Lecture 5 - Retina And Central Visual Pathways Flashcards
What is the outermost tough layer roof the eye?
Sclera
What are some components of the retina?
Pigmented layer
Photoreceptor cells
Bipolar cells
Horizontal cells
What is the function of the pigmented layer of the retina?
Helps absorb excessive light preventing overstimulation of the optic nerve
They anchor photoreceptors
What is an an example of a condition that has problems with the pigmented layer of the retina?
Albinism
What are the 2 types of photoreceptor cells?
Rods
Cones
What is the function of the rods?
Black and white night vision
What is the function of cones?
Colours and light
What is the function of horizontal cells in the retina?
Lateral inhibition of photoreceptors either side of the activated photoreceptor preventing excess signals being sent to the brain
What is the function of bipolar cells in the retina?
Connect photoreceptors to axons
What artery supplies the retina with blood?
What is this a branch of?
What is this a branch of?
Central retinal artery
Ophthalmic artery
Ophthalmic artery branches from the internal carotid artery
What disease can fundoscopy reveal?
Hypertensive retinopathy
Diabetic retinopathy
Macular degeneration
Potential meningitis so can see papilloedmea
What blood vessel is occluded if a patient describes a curtain coming down on their vision?
What is this sign called?
Central retinal artery
Amaurosis fugax
Go to the last slide and label the retina (1):
1 = fovea
2 = macula
3 = central retinal artery
4 = central retinal vein
5 = optic disc
What is the name of the specialist technique used to visualise the layers of the retina?
Optical coherence tomography (OCT)
What are the 2 types of visual field?
Temporal visual field
Nasal visual field
What are the 2 types of retinal fibres in the optic nerve?
Nasal retinal fibres
Temporal retinal fibres
What retinal fibres are responsible for the nasal visual field?
Temporal fibres (since eye is a pinhole and inorder for light from the nasal field to hit the retina it must hit temporal fibres)
What retinal fibres are responsible for the temporal visual field?
Nasal fibres (for light to be detected from the temporal field it must come in and hit the nasal fibres)
How do the nasal fibres and temporal fibres differ in the way that they travel once they reach the optic chiasm?
Nasal fibres decussate and cross sides
Temporal fibres stay on the same side
What part of the brain do the nasal and temporal retinal fibres travel to following the optic chiasm?
Lateral Geniculate nucleus in the thalamus
What is the name of the structure following the optic chiasm?
Optic tract
What fibres (specifically which sides do the fibres come from) are contained within an optic tract?
Right optic tract
Ipsilateral (right) superior and inferior temporal fibres
Contralateral (left) superior and inferior nasal fibres
What are optic radiations?
The temporal and nasal fibres travelling on from the lateral geniculate nucleus to the primary visual cortex
What are the 2 different types of optic radiation?
Superior optic radiations
Inferior optic radiations
What lobe of the brain do the superior optic radiations travel through to reach the primary motor cortex?
Parietal lobe
What lobe of the brain do the inferior optic radiations travel through to reach the primary visual cortex?
Temporal lobe
Go to the last slide and draw tthe retinal fibres and their pathways:
How are visual field defects named?
Named after the part of the vision that has been lot not where the lesion is located
What are the names of all the structures running from the retinal fibres to the end?
Nasal and retinal fibres
Optic nerve
Optic chiasm
Optic tract
Lateral geniculate nucleus
Optic radiations (superior and inferior)
Primary visual cortex
What is a Scotoma?
Localised defect in retina causing a small patch of visual loss
What type of vision do we have?
What is it good for?
Binocular vision
Good for depth perception
What type of visual defect is caused by an optic nerve lesion?
Monocular blindness
What fibres are affected in a left sided optic nerve lesion casuing monocular blindness?
Temporal and nasal fibres on the Ipsilateral side (left)
Leads to Ipsilateral loss of temporal and nasal visual fields
What type of visual loss is caused by a lesion at the optic chiasm?
Bitemporal hemianopia
What fibres are affected in an optic chiasm lesion leading to Bitemporal hemianopia?
The nasal fibres on both sides leading to both temporal visual fields being lost
What condition often leads to Bitemporal hemianopia?
Pituitary adenoma
What visual field defect occurs as a result of a lesion in the optic tract?
Homonomous hemianopia
What is homonomous hemianopia (optic tract lesion)?
What fields are lost?
What fibres are affected?
When the visual fields on the same side of thh eye are lost (right optic tract lesion means right side of both eyes visual fields are lost)
Ipsilateral temporal fibres damaged
Contralateral nasal fibres damaged
So Ipsilateral nasal field gone
Contralateral temporal field gone
What visual fields are lost with left sided homonomous hemianopia?
Left eyes temporal field and right eyes nasal field
Right optic tract must be damaged
What must be damaged if a patient has visual loss in quadrants?
Optic radiations
What is responsible for the superior visual field (quadrant)?
Inferior optic radiations
What is responsible for the inferior visual field (quadrant)?
Superior optic raiations
What condition would be caused by damage to the right superior optic radiation?
So damage to the superior right temporal fibre+ damage to superior Left nasal fibre
So loss of vision in the INFERIOR right Nasal visual field and INFERIOR temporal visual field on the left
Called Homonomous inferior quadrantanopia
What part of the brain does the superior optic radiation travel through?
Parietal lobe
What visual field defect is produced by a lesion in the inferior optic radiation?
Homonomous superior quadrantopia
Superior nasal field on Ipsilateral side lost
Superior temporal field lost on Contralateral side
What conditions often lead to both superior and inferior radiations being damaged?
Which blood vessel?
Stroke
Middle cerebral artery
What visual field defect is caused by a stroke due to a middle cerebral artery occlusion damaging both the superior and inferior radiations on the same side?
Homonomous hemianopia
What does occlusion of the posterior cerbral artery cause to the vision?
Contralateral homonomous hemianopia with macular sparing
Why does macular sparring occur if a stroke is caused by the posterior cerbral artery?
It has a dual blood supply since it still receives blood from the middle cerebral artery
What is the accommodation reflex?
Where you are able to focus on nearby objects
What is the afferent and efferent for the accommodation reflex?
Afferent = optic nerve
Efferent = occulmotor nerve
What are the 3 Cs of the accomodation reflex?
Convergence of eyes
Constriction of pupils
Convexity of lens to inc refractive power
What is responsible for convergin the eyes in the accomadtion reflex?
Medial Rectus
What is responsible for constriction of the pupils in the accomodation reflex?
Constrictor papillae
What is responsible for fattening the lens in the accomadtion reflex??
Ciliary muscle
What part of the brain processes in the accomadtion reflex?
Visual cortex via the lateral geniculate neucles
Then to oculomotr and edinger Westphal nuclei
What is the pathway for the light reflex?
Light
Optic nerve
Pre-tectal nucleus
Then to both edinger westphal nuclei (parasympathic ganglionics)
Then to occulmotor nerve (ciliary ganglion) then sphincter pupillae