CN 1,2,3,4,6 Examinations

Question 1

Normal disc to cup ratio

Answer 1

2:1

Question 2

Normal retina color? Physiological cup color?

Macula?

Answer 2

Red/orange
Pale
Dark

Question 3

Arterial to venous ratio in eye

Answer 3

2:3

Question 4

When might you find an elevated disc with blurred margins?

Answer 4

Optic neuritis/papillitis

Question 5

What would the Disc, retina, vessel findings be in papilledema (due to increased ICP)?

Answer 5

Disc: elevated, blurred disc margins and vessels engorged

Retina: flame retinal hemorrhage close to disc

Vessels: engorged and tortuous

BILATERALLY except F-K

Question 6

What two conditions have elevated and blurred disc

Answer 6

Papilledema and optic neuritis

Question 7

How would you differentiate papilledema vs optic neuritis?

Answer 7

In papilledema: NO VISUAL complaint/loss

Optic neuritis: inflammation of nerve causes visual complaint/loss
-early and quick!

Question 8

Ophthalmoscopic exam findings of disc, retina, vessels seen in optic atrophy?

Answer 8

Disc: sharp clear margins with an overall pale white color

Retina: normal

Vessels: A: attenuated V: normal

Question 9

Is vision affected with optic atrophy?

Answer 9

Yes

Question 10

Ophthalmoscopic findings in tay-Sachs?

Answer 10

Dark cherry red spot in place of the macula lutea

Question 11

Ophthalmoscopic findings for disc, retina, vessels in glaucoma?

Answer 11

Recall: intraOCULAR pressure increase

Disc: large cup to disc ratio (norm 1:2), vessels discplaced peripherally, pale white, pigment surrounding disc

Retina: normal

Vessels: normal

Question 12

Ophthalmoscopic findings in retinal detachment. Disc, retina, vessels

Answer 12

Disc: normal
Retina: gray elevation with folds in detached section
Vessels: tortuous and elevated over detached retina

Question 13

S/s of retinal detachment

Answer 13

Flashes/floaters or veil/shadow/curtain across vision

Question 14

Ophthalmoscopic exam findings in non-proliferative diabetic retinopathy: disc, retina, vessels

Answer 14

Disc: Normal
Retina: many scattered exudates/retinal hemorrhages
Vessels: mild dilation of retinal veins

Question 15

Ophthalmoscopic exam findings in proliferative diabetic retinopathy: disc, retina, vessels

Answer 15

Disc: new vessels growing on disc
Retina: numerous hemorrhages, new vessels at superior disc margins
Vessels: dilation of veins

Question 16

Ophthalmoscopic exam findings for hypertensive retinopathy; disc, retina, vessels

Answer 16

Disc: clear outline
Retina: exudates and flame hemorrhage
Vessels: narrowed, increased tortuosity, copper wiring, AV nicking

Question 17

CN 3,4,6 exam process

Answer 17

• inspection
• accommodation (3)
• corneal light reflex (3,4,6)
• pupillary light reflex (2,3)
• 6 cardinal fields of gaze (3,4,6)

Question 18

MC causes of unilateral and bilateral ptosis

Answer 18

Unilateral: horners syndrome, pancos tumor, stroke, Bell’s palsy, TIA, stroke, cluster HA/migrane

Bilateral: MG

Question 19

What CN does accommodation test

Answer 19

3

Question 20

What 3 things should occur during accommodation test

Answer 20

Convergence (medial recti)
Pupilloconstruction (parasympathetic fibers)
Lens thickening (ciliary muscle-unnoticeable—allows focus)

Question 21

CN tested during corneal light reflex

Answer 21

3,4,6

Question 22

Process in corneal light reflex test

Answer 22

Patient focus on distant object and shine lights t nasal bridge (12 inches)

Eye should reflect symmetrically

Question 23

CN tested with pupillary light reflex

Answer 23

CN 2,3

Question 24

CN tested with cardinal fields of gaze

Answer 24

3,4,6

Question 25

Explain each muscle tested in each eye during cardinal fields of gaze

Answer 25

See picture on slide 68

Question 26

CN 3 abnormals

Answer 26

Ptosis Mydriasis (pupil dilation) Eye deviated down and out

Question 27

MC cause of CN 3 abnormals

Answer 27

Ischemia and aneurysm

Question 28

What CN is affected during: ptosis

Answer 28

CN 3

Question 29

What CN is affected during: mydriasis

Answer 29

CN3

Question 30

What CN is affected during: eye deviation down and out

Answer 30

CN3

Question 31

Abnormals with CN 4

Answer 31

- difficulty looking down and in | - patient commonly tilts head to opposite shoulder (minimize diplopia)

Question 32

MC cause of damage to CN 4

Answer 32

Head trauma

Question 33

What CN is affected during: difficulty looking down and in

Answer 33

CN4

Question 34

What CN is affected during: when patient tilts head to R shoulder

Answer 34

L CN4

Question 35

Abnormals with CN 6

Answer 35

- eye deviates medically | - difficult looking laterally

Question 36

CN6 damage usually caused by

Answer 36

Neoplasms Trauma Microvascular neuropathy MC etiologies

Question 37

What CN is affected during: deviation of eye medically

Answer 37

6

Question 38

What CN is affected during: issues looking laterally

Answer 38

6

Question 39

Nystagmus

Answer 39

Involuntary eye oscillations | -may occur side/side, up/down, or circular

Question 40

Nystagmus that is fast and represents saccadic movement. Lobe?

Answer 40

Frontal

Question 41

Nystagmus slow represents following movement. Lobe?

Answer 41

Occipital

Question 42

Where is nystagmus common that is not pathological

Answer 42

“End point”