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Ophthalmology Anatomy > Eye and Raised Intracranial Pressure > Flashcards

Eye and Raised Intracranial Pressure Flashcards

1
Q

What are the two humours of the eye and where are they located?

A

Aqueous humour = Anterior to lens

Vitreous humour = Posterior chamber

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2
Q

Where are the anterior and posterior chambers of the eye?

A

Anterior to the lens
Ant = in front of iris
Post = behind iris

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3
Q

What is the pathway of aqueous humour movement?

A

Produced in posterior chamber
Passes out and round the iris
Into anterior chamber

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4
Q

What might occur as a result of blockage of the aqueous humour pathway?

A

Increased pressure in anterior an posterior chamber

Glaucoma

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5
Q

What might cause raise intracranial pressure?

A

Head injury
Space occupying lesion, tumour, abscess or haemorrhage
Hydrocephalus
Meningitis

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6
Q

What are the three main contents of the cranial cavity?

A

Brain
Cerebrospinal fluid
Blood

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7
Q

What is the Munro-Kellie Hypothesis?

A

An increase in volume of any of the brain cavity content must lead to a decrease in another (relationship between intracranial components and pressure)

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8
Q

If not relieved, what is the result of raised intracranial pressure?

A

Brain damage

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9
Q

What is hydrocephalus?

A

Water on the brain

CSF volume enlarges, ventricles enlarge, brain matter gives way

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10
Q

Why can an infant’s brain increase in size with hydrocephalus, whereas an adults cannot?

A

Sutures in the child’s cranial cavity have yet to fuse

Ability for growth and expansion

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11
Q

What is the sunset sign in hydrocephalus?

A

Sight of whites of the eye above the iris

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12
Q

What are meninges?

A

Membranes around the brain

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13
Q

What are the three layers surrounding the brain, and the spaces in between them?

A 
Extradural space 
DURA MATER
Subdural space 
ARACHNOID MATER 
Subarachnoid space
PIA MATER
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14
Q

What is the composition of the dura mater?

A

Hard, fibrous membrane
Endoesteal layer (stuck to inside of cranial cavity)
Meningeal layer

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15
Q

What is the composition of the arachnoid mater?

A

Spiders web like composition

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16
Q

What is contained in the subarachnoid space?

A

CSF

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17
Q

What is the composition of the pia mater?

A 
Thin layer (one cell thick) 
Surrounds brain (follows the gyri and sulci)
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18
Q

What is the falx cerebri?

A

Extension of dura mater

Separates the two cerebral hemispheres

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19
Q

What is the tentorium cerebelli?

A

Extension of dura mater

Separates cerebellum form cerebral hemispheres

20
Q

What is the falx cerebelli?

A

Extension of dura mater

Separates the two hemispheres of the cerebellum

21
Q

What is the tentorial notch?

A

Mid brain passes through here

22
Q

What is the infundibulum of hypophysis cerebri?

A

Stalk of the pituitary

23
Q

What is diaphragma sellae?

A

Part of dura mater where pituitary sits

24
Q

Where are veins of the brain located?

A

Subarachnoid space

25
Q

What are the dural venous sinuses?

A

Spaces between the folds of the dura mater containing venous blood (histologically, NOT veins)

26
Q

What re the components of the lateral ventricles?

A

Body
Frontal (anterior) horns
Occipital (posterior) horns
Temporal (inferior) horns

27
Q

Where is the third ventricle located?

A

Between thalami

28
Q

Where is the fourth ventricle located?

A

Between pons/medulla and cerebellum

29
Q

What connects the lateral ventricles to the third ventricle?

A

Interventricular foramina

30
Q

What connects the third ventricle to the fourth ventricle?

A

Cerebral aqueduct

31
Q

What is the route of CSF circulation?

A 
Chroroid plexus (production in all ventricles!) 
Two lateral ventricles 
Interventricular foramina 
Third ventricle 
Cerebral aqueduct 
Fourth ventricle 
Median aperture/two lateral apertures (or central canal of spinal cord) 
Subarachnoid space 
Arachnoid villi 
Superior sagittal sinus 
Reabsorption into venous system
32
Q

What visual problems can result form raised intracranial pressure?

A 
Transient blurred vision 
Double vision 
Loss of vision 
Papilloedema 
Pupillary changes
33
Q

Compression of which CN may lead to diplopia?

A

CN III, IV or VI

34
Q

How may diplopia due to raised ICP present?

A

Will be worse when looking in direction of affected muscle

E.g. compression of CN IV affects superior oblique -> diplopia worse on looking down and out

35
Q

Compression of which CN may lead to a dilated pupil, and how?

A

CN III
Parasympathetic supply to sphincter pupillae compromised
Unopposed sympathetic stimulation of dilator pupillae

36
Q

What is an early sign of raised intracranial pressure?

A

Fixed, dilated pupil

37
Q

Why is the optic nerve different to other cranial nerves?

A

It is an extension of the CNS tract

38
Q

What covers the optic nerve?

A

Meninges (dura, arachnoid and pia mater)

39
Q

What affect does raised ICP have on the optic nerve?

A

Raised ICP = raised pressure in subarachnoid space
Transmitted along length of optic nerve
Compresses optic nerve, central artery and vein of retina

40
Q

What are the consequences of raised ICP on the optic nerve?

A 
Papilloedema (bulging/swollen discs) 
Transient visual obsurations 
Transient flickering 
Blurring of vision 
Constriction of the visual field 
Decreased colour perception
41
Q

What are the possible outcomes of damage to CN III?

A

Paralysis of somatic motor innervation (4 extra ocular muscles and eyelid)
Paralysis of parasympathetic innervation of sphincter pupillae
Lose/slowness of pupillary light reflex, dilated pupil, ptosis, eye turned inferolaterally

42
Q

What are the possible outcomes of damage to CN IV?

A

Paralysis of superior oblique (so inferior oblique is unopposed)
Eye cant move inferomedially
Diplopia when looking down

43
Q

What are the possible outcomes of damage to CN VI?

A

Paralysis of lateral rectus

Eye cannot move laterally in horizontal plane

44
Q

In which ways is CN III susceptible to damage?

A

Compression

Tentorial herniation

45
Q

In which ways is CN IV susceptible to damage?

A

Stretching

Compression

46
Q

In which ways is CN VI susceptible to damage?

A

Stretching

Ophthalmology Anatomy (3 decks)

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