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Head, Neck and Neurological Systems > Week 6 > Flashcards

Week 6 Flashcards

1
Q

Briefly outline the visual pathway from eyes to brain

A

Eyes → optic nerves → optic chiasm → optic tracts → optic radiations

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2
Q

Where are images of the right external environment relayed to?

A

Left side of the back of the eye

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3
Q

What is the result of optic nerve damage?

A

Loss of vision in that eye

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4
Q

What is the result of optic chiasm damage?

A

Crossing fibres are affected which causes loss of outer part of visual field of each eye

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5
Q

What could be the cause of optic chiasm damage?

A

Pituitary tumour compressing the chiasm

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6
Q

What is the result of optic radiation or cortical damage?

A

Loss of vision on opposite side to lesion

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7
Q

What does the red test look for?

A

Relative field defect

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8
Q

What does the finger movement test look for?

A

Absolute field defect

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9
Q

What is hemianopia?

A

Loss of vision on one side

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10
Q

What can cause hemianopia?

A

Ischaemia due to blockage of posterior or middle cerebral artery

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11
Q

What does homonymous mean?

A

Of the same distribution on both sides

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12
Q

What are the signs of homonymous hemianopia?

A

Complaint of poor vision with normal visual acuity
Bumping into objects
Stroke with movement problems on one side

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13
Q

What is the normal pupil response to light?

A

Rapid constriction of pupil to light (direct) and simultaneous constriction of other pupil (consensual)

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14
Q

Briefly outline the pathway of the pupil response

A

Light shone in one eye → signal passed down optic nerve → splits in chiasm → passes down both sides to upper tectal region of midbrain → passed to CN 3 on both sides → causes constriction of both pupils

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15
Q

What part of the visual pathway is affected by optic nerve, optic chiasm and optic radiations damage?

A

Nerve - clarity, pupil
Chiasm - visual fields
Radiations - homonymous

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16
Q

What part of the brain receives visual information?

A

Primary visual cortex/V1/striate cortex

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17
Q

How does light interact with the retina?

A

Deepest layers of retina (photoreceptors) receive light first; back-to-front mechanism

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18
Q

Approximately how long is the optic nerve?

A

50mm

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19
Q

How many optic fibres decussate at the optic chiasm?

A

50-60%

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20
Q

What is the LGN?

A

Lateral geniculate nucleus

Relay centre of the thalamus, alternating white and grey matter, 6 layers

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21
Q

What is the superior colliculus?

A

Area of the midbrain involved in control of eye movement to track a moving stimulus

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22
Q

Where is the pituitary stalk in relation to the optic chiasm?

A

Underneath

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23
Q

Where can optic fibres project?

A

LGN
Superior colliculus
Pretectal area

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24
Q

Input to which part of the retina will always cross over?

