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DT2 Exam 2 > Eye > Flashcards

Eye Flashcards

1
Q

what kind of protection should you take on your knees

A

glasses or remember you can breath out of your nose

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2
Q

viruses that cause eye infections

A 
HSV
varicella
adenovirus
enterovirus 70
coxsackie A24
newcastle disease
West nile
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3
Q

viruses that cause infections for fetus

A

CMV

rubella

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4
Q

latent infection of HSV

A

trigeminal ganglia or sacral ganglia

can be reactivated and cause secondary infections of the eye

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5
Q

components of stromal layer

A

keratocytes (fibroblastoid)

orderly collagen fibers

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6
Q

function of innermost layer of cells

A

endothelial

osmotic pump to keep stromal layer dehydrated

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7
Q

characteristic destruction of dendritic keratitis

A

winding stream
visualized with fluorescent dye and blue light
rose bengal and slit lamp

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8
Q

receptors for HSV

A

outer cornea

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9
Q

broader lesions from HSV

A

geographic ulcers

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10
Q

involvement of keratocytes in stromal layer with HSV infection

A

stromal ulcers
cannot form collagen in orderly array
results in loss of visual acuity

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11
Q

corneal melting

A

immune system attacks stromal layer of cornea
antigens present in stroma elicit infiltration of stroma by PMNs
macrophages and activated T cells cause further damage
treatment with steroids can exacerbate destruction
endothelial cell layer destroyed and corneal hydrated

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12
Q

corneal transplants after HSV

A

latent virus in trigeminal ganglia

reactivation can cause infectious process to start all over again

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13
Q

herpes varicella zoster virus

A

infection of conjunctiva

also corneal infection

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14
Q

recurrent infections from varicella

A

keratoconjunctivitis, uveitis, optical nerve palsies

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15
Q

CMV in eye

A

chorioretinitis
results in cataract formation and microphthalmia
AIDs and fetus

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16
Q

rubella in eye

A

shunts the growth of tissue (decreased replication in tissue)
cataract formation

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17
Q

adenovirus in eye

A

resistant to activation in environment
viable in water
causes keratoconjunctivitis
shipyard conjunctivitis

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18
Q

enterovirus 70 and coxackie A24

A

cause hemorrhagic conjunctivitis

seen in tropics

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19
Q

newcastle disease virus

A

infects chickens and farmers occasionally

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20
Q

first order neuron of sympathetic innervation of eye

A

cell body in hypothalamus
descend, synapse C8-T1
known as cilospinal center of Budge (lateral horn grey matter)

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21
Q

second order neuron of sympathetic innervation of eye

A

exit spinal cord, ascend sympathetic chain and terminate in superior cervical ganglion

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22
Q

third order neuron of sympathetic innervation of eye

A

ride along common carotid artery

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23
Q

internal carotid artery sympathetic to

A

dilator muscle
mullers muscle
sweat glands of forehead

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24
Q

external carotid artery sympathetic to

A

sweat glands of face

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25
Q

edinger-westphal nucleus

A

axons emerge from interpeduncular fossa of midbrain

synapse with ciliary ganglion

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26
Q

ciliary ganglion

A

enter posterior globe around optic nerve as short posterior ciliary nerves
innervate iris sphincter muscle and ciliary muscle

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27
Q

alpha 1 innervation

A

iris dilator (radial muscle)
mueller’s smooth muscle
conjunctival blood vessels

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28
Q

beta 2 innervation (some alpha 2)

A

ciliary processes

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29
Q

M3 innervation

A

iris sphincter

ciliary muscle

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30
Q

phenylephrine

A

alpha1

dilation for diagnosis

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31
Q

apraclonidine

A

alpha2
fast reduction in IOP
pre/post op laser treatment
loses effectiveness long term

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32
Q

brimonidine

A

alpha2

for glaucoma

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33
Q

cocaine

A

diagnosis of Horners

indirect-blocks NE reuptake

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34
Q

hydroxy amphetamine

A

isolate Horners

indirect-NE release of postganglionic

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35
Q

decrease of IOP from apraclonidine

A

activation of alpha2 presynaptic leads to reduced activation B2 of epithelium to decrease aqueous production
post junction A2 decreases production
A2 episcleral increase outflow through uveoscleral drainage

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36
Q

ocular side effects of apraclonidine

A

allergic reaction

alpha1 stimulation-mydriasis, conjunctival vascualr constriction, lid retraction

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37
Q

decrease IOP from bromonidine

A

selective for alpha2

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38
Q

neuroprotective properties of bromonidine

A

stimulates blood flow to optic nerve

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39
Q

first line of treatment for primary open angle glaucoma

A

beta blockers and prostaglandins

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40
Q

first line for normal tension glaucoma

A

bromonidine

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41
Q

ocular side effects of bromonidine

A

allergic reaction

no alpha1

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42
Q

Horners

A

miosis-loss of iris dilator function
ptosis-loss of Muellers (still have levator muscle so not full ptosis)
anhydrosis-loss of sweat gland

