Lecture 6– The retina and the visual pathway Flashcards

1
Q

purpose of the pigmented layer of the retina

A
  • Acts as the site of absorption of light- to modulate amount of light being received by the photoreceptors
    • People with albinism (lack of pigment- melanin) have photophobia
  • Anchors photoreceptor
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2
Q

function of Rods and cones

A
  • Rods- black and white vision
  • Cones – colour vision- high acuity vision
    • Found in the fovea (macula densa)
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3
Q

function of bipolar cells

A
  • Act to connect photoreceptor cells to the ganglion cells
  • Ganglion cells axons come together to form the optic nerve
  • Optic nerve exits via the optic disc
    • Blind spot- not photoreceptor cells
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4
Q

function of Horizontal cells

A

Lateral inhibition- detects area where image is coming from and detects the photoreceptor that is most in line to pick up that signal and inhibits photoreceptors next to it prevents too many neural impulses

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5
Q

fundoscopies can be used to look at the….

A
  • Retinopathies
    • E.g. hypertension, DM
  • Vascular occlusion
    • E.g. branch of central artery or vein
    • ‘amaurosis fugax’- like a curtain coming down
  • Macula
    • E.g. degeneration
  • Optic disc
    • E.g. papilledema
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6
Q

Optical coherence tomography (OCT)

A
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7
Q

label the retina

A

thin layer of tissue that lines the back of the eye on the inside

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8
Q
A
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9
Q

the central visual pathway is comprised of:

A
  1. The optic nerve (CN II)
  2. The optic chiasm
  3. The optic tracts
  4. Optic radiations
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10
Q

the optic nerve can be split into…… divisions

A

4 different fibres of the retina

  • Temporal (lateral)- orange
  • Nasal (medial)- green
  • Also have up and down
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11
Q

nasal fibres

A

medial

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12
Q

temporal fibres

A

lateral

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13
Q

The optic chiasm

A
  • Nasal fibres decussate
  • Temporal fibres remain ipsilateral
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14
Q

The optic tracts runs from the

A

From optic chiasm to lateral geniculate nucleus (LGN

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15
Q

what do optic tracts contain

A

Contains temporal fibres from the ipislateral side

Contains nasal fibres from tbe contralateral side

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16
Q

Optic radiations run from the

A

From LGN to primary visual cortex (x2 ) in the occipital lobe (x2 lobes)

17
Q

the optic radiations have

A

2 routes to the occipital lobe

  1. Superior route via the parietal (superior optic radiations)
    • Continuation of superior quadrant fibres (temporal and nasal)
    • ‘Baums loop’
  2. Inferior route via the temporal (inferior optic radiations)
    • Continuation of inferior quadrant fibres (temporal and nasal)
    • “meyes loop’
18
Q

summary of the visual pathway

A
19
Q

Visual fields

A

Visual fields relate to peripheral vision (also called temporal and nasal). Each eye has its own set of visual filed

  • These overlap to form binocular vision
  • Good for depth perception
20
Q

nasal fibres are responsible fore …….. visual fields

A

temporal

21
Q

temporal fibres are responsible for

A

nasal visual fields

22
Q

If we want to detect something in the temporal visual field, light will travel through the pupil straight to

A

the nasal retinal fibres (temporal visual field detected by nasal retinal fibres)

23
Q
  • If we want to detect something in the nasal visual field, light will travel through the pupil straight to the
A

temporal retinal fibres (nasal visual field detected by temporal retinal fibres)

24
Q

Visual field defects

A

Named based on the area of visual loss rather than site of lesion

  • monocular blindness
  • bitemporal hemianopia
  • homonomous hemianopia
25
Q

CN II lesion: Monocular blindness

A
  • Temporal and nasal fibres on the ipsilateral side affected
  • Therefore the nasal and temporal visual field are lost on the ipsilateral side
26
Q

Bitemporal hemianopia

A
  • lesion at the chiasm where the nasal fibres decussate
  • Nasal fibres on both sides affected
  • Temporal visual field loss on both sides
  • ‘tunnel vision’
  • Cause e.g. pituitary adenoma
27
Q

Homonomous hemianopia

A
  • Lesion of the optic tract on the right hand side
  • Left nasal retinal fibres (contralateral) and right temporal nasal fibres (ipsilateral) affected
  • Left temporal (contralateral) visual field lost and right nasal (ipsilateral) field loss
  • ‘left homonomous hemianopia’- even though lesion is on the right- due to decussation
    • Name the visual defect on visual loss not lesion

i.e. homo- loss of both left or loss of both right

28
Q

Optic radiation lesion

A
  • Superior visual fields are detected by inferior retinal fibres
  • Inferior visual fields are detected by superior retinal fibres
29
Q

Quadrantanopia’s

A

Affects left/right superior quadrant fibres and inferior quadrant fibres

30
Q

Homonomous inferior quadrantanopia (left)

x

A

Lesion on right superior optic radiation (parietal lobe)

  • Superior ipsilateral temporal fibre affected
    • Loss of inferior nasal visual field
  • Superior contralateral nasal fibre affected
    • Loss of inferior temporal visual fields
31
Q

Homonomous superior quadrantanopia (left)

A
  • Inferior temporal fibres on ipsilateral side affected
    • Loss of superior nasal visual field
  • Inferior nasal fibre on contralateral side is affected
    • Loss of superior temporal visual field
32
Q

What if superior and inferior radiations are affected? E.g. stroke

A
  • Superior and inferior ipsilateral temporal fibres affected
  • Superior and inferior nasal fibres contralateral affected
  • Homonomous hemianopia
33
Q

macula sparing strokes

A

Occipital lobe has dual blood supply

  • Middle Cerebral Artery (occipital pole)
  • Posterior Cerebral Artery

In stroke affecting the posterior cerebral artery…

  • Most occipital lobe will be lost
  • However middle cerebral supplies the occipital pole (represents the macula)
  • Therefore macular function (central vision) will be saved
34
Q

The light reflex (i.e. light shone in left eye)

A
  1. Sensory afferent from left retina (optic nerve)
  2. Some branches leave the optic nerve and enter the midbrain and synapse in pre-tectal nucleus
  3. Synapse with EDW nuclei (left and right)
  4. Pre-ganglionic parasympathetic fibres from EDW leave brainstem with oculomotor (left and right)
  5. Pre-ganglionic synapse in the ciliary ganglion, becoming post-ganglionic
  6. Reach sphincter pupillae muscle of iris
  7. Direct and consensual light reflex
35
Q

accomodation reflex required for

A

near vision

36
Q

accomodation reflex requires 3 C’s

A
  • Convergence (medial rectus)
  • Pupillary constriction (constrictor pupillae)
  • Convexity (becomes thicker) of the lens to increase refractive power (ciliary muscle)
37
Q

why must the cerebral cortex be involved in the accomodation reflex

A
  • Cerebral cortex must be involved because its relating to image analysis
    • Therefore the reflex follows the visual pathway via the lateral geniculate nucleus to the visual cortex
    • Midbrain receives info from visual cortex
    • Sends off information via cranial nerve 3 nuclei (MR) and the Edwinger Westphal nuclei (EWN) (pupillary constriction)