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ophthomology > the eye and raised ICP anatomy > Flashcards

the eye and raised ICP anatomy Flashcards

1
Q
A

CNV (trigeminal nerve)

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2
Q
A

Pia

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3
Q
A

S2

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4
Q
A

4th ventricle

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5
Q
A

choroid plexus

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6
Q

True or False

Most patients with ICP will report visual problems

A

true

65-75% of patients with ICP will report visual problems

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7
Q

why is a raised ICP dangerous?

A

-as it can cause damage to tissues, shifts in tissues, herniation and constriction to blood vessels

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8
Q

what must exist in equilibrium with echother in the cranial cavity?

A
  • brain
  • blood
  • CSF

This is the Monroe-kellie hypothesis so if one increases another must decrease

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9
Q

what are optic nerves surrounded by?

A

-cranial meninges

dura on outside, arachnoid in middle and Pia which completely sits closest to optic nerve

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10
Q

what is the space between the arachnoid and Pia called?

A

sub-arachnoid space (filled with cerebrospinal fluid)

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11
Q

what is the subarachnoid space filled with?

A

cerebrospinal fluid

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12
Q

why does raised ICP affect vision?

A
  • raised ICP will compress the optic nerve as the is cerebrospinal fluid in the sub arachnoid space of the nerve
  • it will also compress the nerve and artery
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13
Q

what are meninges?

A

-the protective coverings of the brain and spinal cord

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14
Q

what are the levels of meninges?

A
  • dura
  • arachnoid
  • subarachnoid space
  • pia
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15
Q

what are dural septa?

A

-folds of dura mater

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16
Q

what does the tentorium cerebelli do?

A

-divides the cerebellum

EDIT

16
Q

what does the tentorium cerebelli do?

A

-divides the cerebellum

EDIT

17
Q

where does the brain stem pass in relation to the tentorium cerebelli?

A

-tentorium notch (brain can herniate through the tentorium notch)

18
Q

when may raised ICP compress/stretch the oculomotor nerve?

A

-if the medial temporal lobe herniates through tectorial notch

19
Q

what effect does the medial temporal lobe herniating through the tentorial notch have on the eye ?

A
  • paralyis of somatic nerve intervention (4 extra ocular muscles and eyelid)
  • paralysis of parasympathetic innervation sphincter of pupil
  • lose/slowness of pupillary light reflex, dilated pupil, ptosis, eye turned inferolaterally ‘down and out’
20
Q

what occurs if there is damage to trochlear nerve?

A
  • paralysis of superior oblique muscle

- inferior oblique is unopposed so eye cannot move inferomedially and there will be diplopia when looking down

21
Q

how may raised intracranial pressure affect the adbducent nerve?

A

-there may be damage by it stretching

  • there will be paralysis of lateral rectus muscle
  • the eye cannot move laterally in horizontal plane (medial deviation of the eye)
22
Q

what abnormal anatomy can you see?

A
  • lack of symmetry (right orbital floor fracture and herniation)
  • fluid in the sinus
23
Q

baby scratches mums eye, she feels extreme pain in the eye

-why is this?

A
  • CNV1 picks up sensation of pain

- extremely painful as it is very densely innervated

24
Q

baby scratches mums eye, she has redness in the eye

-why is this?

A

-inflammation of conjunctival vessels

25
Q

baby scratches mums eye, she has increased lacrimation in the eye
-why is this?

A

-CNVII (facial nerve) secretomotor innervation to the lacrimal gland to secrete extra tears to flush out irritants

26
Q

what is meningitis describing?

A

-inflammation of the meninges

27
Q

what are the two layers of dura?

A
  • periosteal layer which covers the inner surface of the skull
  • the meningeal layers which covers covers the other meninges
28
Q

what is contained in the subarachnoid space?

A

-circulating CSF and blood vessels

29
Q

what does the Pia adhere to?

A

the brain

30
Q

how can CSF be accessed?

A

-via a lumbar puncture at L3/4 of L4/5

31
Q

where is CSF produced?

A

-in the choroid plexus

32
Q

where is the choroid plexus found?

A

-in the lateral and third ventricles

ophthomology (32 decks)

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