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Boards Part 1 > Ocular Anatomy / Physiology > Flashcards

Ocular Anatomy / Physiology Flashcards

1
Q

a CN X lesion will have what effect in the mouth? How does this compare to a CN XII lesion?

A

CN X: Uvula will pull away from side of lesion

CN XII: Tongue pushes towards the side of lesion

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2
Q

What are the three possible destinations for a ganglion nerve fiber coursing through the optic nerve? What do these destinations control?

A

LGN: Primary visual cortex
Superior Colliculus: Saccades
Pretectal Nucleus: Pupils

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3
Q

What does CN I control?

A

Smell

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4
Q

What does CN II control?

A

Vision

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5
Q

What does CN III control?

A

EOMS (superior rectus, inferior rectus, inferior oblique, medial rectus)
Pupil Size
Accommodation

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6
Q

What does CN IV control?

A

Superior Oblique

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7
Q

What does CN V control?

A

Facial sensation

Mastication

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8
Q

What does CN VI control?

A

Lateral Rectus

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9
Q

What does CN VII control?

A

Facial Expression
Anterior 2/3 taste
Salivation (Submaxillary, Submandibular)
Lacrimation

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10
Q

What does CN VIII control?

A

Hearing

Balance

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11
Q

What does CN IX control?

A

Swallowing
Salivation (Parotid)
Posterior 1/3 taste
Monitor carotid sinus

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12
Q

What does CN X control?

A

Taste (epiglottis)
Palate elevation
Talking
Thoracoabdominal viscera

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13
Q

What does CN XI control?

A

Shoulder movement

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14
Q

What does CN XII control?

A

Tongue movement

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15
Q

The medial longitudinal fasciculus connects what four cranial nerves?

A

CN III, CN IV, CN VI, CN VIII

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16
Q

What sub-nucleus of CN III decussates to innervate the contralateral muscle?

A

Superior Rectus

Sub-nuclei for IR, IO, and MR go to ipsilateral muscle

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17
Q

What is unique about the levator sub-nucleus?

A

There is only ONE sub-nucleus for BOTH levators

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18
Q

What are the divisions of the CN III?

A

Superior - Superior Rectus and Levator, Sympathetic fibers (Muller’s muscle)
Inferior - Inferior Rectus, Inferior Oblique, Medial Rectus

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19
Q

What structures do the fibers of CN III travel with as they course from the sub-nuclei to their respective muscles?

A

Sub-nuclei in Brainstem -> PCOM Artery -> Cavernous Sinus -> Superior Orbital Fissure

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20
Q

Where do sympathetic fibers join CN III? Where do they come from? What division of CN III do they join?

A

Superior division of CN III receives sympathetic fibers from the ICA in the cavernous sinus

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21
Q

Where do parasympathetic fibers join CN III? Where do they come from? What division of CN III do they join?

A

Inferior division of CN III receives parasympathetic fibers from the EW nucleus

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22
Q

What would happen to the eye in a complete CN III palsy?

A

Severe ptosis. Eye would be DOWN and OUT.

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23
Q

Pupil involved CN III palsy is most likely due to ______. Pupil-sparing CN III palsy is most likely due to ______.

A

Pupil-involving CN III palsy -> PCOM and ICA junction (tumor / aneurysm)
Pupil-spring CN III palsy -> Microvascular ischemia (DM / HTN)

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24
Q

What is unique about the course of CN IV?

A

Exits DORSALLY from the midbrain (at the level of the inferior colliculus) and decussates to innervate the CONTRA superior oblique

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25
Q

The ______ connects the sub-nucleus of CN IV to the visual cortex through the _________

A

The tectobulbar tract connects the sub-nucleus of CN IV to the visual cortex through the superior colliculus

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26
Q

Damage to the LEFT CN IV sub-nucleus will cause a _____ superior oblique palsy and _____ head tilt

A

Damage to the LEFT CN IV sub-nucleus will cause a RIGHT superior oblique palsy and LEFT head tilt

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27
Q

The anatomical origin of the superior oblique is the _______, the physiological origin is the _______

A

Anatomical origin - lesser wing of sphenoid

Physiological origin - trochlea

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28
Q

What is the Arden Ratio? What value is considered normal?

A

EOG measurement of the differences in the RPE response under light and dark conditions
normal Arden Value = Greater than 1.80

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29
Q

What do the waves of an ERG correspond to?
A-wave?
B-wave?
C-wave?

A

A-wave: Photoreceptors
B-wave: Bipolar and Amacrine cells
C-wave: RPE

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30
Q

How fast will a healthy visual cortex respond to visual stimuli in a healthy patient?

A

Less than 100 msec

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31
Q

Henle’s nerve fiber layer in the Macula is another name for what layer in the retina?

