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Clinical Neurology > Neuro-ophthalmic disorders > Flashcards

Neuro-ophthalmic disorders Flashcards

1
Q

Retrochiasmal lesions in the occipital cortex produce and affect what?

A

homonymous hemianopia affecting contra-lateral visual field

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2
Q

What is the mc cause of Retrochiasmal Lesion in the occipital cortex?

A

infarction of posterior cerebral artery (90 percent)

Note: characterized by cortical blindness w/tunnel vision & pupillary reaction to light

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3
Q

Optic radiations in the Retrochiasmal has a lesion that produces what type of deficit?

A

Temporal-mc tumors makes superior quadrantanopia

Parietal-mc tumors/vascular

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4
Q

chiasmal lesions associated with pituitary symptoms are

A 
HA
acromegaly
amenorrhea
galactorrhea
Cushing's syndrome
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5
Q

chasmal lesions empty sella syndrome has not tumor but is associated withy what symptoms?
What age is mc with this condition?

A

HA, endocrine abnormalities, and occ blurred vision

MC 40-70 yoa

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6
Q

What type of lesion is usually d/t tumors pituitary in origin, produces a bitemporal hemianopia, gradual vision loss and tumore expansion in the cavernous sinus?

A

chiasmal lesions

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7
Q

What are the 3 reasons for eye constriction?

A

sympathetic response, in light, focus on very close objects

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8
Q

Suspect tumor expansion into cavernous sinus if associated symptoms involve what CN?

A

III, IV, V or VI

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9
Q

A pseudotumor cerebri mc occurs in __ and is usually self limiting.

A

Females of childbearing age

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10
Q

What will a Fundoscopic exam reveal about papilledema?

A

blurring N. fiber layer
absent venous pulsations
dis elevation & blurred margins
dic hyperemia

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11
Q

Define papilledema

A

bilateral disc swelling associated w/increased intracranial pressure (ICP)

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12
Q

Papilledema develops over what period of time?

A

over days

resolves 2-3 month After normalized ICP

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13
Q

Papilledema is associated w/what symptoms?

A

HA
vomiting
diplopia (double vision) form Abducens palsy

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14
Q

What is the aka for Giant Cell arteritis?

A

Temporal arteritis

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15
Q

What is temporal arteritis characterized by?

A

sudden vision loss can be total
optic disc swelling w/a pale optic dis
Fever, malise, night sweats, weight loss, HA poly myalgia rheumatic

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16
Q

What is the predilection of poly myalgia rheumatic?

A

F 4:1 M

increased ESR, morning Stiffness

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17
Q

What is the end-organ of the afferent visual system?

A

striate cortex aka Calcarine cortex, primary visual cortex, Brodman Are 17

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18
Q

Where does the visual pathway end?

A

Calcarine Cortex

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19
Q

What does AION stand for?

A

Anterior Ischemic Optic Neuropathy

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20
Q

What is the vascular supply for the following structures?

a. reina
b. optic N
c. optic radiations
d. primary visual cortex

A

a. Central retinal artery
b. Ophthalmic artery
c. Middle cerebral artery
d. Posterior cerebral artery

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21
Q

How to distinguish AION from Giant cell arteritis?

A

ESR greater than 50 mm/h

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22
Q

Extra-ocular muscle superior oblique has innervation from what CN?

A

IV (inf and medial)

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23
Q

Damage to CN IV leads to what kind of muscle weakness?

A

Ophthalmoplegia: paralysis or weakness of the eye muscles
Note: can also cause diplopia

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24
Q

Tourette syndrome has a predilection to

A

M 5:1 childhood 5-10 yoa

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25
Q

Define Hemiballismus

A

unilateral large-amplitude and poorly patterned flinging or flailing movements of a limb

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26
Q

A contralateral lesion in the caudate , putamen or sub thalamic nucleus can cause what type of movement?

A

Hemiballimus

27
Q

Rhythmic repetitive movements of voluntary motor activity what type of movement?

28
Q

Irregular jerking movements that are rapid and repetitive are what?

