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WSUNeurology > A&V:13 Disturbances of Vision | 235-258 > Flashcards

A&V:13 Disturbances of Vision | 235-258 Flashcards

1
Q

About what percentage of sensory input does CNII provide based on number of fibers ?

A

44%

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2
Q

Define amarousis

A

partial or complete loss of sight

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3
Q

define ambylopia

A

monocular deficit with normal ocular structures

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4
Q

Define Nyctalopia and 5 associated conditions

A

poor twilight vision - Vit A def, Ret. Pigmentosa, extreme myopia, cataracts,color blindness

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5
Q

4 positive visual symptoms

A

phosphenes, migranous, scintillations, illusions, hallucinations,

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6
Q

define presbyopa

A

decrease in ability to accommodate

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7
Q

Visual acuity corrects with pinhole indicating a refractive issue …why ?

A

light is focused on the fovea without excess distortion

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8
Q

What can you not see with the direct ophthalmoscope ?

A

anything on the retina/ora serrata/pars plana ,anterior to the equator of the globe

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9
Q

Three important things to note on the cornea

A

band keratopathy, pigment changes in descemet’s membrane, arcus senilis (high cholesterol if younger)

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10
Q

visual deficits in the lower nasal field could indicate

A

glaucoma

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11
Q

Two things to note when looking at the lens

A

Cataract ?

subluxation - up in marfans down in homocystinuria

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12
Q

Two tings to note about the vitreous humor

A

hemorrhage
vitreal traction with age = increased RD (burst of flashing lights and increased loaters, Moore temporal lightning streaks (phosphenes) may indicate incipient dtear/detach

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13
Q

Anterior Uveitis two associations

A

HLA-B27 and Vogt-koyanagi-Harada disease (recurrent meningitis)

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14
Q

Posterior uveitis tow associations

A

Sarcoidosis, Behcet disease , lymphoma

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15
Q

Describe pathway from ganglion cells to hypothalamus

A

light–> ganglion cell layer –> optic nerve –> chiasm –> optic TRACT –> Lateral Geniculate ganglion – superior colliculi –> midbrain pretectum –> suprachiasmatic nucleus of hypothalamus

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16
Q

Most sensitive nerve bundle to metabolic/toxic effects

A

papillomacular bundle runs temporal then central (cecocentral scotoma on exam)

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17
Q

type of visual deficit seen with compressive damage at nerve/chiasm junction

A

junctional scotoma (c/l superior quadrantopsia), wilbrands knee possibly a nasal bundle that turns contralaterally breifly

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18
Q

anterior wall of the third ventricle is formed by the

A

optic chiasm

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19
Q

3 inferior and 2 superior optic chiasm compressive etiologies

A

pituitary adenoma, aneurysm, meningiom of the tuberculum sellae
superiorly by a craniopharyngioma or dilated 3rd ventricle

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20
Q

blood supply of lateral geniculate body and visual deficit seen

A

ant/post choroidal arteries

multiple sectoral field deficit

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21
Q

two major branches of the ophtalmic artery to the eye

A

posterior ciliary artery (gives rise to arterial circle of zinn haller in lamina cribrosa)
central retinal artery

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22
Q

Antomical deviation seen in albinism

A

majority of optic fibers (including temporal) decussate at chiasm

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23
Q

Two findings in chronic HTN on the retina

A 
straightened arterioles (nicking) 
silver wire
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24
Q

HTN findings that are likely indicators of CNS HTN changes.

A

cotton wool spots (soft exudates, infarct of NFL causing cytoid bodies (terminal swelling of nerve heads) and, micro aneurysms

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25
Q

Hard vs soft exudates

A

soft will obscure vessels , blurry.

26
Q

falme/splinter hemorrhages vs. dot and blot hemorrhages

A

superficial layer of horizontal nerve fibers vs. vertical alignment of outer plexiform layer (deeper)

27
Q

Roth spot , define

A

hemorrhage (splinter and dot) that has an white spot of lipid/histiocytes,fibrin and amorphous material)

28
Q

Drusen are associated with

A

ARMD

29
Q

buried drusen vs peripheral dursen

A

pseudopapilledema vs. not dead axons and not visibel on CT

30
Q

You see a big artery and big vein extending out of view what should be concerned for ?

A

hemangioblastoma

31
Q

Four ischemic lesions to the retina

A

TMB (embolus)
CRAO
CRVO
AION

32
Q

metamorphopsia

A

distortion of vision and generally not acuity (serous retinopathy possibly caused by cstoids)

33
Q

Examples of chorioretinits and degnetrations of retina

A

toxo,histo etc.

RP (assoc with other mitos) , paraneos, medications (vigabatrin,toxifen,phenothiazine,niacin,plaquenil bulls eye)

34
Q

What is a macular photostress test

A

test for retinal disease by shining strong light in eye for 10s and timing necessary to return to pretest visual acuity (nl =

35
Q

does papilledema cause RAPD ?

A

No unless is it succeeded by optic atrophy

36
Q

signs of mild papilledema

A

blurring of sup/ing disc margin and vein enlargement/hyperemia of dics

37
Q

SVP are a reliable indicator that…

A

pressure is below 200 mm H20

38
Q

signs of more serious papilledema

A

optic disc mushrooming, cottonwool spots

39
Q

papilledema with cl optic atrophy

A

Foster-kennedy syndrome think olfactory meningioma or frontal lobe tumor I/L to atrophy

40
Q

two elements of pathogenesis of papilledema

A

blockage of axoplasmic flow and vascular congestion

41
Q

visual loss with papilledema

A

binocular,non or transient blurring, enlargement of blind spot and constriction of visual fields

42
Q

commonality between AION and Optic neuritis

A

RAPD

43
Q

pain difference in AION vs optic neuritis

A

temporal in AION vs. in the globe

44
Q

visual loss in optic neuritis

A

monocular usually, rapid, central scotoma

45
Q

does acute papilledema affect visual acuity ?

A

not greatly

46
Q

blurring of vision when hot

A

uhthoff phenomenon

47
Q

8 general categories of optic neuropathy

A

Demyelinative, Ischemia, parainfectious, toxin/drugs, deficiency, hereitary, compressive, radiation

48
Q

why are most cases of optic neuritis not seen on exam ?

A

most are retrobulbar

49
Q

temporal pallor of the optic disc may indicate a h/o

A

optic neuritis

50
Q

three things about AION

A

abrupt, central fixation visual loss (altitudinal in ischemic), painless

51
Q

RF for AION

A

small cup-disc ratio

52
Q

Three things that have been temporally linked with ION

A

sildenafil, massive blood loss , laminectomy

53
Q

Visual point to point projections exists at the ____ then the same again to the ____.

A

Lateral geniculate ganglion

calcarine cortex

54
Q

what color is best for tangent screen ?

A

red-green

55
Q

changes of red hue may indicate ___

A

a scotoma

56
Q

what lesions cause a scotome

A

those that are prechiasmal (optic nerve, macula, retina)

57
Q

how are scotomas described

A

position and shape

58
Q

define dolichoectatic

A

elongation and dilation of artery

59
Q

define palinopsia and locate the lesion

A

persistence of repetitiive after images , right parietooccipital

60
Q

blue yellow vs red green

A

retina damage - loss of blue yellow

optic nerve red green is more likely to be lost

61
Q

Localize prosopagnosia

A

bilateral occipitotemporal (specifically the infer medial fusiform and lingual gyri)

62
Q

two types of ambylopia (degradation of vision and disuse of fovea)

A

anisometropic (unequal refraction)

strabismus

WSUNeurology (10 decks)

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