Pupillary Assessment 4%

Question 1

Which nerve pathway originates from cortex(sensory)?

Answer 1

Efferent

Question 2

Which muscles are innervated by fibers that are carried superficially on 3rd CN?

Answer 2

Ciliary and Iris Sphincter

Question 3

Which nerve pathway originates in the retinal receptor cells and lead to the cortex (motor)?

Answer 3

Afferent

Question 4

_____________tests integrity of anterior visual system.

Answer 4

Afferent nerve pathway

Question 5

Where do nasal fiber cross?

Answer 5

At the chiasm

Question 6

Temporal fibers are on which side of the body?

Answer 6

They remain on the same side of the body.

Question 7

What is the normal shape of the pupil?

Answer 7

Round

Question 8

A not normal or irregular pupil can be cause by……..

Answer 8

Surgery, Synechiae, Trauma, Acute Angle Closure GLC

Question 9

Size of pupil varies with……..

Answer 9

Age, refractive error, or color of Iris.

Question 10

Do light colored iris, myopes, and children usually have large or small pupils?

Answer 10

Large

Question 11

There is no clinical condition in which the light reflex is ______ and the near response is _________.

Answer 11

Present
Absent

Question 12

What does the Near Reflex Triad consist of?

Answer 12

Accommodation
Convergence
Pupillary constriction

Question 13

With Light-Near Dissociation ___________ is absent or abnormal and ________is intact>

Answer 13

Light Reflex
Near Response

Question 14

*Condition in which pupil is > 1 mm difference in size

Answer 14

Anisocoria

Question 15

With anisocoria pupil should be measured and documented in ………

Answer 15

dark and light
also lid position and iris color should be documents

Question 16

Nasal fibers cross at the chiasm, temporal pupillary fibers remain on the _____side of the body

Answer 16

Same

Question 17

*What are some causes of anisocoria?

Answer 17

Horner’s syndrome, 3N palsy, Adie’s pupil, siderosis Bulbi, trauma, pharmacologic agents, physiologic anisocoria(heterochromia)

Question 18

Condition that is acquired/congentital, benign. Causes ptotic lid, anisocoria, and heterochromia(2diff color irises, light color on side with ptotic lid). Can be caused by lung cancer, trauma, corpus artery aneurism. Pt does not have sweating on the side of face with ptotic lid.

Answer 18

*Horner’s Syndrome

Question 19

Condition in which pt has anisocoria, larger pupil will not have ptotic lid. Tested with 2.5 methacholine.

Answer 19

Adie’s pupil

Question 20

*With this condition anisocoria is greater with bright lights on, less with dim lights. Ptotic lid on the side with larger pupil

Answer 20

Third nerve palsy

Question 21

Diabetic 3rd Nerve Palsy will_____ have pupil involvement

Answer 21

Not

Question 22

Rust in eye, can cause anisocoria and heterochromia, can darken the iris with FB.

Answer 22

Siderosis Bulbi

Question 23

When check pupils have or fixate in a ____target, Have a _____lit room, have a ____light in hand. Measure pupils in ______light and _____illumination.

Answer 23

Distant
Dim
Bright
Ambient
Indirect

Question 24

What can you use to measure pupils?

Answer 24

Pupil gauge

Question 25

What does PERRLA stand for?

Answer 25

Pupils equal, round, reactive to light , and Accommodative

Question 26

What are the steps to evaluating pupils?

Answer 26

1. Size and shape (indirect light)
2. If anisocoria, check size in light and dark
3. Reaction to direct light testing
4. Reaction to consensual light testing
5. SWIFT

Question 27

Pupils should constrict ____ and have a ____dilation to normal size folllowed by a state of unrest known as____

Answer 27

Briskly
Slow
Hippus

Question 28

What does the amount of constriction and redilation depend upon?

Answer 28

The ambient illumination and brightness of the test light.

Question 29

In the normal eye characteristics of the pupil reaction will be the ___ in ____ eyes

Answer 29

Same
Both

Question 30

RAPD is also known as…

Answer 30

Marcus Gunn pupil

Question 31

*An afferent defect, nerve pathways fail to properly transmit messages, can be mild to severe (trace to 4+), always is a sign of an underlying disorder. Usually caused by ON disorder

Answer 31

RAPD(Marcus Gunn pupil)

Question 32

*Marcus Gunn Pupil (RAPD) is usually caused by….

Answer 32

Optic Nerve Disorder

Question 33

An APD with only 1 reactive pupil.

Answer 33

Revers Marcus Gunn Pupil

Question 34

In Reverse Marcus Gunn Pupil, if the abnormal eye is the eye with the fixed pupil of the normal eye will ________ when the light is shined directly in it and will ______ when the light is shinned in the opposite eye. If the abnormal eye is the eye with the reactive pupil, then the pupil will______when the light is shined in the opposite eye and will_____when the light is shined directly into it.

Answer 34

Constrict briskly
Dilate
Constrict
Dilate