Pupils

Question 1

what are the 4 fundamental rules of the pupils?

Answer 1

1. The normal pupils are equal members of a team
2. The pupil control system is so important it has two “managers”
3. The normal pupils are subject to a near triad or synkinesis
4. The pupils reflect the body in which they live

Question 2

Both pupils will respond equally if a light stimulus is moved from one eye to another

True or False

Answer 2

True

Question 3

Both pupils constrict and dilates together. What happens when constrict? dilate?

Answer 3

constrict= get smaller (allows to focus)
dilate= get bigger (allows more light in)

Question 4

Pupils are equal in size. There is about a 0.5mm difference.

True or False

Answer 4

True

Question 5

what is anisocoria? how much of the population has this?

Answer 5

two different size pupils. 20% of the population has this.

Question 6

With anisocoria the lids are in normal position. Anisocoria remains the same in any level of illumination.
True or False

Answer 6

True

Question 7

what are the two pupil managers?

Answer 7

parasympathetic and sympathetic

Question 8

Rest and Digest
Target is the iris sphincter (responsible for closing the pupil)
Responsible for closing (miosis/pupil constriction)
Pupillary light reflex

Am I parasympathetic or sympathetic?

Answer 8

parasympathetic

Question 9

what is the neurotransmitter that controls the parasympathetic system?

Answer 9

acetylcholine

Question 10

name the two types of pupillary light pathways?

Answer 10

afferent= toward the brain
efferent= towards the eye

Question 11

Light illuminates the retina and
Signals are carried by the nerve fibers to brain
am I afferent or efferent?

Answer 11

afferent

Question 12

The pupil fibers leave the optic tract and enter the brachium of the superior colliculus
To the pretectal nucleus in the midbrain
what pathway is this associated with? afferent or efferent?

Answer 12

afferent

Question 13

where do the about half the fibers cross? name the fibers that cross.

Answer 13

they cross at the optic chiasm. the nasal fibers are the ones that cross.

Question 14

From the pretectal nucleus, information is sent to the Edinger-Westphal nuclei on both sides
who am I? afferent or efferent?

Answer 14

efferent

Question 15

where do fibers synapse in the efferent pathway? where is the end destination? what does it cause the eye to do?

Answer 15

Fibers synapse at the ciliary ganglion
End destination is the iris sphincter
Both pupils constrict!

Question 16

The pathway back to the eye is via what CN?

Answer 16

CN 3

Question 17

Fight or Flight
Responsible for opening (mydriasis/dilation)
Active in a an alert person
Target is the iris dilator
Two neurotransmitters:
Preganglionic is acetylcholine
Post ganglionic is nor-epinephrine
Am I parasympathetic or sympathetic?

Answer 17

sympathetic

Question 18

what are the neurotransmitters that control preganglionic and post ganglionic in sympathetic system?

Answer 18

preganglionic= acetylcholine

post ganglionic= norepinephrine

Question 19

what does the hypothalamus control?

Answer 19

Sympathetic impulses

Via brain stem and cervical cord

Question 20

In a 3 Neuron Arc
First order neuron
Second order neuron
Third order neuron
This is part of the sympathetic pathway.
Yes or No

Answer 20

Yes

Question 21

For the sympathetic pathway:
End of the first pathway ends at C8 T1. (the transmitter that works here is acetylcholine)
Superior ganglion up to the forehead.
True or False

Answer 21

True

Question 22

sweating is controlled by which neurons in the 3 neuron arc?

Answer 22

1st and 2nd neurons

Question 23

the 3 neuron arc is mediated by what?

Answer 23

hypothalamus.

Question 24

Transmitter for 3rd order neuron is norepinephrine (naso-ciliary nerve to pupil dialotor, upper ciliary muscle and lower ciliary muscle).
Reverse ptosis.

True or False

Answer 24

True

Question 25

what is mydriasis?

Answer 25

“blown pupil” dilation of pupil even in bright light it remains large.

Question 26

what does hippus mean?

Answer 26

parasympathetic and sympathetic working in unequal equilibrium. sphincter and dilator not working together equally.

Question 27

what does hippus result in?

Answer 27

results in different types of movement:

1) vermiform movement
2) rhythmic movement
3) normal

Question 28

Three concurrent events:
Not a true synkinesis
1) Accommodation
Hyperopes accommodating at distance
2) Convergence
3) Miosis
Follows the Para-Sympathetic Pathway
To iris sphincter and ciliary muscles
Independent of 
Illumination
Decreased accommodative ability (presbyopia)
Most of the fibers go to accommodation
Can have accommodation but absent pupil reaction
Light-near dissociation
what is this?

Answer 28

near traid

Question 29

pupils reflect the body in which they live. in what individuals will you find smaller pupils?

Answer 29

1) Older pupils are smaller
2) The pupils of Diabetics are smaller
3) The pupils of chronic alcoholics are smaller
4) Pain or ocular inflammation will constrict the pupil