Neuro VII Flashcards
age related macular degeneration
loss macula - central retina
scotoma - loss central vision
dry or wet
wet macular degeneration
with neovascularization
-anti-VEGF tx - bevacizumab
dry macular degeneration
yellow extracellular deposit beneath retinal pigment epithelium - drusen
tx - MTV and anti-oxidants
diabetic retinopathy
nonproliferative - damaged cap leak blood
-tx blood sugar control
proliferative - chronic hypoxia - new vessel formation
-tx - bevacizumab
retinal vein occlusion
block central or branch retinal vein
compression nearby arterial atherosclerosis
edema of affected area
retinal detachment
separation of neurosensory layer of retina from outer pigmented epithelium
get vision loss
surgical emergency
central retinal artery occlusion
acute painless monocular vision loss
retinal cloudy
cherry red spot on fovea
retinitis pigmentosa
retinal degeneration
-inherited
night blindness - rods first
bone spicule shape deposit around macula
retinitis
retinal edema and necrosis - get scar
often viral - CMV, HSV, HZV
with immunosuppression
papilledema
optic disc swelling
with increased ICP
large blind spot and elevated optic disc
pupil control - miosis
1st neuron - edinger westphal nucleus to ciliary ganglion
2nd neuron - short ciliary nn to pupil sphincter
miosis - constriction - PS
pupil light reflex
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
mydriasis
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
marcus gunn pupil
afferent pupil defect
optic n damage
loss B/L pupil constriction when light shone in affected eye
horner syndrome
sympathetic denervation of phase
ptosis
miosis
anhidrosis
lesion spinal cord above T1 - pancoast, brown sequard, late stage syringomyelia
superior oblique m
nerve- CN IV
abduct, intort, depress while adducted
best tested when adducted
CN 3 damage
motor and PS component
central - motor
peripheral - PS
motor - affected with ischemia
peripheral - affected with compression
-loss pupil light reflex and blown pupil
CN 6 damage
eye cannot abduct
loss lateral rectus
CN 4 damage
eye move upward with C/L gaze
head tilt toward side of lesion when go downstairs
down and out gaze
loss of CN 3
anopia
visual loss one eye
optic n lesion
bitemporal hemianopia
loss lateral visual field both eyes
pituitary mass
homonymous hemianopia
loss same side visual field both eyes
-optic tract lesion - side of visual defect
upper guadrantic anopia
pie in sky
lost C/L temporal lobe - meyer loop - MCA
lower quadrantic anopia
pine on ground
lost C/L parietal lobe - MCA
-dorsal optic radiation
homonymous hemianopia with macular sparing
PCA infarct
PCA infarct
macular sparing - collateral flow
meyer loop
inferior retina - inferior visual field
loops around inferior horn of lateral ventricle
parietal lobe
dorsal optic radiation
superior retina - superior visual field
shortest path via internal capsule
temporal lobe
MLF
medial longitudinal fasciciulus
communcation between CN VI and CNIII - 6 and 3
coordinate eye movement horizontally
highly myelinated
lesion of MLF
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
internuclear opthalmoplegia
INO - MLF lesion
right INO - refer to eye paralyzed
