Visual/Auditory/Vestibular Systems

Question 1

Scotoma

Answer 1

Pathological blind spots in one eye from ocular, retinal or nerve disorder

Question 2

Papilledema

Answer 2

Optic disc swelling that is caused by increased intracranial pressure

Question 3

What impairment of visual acuity is NOT improved with looking through a pinhole?

Answer 3

Lesion of optic nerve or macula

Question 4

Perimetry

Answer 4

Computed visual test that puts together a visual field of a patient using lights and the response of the patient

Question 5

What is suspected if the visual field enlarges as a cone with increased distance?

Answer 5

• Glaucoma

- Retinal Degeneration

Question 6

What is suspected with tunnel vision?

Answer 6

Psychiatric cause

Question 7

What lesion causes left eye blindness?

Answer 7

Left Optic Nerve

Question 8

What lesion causes bitemporal heteronymous hemianopia?

Answer 8

Lesion of Inner Optic Chiasm

Question 9

What lesion causes left nasal hemianopia?

Answer 9

Lesion of the Outer Optic Chiasm on the Left Side

Question 10

What lesion causes right homonymous hemianopia?

Answer 10

Left Optic Tract

Question 11

What lesion causes right superior homonymous quadrantanopia?

Answer 11

Left Inferior Optic Radiation - Meyer’s Loop (Temporal Lobe)

Question 12

What lesion causes right inferior homonymous quadrantanopia?

Answer 12

Left Superior Optic Radiation - Parietal Lobe

Question 13

What lesion causes right homonymous hemianopia with macular sparing?

Answer 13

Left Occipital Lobe

Question 14

What are the characteristics of optic neuritis?

Answer 14

• Associated with MS
• Scotoma in one eye with pain
• Optic disc is swollen unilaterally

Question 15

What is optic atrophy?

Answer 15

Occurs weeks after optic nerve lesion with a pale optic disc with sharp, distinct margins - due to destruction of retinal ganglion cell axon

Question 16

Papilledema

Answer 16

• Bilateral swollen discs (neuritis will rarely be bilateral)
• Increased intracranial pressure
• Flame hemorrhages can be seen
• Vision loss will occur if untreated

Question 17

What is a common lesion that can affect the optic chiasm?

Answer 17

Pituitary Tumor

Question 18

What can cause cortical blindness?

Answer 18

Stroke of the posterior cerebral arteries

Question 19

What is a finding with cortical blindness?

Answer 19

Despite total blindness, the pupillary light reflex is normal because the optic nerve is normal

Question 20

Weber Test

Answer 20

Tuning fork on the top of the head and if one side is heard better it indicates conductive deafness on that side OR nerve problem on the contralateral side

Question 21

Rinne Test

Answer 21

Tuning fork at mastoid bone and when the sound stops, hold it in the air and the sound should be heard again because air conduction is better than bone conduction in normal patients. If nothing is heard -> conduction deafness

Question 22

Acute Labyrinthitis

Answer 22

Viral infection or inflammation of inner ear labyrinth; leading to asymmetrical nystagmus, unilateral hearing loss and gait ataxia on examination

Question 23

Benign Positional Vertigo

Answer 23

Minor movements of head creates impulses in vestibular
system due to lodged Ca2+ crystals - common in elderly patients
- Dix Hallpike can be used to test for this