Neuro-ophthalmic disorders Flashcards by Deleted Deleted

Retrochiasmal lesions in the occipital cortex produce and affect what?

homonymous hemianopia affecting contra-lateral visual field

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

infarction of posterior cerebral artery (90 percent)

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

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

Temporal-mc tumors makes superior quadrantanopia

Parietal-mc tumors/vascular

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chiasmal lesions associated with pituitary symptoms are

HA
acromegaly
amenorrhea
galactorrhea
Cushing's syndrome

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

HA, endocrine abnormalities, and occ blurred vision

MC 40-70 yoa

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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?

chiasmal lesions

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What are the 3 reasons for eye constriction?

sympathetic response, in light, focus on very close objects

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

III, IV, V or VI

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

Females of childbearing age

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What will a Fundoscopic exam reveal about papilledema?

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

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Define papilledema

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

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Papilledema develops over what period of time?

over days

resolves 2-3 month After normalized ICP

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Papilledema is associated w/what symptoms?

HA
vomiting
diplopia (double vision) form Abducens palsy

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What is the aka for Giant Cell arteritis?

Temporal arteritis

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What is temporal arteritis characterized by?

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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What is the predilection of poly myalgia rheumatic?

F 4:1 M

increased ESR, morning Stiffness

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

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

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Where does the visual pathway end?

Calcarine Cortex

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What does AION stand for?

Anterior Ischemic Optic Neuropathy

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What is the vascular supply for the following structures?

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

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

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How to distinguish AION from Giant cell arteritis?

ESR greater than 50 mm/h

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

IV (inf and medial)

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

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

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Tourette syndrome has a predilection to

M 5:1 childhood 5-10 yoa

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Define Hemiballismus

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

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

Hemiballimus

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

Tremor

Irregular jerking movements that are rapid and repetitive are what?

Chorea (Dance)

Pill rolling tremor is associated with what condition?

Dementia

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

Tics of Tourette syndrome

Tics are suppressed with what actions?

winking, shoulder shrugs, sniffing and throat clearing

What is coprolalia and what condition is it associated with?

obscene utterance seen in Tourette syndrome

What motions disorder that does not decrease life expectancy?

Tourette syndrome

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

Restless legs syndrome | Female- Note: abnormal central subcortical dopamine pathways

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

Restless leg syndrome | Note: Can runs in families and be genetic

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

Retina

The inferior fascicle forms what structure?

Meyer's loop

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

Meyer’s Loop

A nerve lesion damages

same side (ipsilateral)

A nuclear lesion damages

both side bilateral

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

CN III | cilliary

What fibers mediate pupillary contraction?

PSN PostGanglia

Pain and temp from the head goes to what structure?

VPM

Pain and temp from lower limbs goes to what structure?

VPL

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

Bitemporal Hemianopsia aka Tunnel vision

Superior rectus receives fibers from where?

contralateral oculomotor nucleus

Levator palpebral receives

bilateral innervation

What are the nerve lesions

pituitary adenoma meningioma primary or metastatic tumors inflammation

What are the nuclear lesion?

ischemia central demyelinating disorders (MS) infections

Excyclodeviation of the eye is

down and out to the side

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

nose via superior oblique muscle

What is Ophthalmoplegia:

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

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

CN IV

Esotropia form a squint or

cross-eyed | greater w/gaze toward affected side

Face weakness is damage to what CN?

VI d/t its proximity w/CN VII

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

superior rectus

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

Rotation

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

Blindness d/t ophthalmic artery branch of internal carotid artery

What branches come from circle of willis?

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

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

Herring's law

TOTAL Sudden vision loss what monocular disorder?

Temporal aka Giant Cell arteritis | note: optic disc swelling w/pale optic disc. associated w/polymyalgia rheumatica

Sudden onset painless vision loss is what monocular disorder?

AION | anterior ischemic optic neuropathy

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

ipsilateral disc swelling w/ peripapillary hemorrhage

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

optic neuritis | note: progression to MS