Neuro-Ophthalmologist

Question 1

If you interrupt the sympathetic input, you get an abnormal __________ reaction.

Answer 1

dark (that is, the pupil won’t dilate in the dark)

Question 2

Interruption of the parasympathetic input results in _______________.

Answer 2

abnormal light reaction

Question 3

Horner syndrome results in _____________.

Answer 3

small pupil and mild ptosis (baby ptosis)

Question 4

Painful Horner syndrome can be _____________.

Answer 4

carotid artery dissection –extremely important because it can be stroke

Question 5

Most of the axons that stimulate miosis are due to the __________ response.

Answer 5

near response (the light response only takes up about 10% of the fibers)

Question 6

A disorder that leads to defective quadrants of the visual field are called _____________.

Answer 6

quadrantanopia

Question 7

What does homonymous field defect mean?

Answer 7

That each eye has the same piece missing (e.g., both eyes cannot see the upper right quadrant)

Question 8

Lesions to the ___________ produce “pie-in-the-sky” visual disturbances without affecting the central focus.

Answer 8

inferior occipital

Question 9

Learn the retinotopy of the occipital cortex.

Answer 9

Imagine a small circle at the center of the visual divided into quadrants: 1 is UL, 2 is LL, 3 is UR, and 4 is LR. The quadrants are represented on the opposite hemisphere, and on the opposite side of the calcarine sulcus (so 1 –the UL –is on the right hemisphere inferior to the calcarine sulcus). The smallest number ism most superficial (so 1 is superficial) and then count up by 4s (so 5 is deep to 1 and 9 is deep to 5).

Question 10

Afferent pupillary defects must occur in the axons of ____________.

Answer 10

cells prior to the LGN

Question 11

The most important question to ask in a double-vision case is _______________. Later ask which directions make the diplopia worse or whether it’s worse with neat or far objects.

Answer 11

“is it present when one eye is closed?”

Question 12

Physiologic anisocoria is less than __________.

Answer 12

1.0 mm

Question 13

The _____________ muscle is innervated by the sympathetic nervous system and leads to dilation of the pupil.

Answer 13

radial iris

Question 14

Where is the first-order neuron in the Horner-system pathway?

Answer 14

Hypothalamus to spinal cord

Question 15

The superior oblique muscle moves the eye _____________.

Answer 15

down and intorsion

Question 16

The inferior oblique muscle moves the eye ______________.

Answer 16

up and extorsion

Question 17

Static downbeat nystagmus can result from what condition?

Answer 17

Arnold-Chiari with compression of the flocculonodular lobe

Question 18

What is a tonic pupil?

Answer 18

An abnormally dilated pupil because of “a portion not wired up to the light reaction”; results from damage to ciliary ganglion that provides parasympathetic input; slow reaction to light –faster reaction to accommodation