Control of Eye Movements Flashcards

1
Q

What is smooth pursuit?

A

Supranuclear gaze system that keep a moving image centered on the fovea

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2
Q

What is vergence?

A

Supranuclear gaze control that keeps the image on the fovea when the object is moved near

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3
Q

What system executes voluntary saccadic movement?

A

Frontal eye fields

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4
Q

What structure do the fibers from the frontal eye fields synapse on to initiate eye movement?

A

Contralalteral Paramedian Pontine Reticular Formation (PPRF)

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5
Q

Where is the Rostral Interstitial Nucleus of the Medial Longitudinal Fasciculus (riMLF) found? What does it control?

A

Found near superior colliculus and posterior commissure of the brain

Controls vertical gaze

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6
Q

A turmor in what structure can cause vertical gaze palsy? Which direction is the pt unable to look?

A

Pineal gland

Cannot look up

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7
Q

Lesion to what nucleus can create a palsy where the pt cannot look down?

A

Lesion to red nucleus

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8
Q

What structure is involved in controlling reflexive saccadic eye movements?

A

Superior colliculus

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9
Q

What nuclei are the pause cells located in?

A

Raphe nuclei

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10
Q

What is the function of the burst cells?

A

Move eyes towards target

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11
Q

What is the function of the tonic cells?

A

Fix gaze on target

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12
Q

What are the tonic cells for horizontal movement? Where are they located?

A

Nucleus prepositus hypoglossi

Located in pons

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13
Q

What are the tonic cells for vertical eye movement? Where are they located?

A

Interstitial nucleus of Cajal

Found in midbrain

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14
Q

What are the burst cells for horizontal eye movement? Vertical eye movement?

A

Horizontal: Paramedian Pontine Reticular Formation (PPRF)

Vertical: Rostral Interstitial Nucleus of MLF (riMLF)

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15
Q

How would a destructive lesion to the frontal gaze center present?

A

Eye deviation towards the side of lesion, difficulty looking away

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16
Q

How would seizure activity in the frontal gaze center present?

A

Eyes deviate away from firing gaze center

17
Q

What Broadmann area is associated with smooth pursuit?

A

19 - Parieto-occipital junction

18
Q

If the right parieto-occipital junction is stimulated, what direction do the eyes move?

A

To the Right

19
Q

What is optokinetic nystagmus?

A

Quick motion in opposite direction when visual target reaches the limit of the visual field

20
Q

What eye field is required for optokinetic nystagmus?

A

Intact parietooccipital eye field

21
Q

Where is the lesion if there is loss of smooth pursuit movements towards the side of the lesion?

A

Parietal lobe

22
Q

What is the result of the ice water caloric is the patient is not conscious?

A

Opposite from COWS

Cold water causes toward nystagmus

Warm water causes away nystagmus

23
Q

Lesion in what structure causes Intranuclea ophthalmoplegia?

A

Medial Longitudinal fasciculus

24
Q

Upon exam, a patient has weak adduction in the left eye, and nystagmus on abduction in the right. Movement to the other side is normal. What is the most likely diagnosis? Where is the lesion?

A

Left Interocular Ophthalmoplegia

Left MLF

25
Q

What eye motion remains intact in INO?

A

Convergence

26
Q

In a Left CN VI nucleus lesion, what eye movements are inhibited?

A

Cannot abduct left eye or adduct right eye (Cannot look left)

27
Q

In a left CN VI palsy, what movements are inhibited?

A

L eye cannot abduct

28
Q

Why can convergence still happen if there is a lesion in the MLF?

A

Near reflex pathway bypasses MLF to get to medial rectus muscles

29
Q

Argyll-Robertson pupil is a sign of what disease?

A

Neurosyphilis

30
Q

What happens in an Argyle-Robertson pupil?

A

Absent light reflex but pupil constricts in near reflex testing