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Neuro > neuro4 > Flashcards

neuro4 Flashcards

1
Q

ninety percent of retinl axons terminate where

A

lateral geniculate nuc

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2
Q

PRIMARY visual cortex corresponds to brodman area what

A

brodman are 17 or striate cortex

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3
Q

brodman areas of associated visual cortex

A

18 and 19

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4
Q

in what lobes are the higher order vision processing centers

A

posterior parietal and inferior temporal cortices

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5
Q

one eye visual field loss- where is the lesion

A

optic nerve on that side

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6
Q

bitemporal visual field defect- where is the lesion

A

chiasm (because it only affects the crossing fibers, which come from the nasal portion but see the outside visual field)

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7
Q

homonymous hemianopsia- where is the lesion

A

optic tract on the opposite side OR optic radiations (both parietal and temp or meyer’s loop) on the opp side

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8
Q

homonymous quadrantonopia-where is the lesion?

A

optic radiations; parietal if lower field out and temporal or meyers loop if upper field is out

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9
Q

homonymous hemianopia with macular sparing

A

occipital cortex

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10
Q

how to detect an afferent pupillary defect

A

show light in good eye and then in bad eye; if bad eye dilates instead of constricts, that is an afferent pupillary defect

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11
Q

where do the retinal nerves synapse?

A

edinger-westphal nuc in the pretectal midbrain; it in the rostral aspect of the third nerve nuc

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12
Q

efferent parasymp fibers from edinger-westphal nuc travel with what

A

cn3

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13
Q

efferent parasymp from the EWN travel how?

A

through the cavernous sinus with the inferior divison of the third nerve and synapse in the ciliary ganglion

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14
Q

the iris contains how many muscles that regulate pupil size

A

two

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15
Q

what innervates the pupilloconstrictor?

A

parasymp fibers of the third nerve

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16
Q

what innervates pupillodilator

A

cervical sympathetic system

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17
Q

describe the path of the symp system innervating the pupillodilator of the eye

A

first order neuron to pregang to postgang

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18
Q

where is the first order neuron in symp control of the pupillodilator?

A

starts in the ipsilateral posterolateral hypothalamus (first order) then porjects down the brainstem to the intermediolateral cell column at the C8-T1 spinal level.

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19
Q

where is the second order neuron in the symp control of the pupillodilator

A

cell body at c8/t1 level and neurons synapse in the superior cervical gang;

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20
Q

where is the third order neuron for symp control of the pupil?

A

start in the superior cervical gang and neurons travel along the internal carotid artery in teh cavernous sinus and from there into the orbit to teh pupillodilator muscles

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21
Q

horner’s syndrome

A

ipsilateral miosis (small pupil), ptosis (drooping of the upper lid), inverted ptosis (elevation of lower lid), and sometimes impaired ipsilateral facial flushing and sweating (anhidrosis)

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22
Q

cocaine test

A

for horners syndrome; cocaine drops will fail to dilate the abnormal pupul

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23
Q

how does cocaine work?

A

inhibits the reuptake of norepi from the synaptic cleft

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24
Q

apraclonidine

A

weak direct acting alpha 1 and alpha 2 agonist that dilates the affected eye due to denervation supersensitivity of the iris dilator muscle

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25
Q

hydroxyamphetamine

A

pupil with a postgang horners fais to dilate with this drug; distinguishes pre from postgang neuron issue

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26
Q

where is the lesion if relative afferent pupillary defect

A

in the eyee, optic nerve, or chiasm

27
Q

sign of lesion in the lateral geniculate nucleus

A

binocular visual loss; no RAPD

28
Q

ipsilateral smooth pursuit abnormalities and spasticity of conjugate gaze. Where is the lesion

A

optic radiation

29
Q

differences in visual field defects in the temporal, parietal, or occipital lobes

A

temporal means superior contralateral quandrantopia; parietal is inferior contralateral quadrantopia; occipital is congruous contralateral hemianopsia with mac sparing