A

Outer Plexiform Layer

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32
Q

The synaptic endings of rods are called ______ while the synaptic endings of cones are called ______

A

Rods - Spherules (smaller are more “sphere”-like)

Cones - Pedicles (larger and flatter like a “pedestal”)

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33
Q

How long does it take for a demarcation line to become present after a retinal detachment stabilizes?

A

3 months

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34
Q

What is the patellar fossa?

A

Depression of the vitreous which abuts the posterior surface of the lens

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35
Q

What is the name of the additional retinal layer that many nocturnal vertebrate animals posses that functions to enhance visual sensitivity at low light levels?

A

Tapetum Lucidum

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36
Q

Cone photoreceptors are neatly organized in what type of arrangements in the macula?

A

Hexagonal

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37
Q

What are the three photopigment in cones? What are their peak wavelength absorbency?

A

Erythrolabe - 565 nm
Chlorolabe - 535 nm
Cyanolabe - 430 nm

38
Q

What branch of the nasociliary nerve carries sympathetic fibers to the dilator muscle of the iris?

A

Long Posterior Ciliary Nerves

39
Q

Increase intracranial pressure will most likely affect which cranial nerve first?

A

CN VI

40
Q

Where is the lacrimal artery, lacrimal nerve, and ciliary ganglion in relation to CN VI in the orbit?

A

Lacrimal nerve and artery - superior to CN VI

Ciliary ganglion - medial to CN VI

41
Q

Why does a CN VI palsy with ipsilateral horner’s localize to the cavernous sinus?

A

ICA aneurysm in the cavernous sinus will compress CN VI and sympathetic fibers

42
Q

What is the difference between the facial manifestations of Bell’s Palsy and a stroke?

A

Bell’s Palsy - IPSI LMN lesion -> entire side of face is affected
Stroke - CONTRA UMN lesion -> only lower side of face is affected

43
Q

What nerve carries the final parasympathetic innervation to the pupillary sphincter muscle and ciliary body?
What nerve carries the final sympathetic innervation to the pupillary dilator muscle?

A

SPCN - Pupillary sphincter and ciliary body

LPCN - Pupillary dilator

44
Q

Wha is the Canal of Hannover?

A

Between anterior and posterior lens zonules over the equator. Contains equatorial zonules.

45
Q

What is the Canal of Petit?

A

Between posterior zonules and anterior hyaloid membrane and ciliary body

46
Q

Iris cysts can develop if there is a separation between what two layers?

A

Anterior and posterior pigmented iris epithelium. Typically they are joined apex to apex by desmosomes and microvilli.

47
Q

What layer of the ciliary body secretes aqueous humor?

A

Non-pigmented ciliary body of the pars plicata

48
Q

What are the valley of Kuhnt?

A

Heavily pigmented areas located between the ciliary processes

49
Q

What produces lens zonules?

A

Pars Plana

50
Q

_____ produces zonules, which travel through _____ before inserting on the _______

A

Pars plana NPCE produces zonules, which travel through the Valley of Kuhnt and insert onto the lens capsule

51
Q

What is the Supraciliaris?

A

Potential space! Outermost layer of the ciliary body that is loosely attached to the underlying sclera

52
Q

What structures must nerves and blood vessels travel through to get from the choroid to the anterior portion of the eye?

A

Choroid -> Suprachoroid -> Supraciliaris -> Anterior portion of eye
*Suprachoroid is continuous with supraciliaris at the ora serrata

53
Q

Where does fluid accumulate in a ciliary body detachment?

A

Supraciliaris

54
Q

What is the largest intrinsic muscle of the eye?

A

Ciliary muscle

55
Q

The ciliary muscle is anchored anteriorly by what structure?

A

Scleral spur

56
Q

What are the Longitudinal muscle fibers of the ciliary muscle also known as?

A

Longitudinal muscle fibers of Brucke

57
Q

What comprise the largest proportion of CM fibers?

A

Longitudinal muscle fibers (of Brucke)

58
Q

What is Muller’s annular muscle?

A

Most medial portion of the ciliary muscle. Has a similar action as pupillary sphincter of iris.

59
Q

What are the two routes aqueous can take once it reaches schlemm’s canal?

A

SC -> short efferents -> deep scleral venous plexus -> intrascleral venous plexus -> episcleral venous plexus
OR
SC -> veins of Ascher -> episcleral venous plexus

60
Q

Schwalbe’s line represents the termination of what structure?

A

Descemet’s Membrane

61
Q

Name the structures seen on gonioscopy from most posterior to most anterior

A 
"I Can't See This Stupid Shit, Seriously"
Iris
Ciliary Body Band
Trabecular Meshwork
Scleral Spur
Schwalbe's Line
Sampolesi's Line
62
Q

What is the internal scleral sulcus?

