Neuro-Ocular Exam (F) Flashcards
If the oculocephalic response is intact in a patient with limited eye movements, what does it suggest?
supranuclear disorder
What is the neutral density filter method for grading relative afferent pupillary defect?
increase filter in front of normal eye until APD disappears Grade 1 – ND 0.4 Grade 2 – ND 0.7 Grade 3 – ND1.1 Grade 4 – ND 2.0
What aspects of the facial nerve (VII) need to be assessed?
- motor function
- taste
- tear function
- blink
What is the cerebellar test that asks the patient to alternately point from his or her nose to the examiner’s finger and the examiner typically moves their finger to different locations?
Finger-nose-finger test
What are the aspects of the patients history that should be addressed in a neuro-ocular exam?
- age and gender
- chief complaint
- Associated symptoms, neuro and general
- review of systems and past ophthalmologic and medical history
- family history
- social history
What should be noted about motor function of the facial nerve (VII)?
facial asymmetry, blink pattern, forehead wrinkling, lagophthalmos, and facial emotional response and response to command, and orbicularis strength
What can the Photostress Test (Glare Recovery) be useful in detecting?
macular disease more likely to impair glare recovery than optic nerve disease
What are the different types of pathological processes that can cause a dyschromatopsia?
- macular
- retinal
- chiasmal
- retro-chiasmal
- optic nerve
What type of VA charts are best for repeatability, consistency, and testing with relatively poor vision?
LogMAR
What do color tests help differentiate?
congenital from acquired
What do diseases of the corticobulbar tracts tend to spare regarding facial nerve motor function? 1. Basal ganglia? 2
- emotional facial responses
2. voluntary movements
How is LPS function determined? 1. What is normal? 2. When is it reduced? 3
- Measure upper lid margin position in downgaze, then in upgaze with brow fixed.
- Normal is 12 mm or greater change
- ptosis from Myasthenia Gravis, myopathies, III palsy, and congenital ptosis, but normal in Horner Syndrome or LPS dehiscence.
What often presents with dissociation between spontaneous and voluntary facial movement with preservation of forehead wrinkles and brow?
supranuclear VII palsies
What is the number-plus system for grading relative afferent pupillary defect?
1+:initial constriction, but early redilation
2+:no initial movement of the pupil, then dilation
3+:immediate redilation
4+:amaurotic pupil
What is the cerebellar test that asks the patient to stand, feet together with eyes closed and arms at sides? 1. What is a positive of this? 2
- Romberg test
2. loss of balance occurs
