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COM - Neuro Test 2 > Orbit And Cavernous Sinus - 4/7 Neal > Flashcards

Orbit And Cavernous Sinus - 4/7 Neal Flashcards

1
Q

Post-ganglionics from the SCG to the lacrimal gland travel through what nerves?

A

Deep petrosal joins greater petrosal to form the vidian nerve

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2
Q

Describe the effects of Oculomotor nerve palsy?

A

Down and out gaze
Dilated pupil
Eyelid must be manually elevated due to ptosis

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3
Q

What motions of the eye are not included in the cardinal signs of gaze?

A

Straight up/down

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4
Q

Complete ptosis of the eye may be due to a lesion in what muscle?

From what nerve and what type of fibers?

A

Levator palpebrae Superioris (LPS)

CN 3, GSE

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5
Q

What are the PS responses of the eye?

A 
Pupillary constriction (sphincter pupillae m.)
Thickening of the lens for near vision (ciliary m.)
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6
Q

Lesion to the lateral rectus muscle results in what?

superior oblique?

A

Inability to ABduct the affected eye

When ADducted cannot depress the affected eye

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7
Q

Oculomotor nerve palsy has what 3 clinical signs associated with it?

A

Down and out eye
Complete ptosis
Pupil dilation

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8
Q

Loss of consensual light reflex is due to the destruction/lesion of what?

A

Posterior commissure

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9
Q

An aortic or carotid aneurysm can cause what?

What else may cause this symptom?

A

Decrease in Sympathetic outflow to the dilator pupillae muscle -> therefore pupillary constriction

Pancoast tumor (mass effect)

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10
Q

Lesion to what muscle will cause partial ptosis?

Innervated by what?

These fibers originate where?

A

Tarsal muscle of Muller

POST-ganglion if Sympathetic fibers

T1

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11
Q

What is anhydrosis?

If anhydrosis is absent, what else can you look for as a clinical Sx?

A

Lack of sweating

Flushing of the face (dilation of facial blood vessels) to half of the face

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12
Q

What is an Argyll Robertson pupil?

A

Unreactive to light with

Normal accommodation

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13
Q

What kind of response is accommodation? For what?

What is its associated triad?

A

Cortically-mediated response for near vision

Convergence of gaze
Pupillary constriction
Thickening of lens

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14
Q

What is a Holmes-Adie Pupil?

A

Topically slow reacting pupil to light
Normal accommodation
Transient, usually due to infection

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15
Q

What is hyphema?

Damage to what vessel causes it?

A

Pooling of blood in the anterior chamber of the eye

Arterial circle of iris

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16
Q

Grade 1 hyphema?

3?

A

Less than 1/3 volume in ant. Chamber

greater than 1/2 volume in anterior chamber

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17
Q

Damage to what vessel causes subconjunctival hemorrhage?

Where is bleeding restricted to?

A

Deep pericorneal plexus

Subconjunctival tissue or bulbar fascia

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18
Q

Damage to the superficial pericorneal plexus causes what?

A

Conjunctivitis

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19
Q

What structures are involved in a Le Fort 1 fracture?

Where does the fracture line pass through?

A

Horizontal maxillary fracture, separates teeth from upper face

Alveolar ridge, lateral nose and inferior wall of maxillary sinus

iMAN

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20
Q

What kind of fracture is Le Fort 2?

Fracture passes through what?

A

Pyramidal w/teeth at the base and nasofrontal suture at its apex

Alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones

LMAIN

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21
Q

Le Fort 3 fracture involves what?

Passes through what structures?

A

Craniofacial disjunction

Nasofrontal suture, maxillo-frontal suture, orbital wall, zygomatic arch

ZMON

22
Q

The Ophthalmic artery comes off of what?

What are its branches?

A

ICA

Supraorbital
Posterior ethmoidal a.
Anterior ethmoidal a.
Lacrimal
Short ciliary arteries
23
Q

What veins drain into the cavernous sinus?

A

Superior and inferior ophthalmic veins

24
Q

Occlusion of the central retinal artery may cause what?

A

Abrupt, painless presentation

Cherry red macula seen on exam

25
Q

What nerve in the eye is vulnerable to ischemia secondary to orbital fracture?

A

Inracanalicular portion of the optic nerve

26
Q

What are the branches off of V1?

Where does it exit the skull?

A

Nasociliary
Frontal (Supraorbital and supratrochlear)
Lacrimal

Superior orbital fissure

27
Q

Where does the maxillary nerve exit the skull?

A

Foramen rotundum

28
Q

Where does V3 exit the skull?

What does it supply?

A

Foramen ovale

Muscles of mastication

29
Q

The corneal reflex afferent component is sensed by what nerve?

Efferent component?

A

V1 (Nasociliary nerve)

Zygomatic and Temporal branch of CN 7

IN by 5
OUT by 7

30
Q

Blow-out fractures cause Herniation of orbital structures such as ____ into the maxillary sinus?

A

Periorbita
Inferior oblique
Inferior rectus
Orbital fat pad

31
Q

All extraocular muscles are attached to the tendinous ring (annulus tendinius) except what?

A

Inferior oblique muscle

32
Q

Increased intracranial pressure may compress what nerve?

Causes what?

A

Abducens nerve (CN 6)

Paralysis of lateral rectus m.

33
Q

What is the main sensory (GSA) nerve to the eyeball?

A

Nasociliary nerve

34
Q

What is the chief artery of the orbit?

Where does it branch from?

A

Opthalmic a.

ICA

35
Q

The opthalmic artery gives rise to what arteries which supply the optic nerve?

A

Posterior ciliary a

Central retinal a

36
Q

The central retinal artery provides what with a centrifugal vascular supply?

What does it not supply?

A

Anterior optic nerve

Posterior optic nerve

37
Q

How does the central artery supply the 4 quadrants of the retina?

A

Through upper and lower temporal branches

Upper and lower nasal branches

38
Q

What forms the superior ophthalmic vein?

Where does it drain?
What else drains here?

A

Supraorbital and angular veins

Cavernous sinus
Central vein of the retina

39
Q

The afferent component of the direct light reflex is mediated by what?

Where does the information first synapse?

Then where?

A

Optic nerve

Superior colliculus

Pretectum

40
Q

The efferent component of the direct light reflex is mediated by what?

What nucleus?

What ganglion?

A

PS CN 3

Edinger-Westphal

Ciliary ganglion

41
Q

Preganglionic sympathetic neurons for pupillary dilation are located where?

A

ILCC at T1

42
Q

What is the site called for focusing detailed vision?

A

Fovea centralis

43
Q

What causes papilledema?

Result?

A

Increased intracranial pressure

Swelling/edema of the optic disc

44
Q

Sympathetic innervation to the lacrimal gland originates where?

Where do Pre-ganglionics synapse?

Post-ganglionic?

A

Sympathetic trunk

SCG

Travel through SPG but do not synapse

45
Q

Blow-out fractures cause Herniation of what into the maxillary sinus?

A

Inf oblique m.
Inf rectus m.
Orbital fat pad

46
Q

Describe draining of tears from the eye starting from the surface:

A

Lacrimal canaliculi -> lacrimal sac -> nasolacrimal duct -> inferior meatus

Csdim

47
Q

Diplopia due to internal strabismus is the result of what lesion?

A

Abducens nerve

48
Q

External strabismus is from lesion to what?

A

Oculomotor nerve

49
Q

When a patient presents with their head tilted away from an eye that is stuck up and in, what lesion exists?

A

Trochlear nerve

50
Q

What does the lacrimal artery give off?

A

Recurrent meningeal a.

COM - Neuro Test 2 (11 decks)

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