Exam II

Question 1

What is the ciliospinal reflex?

Answer 1

pinching the neck (sympathetic stimulation) leads to pupillay dilation

Question 2

What are the 2 mechanisms of pipillary constriction?

Answer 2

• Light reflex
  
  • direct
  • indirect
• Accomodation

Question 3

What are you looking for when testing accomodation?

Answer 3

pupillary constriction

ciliary lens accomodation

convergence of the eyes

Question 4

What happens in near light dissociation?

Answer 4

the pupils constrict more the accomodation than to light

accomodation circuitry is stronger than light reflex

Question 5

What are the symptoms of Tonic Pupil?

Causes?

Answer 5

• Symptoms
  
  • no pupillary response to light or accomodation
  • no associated CN III palsy
• Causes
  
  • insult to ciliary ganglion
  • mydriatic eye drops or atropine

Question 6

How do you diagnose / determine the cause of tonic pupil?

Answer 6

• give dilute pilocarpine as a drop
  
  • pupilary constriction - insult to ciliary ganglion
  • no constriction - mydriatic eye drops or atropine

Question 7

What is an Argyll-Robertson Pupil?

Causes?

Answer 7

• small pupil that does not react to light but it does react to near stimulus
  
  • “accomodates but does not react”
• Causes
  
  • diabetes & late syphilis

Question 8

What syndrome is characterized by ptosis & meiosis with dilated conjunctival vessels?

Answer 8

Horner’s Syndrome

Question 9

What are the causes of Horner’s syndrome?

Answer 9

1. medullary infarction (wallenberg syndrome)
2. T1 root injury (Klumpke - Dejerine palsy)
3. Apical lung tumor involving brachial plexus (Pancoast tumor)
4. Carotid trauma (damaging sympathetic fibers)

Question 10

What are the symptoms of Lateral Medullary Syndrome?

This is caused by an stroke from what artery?

Answer 10

• Descendign sy

PICA