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From Flashcardlet > Lids: Ptosis > Flashcards

Lids: Ptosis Flashcards

0
Q

neurogenic, myogenic, aponeurotic, mechanical

A

four types of ptosis

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1
Q

an abnormally low position of the upper lid

A

define ptosis

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2
Q

third nerve, oculosympatheic

A

two types of palsy in neurogenic ptosis

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3
Q

third nerve palsy, Horner syndrome, Marcus Gunn jaw winking syndrome, third nerve misdirection

A

four examples of neurogenic ptosis

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4
Q

myotonic dystrophy, blepharophimosis syndrome, simple congenital

A

three examples of congenital myogenic ptosis

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5
Q

myotonic dystrophy, myasthenia gravis, ocular myopathy

A

three examples of aquired myogenic ptosis

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6
Q

involutional, postoperative

A

two examples of aponeurotic ptosis

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7
Q

dermatochalasis, tumor, edema, anterior orbital lesion, scarring

A

five examples of mechanical ptosis

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8
Q

old photo

A

history tool that is useful in diagnosing causes of ptosis

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9
Q

myasthenia gravis

A

most important disease to rule out in ptosis

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10
Q

lack of lid support by globe, contralateral lid retraction, ipsilateral hypotropia, brow ptosis, dermatochalasis

A

five causes of pseudoptosis

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11
Q

margin-reflex distance

A

distance between the upper lid margin and the corneal reflection of a pen light held by the examiner

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12
Q

4-4.5 mm

A

normal MRD range

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13
Q

palpebral fissure height

A

distance between the upper and lower lid margins, measured in the pupillary plane

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14
Q

7-10 mm

A

normal palpebral fissure height in males

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15
Q

8-12 mm

A

normal palpebral fissure height in females

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16
Q

2 mm

A

normal distance of the upper lid from the upper limbus

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17
Q

1 mm

A

normal distance of the lower lid from the lower limbus

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18
Q

levator function

A

degree of upper lid excursion from downgaze to upgaze with the thumb pressing on the patient’s brow

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19
Q

15 mm

A

normal levator function

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20
Q

upper lid crease

A

the vertical distance between the lid margin and the lid crease in downgaze

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21
Q

poor levator function

A

absence of upper lid crease points to this

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22
Q

aponeurotic defect

A

high upper lid crease points to this

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23
Q

pretarsal show

A

the distance between the lid margin and the skin fold with the eyes in primary position

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24
Q

2 mm

A

mild ptosis

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25
Q

3 mm

A

moderate ptosis

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26
Q

4 mm

A

severe ptosis

27
Q

increased innervation

A

when manual correction of unilateral ptosis induces droop of the opposite lid, this exists in the opposite eye

28
Q

myasthenia gravis

A

inability of the patient to maintain upgaze for 30 seconds points to this diagnosis

29
Q

superior rectus

A

what muscle is frequently weak in patients with congenital ptosis (other than the levator)?

30
Q

exposure keratopathy

A

what is the patient at risk for postoperatively following large levator resections or suspension procedures if they have a weak Bell phenomenon

31
Q

failed neuronal migration

A

probable cause of simple congenital ptosis

32
Q

both

A

simple congenital ptosis: unilateral, bilateral, or both

33
Q

congenital

A

ptosis in which the affected lid is higher than the unaffected lid in downgaze

34
Q

poor levator relaxation

A

reason for lid lag in congenital ptosis

35
Q

compensatory chin elevation

A

sign seen in severe bilateral congenital ptosis

36
Q

ametropia

A

common ocular association of simple congenital ptosis

37
Q

4-6

A

typical age range for surgery in simple congenital ptosis (in years)

38
Q

levator resection

A

surgery for simple congenital ptosis

39
Q

mandibular

A

Marcus Gunn jaw-winking phenomenon thought to be due to aberrant innervation of the levator by this nerve

40
Q

5%

A

percentage of cases of congenital ptosis that demonstrate the Marcus Gunn jaw winking phenomenon

41
Q

true

A

True or False: the vast majority of cases of Marcus Gunn jaw winking phenomenon are unilateral

42
Q

pterygoids

A

MG jaw winking phenomenon induced by activity of these ipsilateral muscles

43
Q

false

A

True or False: Marcus Gunn jaw winking phenomenon usually improves with age

44
Q

unilateral levator resection

A

treatment of mild ptosis with Marcus Gunn jaw-winking phenomenon

45
Q

unilateral levator disinsertion and part resection with ipsilateral frontalis suspension

A

treatment of moderate-to-severe ptosis with Marcus Gunn jaw-winking phenomenon (asymmetric)

46
Q

unilateral levator disinsertion and part resection with ipsilateral frontalis suspension

A

treatment of moderate-to-severe ptosis with Marcus Gunn jaw-winking phenomenon (symmetric)

47
Q

third nerve misdirection syndrome

A

bizarre movements of the upper lid which accompany various eye movements (may be congenital but usually acquired)

48
Q

levator disinsertion and frontalis suspension

A

treatment of third nerve misdirection syndrome

49
Q

involutional ptosis

A

age-related condition caused by dehiscence, disinsertion, or stretching of the levator aponeurosis

50
Q

high upper lid crease, absent upper lid crease, deep upper sulcus, good levator function

A

signs of involutional ptosis

51
Q

myasthenia gravis, involutional ptosis

A

two causes of ptosis that worsen as the day progresses

52
Q

Muller muscle

A

which muscle is overworked in involutional ptosis

53
Q

levator resection, levator reinsertion, anterior levator repair

A

three treatment options for involutional ptosis

54
Q

4 mm

A

distance between the superior border of the tarsus and where the levator aponeurosis fuses with the orbital septum

55
Q

skin, conjunctiva

A

approach(es) to the levator aponeurosis

56
Q

superior border of the tarsus

A

insertion point of Muller muscle

57
Q

conjunctiva

A

approach(es) to Muller muscle

58
Q

capsulopalpebral expansion of the inferior rectus

A

anatomical basis of the inferior tarsal aponeurosis

59
Q

inferior tarsal muscle

A

inferior lid analog of the Muller muscle

60
Q

conjunctival Muller resection

A

treatment for mild ptosis with at least 10 mm of levator function

61
Q

3 mm

A

maximal lift achieved by conjunctival Muller resection

62
Q

5 mm

A

minimum levator function required to perform a levator resection

63
Q

severe ptosis with very poor levator function

A

indications for frontalis suspension

64
Q

autologous fascia lata, prolene, silicone

A

sling materials in frontalis suspension (three)

From Flashcardlet (61 decks)

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