A

Nasal retina

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25
What defect results from a partial optic nerve lesion?
Ipsilateral scotoma
26
What defect results from a complete optic nerve lesion?
Blindness in that eye
27
What defect results from an optic chiasm lesion?
Bitemporal hemianopia
28
What defect results from an optic tract lesion?
Homonymous hemianopia
29
What defect results from a Meyer's loop lesion?
Homonymous upper quadrantanopia
30
What is Meyer's loop?
Part of the optic radiation which sweeps back on itself into the temporal lobe, just lateral to the temporal horn of the lateral ventricle
31
What defect results from an optic radiation lesion?
Homonymous hemianopia
32
What defect results from a visual cortex lesion?
Homonymous hemianopia
33
What defect results from a bilateral macular cortex lesion?
Bilateral central scotoma
34
What can cause optic nerve lesions?
Acute optic neuritis Multiple sclerosis Indirect traumatic optic neuropathy Optic atrophy
35
What can cause optic chiasm lesions?
Tumours (pituitary adenoma, meningioma) | Aneurysms (ACA)
36
What can cause optic tract lesions?
Tumours Trauma Aneurysm of posterior cerebral artery
37
What is Goldmann perimetry?
Assesses the extent of visual field A test light is used as the stimulus (kinetic or static) and visual field can be mapped according to detection of the light
38
What is the pupillary light reflex?
Pupil constriction in response to light
39
What is the accommodation reflex?
Pupil constriction and convergence of the eyes when looking from a distant object to a close one
40
Is pupil constriction under sympathetic or parasympathetic control?
Parasympathetic
41
What is the pathway for pupil constriction?
Edinger-Westphal nucleus → ciliary ganglion → eye
42
What is the pathway for pupil dilation?
Spinal cord → superior cervical ganglion → eye
43
Is pupil dilation under sympathetic or parasympathetic control?
Sympathetic
44
What nerves are involved in the afferent and efferent pathway of the pupillary light reflex?
Afferent - optic nerve | Efferent - occulomotor
45
Briefly outline the pathway of the pupillary light reflex
Light shone in right eye → information from right eye reaches pretectal nuclei on right and left → both Eddinger-Westphal nuclei activated → right and left oculomotor nerves activated → constriction of both pupils
46
What is hippus and when might it be seen?
Initial dilation/oscillation in response to light which is normal and can be found in some healthy young people
47
What is the swinging flashlight test?
Test to identify asymmetry of afferent input in the pupillary light reflex (called a relative afferent pupil defect (RAPD))
48
What can cause a RAPD?
Optic neuritis | Large retinal detachment
49
What would be seen in an abnormal swinging flashlight test?
When moving the light source from the right to left eye, the left eye paradoxically dilates (problem with left eye afferent limb)
50
What are the 3 components of the accommodation-convergence reflex and what muscles are responsible for each?
``` Pupil constriction (constrictor pupillae) Lens accommodation (ciliary muscles) Convergence of eyes (medial rectus muscles) ```
51
What is the stimulus in the accommodation-convergence reflex test?
Out-of-focus image
52
What nerves constitute the afferent and efferent limbs of the accommodation-convergence reflex?
Afferent - optic nerve | Efferent - oculomotor nerve
53
How are the pupils clinically examined?
1. Inspect (irregularity/asymmetry) 2. Direct and consensual light response 3. Swinging light test 4. Accommodation-convergence reflex test
54
What is the Edinger-Westphal nucleus?
Accessory oculomotor nucleus | Parasympathetic pre-ganglionic nucleus that innervates the iris sphincter muscle and the ciliary muscle
55
What is the calcarine sulcus a landmark for?
Marks primary visual cortex within the superior and inferior calcarine gyri
56
What is the superior colliculus also known as?
Tectum
57
What cranial nerves pass through the venous cavernous sinus?
Oculomotor Trochlear Abducens
58
What percentage of brain tumours are anaplastic astrocytomas?
80%
59
What cranial nerve is affected by suprasellar meningioma?
Oculomotor nerve
60
What signs indicate that the oculomotor nerve has been compromised?
Fixed and dilated pupil
61
What epithelium lines the air sinuses of the skull?
Respiratory epithelium
62
What mneumoic can be used to determine what cranial nerves are sensory and/or motor in order?
Small ships make money but my brother says big boats make more
63
What piece of equipment is required for a fundoscopy?
Ophthalmoscope
64
What is the red reflex?
Reddish-orange reflection of light from the back of the eye observed when using an ophthalmoscope
65
What vascular arcades are found in the eye?
Retinal - superior and inferior
66
How can veins and arteries in the eye be distinguished?
Arteries - thin and bright | Veins - thick and dark
67
How would you check the macula during a fundoscopy?
Ask the patient to look directly into the light
68
How are facial injuries classified?
Le Fort I (lower) Le Fort II (middle) Le Fort III (upper)
69
What Le Fort classifications are associated with base of skull fractures?
II and III
70
How might surgeons use hyaluronic acid?
Lip fillers | Scar reduction

Head, Neck and Neurological Systems (6 decks)

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