A

Fancy name for the angle: the cornea-slcera junction

63
Q

What is the Becker-Shaffer grading system?

A 
Grade 0 - No structures visible
Grade 1 - Anterior aspect of TM
Grade 2 - 1/2 to 1/3 of TM
Grade 3 - Scleral Spur
Grade 4 - Ciliary body
64
Q

What are the only two parts of the sclera that contain elastin?

A

Scleral Spur

Lamina Cribosa

65
Q

The TM is triangular in shape, with the base of the triangle abutting the _____ and the apex pointing towards the _____

A

The TM is triangular in shape, with the base of the triangle abutting the scleral spur and the apex pointing towards the cornea

66
Q

What portion of the angle typically has the greatest amount of pigment?

A

Inferior TM

67
Q

Aqueous is transported from the JXT to schlemm’s canals through ______

A

Giant vacuoles?

68
Q

Schlemm’s canal often contains multiple channels formed by CTT septae that increase the surface area for aqueous filtration. These channels are known as _______

A

internal collector channels

69
Q

Posterior Embryotoxin represents an anteriorly displaced _______

A

Schwalbe’s line

70
Q

The pupil is not in the center of the iris. How is it displaced?

A

Inferior and nasal to center

71
Q

What are Schwalbe’s contraction furrows?

A

Variations in the thickness of the posterior pigmented iris epithelium

72
Q

Where is the iris thickest?

A

Collarette

73
Q

What are the Crypts of Fuchs?

A

Depressions / openings near the collarette of iris

74
Q

What zone of the iris is expected to have radial streaks? What are these radial streaks? What color are they?

A

The ciliary zone of the iris has radial streaks that are white and represent collagen traveling along iris vessels

75
Q

Which is bigger…. The anterior iris stromal leaf or the posterior iris stromal leaf?

A

Posterior Iris Stroma Leaf

76
Q

Is Aniridia bilateral or unilateral? What condition is it mostly associated with? What other conditions is it associated with?

A

Bilateral
Associated with Glaucoma
Also a/w foveal hypoplasia, nystagmus microcornea, lens subluxation, optic nerve hypoplasia

77
Q

What makes an eye blue?

A

Thin anterior border layer

Melanocytes contain a small amount of melanin

78
Q

What is the only condition characterized by a lack of pigment within the iris epithelial layers?

A

Oculocutaneous albinism

79
Q

The non-pigmented CB epithelium is continuous with what layer of the iris?

A

The non-pigmented CB epithelium is continuous with the posterior pigmented iris epithelium

80
Q

Keratic Precipitates are made of what two types of cells?

A

Macrophages

Epithelioid Cells

81
Q

The ciliary body is triangular in shape and its apex points towards the _______

A

ora seratta

82
Q

What is Vossius’s Ring? What can cause this?

A

Annular ring of iris pigment on the anterior lens capsule.

Trauma, Posterior Synechiae

83
Q

What is the difference between Dalen-Fuchs, Busacca, Koeppe, and Berlin Nodules?

A

Koeppe Nodules - Pupillary border
Busacca Nodules - Mid-Iris border
Berlin Nodules - Anterior Angle
Dalen-Fuchs Nodules - Chorioretinal lesions

84
Q

What vitamin interferes with vitamin A absorption?

A

Vitamin E

85
Q

What is Salus’s sign? Bonnet Sign? Gunn Sign? What are they all indicative of? What grade do they represent?

A

Salus’s sign - venule changes course due to arteriolar hardening. Grade 2.
Bonnet sign - banking of the venule around the arteriole. Grade 3.
Gunn sign - tapering of the venule around a hardened artery. Grade 3.

86
Q

What is HYPERfluorescent on FFA?

A

Neovascularization (retinal, CNVM), CME, Central Serous, PED, RPE dropout

87
Q

What is the classic “triad” of Retinitis Pigmentosa?

A

Arteriolar Attenuation, Waxy ONH pallor, Bone-Spicule Pigmentation

88
Q

What is the most likely place that a Hollenhorst plaque comes from?

A

ICA

Order Carotid-Doppler ultrasound

89
Q

What layers of the LGN contain Magno fibers? What layers contain Parvo fibers?

A

Layers 1 and 2 = MAGNO

Layers 3, 4, 5, 6 = PARVO

90
Q

The cornea gets the majority of its glucose from ______

A

Aqueous

91
Q

What bone of the orbit is the thinnest? What bone is the weakest?

A

Thinnest - ethmoid

Weakest - maxillary

Boards Part 1 (5 decks)

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