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43
Q

cocaine for diagnosis

A

normal-dilation due to increased iris dilator function

Horner-no response, no NE in synapse

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44
Q

MOA hydroxyamphetamine

A

causes release of NE from presynaptic axon terminals of post ganglionic neuron on the iris dilator

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45
Q

hydroxyamphetamine preganglionic

A

dilates from topical
lesions-pancoast tumor (tumor apex of lung)
thoracic aortic aneurysm

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46
Q

hydroxyamphetamine postganglionic

A

no dilation
goiter
cavernous sinus syndrome

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47
Q

ocular side effects for beta blockers

A

corneal anesthesia

infrequent irritation

48
Q

contraindication for beta blockers

A

CHF

advanced COPD/chronic bronchitis, asthma

49
Q

timolol

A

lasts 24 hours

only mild drift

50
Q

levobunolol

A

longer duration than timolol

51
Q

metipranolol

A

no difference from timolol

52
Q

betaxolol

A

beta1 selective blocker
less potent than timolol
good for patients with COPD/asthma
still contraindicated in patients with cardiac issues

53
Q

carteolol

A

intrinsic sympathomimetic activity (non selective for B1 or B2)
competes with NE and E in binding to B receptors
beta blocker because it decreases activity

54
Q

cholinergic agonists for miosis

A

pilocarpine

acetylcholine and carbachol

55
Q

cholinergic agonists for glaucoma

A

pilocarpine

good for angle closure glaucoma

56
Q

pilocarpine

A

muscarinic>nicotinic

not susceptible to AchE

57
Q

pilocarpine in angle closure glaucoma

A

stimulation of muscarinic receptors in iris sphincter muscles causes miosis and pulls iris out of angle-allows drainage

58
Q

pilocarpine in primary open angle glaucoma

A

pulls trabecular meshwork making it wider

59
Q

ocular side effects of pilocarpine

A

blurred distance vision
accommodative spasm if under 40
miosis causes dimming of vision

60
Q

acetylcholine

A

AchE causes limited usage

intraocular injection in surgeries

61
Q

carbachol advantages

A

miosis lasts longer
used in complicated cataract surgeries
miosis of iris maintains intraocular lens
more intense side effects of pilocarpine

62
Q

indirect parasympathomimetics

A

inhibit AchE

63
Q

mydriasis by tropicamide, cyclopentolate

A

inhibit muscarinic receptors of iris sphincter muscle

diagnostic in dilated fundus exam

64
Q

cycloplegia by cyclopentolate and atropine

A

inhibit muscarinic receptors of ciliary muscle
accurate refraction in hyperopes and vision therapy in accommodative estropia
used in infants and children

65
Q

uveitis relief from homatropine

A

inhibition of iris and ciliary muscle movement

release WBC, fibrin, PG

66
Q

contraindications of atropine

A

glaucoma patients-particularly narrow angle

can use tropicamide in glaucoma patients

67
Q

trabecular meshwork

A

inner aspect where cornea meets sclera and drainage of aqueous fluid

68
Q

limbus

A

area where opaque sclera transitions into clear cornea

69
Q

posterior chamber

A

between lens and the iris

70
Q

ciliary body

A

in the posterior chamber and produces aqueous fluid

goes around iris and to anterior chamber

71
Q

anterior chamber

A

anterior aspect of iris to inner aspect of cornea

72
Q

bulbar conjunctiva

A

region that covers globe

73
Q

palpebral conjunctiva

A

inner aspect of the eyelid

74
Q

forniceal conjunctiva

A

folding goes from palpebral to bulbar

75
Q

tear film

A

responsible for refractive power of eye

76
Q

components of tear film

A

lipid-prevents evaporation
water-majority
mucin-holds against cornea

77
Q

origin of components of tear film

A

water from lacrimal
mucin from goblet cells
lipid from meibomian glands

78
Q

angle closure glaucoma risk factors

A 
emergency
narrow anterior chamber gangle
hyperopia
pharmacologic dilation 
older age-lens grows
more prevalent in some Asian populations
79
Q

symptoms and signs of angle closure glaucoma

A

pain, redness, nausea, blurred vision, halos

sign-dilated fixed pupil

80
Q

flow of aqueous fluid

A

ciliary body produces
flows from posterior chamber through pupil
around iris into anterior chamber
out through trabecular meshwork into Schlemms canal
into episcleral venous circulation

