motility and diplopia

Question 1

diplopia: cover straight eye, other eye moves out to in. Other eye moves in to out. Eye moves down

Answer 1

exotropia (3rd nerve palsy). Esotropia (6th nerve). Hyperopia (4th nerve)

Question 2

1 1/2 syndrome

Answer 2

lesion in dorsal pons knocks out nucleus of 6, expands to knock out MLF. Only horizontal movement left tact is contralateral abduction

Question 3

internuclear ophthalmoplegia: who? what? signs? Convergence?

Answer 3

brainstem stroke (older ppl) or MS (younger). Medial longitudinal fasciculus. Abducting nystagmus of OTHER eye. Convergence normal

Question 4

signs of CN3 palsy

Answer 4

down and out, binocular diplopia with ptosis, weakness of 2 or more muscles, unequal pupil size worse in light

Question 5

signs of CN 4 palsy

Answer 5

vertical binocular diplopia, eye movements appear full, head tilt or turn, diagnose with 3 step test (right 4th worse on left gaze and right head tilt)

Question 6

three step test for 4th nerve palsy

Answer 6

1. determine which eye is hypertropic 2. hypertropia will be greater on gaze to contralateral side. 3. hypertropia will be greater on head tilt to ipsilateral side

Question 7

lesion of nucleus/fascicle of 4th

Answer 7

contralat SO weakness. Ipsilateral horners

Question 8

cavernous sinus syndromes

Answer 8

3,4,6, V1,V2 palsies. Horners. optic chiasm involvement.

Question 9

orbital apex syndromes

Answer 9

3,4,6,v1, optic neuropathy, proptosis

Question 10

trap door blowout fracture

Answer 10

traps IR so cant move eye up or down