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Flashcards in Clinical- 7 Deck (56)
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1

Review the eye anatomy

on yer own ya filthy animal

2

What is diplopia?

double vision

3

What causes diplopia?

misalignment of the eyes

4

What is opthalmoplegia?

When the extraocular muscle fxn is disrupted

5

How is the derp in opthalmoplegia?

You derp to the opposite direction because of unopposed action of the other muscles

6

What is ptosis?

droopy eyelid

7

What are the 2 causes for ptosis?

damage to either III (LPS) or symapathetics (sup tarsal)

8

Quick fire eye lesions/conditions/Sx: I will say a Sx and you tell me where the lesion is. Ready?

Total blindness of L eye

L optic n lesion

9

Bitemporal hemianopia

pituitary tumor/ optic chiasm lesion

10

L nasal hemianopia

calcified internal carotid

11

central scotoma

optic or retrobulbar neuritis

12

L homonymous hemianopia (2)

R optic tract lesion OR complete lesoion of the R optic radiation

13

L homonymous hemianopia + macular sparing

R PCA occlusion

14

L homonymous inferior quadrantanopia

R parietal lobe lesion

15

L homonymous supeiror quadrantanopia

R temporal lobe lesion

16

What is papilledema?

optic disk swelling due to increased intracranial pressure

17

What are the clinical features of papilledema?

almost always bilateral, typically doenst impair vision, no eye pain, assocaited w/just ↑ ICP Sx.

18

What happens in early papilledema?

retinal veins engorged; spontaneous venous pulsations absent; disk hyperemic (increased blood flow); linear hemorrhages at the disk borders; disk margins blurred

19

What happens in fully developed papilledema?

optic disk is elevated above the plane of the retina; blood vessels crossing the border of the disk are obscured

20

Papilledema- etiologies

• Intracranial mass (urgent evaluation!)
• Meningitis
• Venous sinus thrombosis, subarachnoid hemorrhage
• Polycythemia, endocrinopathy, hypervitaminosis A
• Pseudotumor cerebri (idiopathic intracranial hypertension)
• Congenital cyanotic heart disease
• Spinal cord tumor
• Guillan-Barre

21

What is the pathway for the pupillary light response?

light --> II --> optic tracts --> pretectal N. --> stimualtion of BOTH EWN --> PANS to ciliary gang --> ciliary m contraction

22

What are the 4 things to cause nonreactive pupils?

o local disease of the iris (trauma, iritis, glaucoma)
o oculomotor nerve compression (tumor, aneurysm)
o administration of a mydriatic agent
o optic nerve disorders (neuritis, M.S.)

23

What is light-near dissociation?

impaired reactivity to light but accomodation is fine.

24

What causes light-near dissociation?

neurosyphilis, diabetes, optic n disorders, tumors compressing the tectum

25

Argyll-Robertson- Sx

bilateral, small pupils and irregular and unequal

26

Argyll-Robertson- response

pupils will accomodate but wont react to light. no change with pilocarpine.

27

Argyll-Roberston- differential

neurosyphilis, diabetes, pineal region tumors, MS

28

Tonic/Adies- appearance

unilateral or bilateral, tonic pupil is larger

29

Adies- response

sluggish to react, reacts with pilocarpine, accommodation is less affected

30

Adies- differential

holmes-adies (benign, often familial disorder, women more affected), ocular trauma, ANS neuropathy, degeneration of the ciliary gang