81
Q

layers of retina

A

derived from diencephalon
galgion, bipolar, photoreceptors
outermost is non-neural retinal pigmented epithelial cell layer

82
Q

role of retinal pigmented epithelium

A

absorbs light that penetrates

reduces scattering to help have sharper image

83
Q

choroid

A

produces oxygen and nourishment to outer layers of retina
forms the uveal tract
no direct vascular blood supply to outer portion of retina-gets blood from choroid

84
Q

blood supply to eye in fetal development

A

hyaloid artery which originates from optic nerve
passes through vitreous jelly to supply lens and iris
resorbed at 34 weeks
is the stalk that originates from the optic nerve

85
Q

role of eyelashes

A

filter that protects the eye
early warning system that something is approaching the eye
triggers blink reflex

86
Q

lacrimal gland

A

eccrine gland located in the suprolateral orbit
divided into orbital lobe and palpebral lobe
produces aqueous layer of the tear film

87
Q

iritis

A

unilateral, photophobia, ciliary flush

88
Q

bacterial conjunctivitis

A

unilateral, muculopurulent discharge

89
Q

viral conjunctivitis

A

bilateral, asymptomatic onset, lymph nodes

adenovirus most common cause

90
Q

allergic conjunctivitis

A

bilateral, itching, rhinitis

91
Q

neonatal conjunctivitis

A

5-19 days chlamydial-treat with erythromycin

1-3 days-gonococcal with systemic penicillin

92
Q

thyroid eye disease

A

can have with no evidence of thyroid dysfunction-sometimes select eye over thyroid
IgG causes hypertrophy of the extraocular muscles (increase in glycosaminoglycans)

93
Q

dacryocystitis

A

infection of the lacrimal sac
usually secondary to nasolacrimal duct obstruction
tears stagnate in lacrimal sac
present with tender, red, swollen lsion in medial canthus
treat with ABX and warm compresses

94
Q

chalazion

A

inflammatory
of meibomian gland
chronic lipogranulomatous inflammatory lesion

95
Q

hordeolum

A

infection-microabscess

gland of zeis and moll

96
Q

keratoconjunctivitis sicca

A

dry eye
primarily from aqueous tear deficiency
primary cause-atrophy, fibrosis of lacrimal tissue as a result of infiltration of mononuclear cells
immune modulators-cyclosporine

97
Q

pterygium

A

triangular shaped fibrovascular growth on the surface of the cornea

98
Q

Bells palsy

A

damage to 7th CN
have incomplete closure of eye (lagopthalmos)
corneal exposure

99
Q

lagopthalmos

A

incomplete closure of the eye

100
Q

chemical eye injury

A

COPIOUS IRRIGATION!!

101
Q

infoliation

A

lens is encapsulated in basement membrane
old epithelium and proteins accumulate and lens increases with age-results in presbyopia
contributes to opacification of lens in cataracts

102
Q

Horner syndrome

A

ptosis
miosis
anhydrosis
palsy of oculosympathetic input-sympathetic fibers innervate mueller muscle (2mm ptosis)

103
Q

third nerve palsy

A

causes ptosis due to defect to levator

also causes strabismus

104
Q

pupil+third nerve palsy

A

URGENT! from compression

aneursym of PCA

105
Q

homonymous hemianopsia

A

lesion on optic tract

106
Q

bitemporal hemianopsia

A

optic chiasm

often from pituitary

107
Q

non-proliferative diabetic retinopathy

A

caused by microvascualr occlusion and leakage
capillary thickening of basement membrane, endothelial cell damage, deformation of red blood cells, changes in platelets that leads to increased aggregation
loss of pericytes allows liquids to leak-edema

108
Q

source of fluid leak in diabetic retinopathy

A

pericytes lost

109
Q

proliferative diabetic retinopathy

A

prolifreation of abnormal blood vessels from chronic ischemia
VEGF

110
Q

retinal artery occlusion

A

thromboembolic occlusion

frequently from chronic diseases

111
Q

retinal vein occlusion

A

compression of vein by overlying artery

frequently from acute elevation in BP

112
Q

leukocoria

A

absence of red reflex
presence of white reflex
child with leukocoria should be checked for Rb

113
Q

giant cell arteritis

A

typical symptoms-weight loss, scalp tenderness, jaw claudication
temporal artery biopsy, elevated ESR, CRP

114
Q

myopia

A

eyeball is too long for refractive power

115
Q

hyperopia

A

eyeball is too short for refractive power

116
Q

astigmatism

A

refractive power greater along one meridian than 90 degrees away
you got a football eye

DT2 Exam 2 (6 decks)

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