Flashcards in Clinical- 7 Deck (56)
Review the eye anatomy
on yer own ya filthy animal
What is diplopia?
What causes diplopia?
misalignment of the eyes
What is opthalmoplegia?
When the extraocular muscle fxn is disrupted
How is the derp in opthalmoplegia?
You derp to the opposite direction because of unopposed action of the other muscles
What is ptosis?
What are the 2 causes for ptosis?
damage to either III (LPS) or symapathetics (sup tarsal)
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
pituitary tumor/ optic chiasm lesion
L nasal hemianopia
calcified internal carotid
optic or retrobulbar neuritis
L homonymous hemianopia (2)
R optic tract lesion OR complete lesoion of the R optic radiation
L homonymous hemianopia + macular sparing
R PCA occlusion
L homonymous inferior quadrantanopia
R parietal lobe lesion
L homonymous supeiror quadrantanopia
R temporal lobe lesion
What is papilledema?
optic disk swelling due to increased intracranial pressure
What are the clinical features of papilledema?
almost always bilateral, typically doenst impair vision, no eye pain, assocaited w/just ↑ ICP Sx.
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
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
• Intracranial mass (urgent evaluation!)
• Venous sinus thrombosis, subarachnoid hemorrhage
• Polycythemia, endocrinopathy, hypervitaminosis A
• Pseudotumor cerebri (idiopathic intracranial hypertension)
• Congenital cyanotic heart disease
• Spinal cord tumor
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
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.)
What is light-near dissociation?
impaired reactivity to light but accomodation is fine.
What causes light-near dissociation?
neurosyphilis, diabetes, optic n disorders, tumors compressing the tectum
bilateral, small pupils and irregular and unequal
pupils will accomodate but wont react to light. no change with pilocarpine.
neurosyphilis, diabetes, pineal region tumors, MS
unilateral or bilateral, tonic pupil is larger
sluggish to react, reacts with pilocarpine, accommodation is less affected