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My Ophthalmology > Week 1 - Important Anatomy > Flashcards

Week 1 - Important Anatomy Flashcards

1
Q

what are the 3 layers of the CNS meningeal layers - names, order from outer to inner, characteristics

A

order = DAP
Dura mater - thick dense connective tissue. Encloses dural venous sinuses.

Arachnoid mater - thin delicate tissue - lines longitunindal fissure. Has arachnoid granules that protrude into the dural venous sinuses.

subarachnoid space - contains CSF + blood vessels.

Pia mater - thin, fibrous, covers the brain + attached nerves + vessels

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2
Q

what are the 2 parts of the midbrain that are part of the pupillary sphincter reflex?

A
  1. Pretectal nucleus

2. EWN

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3
Q

where is the synapse of CN3 ?

A

in the ciliary ganglion

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4
Q

where are the choroid plexuses?

A

mostly in the lateral ventricles

also 3rd and 4th ventricles

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5
Q

what are the 3 parts of the trigeminal nerve CN 5 ?

A 
V1 = Ophthalmic 
V2 = maxillary 
V3 = mandibular
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6
Q

what does CN V1 cover?

A

Ophthalamic nerve

  • upper eyelid
  • eye
  • middle to tip of nose
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7
Q

what does CN V2 cover?

A

Maxillary

  • lower eyelid
  • maxillary area of face
  • side of nose
  • upper lip
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8
Q

what does CN V3 cover?

A

Mandibular

  • lower lip
  • jaw area
  • NOT the angle of the mandible
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9
Q

what 2 CNs are involved in the blink (corneal) reflex?

A 
CN V (V1) = afferent
(V1 --> trigeminal ganglion --> pons --> CN 7)
CN VII = efferent to eyelid of orbicular oculi
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10
Q

where do presynaptic Cervical sympathetic axons from the CNS synapse into post synaptic axons?

A

at the superior cervical sympathetic GANGLION

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11
Q

At what spinal level do pre-synaptic sympathetic axons leave the spinal cord?

A

T1

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12
Q

how do post-synaptic sympathetic axons travel to the head organs ?

A
  1. enter int/external carotid nerves
  2. these nerves are on surface of the int/external carotid arteries which do into the organs
  3. get to eyes on the ophthalmic artery branch
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13
Q

what 3 things in the head are supplied by oarasympathetic axons?

A

eyes
lacrimal glands
salivary glands

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14
Q

CN3 exit from the brain

  • what sinus?
  • what fissure?
A

cavernous sinus

superior orbital fissure

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15
Q

where do presynaptic parasympathetic axons of CN3 synapse?

A

in the ciliary ganglion

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16
Q

the post-sympathetic part of the CN3 is dividied in 2 parts - superior and inferior. what 2 muscles are superior + what 3 are inferior?

A

superior = superior rectus + LPS

inferior = medial rectus + inferior rectus + inferior oblique

remember that lateral rectus = CN6
and superior oblique is CN 4

LR6 SO4 AO3

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17
Q

ciliary nerves control iris diameter + refractive shape of lens

what part of autonomic control is are long ciliary nerves?

what are short ciliary nerves for?

A

long = sympathetic (and sensory - 1st part of blink reflex)

short = symp + parasympathetic

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18
Q

what does mydriatic mean?

A

enlarged pupil

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19
Q

what does miotic mean?

A

constricted pupil

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20
Q

terms for

  • enlarged pupil
  • constricted pupil
A 
enlarged = mydratic
constricted = miotic
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21
Q

what fibres allow dilation?

A

dilator pupillae

22
Q

what fibres allow constriction?

A

sphincter pupillae

23
Q

the pupillary light reflex involves which 2 cranial nerves?

A

2 (optic) - afferent

connections in the midbrain - pretectal + EWN

3 (oculomotor) - efferent

24
Q

what connects the lens and the ciliary body?