30
Q

miotic versus mydriatic pupil

A

miotic pupil is too small and mydriatic is too big

31
Q

characteristics of a third nerve palsy

A

ptosis, dilated pupil, and ophthalmoplgia

32
Q

ophthalmoplegia

A

extraocular muscle palsy

33
Q

compression of the third nerve initially causes what

A

dilated pupil because parasymp run on the outside; eye movements come later bc motor on the inside

34
Q

third nerve ischemia causes what

A

pupil-sparing third nerve lesion in which pupil is normal but palsy of ocular muscles

35
Q

Adie’s pupil cause

A

interruption of the parasymp supply from the ciliary gang (cell bodies or postgang fibers)

36
Q

adie’s pupil symptoms

A

ansiocoria, photophobia, and blurred near vision (due to accomodation paresis)

37
Q

adie’s pupil exam

A

dilated pupil, poor light reaction and light-near dissociation

38
Q

how to confirm adie’s pupils

A

supersensitivity of the affected pupul to 0.1% pilocarpine, which will produce more contraction in the affected pupil than in the normal

39
Q

Argyll Robertson pupil associated with what

A

syphilis

40
Q

describe argyll robertson pupil

A

both pupils small and irregular with impaired light reaction and intact light-near dissociation; pupils dilate poorly to mydriatic agents

41
Q

what is light near dissociation

A

normally pupil constricts more to light than to near things; if the opposite happens, it is called LND

42
Q

most common symptom of optic disk swelling

A

transient visual obscurations, described as dimming or blacking out of visio asting a few seconds, usually ppt by changes in posture of valsalva

43
Q

most common causes of unilateral optic disc swelling

A

optic neuritis; anterior ischemic optic neuropathy, and orbital compressive lesions

44
Q

disc hemorrhage and optic disk swelling

A

usually anterior ischemic optic neuropathy

45
Q

foster kennedy syndrome

A

ipsilateral optic disc atrophy due to compression fo the optic nerve by a space-occupying lesion in the frontal lobe and papilledema in the contralateral optic disc due to increased ICP

46
Q

treatment for idiopathic intracranial htn

A

acetazolamide, nerve decompression, shunt

47
Q

what is drusen

A

calcified hyaline bodies

48
Q

asymptomatic enlarged blind spot with normal visual acuity initially

A

drusen

49
Q

fundi with glistening hyaline bodies and venous pulsation

A

drusen

50
Q

how to diagnoise drusen on the optic disc

A

CT and orbital ultrasound to see calcified hyaline bodies

51
Q

causes of optic neuritis

A

demyelination (MS, SLE, adrenoeukodystrophy, sarcoidosis, tumor); behcets, viral, meningitis, whipple and crohn disease

52
Q

painful vision loss

A

optic neuritis

53
Q

Uthoff’s phenomenon

A

worsening visual function during exercise, hot baths; assoc with optic neuritis

54
Q

Central scotoma

A

classic for optic neuritis; central vision loss

55
Q

how to diagnose optic neuritis

A

MRI looking for demyelination; visual evoked potentials

56
Q

therapy for optic neuritis

A

IV methylprednisolone

57
Q

if MRI of the head shows more than three demyelinating lesions, what is the prob of developing MS within 5 yr

A

fifty percent

58
Q

causes of anterior ischemic optic neuropathy

A

carotid occlusion, embolic; TIAs; temporal arteritis

59
Q

sudden painless vision loss

A

anterior ischemic optic neuropathy

60
Q

anterior ischemic optic neuropathy associated with what other disease

A

hypertension, diabetes, hypotensive episodes

61
Q

do you have relative afferent papillary defect in anterior ischemic optic neuropathy?

A

yes

62
Q

CN 3 innervates what EO muscle

A

SR, MR, IR, levator palpebrae, pupil constrictor, and inferior oblique

63
Q

CN3 dysfuncton

A

eye is down and out; ptosis; mydriasos

Neuro (43 decks)

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