
Pilocarpine 0.1 %
Absence of knee or anke jerks + Adie’s pupil (p. 299)
Holmes- Adie Syndrome
Percent of people with inequality of 0.3 to 0.5 mm or more in pupilary diameter (p 299)
20%
light exaggeraes anisocoria caused by third nerve, darkness accentuates anisocira in case of Horner syndrome (p. 299)
TRUE
this drug causes reversal of miosis on affected side of Horner syndrome (p. 300)
Apraclonidine