A

the suspensory ligament

25
how do you achieve a "flat lens" for far vision?
- ciliary muscle relaxes - suspensory ligament tightens (no parasympathetic control)
26
how do you achieve a "round lens" for near vision?
- ciliary muscle contracts - suspensory ligament relaxes under CN3 !!! parasympathetic control = near vision more important than far in parasympathetic states
27
what is needed for the accommodation reflex? (3)
parasympathetic control: round lens (near vision) = so CN3 convergence = CN3 causes medial rotation of eyes pupillary constriction = CN3 also
28
compression of WHAT causes horners?
compression of the cervical parts of the sympathetic trunk - impairs sympathetic innervation eg. ptosis instead of wide opened eyelids eg. miosis instead of dilated eg reduced steating
29
could add lacrimilisation nerve Qs
??
30
what spinal levels is lumbar puncture done at ?
either L3/4 or L4/5
31
how does CSF get from the subarachnoid space back into the brain?
subarachnoid --> arachnoid --> arachnoid granules --> dural venous sinuses
32
what happens when the optic nerve is compressed by high ICP?
1. compression of the central vein and artery of the retina too 2. papilloedema - optic disc swelling
33
what specifically damages CN 3 when there is raised ICP?
Tentorial herniation - herniation of the medial temporal lobe through the tentorial notch. likely to compress CN3
34
what happens to the eye when CN3 is compressed by high ICP?
1. paralysis of eyelid = PTOSIS 2. paralysis of SR + IO + IR + MR = TURNED DOWN AND OUT 3. paralysis of parasympathetic pupillary control = DILATED PUPIL
35
What eye movement is restricted when CN 4 is compressed ?
Trochlear nerve = SO paralysis | The eye cant move inferomedially
36
what eye movement is restricted when CN6 is compresed
Abducens = Lateral rectus Eye cant move horizontal + lateral stuck in medial
37
afferent and efferent in the blink reflex?
``` afferent = V1 (ophthalmic - nasociliary branch) efferent = CN 7 ```
38
what is cupping? what are the clinical signs of cupping?
Cupping is progressive thinning of the neuroretinal rim – increasing cup size. Progressive loss of peripheral vision before central. Happens in glaucoma - raised IOP for some reason.
39
what 2 eye nerve conditions are common in MS?
optic neuritis intranuclear opthalmoplegia
40
most common + other causes of CN6 palsy?
``` #1 is microvascular temporal injury raised ICP - petrous tip impingement tumour congenital ```
41
signs of CN 4 palsy
Can't turn "down and in" head tilting if chronic vertical double vision
42
most common + other causes of CN 4 palsy?
#1 is congenital microvascular tumour trauma
43
Signs of a CN3 palsy
ptosis dilated pupil turned down and in
44
describe inter-nuclear ophthalmoplegia + its effect
damage to the connection between CN4 + 6 in the medial longitudinal fasciculatus in the brainstem affects connection between eyes that allow both to look right / left simultaneously at the same time + speed
45
2 systemic conditions that predispose to internuclear opthalmoplegia
1. MS | 2. Vascular eg. stroke
46
what visual field defect is caused by lesion at the occipital visual cortex?
Contralateral homonymous hemianopia +/- macular sparing
47
where is the right upper visual field processed?
left temporal lobe
48
where is the left lower visual field processed?
right parietal lobe
49
what visual field defect is caused by an optic nerve lesion?
Ipsilateral monocular visual loss
50
what nerve problem is caused by GCA? describe it..
ION = ischaemic optic neuropathy Obstructution / stenosis of the posterior ciliary arteries which supply the head of the optic nerve. ischaemia causes irreversible vision loss.
51
describe optic neuritis
progressive visual loss getting worse for 2 weeks. colour vision inc. Pain behind eye + worse on movement. may have scotoma (central) common in MS
52
what slow growing tumour can affect the optic chiams?
Meningioma | Becase slow growing it doesn't cause increased ICP

My Ophthalmology (7 decks)

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