midterm Flashcards
what are the categories of pupil abnormalities? (2)
- abnormal pupil size
- abnormal pupil reaction
conditions with abnormal pupil size (2)
- adie’s tonic pupil
- horner’s syndrome pupil
what is BLOCKED in Adie’s tonic pupil?
parasympathetic block
what is BLOCKED in horner’s syndrome?
sympathetic block
conditions with abnormal pupil reactions? give the defects (3)
- marcus gunn pupil
- parinaud’s syndrome
- argyll robertson pupil
point to remember in PUPILLARY DEFECTS/ ABNORMALITIES:
- relative afferent pupillary defect
- relative efferent pupillary defect
defect when a lesion is at retina —-> pretectal nucleus
relative afferent pupillary defect
defect when a lesion is at preganglionic —- postganglionic
relative efferent pupillary defect
location of lesion if relative afferent pupillary defect
located from the retina to the pretectal nucleus
location of lesion if relative efferent pupillary defect
located from the preganglionic to the post ganglionic fibers
it is also known as relative afferent pupillary defect:
marcus gunn pupil
what does RAPD mean?
relative afferent pupillary defect
what is the other term for marcus gunn or RAPD/ APD?
pupillary escape
marcus gunn:
is the damage unilateral or bilateral?
bilateral
marcus gunn:
where is the damage at?
retinal ganglion
what diseases can cause marcus gunn? (5)
- CRAO
- CRVO
- BRVO
- optic atrophy
- marketed retinal detachment
assymetric POAG
does
1. corneal
2. lenticular
3. vitreous
4. refractive or emotional loss of vision
cause marcus gunn? yes or no?
no because its not connected to retina
what disease/disorder does not cause marcus gunn response? (4)
- corneal
- lenticular
- vitreous
- refractive or emotional causes
does loss of vision due to refraction cause marcus gunn?
no
true of false
CRAO, CRVO, BRVO causes marcus gunn
true
what test do you use to diagnose marcus gunn?
swinging flashlight
in an afferent eye, the ______________ response is greater.
consensual
what response is lesser?
direct response
what equipment is used in the swinging flashlight test?
penlight
marcus gunn can be detected at what part of the eye?
pupil
argyll robertson pupil is always bilateral
true
normal near response (light-near dissociation)
agryll robertson pupil
does not respond to light or sometimes responds poorly to light
argyl robertson pupil
this condition makes your pupil dilate poorly in darkness
argyll robertson pupil
a parasympathetic condition that is CENTRAL and BILATERAL in nature
argyll robertson pupil
list the common causes of argyll robertson pupil (3)
- neurosyphilis
- long term diabetes
- alcoholism
any interruption of both afferent pathway and the central inhibitory fibers ___________________ to the aqueduct
ventral
it is caused by any interruption in the pattern of CN2 to CN3
Argyll robertson pupil
what is CN 3
oculomotor nerve
what is the function of CN 3
provides motor and parasympathetic innervation to some of the structures within the bony orbit.
what is CN 2
optic nerve
what is the function of CN 2
responsible for transmitting visual information. The optic nerve contains only afferent (sensory) fibers, and like all cranial nerves is paired.
give the 4 types of neurosyphilis
- primary
- secondary
- latent
- tertiary
it is a bacterial infection of the brain or the spinal cord
neurosyphilis
it is a sexually transmitted infection that spreads through direct contact with syphilis sores.
syphilis
a life threathening disease which is a result of an untreated syphilis for many years
neurosyphilis
is syphilis treateble? yes or no bitch
yes, perhaps, it is very much preventable
slowly progressive degeneration of the spinal cord that occurs in the tertiary phase of the syphilis
tabes dorsalis/ syphilitic myelopathy
tabes dorsalis can start to affect ____________ years or more
20 years or more
tabes dorsalis is common, yes or no
no
syphilitic myelopathy is characterized by a triad of clinical symptoms namely what?
- gait unsteadiness
- lighting pains
- urinary inconvenience
a chronic disorder of carbohydrate metabolism due to relative or absolute insulin deficiency
long term diabetic mellitus
long term diabetes affects the kidney
Over time, high blood sugar from diabetes can damage blood vessels in the kidneys as well as nephrons so they don’t work as well as they should. Many people with diabetes also develop high blood pressure, which can damage kidneys too.
which organ produces insulin?
pancreas
if the insulin is not functioning properly, what happens?
glucose cannot enter the cells
function of pancreas
creates natural juices called pancreatic enzymes to break down foods
another central defect disorder which manifests a lesion affecting the posterior commissure and the pretectal nuclei with interruption to the more dorsal afferent light pathway
parinaud’s syndrome
parinaud’s syndrome is another central defect disorder which manifests a lesion affecting the ________ and the _____ with interruption to the more dorsal afferent light pathway
posterior commissure and pretectal nuclei
parinauds syndome is another central defect disorder which manifests a lesion affecting the posterior commissure and the pretectal nuclei with interruption to the _______
more dorsal afferent light pathway
give the 3 things we should observe in a person with parinaud’s syndrome
- large pupils
- constricts briskly to an accommodative target
- constricts poorly to light
give the other names for parinaud’s syndrome (4)
- dorsal midbrain
- pretectal
- sylvian aqueduct
- koerbersalus-elshnig syndrome
associated signs and symptoms for parinaud’s syndrome (3)
- vertical gaze
- collier’s sign
- convergence- retraction nystagmus
what is collier’s sign?
is well known as unilateral or bilateral eyelid retraction due to midbrain lesions. This sign is usually caused by infarction, tumor, multiple sclerosis, neuro-degenerative disease, or encephalitis.
