Neuro VII

Question 1

age related macular degeneration

Answer 1

loss macula - central retina

scotoma - loss central vision

dry or wet

Question 2

wet macular degeneration

Answer 2

with neovascularization

-anti-VEGF tx - bevacizumab

Question 3

dry macular degeneration

Answer 3

yellow extracellular deposit beneath retinal pigment epithelium - drusen

tx - MTV and anti-oxidants

Question 4

diabetic retinopathy

Answer 4

nonproliferative - damaged cap leak blood
-tx blood sugar control

proliferative - chronic hypoxia - new vessel formation
-tx - bevacizumab

Question 5

retinal vein occlusion

Answer 5

block central or branch retinal vein

compression nearby arterial atherosclerosis

edema of affected area

Question 6

retinal detachment

Answer 6

separation of neurosensory layer of retina from outer pigmented epithelium

get vision loss

surgical emergency

Question 7

central retinal artery occlusion

Answer 7

acute painless monocular vision loss

retinal cloudy
cherry red spot on fovea

Question 8

retinitis pigmentosa

Answer 8

retinal degeneration
-inherited

night blindness - rods first

bone spicule shape deposit around macula

Question 9

retinitis

Answer 9

retinal edema and necrosis - get scar

often viral - CMV, HSV, HZV

with immunosuppression

Question 10

papilledema

Answer 10

optic disc swelling
with increased ICP

large blind spot and elevated optic disc

Question 11

pupil control - miosis

Answer 11

1st neuron - edinger westphal nucleus to ciliary ganglion
2nd neuron - short ciliary nn to pupil sphincter

miosis - constriction - PS

Question 12

pupil light reflex

Answer 12

afferent CN 2 - to pretecal nucleus

activate B/L edinger westphal

efferent to ciliary ganglion - CN 3 - pupil contract B/L

get B/L constriction with illumination of 1 eye

Question 13

mydriasis

Answer 13

dilation of pupil - sympathetics

neuron 1 - hypothalamus to ciliospinal center of budge

neuron 2 - exit at T1 - to superior cervical ganglion

neuron 3 - plexus along internal carotid - through cavernous sinus - enter orbit

to pupil dilatory muscle

Question 14

marcus gunn pupil

Answer 14

afferent pupil defect

optic n damage

loss B/L pupil constriction when light shone in affected eye

Question 15

horner syndrome

Answer 15

sympathetic denervation of phase

ptosis
miosis
anhidrosis

lesion spinal cord above T1 - pancoast, brown sequard, late stage syringomyelia

Question 16

superior oblique m

Answer 16

nerve- CN IV

abduct, intort, depress while adducted

best tested when adducted

Question 17

CN 3 damage

Answer 17

motor and PS component

central - motor
peripheral - PS

motor - affected with ischemia

peripheral - affected with compression
-loss pupil light reflex and blown pupil

Question 18

CN 6 damage

Answer 18

eye cannot abduct

loss lateral rectus

Question 19

CN 4 damage

Answer 19

eye move upward with C/L gaze

head tilt toward side of lesion when go downstairs

Question 20

down and out gaze

Answer 20

loss of CN 3

Question 21

anopia

Answer 21

visual loss one eye

optic n lesion

Question 22

bitemporal hemianopia

Answer 22

loss lateral visual field both eyes

pituitary mass

Question 23

homonymous hemianopia

Answer 23

loss same side visual field both eyes

-optic tract lesion - side of visual defect

Question 24

upper guadrantic anopia

Answer 24

pie in sky

lost C/L temporal lobe - meyer loop - MCA

Question 25

lower quadrantic anopia

Answer 25

pine on ground

lost C/L parietal lobe - MCA
-dorsal optic radiation

Question 26

homonymous hemianopia with macular sparing

Answer 26

PCA infarct

PCA infarct

macular sparing - collateral flow

Question 27

meyer loop

Answer 27

inferior retina - inferior visual field

loops around inferior horn of lateral ventricle

parietal lobe

Question 28

dorsal optic radiation

Answer 28

superior retina - superior visual field

shortest path via internal capsule

temporal lobe

Question 29

MLF

Answer 29

medial longitudinal fasciciulus

communcation between CN VI and CNIII - 6 and 3

coordinate eye movement horizontally

highly myelinated

Question 30

lesion of MLF

Answer 30

horizontal gate palsy

get horizontal nystagmus

look left - left nucleus of CN VI fires

• contracts left lateral rectus
• stimulates right nucleus of CN III - contract right medial rectus

Question 31

internuclear opthalmoplegia

Answer 31

INO - MLF lesion

right INO - refer to eye paralyzed