6: Papilloedema Flashcards Preview

Ophthalmology Week 2 2017/18 > 6: Papilloedema > Flashcards

Flashcards in 6: Papilloedema Deck (17)
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1

Does "swollen optic disc" mean papilloedema?

No

Swollen discs have many causes (e.g CRVO, ischaemic optic neuropathy...)

Papilloedema is a swollen optic disc secondary to raised ICP

2

All patients with bilateral optic disc swelling should be suspected of having what?

Space occupying lesion in brain

3

How is CN II examined?

Visual acuity

Pupil exam

Visual field assessment

Colour vision

swinging light test

4

Why does raised ICP affect the optic nerve?

CN II is an extension of the brain and so is found in the subarachnoid space, so it can be compressed by increased ICP

5

What space does ICF circulate in?

Subarachnoid space

6

What does the subarachnoid space surround?

Optic nerve

7

Why do the optic discs become swollen in papilloedema?

Raised ICP causes swelling of subarachnoid space, compressing VEINS

8

What is the Monro-Kellie hypothesis?

Brain, blood and CSF make up the volume of the brain

If one volume increases, the others DECREASE (and thus pressure INCREASES inversely)

9

Can the cranial vault change its volume?

No, fixed

10

Which hole in the cranial floor does the brainstem pass through?

Foramen magnum

11

Why can an increased ICP cause you to die?

Compression of respiratory centres of brainstem

12

What type of hypertension can cause optic disc swelling?

Malignant hypertension

13

What should be investigated in all patients with optic disc swelling?

Head scan for space occupying lesions

Blood pressure for malignant hypertension

Lumbar puncture if suspected inflammation / infection of CNS

14

Where is CSF produced?

What is its path?

Where does it drain?

Choroid plexus of lateral ventricles

Lateral > 3rd > Cerebral aqueduct > 4th ventricle > Subarachnoid space > Arachnoid granulations

Dural venous sinuses

15

What aspects of CSF cause raised ICP?

Obstruction of drainage

Overproduction

16

What is the investigation used to diagnose problems to do with the CSF?

Lumbar puncture

17

Why must optic disc swelling be treated?

Eventually turns atrophic and pale

=> LOSS OF VISION