Pre-Lab

Question 1

Which hold does the middle meningeal artery enter thru?

Answer 1

foramen spinosum

Question 2

Aside from supplying the meninges, what else does the middle meningeal artery supply?

Answer 2

the bone

Question 3

Where is the easiest place to damage the middle meningeal artery?

Answer 3

the pterion b/c here the bones are quite thin.

Question 4

What is the pterion?

Answer 4

this is a thin meeting point of 4 bones:
frontal
parietal
temporal
sphenoid

Question 5

Rupturing the middle meningeal artery will result in what?

Answer 5

epidural hematoma

Question 6

An epidural hematoma is a ___________. This increases intracranial pressure–>to at least the systolic pressure of the arterial system.

Answer 6

space occupying lesion

Question 7

If the pressure from an epidural hematoma is high enough, a portion of the temporal lobe will be squeezed underneath the ________. Which nerves are compressed?

Answer 7

tentorium cerebelli. Not a good situation.
CN3. If you have the pt look @ you–>the expression of the eye will look lateral (lateral rectus is working b/c innervated by abducens, but some other muscles not working.)

Question 8

Aside from a lateral looking eye, what else can tip you off that there might be an epidural hematoma?

Answer 8

some pupil dilation b/c of messed up parasympathetics.

Question 9

What about the babinski sign w/ an epidural hematoma?

Answer 9

this reflex will be messed up b/c of corticospinal pathways

Question 10

What is the shape of the hematoma when a pt has an epidural hematoma?

Answer 10

lentiform or lenticular

Question 11

T/F Talk & Die Syndrome is associated w/ subdural hematoma.

Answer 11

F we have talked about this w/ an epidural hematoma.

Question 12

Subdural hematoma has to do with _____ drainage.

Answer 12

venous drainage
this hematoma creates a subdural space where there was none.
this can be acute or chronic–>can appear 4 of 5 years later after bumping the head.

Question 13

What happens in a blow out fracture?

Answer 13

you punch the eye & the eye is forced down thru the inferior floor of the orbit into the maxilla
**it causes hemorrhage into the maxillary sink & displacement of the orbital structures into the maxillary sinus

Question 14

What are some of the terrible things that can happen w/ a blow out fracture of the orbit?

Answer 14

airway obstruction
infection
displacement of maxillary teeth
dislocate the lens
hemorrhage & rupture of globe
retinal detachment
**can cause blindness

Question 15

Which eye will be higher: normal eye or blow out eye?

Answer 15

normal eye

Question 16

Can you look upward with blow out eye?

Answer 16

maybe no b/c of entrapment of the tissue in a fracture defect

Question 17

What is the normal intraocular pressure?

Answer 17

12–22 mmHg
Over this is considered increased introcular pressure
**this is what happens w/ glaucoma & can cause loss of vision

Question 18

What are the 2 types of glaucoma? Which is more dangerous?

Answer 18

narrow angle/angle closure glaucoma**more dangerous

Open angle glaucoma

Question 19

Which type of glaucoma is frequent when you have diabetes?

Answer 19

open angle glaucoma

Question 20

Why can’t you give ppl meds that dilate the pupil when they have closed angle glaucoma?

Answer 20

b/c the more the iris is dilated–>the more the canal of Schlemm is blocked
**this type of glaucoma can cause loss of vision

Question 21

What is glaucoma?

Answer 21

the thing caused by increased pressure in the eye by intraocular fluid that won’t drain properly.
should go from ciliary processes to scleral venous sinuses (Schlemm’s canal)

Question 22

On fundoscopic exam, what do you see w/ a pt w/ glaucoma?

Answer 22

optic nerve head cupping

Question 23

What is the clinical progression of glaucoma?

Answer 23

optic nerve damage
peripheral field visual loss
loss of central vision
Blindness

Question 24

What is papilledema?

Answer 24

Edema of the optic disc (choked disc)
Optic disc swelling is caused by increased intracranial
pressure; therefore, it is usually bilateral

Question 25

What do you think when you see unilateral papilledema?

Answer 25

If papilledema is present in only one eye, think of orbital pathology (e.g., tumor compressing optic nerve)

Question 26

What is the clinical significance of the subarachnoid space surrounding the optic nerve?

Answer 26

CSF under pressure in subarachnoid space surrounding the optic nerve – compression of central retinal vein – engorged retinal veins – hyperemic and swollen optic disc (edema) – retinal hemorrhages around the disc