Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Studybuddy > Neuro > Flashcards

Neuro Flashcards

(49 cards)

Start Studying
1
Q

Orbit dimensions

A

45 mm wide
35 mm height
Volume 30
Medial wall is 40 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Vascular Supply

A

Common Carotids —> internal and external carotids
External Carotids: facial artery, superficial temporal, occipital, maxillary, middle meningial artery
Internal Carotids: ophthalmic artery —> centra retinal artery , lacrimal artery —> frontal artery (lateral rectus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Blind spot

A

17 degrees from fovea
Measures 5 x 7 degrees
Fovea is 4 mm from and 0.8 mm from ONH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Optic Nerve course

A

Optic Nerve Head (1.5 mm)
Intraorbital Optic Nerve
- Length: 30 mm
- Diameter: 3 mm with myelin, 6 mm with sheath
Optic Canal: 8-10 mm long
Intracranial: 8-12 mm
Optic Chiasm: 8 mm (macular fibers are posterior)
Optic Tract: to LGN (superior 4 are smaller field p cell axons, inferior 2 are large field motion; rotation of 90 degree)
Radiations: to occipital cortex,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Efferent pathway - Cortical Input

A

Saccades

  • from frontal eye fields (Bridgman area 8)
  • supplementary eye fields on superior frontal gyrus
  • can project to BG, thalamus, brainstem, PPRF, MLF

Smooth pursuit
- originates in area V5 , also with input from medial superior temporal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Efferent pathway - subcortical

A

Superficial / dorsal processes sensory signal

Deep / Ventral originates motor signals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Optic Neuropathy Differential

A 
Papilledema 
Glaucoma 
Inflammatory - MS, Devic, systemic
Vascular 
Neoplastic 
Infiltative- thyroid, leukemia, lymphoma, syphilis, granulomatous inflammatory process
Hereditary
Toxic
Traumatic 
Congenitally anomalous
Drusen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Optic Neuritis Treatment Trial

A

Optic neuritis in fellow eye 35% , 48 % in those that converted to MS

Steroids don’t improve long term outcomes but speed recovery
IV methylprednisone 250 mg q6 for three days followed by oral pred for 11 days

If it’s the first episode, you can use interferon, glatiramer acetate to reduce conversion to MS

If treating with natalizumab and have altered mental status, think PML / JC virus

Fingolimid = macular edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic Relapsing Inflammatory Optic Neuropathy

A

Not associated with MS

Steroid dependent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Devic Disease aka NMO

A

Optic neuritis plus acute myelitis
Aquaporin 4 IgG
Treat with high dose steroids , can do IVIG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

AION versus NAION

A

AION - chalky white hyperemia of ONH, cotton wool spots away from ONH, large CD, delayed chorodial filling

NAION - DM, HTN, HLD, apnea; no treatment, if recurrent think of something else

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

PION

A

Coronary bypass grafting

Prolonged spinal fusion surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Optic Nerve sheath meningioma

A

Painless progressive monocular vision loss
Optic atrophy
Optociliary shunt vessels
Hype rosters is on CT, Tram track thickening on MRI, calcification

Treat with fractionated radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Optic Nerve Glioma (pilocytic astrocytoma)

A

Most common primary tumor of ON
No calcification, kinking , no extradural extension, t1 is hypointense

NF1

Observe, chemo, radiotherapy

Malignant optic Nerve glioma of adulthood - rapid vision loss, pain. Death ☹️

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Hereditary Optic Neuropathies

A

Leber: boys, severe vision loss, hyperemia of ONH but no leakage, peripapillary teleangiectasia, tortuousity of medium sized vessels; mutation of mitochondrial 11778 OR 3460 14484
avoid alcohol and smoking

Autosomal dominant optic neuropathy: OPA1 gene on Ch 3 - dynamin GTPase, anchored to mitochondrial membranes ; tritanopia ; vision better than 20/200 due to slowwww progression, there is no treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Toxic Optic Neuropathy

A 
Methanol 
Ethylene glycol
Lead
Tobacco
Ethambutol
Linezolid
Amiodarone
Disulfram
Ciprofloxacin 
Cisplatin 
Vincristine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Traumatic Optic Neuropathy

A

International Optic Nerve Trauma Study - no clear benefit with steroids

Corticosteroid Randomization After Significant Head Injury study found increased mortality with those using steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Optic Disc Drusen

A

Impaired ganglion cell Adonai transport - Drusen build up as the product of deteriorating axons

Contrast with ONH hamartomas that are in the inner retina, fleshy and pinkish, do not autoflouresce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Congenital Optic Nerve Head Anomalies

A

Optic Nerve hypoplasia: small ONH, bilateral, double ring sign

  • Syndrome: absent septum pellucidum, dwarfism = deMorsier
  • teratogens: quinine, ethanol, anticonvulsants