A

Chorea (Dance)

29
Q

Pill rolling tremor is associated with what condition?

30
Q

Abrupt rapid jerky non-rhythmic movements, stereotyped motor or vocals affecting head, neck and trunk.

A

Tics of Tourette syndrome

31
Q

Tics are suppressed with what actions?

A

winking, shoulder shrugs, sniffing and throat clearing

32
Q

What is coprolalia and what condition is it associated with?

A

obscene utterance seen in Tourette syndrome

33
Q

What motions disorder that does not decrease life expectancy?

A

Tourette syndrome

34
Q

What motion disorder involves limbs that often associated with a sleep complaint? this condition is mc seen in who?

A

Restless legs syndrome

Female- Note: abnormal central subcortical dopamine pathways

35
Q

A decreasing availability of serotonin transporter in the brainstem is associated with what condition?

A

Restless leg syndrome

Note: Can runs in families and be genetic

36
Q

cone and rods convert visual images into neuronal signal in what structure?

37
Q

The inferior fascicle forms what structure?

A

Meyer’s loop

38
Q

Inferior Fascicle contains visual info from the contralateral superior quadrant, traveling to the temporal lobe forming

A

Meyer’s Loop

39
Q

A nerve lesion damages

A

same side (ipsilateral)

40
Q

A nuclear lesion damages

A

both side bilateral

41
Q

PSN PreGanglia fibers leave brainstem via ___, synapse in ___ Ganglion

A

CN III

cilliary

42
Q

What fibers mediate pupillary contraction?

A

PSN PostGanglia

43
Q

Pain and temp from the head goes to what structure?

44
Q

Pain and temp from lower limbs goes to what structure?

45
Q

If mass/tumor grows in/on optic chiasm, pt will have

A

Bitemporal Hemianopsia aka Tunnel vision

46
Q

Superior rectus receives fibers from where?

A

contralateral oculomotor nucleus

47
Q

Levator palpebral receives

A

bilateral innervation

48
Q

What are the nerve lesions

A

pituitary adenoma
meningioma
primary or metastatic tumors
inflammation

49
Q

What are the nuclear lesion?

A

ischemia
central demyelinating disorders (MS)
infections

50
Q

Excyclodeviation of the eye is

A

down and out to the side

51
Q

Intorsion: rotation of the point inward (aka eye adduction) toward the

A

nose via superior oblique muscle

52
Q

What is Ophthalmoplegia:

A

Failure to depress fully while in adduction. failure of ipsilateral eye abduction

53
Q

What is the only CN that comes off the dorsum of the brain?

54
Q

Esotropia form a squint or

A

cross-eyed

greater w/gaze toward affected side

55
Q

Face weakness is damage to what CN?

A

VI d/t its proximity w/CN VII

56
Q

The abducted eye
is elevated by the __ and depressed by
the inferior rectus.

A

superior rectus

57
Q

Superior and Inferior oblique muscles control what action of the eye?

58
Q

Temporal arthritis can damage optic N blood supply (ophthalmic artery), gives rise to what condition?

A

Blindness d/t ophthalmic artery branch of internal carotid artery

59
Q

What branches come from circle of willis?

A

optic radiation-Middle cerebral artery and primary visual cortex-Posterior Cerebral artery

60
Q

Yoke muscles of the eye receives equal and simultaneous innervation determined by fixed eye. What law is this?

A

Herring’s law

61
Q

TOTAL Sudden vision loss what monocular disorder?

A

Temporal aka Giant Cell arteritis

note: optic disc swelling w/pale optic disc. associated w/polymyalgia rheumatica

62
Q

Sudden onset painless vision loss is what monocular disorder?

A

AION

anterior ischemic optic neuropathy

63
Q

What’s the hallmark of AION anterior ischemic optic neuropathy?

A

ipsilateral disc swelling w/ peripapillary hemorrhage

64
Q

Painful vision loss w/in hours to days is what monocular disorder?

A

optic neuritis

note: progression to MS

Clinical Neurology (9 decks)

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