Opthalmology and Otalaryngology Flashcards
when does eye development begin
5 weeks
what is the retina derived from
neuroectoderm
what are the vascular layers and sclerocorneal layers derived from?
mesoderm
what is the lens derived from?
surface ectoderm
when does eyelid close in response to light
30 weeks
when do pupils become reactive
30 weeks - well developed at 1 month
when does conjugate horizontal gaze occur?
1 month
when does visual fixation develop
1 month; well developed at 2 months
when does conjugate vertical gaze develop
2 months
when does visual following develop
3 months
when does visual evoked potential develop to adult levels?
6 months
when does optic nerve myelination complete?
2 years
which causes constriction and dilation? SNS vs PNS
Parasympathetic - constriction
sympathetic - dilation
leukocoria ddx
cataracts
retinoblastoma
coloboma
RoP
persistent hyperplastic primary vitreous
retinal detachment or dysplasia
vitreous hemorrhage
intraoccular inflammation
medulloepithelioma
myelinated nerve fibers
hypotelorism
holoprosencephaly
Meckel Gruber
trisomy 13
Williams
hypertelorism
Apert
cat-eye
CHARGE
Cri du chat
Crouzon
del 13q
DiGeorge
Holt-Oram
Noonan
tri 8
hydantoin and isoretinoin`
upward slant
trisomy 21
hydantoin
prader willi
trisomy 13 or 18
downward slant
greater growth of brain above eye - maxillary hypoplasia
apert
noonan
criduchat
cat eye
digeorge
isoretinoin
aniridia
11pdel
wagr
cherry red spot
niemann pick and tay sachs
sialidosis
coloboma
cat eye
charge
13q del
treacher collins (eyelid)
tri 8
goldenhar (eyelid)
corneal opacities
mucopolysaccharidosis
mucolipidosis
fabry
cystinosis
hypophosphatasia
wilson
epicanthal folds
cridu chat
13qdel
fragile x
noonan
smith lemli optiz
stickler
tri21
williams
FAS
methotrexate
valproate
heterochromia
waardenburg
horners
hirshsprung
lens dislocation
homocystinuria
marfan
ehlers danlos
telecanthus
waardenburg
blue sclera
OI 1 and 2, 3 initially, not 4
russel - silver
ehlers danlos and marfans
incontinentia pigment
turner
stage 1 ROP
demarcation line
stage 2 ROP
ridge
stage 3 ROP
ridge + extraretinal neovascularization into vitreous space
stage 4 ROP
partial retinal detachment
stage 5 ROP
complete retinal detachment
plus disease
dilated tortuous vessels
iris vascular engorgement, pupillary regidity, vitreous haze/hemorrhage
screening for ROP
< 30 weeks, < 1500 g
risk of strabismus in PT and FT
12-22% of preterm, 1-3% FT
congenital infections cataracts
HSV
varicella
rubella (50%)
toxo
metabolic cataracts
galactosemia
galactokinase deficiency
mevalonic aciduria
mucolipidoses
hypocalcemia
vitamin A or D
genetic cataracts
smith lemli optiz
stickler
tri 21
WAGR
secondary glaucoma causes
homocystinuria
congenital rubella
RoP
Sturge Weber
Stickler
eye findings in tri 13
hypotelorism
microphtalmia
coloboma of iris
retinal dysplasia
eye findings in tri 18
short palpebral fissures
hypoplastic orbital ridges, inner epicanthal folds, ptosis, corneal opacity
eye findings in tri 21
bruschfield spots
lens opacities
myopia
nyastagmus
strabismus
blocked tear duct
eye findings in del 13q
colobomas
small eyes
hypertelorism
increased risk Rb
ptosis
epicanthal folds
preauricular pit or sinus
beckwith wiedemann
branchio oto renal syndrom
risk of infections and cyst development
NOT associated with hearing loss
pre auricular skin tag
goldenhar
hemifacial microsomia
1st and 2nd branchial arch syndrome
RISK hearing loss
microtia
isoretinoin
RISK hearing loss
treacher collins
goldenhar
hemifacial microtia
small cupped ears
RISK hearing loss
CHARGE
Hirshsprung
agenesis of corpus callosum
when is AABR reliable
after 34 weeks
what is 1-3-6 rule for hearing
screen by 1 month
diagnose by 3 months
intervention by 6 months
ranges of hearing loss
normal - 10 to 15
mild 26 - 40
mod 41- 55
mod sever 56-70
severe 21 - 90
profound > 91
most common genetic cause of hearing loss
connexin 26
syndromes with hearing loss
alport
pierre robin
usher
pendred
waardenburg
treacher collins
charge
klippel feil
tri8
stickler
tri21
when to follow up failed ABR?
< 1 month
development of nose
- formation of NT from ectoderm (3rd week)
- NT into neural crest cells
- migration neural crest into mesenchyme
- nasal cavity from invagination of nasal placodes (3-6 weeks)
- epithelial plug in nostrils until 24 weeks when resorption occurs
nasal encephalocoele
contiguous with CSF
may be pulsatile and expand with crying or compression of jugular veins
nasal glioma
does not have CSF connection
firm, noncompressible
60% external 30% internal 10% mixed
nasal meningocele
contains CSF and brain tissue
may be pulsatile and expand with crying or compression of jugular veins
epulis vs epignathus
epulis from gum
epignathus from jaw/hard palate
ranula vs mucocele
mucocele from minor salivary gland; painless
ranula from major salivary gland; painless
macroglossia
lymphangioma
hemangioma
Beckwith wiedemann
hypothyroid
mucopolysaccharidoses
tri21
MCC laryngeal anomaly
- layngomalaxia
- VC paralysis (L > R)
embryology of laryngeal web
week4-5 primitive tissue obliterates area of larynx
if airway does not canalize the web will form during week 7-8
often in glottis area
endoscopy showing pale or blue compressible mass originating laterally
subglottic hemangioma
grading in subglottic stenosis and treatment
grade 1 <50%
grade 2: 51-70%
grade 3: 71-99%
grade 4: complete obstruction
1 & 2 endoscopic laser with stenting
3 & 4: surgery
preauricular problem
hemangioma
vascular malformation
post auricular problems
branchial cleft cyst (I)
submandibular
hemangioma
ranula
submental and midline neck
thyroglossal duct cyst
dermoid cyst
venous malformation
anterior border of sternocleidomastoid
branchial cleft cyst (I, II, II)
hemangioma
laryngocele
supraclavicular/paratracheal
thyroid mass
parathyroid mass
esophageal diverticulum
lipoma
dermoid cyst
supraclavicular
lipoma
average palatal index in neonate
0.3
MCC neonatal nasal obstruction
mucosal inflammation
% of cleft lip + palate identified prenatally
28%
