HNSS_Week2

Question 1

Blowout fracture

Answer 1

punch to eye region commonly fractures the maxilla portion of the orbit, bruising below eye

Question 2

CNIII deficit

Answer 2

Ptosis: due to lack of LPS innervation; mydriasis (dilation) due to lack of parasympathetic innervatino to pupillary constrictor; look down and out (only LR and SO are innervated)

Question 3

Horner’s syndrome

Answer 3

Damage to sympathetic trunk, Sx some ptosis, miosis (constriction), anhydrosis

Question 4

Fuch’s dystrophy

Answer 4

Can’t remove enough fluid from cornea –> endothelium breakdown

Question 5

Glaucoma

Answer 5

Impaired peripheral vision, Increased intraocular pressure –> damaged ganglion cells, can be caused by decreased drainage at canal of Schlemm

Question 6

Cataract

Answer 6

Any opacification of the lens, blurred vision, causes: age, diabetes, congenital

Question 7

Presbyopia

Answer 7

Normal decrease in elasticity of the lens that occurs by 45-50 years, inability to round lens, corrected with reading glasses

Question 8

Retinal Detachment

Answer 8

Occurs between photoreceptors and RPE cells, loss of proximity to nutrients from RPE cells, can be caused by trauma, emergent surgery

Question 9

Diabetic Retinopathy

Answer 9

Vasculopathy and neuropathy, spots in vision due to blood vessel growth into vitreous humor

Question 10

Macular Degeneration

Answer 10

age-related cause of blindness (RPE, Bruch’s membrane), commonly central loss of vision

Question 11

Retinitis Pigmentosa

Answer 11

“Night blindness” due to loss of rods, loss of peripheral vision, due to mutations in rhodopsin, typical onset in teen years

Question 12

Anopthalmia

Answer 12

Eye globe is absent, may be bilateral or unilateral, due to failure of early inductive processes or regression of partially developed eye, associated with maternal TORCH infections

Question 13

Micropthalmia

Answer 13

Globe less than 2 std dev below mean size, bilateral or unilateral, due to inadequate growth, may have a normal or non-functional retina, associated with maternal TORCH infections

Question 14

Microcornea

Answer 14

lens vesicle especially small

Question 15

Coloboma

Answer 15

deficit of ocular tissue, missing part

Question 16

Optic fissure closure defects

Answer 16

Major type of coloboma, iris coloboma (cats eye), retinal coloboma (severe if macula or optic nerve are affected, lens coloboma (deficit in zonular fibers –> retraction)

Question 17

Eyelid coloboma

Answer 17

due to amniotic band pressing on face or problem with eyelid migration or fusion during embryogenesis

Question 18

Congenital cataracts

Answer 18

defect in lens ultrastructure –> opacity, caused by maternal TORCH infections particularly rubella, metabolic disorders, genetic mutation of crystallins

Question 19

Retinopathy of prematurity

Answer 19

occurs in smallest preemies, altered retina oxygenation, risk retinal detachment

Question 20

Amblyopia

Answer 20

loss of ability to see clearly thorugh one eye, decreases development of associated visual cortex, causes: misaligned eyes, myopia, congenital cataracts

Question 21

Aniridia

Answer 21

small iris due to failure to extend rim of optic cup

Question 22

Corenal clouding

Answer 22

congenital defect in corneal endothelium due to too much hydration

Question 23

Primary Congenital glaucoma

Answer 23

Sx Buphthalmos (large eye, expanded anterior chamber), corneal edema (causes clouding), photosensitivity; due to trabecular meshwork malformation, may have excess mesenchyme cells blocking the anterior chamber angle

Question 24

Scotoma

Answer 24

localized visual defect, causes: infarction of branch of central retinal A

Question 25

Anopia

Answer 25

loss of vision (need to specify location, ie right eye); optic nerve lesion

Question 26

Hemianopia

Answer 26

Loss of vision from half of visual field

Question 27

Quadrantic Anopia

Answer 27

Loss of one quadrant of visual field

Question 28

Anopia w/Macular sparing

Answer 28

Macula portion of visual field is intact

Question 29

Homonymous Anopia

Answer 29

Visual defect in same side of visual field for both eyes (left or right)

Question 30

Heteronymous Anopia

Answer 30

Visual defect is on opposite side of visual field for eyes (temporal or nasal)

Question 31

Homonymous Hemianopia

Answer 31

lose left or right visual field, lesion between optic chiasm and LGN, common cause: anterior choroidal A infarct

Question 32

Bitemporal (Heteronymous) Hemianopia

Answer 32

Loss of temporal portion of left and right visual fields, lesion affecting nerves crossing at optic chiasm, common causes: pituitary adenoma, craniopharyngioma

Question 33

Binasal (Heteronymous) Hemianopia

Answer 33

Loss of nasal portion of left and right visual fields, lesion affecting nerves that do no cross at optic chiasm, common cuases: ICA aneurysm, calcification that compresses temporal fibers of optic chiasm

Question 34

Isocoria

Answer 34

pupils are generally equal size regardless of whether they constrict, suggests CNII lesion if ocular reflexes are impaired, stimulating with light does not constrict either pupil

Question 35

Anisocoria

Answer 35

pupils are not equal size, only one pupil responds to light suggests CNIII lesion on side with larger pupil

Question 36

Marcus Gunn Pupil

Answer 36

Partial CNII lesion, isocoria, weaker constriction than normal; when swinging light from normal to injured side there is the appearance of dilation)

Question 37

Argyll Robertson Pupil

Answer 37

Pupils restrict with near vision (accommodation) but not in response to light, lesion in pretectal area, commonly seen with neurosyphillis, diabetes, Wernicke’s encephalopathy, encephalitis

Question 38

TMJ Disc Displacement

Answer 38

Clicking noise when moving jaw, articular disc loses adhesion to head of condylar process, not typically painful (articular disc does not have nociceptors, Retrodiscal tissue does have nociceptors and can cause pain

Question 39

TMJ Dislocation

Answer 39

“Open Lock”, head of condylar process stuck in front of articular tubercle, jaw is stuck open, Tx reduction by pulling mandible inferior and posterior

Question 40

Inferior Alveolar Nerve Block

Answer 40

Anesthetic injected near mandibular foramen to block mandibular teeth and buccal mucosa anterior to mental foramen, affects inferior alveolar N (branch of CNV3)