PREFINAL Flashcards
shape of pupil
Round
location of pupil
Centrally located
Color of the pupil
No color
pupil composes of
Entrance/exit pupil
Normal size of pupil (normal range)
2-5mm
Normal size of pupil in physiologic state
3-4mm
T/F
younger individuals have smaller pupils than geriatric patients
F- bigger
T/F
Myopes have larger pupils than hyperopes
T
Nature of pupil size for the entire day
Progressively increases at the end of the day
T/F
Anatomy of pupil reflexes size of pupils depends on the balance of parasympathetic (dilation) and sympathetic (constricts) activity of pupil
F- parasympathetic (constrict) and sympathetic (dilates)
Pupil size considered as dilated
5mm in size
Pupil size considered as constricted
1.5mm or less in diameter
Factors that causes dilated pupils
Dim illumination
Far vision
Mydriatics
In pain
Emotions
Stage 1 anesthesia or prolonged anesthesia
Dyspnea or asphyxia
Cutting the parasympathetic
nerve
Stimulating the cervical sympathetic nerve
Death
Factors that cause constricted pupils
Bright illumination
Near vision
Stage 2 anesthesia
Miotics
Close eyelids
During sleep
Stimulating ciliary nerves
Cutting sympathetic nerves
Before dilating check…
Size
Shape
Near relfex
Light reflex
(+/-) RAPD
T/F
Newborns have dilated pupils
F- constricted
T/F
Dyscoria is a condition called when pupil have different sizes
F- Anisocoria
T/F
Isocoria is a condition when pupil have abnormal shapes
F- Dyscoria
T/F
Isocoria is a condition called if there is a displacement of pupil from the center
F- Corectopia
T/F
Corectopia is a condition when pupil have same sizes
F- Isocoria
T/F
Purpose of checking the reflexes is to assess the integrity of the light and pupillary pathway
F- Visual
Purpose of the reflex
○ It controls the diameter of the pupil in response to intensity of light that falls on the retina of the eye
○ Greater intensity of light = smaller pupil = less light in
○ Lower intensity of light = larger pupil = more light in
Types of reflexes of the pupil
Direct light reflex
Indirect light reflex
Accommodative or near reflex
Orbicularis Oculi reflex
Ciliospinal reflex
T/F
In direct light reflex, the stimulation of one retina by light produces contraction of the pupil on the opposite eye
F- same eye
T/F
In indirect light reflex, the stimulation of one retina by light produces contraction in the same eye
F- opposite eye
T/F
In direct light reflex, there is a constriction of the contralateral pupil to the light stimulus
F- ipsilateral
T/F
In consensual light reflex, there is a constriction of the ipsilateral pupil to the light stimulus
F- contralateral
T/F
In direct light reflex, the signal is passed to both sides of the midbrain so that light information given to one eye is passed on to both pupils equally
F- indirect
T/F
In accommodative convergence reflex, the person looking at an object close to the face will cause contraction of the pupils
T
T/F
In orbicularis oculi reflex, there is a ipsilateral constriction of the pupil followed by dilation after closure of eyelids
F- unilateral
Ciliospinal reflex is also known as
Platysmal reflex
T/F
Ciliospinal reflex is a reflex that induces bilateral pupillary dilation to painful stimuli applied to the skin of the neck
T
T/F
Ciliospinal reflex is mediated by first and second-order sympathetic nerves to the pupil dilator muscle
F- second and third-order
T/F
Ciliospinal reflex is useful to differentiate central from peripheral sympathetic dysfunction
T
T/F
Orbicularis oculi reflex is useful for the evaluation of suspected Horner’s syndrome and brain death
F- ciliospinal
T/F
Ciliospinal reflex is more pronounced in sleep and in comatose patients
T
Purpose is to assess the afferent input from the retina, optic nerve, anterior visual pathways as well as efferent neurological pathways responsible for pupillary function
Pupil light reflex
Equipment used in pupil light reflex
Penlight or transilluminator
Distance fixation traget (20/400 E)
T/F
In pupil light reflex, dim and ambient illumination but permits clear view of both the px’s pupils
T
T/F
In direct pupil reflex, eye practitioner is within 30 cm of the patient
25 cm
T/F
In pupil light reflex, patient wears his habitual correction
F- patient removes spectacles
T/F
In direct light reflex, the patient fixates on a distant object in a darkened room
F- semi darkened
T/F
In direct light reflex, a penlight is used to illuminate each pupil taking care to direct the penlight toward the foveal area
F- macular
T/F
In swinging flashlight test, the penlight is swinging for about 5-10 seconds
F- 1-5 sec.
When the pupil fails to constrict when illuminated this phenomenon is called the
Pupillary escape
T/F
In order to detect pupil with marcus gunn, the consensual light reflex is more stronger than direct light reflex
T
Direct pathway
Retina
Optic nerve
Optic tract
Pretectal nucleus
Edinger westphal
Preganglionic fiber of the oculomotor nerve
Ciliary ganglion
Postganglionic parasympathetic fiber of the oculomtor nerve
Sphincter pupillae
Who is responsible for the efferent limb of pupillary reflex
Optic nerve
Who is responsible for the afferent limb of pupillary reflex
Oculomotor nerve
It is when both eyes converge, the intraocular lenses accommodate and both the pupils constrict upon the shift of fixation of the eye from far to near
Accommodation or pupil near reflex
Near reflex is also known as
Associated pupil reflex
T/F
In neuronal pathway of the pupil near reflex, the pupil constriction to a bear stimulus involves activation of neurons in the rostral brain stem
T
In the light reflex, supranuclear input comes from the pretectal nucleus
T
T/F
In pupil near reflex, supranuclear input comes from the cortical areas surrounding visual cortex and from cortical areas within the frontal eye
T
T/F
The smaller the pupil, the greater the spherical and chromatic aberrations
F- lesser
T/F
The smaller the pupil, the diffraction decreases
F- increases
Purpose is to test the responsiveness of the pupil to near viewing
Accommodative response of the pupil
