4.1 Visual System and intro to cerebral circulation Flashcards

1
Q

What is the role of horizon cells in the eye?.

A

They enhance edges via lateral inhibition (less spreading of AP to excitatory neurones that lie laterally)

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2
Q

What are the three layers of the eye?

A

Outermost sclera
(Tough and continuous with dural sheath of optic nerve)

Uvea (pigmented vascular layer)

Retina (neural layer)

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3
Q

What are the components of the uvea?

A

Has choroid which sits just deep to sclera

Ciliary body and iris sit anteriorly

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4
Q

What are the components of the retina?

A

From superficial to deep

  • retinal pigment epithelium (prevents glare)
  • photoreceptors cells
  • bipolar cells (first order neurones), connected by horizontal cells
  • ganglion cell layer
  • nerve fibre layer
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5
Q

What is a fundoscopy and why is it done?

A

Examination of the retina

Can detect signs of many diseases such as hypertensive retinopathy, diabetic retinopathy and macula degeneration

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6
Q

What is amaurosis fugax?

A

Occlusion of the central retinal artery (a branch of the opthalmic artery), causing sudden visual loss

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7
Q

What specialist technique can be used to visualise the layers of the retina?

A

Optical coherence tomography

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8
Q

What is the pupillary light reflex?

A

Light is shone into a patients eyes and it constricts

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9
Q

What is the accommodation reflex?

A

Get patient to fixate on finger, then bring it close to their face while asking them to focus on it

Should see

  • eyeball convergence (cross eyed)
  • pupillary constriction (to focus)
  • lense thickenijg (lense can bend light rays from near object)
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10
Q

Why does the pupil constrict and what is the mechanism?

A

The papillary light reflex

Light ray enters eye hits retina

It is detected by the retina and activity goes down through the optic nerve until it reaches a part of the midbrain called the pretectal nuclear, which is in the tectum (mickey Mouses double chin)

Pretectal nuclear receives afferents from the optic nerve and then sends impulses up to Edinger-Westphal nucleus in midbrain

EW nucleus contains parasympathetic preganglionic fibres. Sends impulses to ciliary ganglion where it synapses

Parasympathetic post ganglionic neurone projects up to the sphincter pupillae muscle = sphincter constricts to regulate light falling on retina

AFFERENT PART IS THROUGH OPTIC NERVE VISUAL PATHWAYS

EFFERENT PART IS THROUGH PARASYMPATHETIC NERVOUS SYSTEM

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11
Q

How does the accommodation reflex work and how do you get the desired responses of

  • pupil constriction
  • convergence
  • lense thickening
A

Afferent arm is the retina

Impulses go down through the visual pathways, then we get a synapse at the lateral geniculate

Then projects down to the visual cortex where the patient processes the image of the finger getting closer to their face

This is communicated to the midbrain, to the Edinger-Westphal nucleus and occulomotor nucleus, activating them

EW nucleus then stimualtes ciliary ganglion which in turn, stimulates sphincter pupillae, constricting the lense
Also get lens thickening as it causes contraction of the ciliary muscles that control this

Get convergence through activation of the occulomotor nucleus which controls medial rectus (eye muscle), causing it to contract.

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12
Q

What is the blind spot of the eye?

A

Where the optic nerve leaves the eyeball, there are no photoreceptors = this is your blind spot

The optic disc

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13
Q

What are the two types of photoreceptors?

A

Rods and cones

Rods - black and white vision, good for low light conditions

Cones - for colour vision, not good in low light conditions

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14
Q

What is the fovea?

A

A part of the retina where we have the highest density of photoreceptors (cones)

Also lack of ganglion cell axons that you have elsewhere in the retina = easier for light to reach these cones

The area is the macula and the fovea is in the centre

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15
Q

What is retinal detachment?

A

Mainly types, however I’m most common form:

Photoreceptors separate from underlying pigment epithelium

= can get fluid building up

Presents with sudden blurring and loss of vision/ seeing visual artefacts

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16
Q

What is amalrosis fugax?

A

A sudden transient loss of vision

Due to transient ischaemic attack as a result of a small embolus blocking opthalmic artery which enters at the optic disc

Like a curtain coming down over patients vision due to hypoxia of the retina so photoreceptors aren’t able to work

Is a prelude to stroke

17
Q

Where is the lateral geniculate nucleus located?

A

In the thalamus

It projects to the visual cortex through optic radiations

18
Q

What is a scotoma?

A

A localised defect in the retina can cause a small patch of visual loss called a scotoma

19
Q

How does occlusion of the posterior cerebral artery effect vision?

A

Get contalateral homonyms hemianopia with macular sparing

This is due to the fact that the area of visual cortex that supplies the macula receives blood from the deep branch of the middle cerebral artery