Congenital tilted disc: bilateral with inferonasal colobomatous excavation

Others: Optic pit (IT) coloboma, dysplastic nerve (PAX2), morning glory ONH (unilateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Optic Tract Syndrome

Study These Flashcards
A

Infarction in anterior chorodial artery

Homonymous hemianopia, bow tie optic atrophy, mild RAPD in other eye

21
Q

Macula sparing homonymous hemianopia

Study These Flashcards
A

Stroke in part of primary cortex supplied by PCA

22
Q

Transient Monocular Vision Loss

Study These Flashcards
A

Ocular Stuff: tear film, EBMD, pigment dispersion, hyphema, angle closure, vitreous debris, orbit mass if gaze evoked

Optic Nerve : compressive , Drusen, papilledema, demyelination (Uthoff)

Vascular: emboli, vasculitis, vasospasm, hypoperfusion, hyperviscosity

23
Q

Transient Binocular Vision Loss

Study These Flashcards
A 
Migraine 
Tumor 
AV malformation 
TIA of basilar or PCA
Occipital seizures
24
Q

Higher Cortical Disorders of recognition

Study These Flashcards
A

Object agnosia: interruption of signal flow from occipital lobe to temporal lobe

Prosopagnosia: bilateral inferior occipitotemporal lobe damage - can’t recognize faces

Akinetopsia: V5 loss of perception of motion

Alexia without agraphia: interruption of visual information between occipital love and dominant angular gyrus (Gertsmann = acalculia, right left confusion, finger agnosia)

