Pupils Flashcards
Muscle that causes dilation
Dilator pupillae
Muscle that causes eye constriction
Sphincter pupillae
Parasympathetic
Constrict
Sympathetic
Dilate
Meiosis
Pupillary light reflex
Parasympathetic inner action
First order of miosis
Afferent
Signal from retina to pretectal nuclei
…
Second order miosis
Efferent
Pretectal nuclei to both Edinburgh-Westphalia nuclei
(Stimulus causes constriction in both)
Third order miosis
Efferent
Preganglion motor
Edinger-Westphal Nucleus to ciliary ganglion
…
Fourth order miosis
Efferent
Postganglion motor
Mydriasis
Sympathetic inner action
First order mydriasis
Efferent
Posterior hypothalamus to ciliospinal center of budge
Second order mydriasis
Efferent
Ciliospinal center of budge to superior cervical ganglion
Third order mydriasis
Superior cervical ganglion to ciliary body and dilator pupillae
Decussation of neurons to contralateral sides
1st order at optic chiasm
Bilateral innervations
2nd order, pretectal nucleus to edinger-westphal nucleus
Direct/consensual/near reflex
part 1
shine light in eye look at eye, then look at secondary eye
dim room just enough to see pupils
Swinging flashlight (marcus-gunn)
go back and forth in a straight line
pause 1 s on each eye to asses response (x3)
pause 3 s on each eye to assess response (x3)
Pupil size
look at pupils for equal size within 0.5 mm, and that they change at an equal size
direct response
reaction of the pupil directly being stimulated
consensual response
reaction of the fellow pupil when opposite eye being stimulated
Hippus
pupil doesn’t stay one size/pupil doesn’t stay still
benign
APD
detection of abnormalities due to disruption of the afferent pathway
measured (-), 1+, 2+, 3+, 4+
Near Accommodative Pupil Response (“Near Triad”)
accommodation
miosis
convergence
only tested when no/poor reaction to light in both pupils
Anisocoria
unequal pupil size
can be pathological or physiological
photopic
light conditions
scotopic
dim conditions
PERRLA
Pupils Equal Round Reactive to Light and Accomadation