Cerebral achromatopsia: bilateral inferior occipitotemporal lobe lesions

25
Higher Cortical Disorders of Visual Spatial Relationships
Simultanagnosia Balint: bilateral occipitoparietalesions = simultanagnosia, Optic ataxia, acquires motor apraxia Visual allesthesia: world is flipped !
26
Higher Cortical Disorders of Visual Deficit
Anton: Cortical blindness but deny it Riddoch Phenomenon: preservation of perception of motion
27
Supranuclear Causes of Diplopia
``` Convergence insufficiency Divergence insufficiency Ocular tilt Skew deviation Thalamic esodeviation ```
28
Cranial Nerve III
Nucleus: affect or spare both upper lids and may affect CL Superior Rectus Brainstem (ipsilateral CN III palsy) 1. Weber: ventral midbrain and cerebral peduncle = contralateral hemiparesis 2. Benedikt: red nucleus and substantia nigra = contralateral ataxia or tremor 3. Claude: dorsal midbrain and superior cerebellar peduncle = contralateral ataxia 4 Nothnagel: dorsal lesion with CNIII nuclear lesion = supranuclear dysfunction Nerve: - complete = Down and out, ptosis +\- pupil Pupil Involving: aneurysm of posterior communicating artery (if other stuff is normal, likely okay) or microvascular Pupil Sparing: microvascular disease if complete, if partial still think aneurysm Aberrant regeneration without hx of palsy - think cavernous sinus lesion
29
Cranial Nerve IV
Nucleus: rare Brainstem: pineal tumor = dorsal midbrain Nerve: Diplopia worse in contralateral gaze, ipsilateral head tilt, down gaze If bilateral - crossed hypertropia, extorsion of 10 degrees, large V pattern eso. New is usually microvascular , image if no improvement 3 months
30
Cranial Nerve VI
Nucleus: horizontal gaze palsy due to MLF Brainstem: 1. Foville: ipsilateral abduction palsy, facial weakness, loss of taste, facial hypothesia 2. Millard-Gubler: Ventral pons = contralateral hemiplegia, ipsilateral facial weakness, abduction deficit Nerve Gradenigo: chronic inflammation of petrous bone causes an ipsilateral abducens palsy and facial pain If older than 50 likely vascular only image if no improvement at 3 months If young - neuroimaging, Duane type 1, spasm of the near reflex, MG, TED, medial orbital was fracture with entrapment
31
Internuclear Diplopia
Disrupts MLF - connect VI nucleus on one side of pons to contralateral medial Rectus subnucleus INO = unilateral slowed Adduction saccadic velocity with abducting nystagmus of other eye Bilateral causes vertical gaze evoked nystagmus because of vestibular nuclei that go through MLF One and a half = horizontal gaze palsy and ipsilateral INO (large pontine abnormality)
32
Ocular Neuromyotonia
Rare but episodic Diplopia after skull based radiation therapy, responds to carbamazepine
33
Supranuclear Ocular Motor Systems
1. Ocular Fixation: fast; keeps stationary object on fovea, countered by square waves 2. Vestibulo- Ocular: slow; holds image on fovea during brief head movements 3. Optokinetic: slow; holds image on fovea during sustained head movement 4. Saccadic: fast; brings object to fovea 5. Smooth pursuit: slow; holds moving object on fovea 6. Vergence: slow; moves eyes opposite so object remains on each fovea
34
Wallenberg Syndrome
Results from occlusion of proximal vertebral artery Ipsilateral loss of pain and temperature on face, cerebellar ataxia,first order Horner, ocular head tilt reaction. Contralateral loss of pain and temperature on body
35
Saccadic System
Volitional : pre motor areas that project to frontal eye fields —> pulse and step - horizontal integration: CNVIII and CNXII - vertical integration: interstitial nucleus of Cajal Gaze evoked nystagmus if problem with integrators, if asymmetric it is an ipsilateral lesion of brainstem or cerebellum Reflexive : superior colliculi to PPRF —> burst cells and omnipause cells Dolls head will determine if supranuclear or nuclear Specific Conditions: 1. Slowed saccades with Parkinson’s like Syndrome with imbalance and impaired cognition = PSP 2. Hyper metric saccades = cerebellum 3. Unidirectional hypermetric saccades = Wallenberg 4. Congenital ocular motor apraxia affects horizontal, not vertical ; if acquired need bilateral strokes
36
Smooth Pursuit Dysfunction
Abnormal gain Delayed initiation Normal OKn drum smooth pursuits when the drum is rotated away from the lesion
37
Vergence System
Fusional vergence is tested by placing a base out prism in front of one eye while the patient fixates , divergence is with base in prism - normal is 25 for distance, 35 for near Normal AC/A = 3-5 = pupillary distance + (deviation near - distance)/ 3
38
Dorsal Midbrain Syndrome
Convergence retraction nystagmus Conjugate limitation of vertical gaze Mid dilated pupils with light near dissociation Collier sign - retraction of eyelids in primary position
39
Types of Nystagmus
Jerk: slow phase from target, fast phase back Pendular: back and forth slow without fast - acquires think MS, if congenital only horizontal Palatal nystagmus: lesion in Giullian mollaret triangle producing inferior olivary hypertrophy See saw: one eye elevates, other depresses and extorts. Chiasm Or midbrain.
40
Infantile Nystagmus
1. Reversal of normal OKN nystagmus - slow phase is opposite to rotation of drum 2. Slow phase increases exponentially with distance from fixation Sensory: Often due to pregeniculate vision loss Latent nystagmus - conjugate horizontal jerk nystagmus accentuated by monocular fixation Spasmus Nutans: asymmetric small amplitude high frequency shimmering movements , resolve spontaneousku
41
Vestibular nystagmus
``` Peripheral: 1. Viral vestibular neuronitis 2. Meniere disease 3. BPPV 4 aminoglycosides 5. Large cerebellarpontine angle tumor - Bruns nystagmus ``` Central: 1. Downbeat : Arnold chiari I, antibodies to GAD And vestibulocerebellum 2. Upbeat 3. Torsional 4. Periodic alternating nystagmus
42
Pupil shape irregularity
Tadpole: focal spasm of dilator that produces peaking | Midbrain corectopia: rostral midbrain disease
43
Causes of light near dissociation
Severe loss of afferent light to both eyes Prp Peripheral neuropathy causing loss of axons to iris sphincter Adie Aberrant regeneration Loss of pretectal light input to EW , infection or compression
44
Causes of Ptosis!
Aponeurotic: attenuation, disinsertion Mechanical : mass or cicatricial Myogenic: CPEO, steroid eye drops, myotonic dystrophy Neurogenic: apraxia, CNIII palsy, Horner, Miller Fisher, migraine Neuromuscular : botox, MG Traumatic : laceration, FB, post surgical
45
Causes of Eyelid Retraction !
1. Mechanical : buphthalmos, axial myopia, orbital fractures with entrapment, proptosis from mass 2. Myogenic: carcinomatous infiltration, postsurgical, TED 3. Neurogenic : aberrant regeneration CNIII, dorsal midbrain, Marcus Gunn jaw winking, progressive supranuclear palsy
46
Seventh Nerve Palsy Location and effects
1 supranuclear : contralateral weakness of lower 2/3 of face 2. Nuclear: ipsilateral gaze palsy and monoplegia Peripheral is ipsilateral - monoplegia
47
Overactivity of 7
1. Benign essential blepharospasm: bilateral, basal ganglia, Botox ; Meige: facial grimace 2. Hemifacial spasm: unilateral, CP angle, Botox 3. Eyelid myokymia: unilateral 4. Facial myokymia: unilateral, nucleus, glioma or MS
48
Pupillary response pathway
``` Retina Midbrain pretectal EW Ciliary ganglion Short ciliary Nerve Iris sphincter ```
49
Random Eponyms
Miller Fisher: areflexia, ataxia, ophthalmoplegia Melkersson-Rosenthal: recurrent unilateral or bilateral facial paralysis with chronic facial swelling

Studybuddy (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions