Neuro-opthamology Flashcards Preview

Neuro Pt 3 > Neuro-opthamology > Flashcards

Flashcards in Neuro-opthamology Deck (13)
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1

Normal pupils on exam

anisocoria 0-1 mm
anisocoria must be the same in all levels of light
react normal to light and dark

2

Anisocoria

Pupils different sizes

3

Sympathetic vs parasympathetic pupillary response

Sypathetic- dilates by radial muscle
Parasympathetic- constricts by sphincter

4

What symptoms are seen with sympathetic dysfunction?

Small pupil with poor rxn to dark

5

What symptoms are seen with parasympathetic dysfunction?

large pupil, poor rxn to light

6

Horner syndrome

sympathetic dysfunction in pupillary reflex

7

Segmental palsy

Only part of the pupil has been rewired so parts don't constrict well

8

Visual field deficits

Describe them from patient's perspective
Break visual fields into quadrants

If lesion in chiasm: Get lateral half of field loss on both eyes
In left optic radiations ("Meyer's Loop"): respects vertical meridian but don't get full loss of half (homonomous- same side on both eyes)
Left inferior occipital: punched out area of fovea is ok but respects vertical and horizontal meridians and is homonymous

9

Optic nerve deficits

Complaints:
Monocular vision loss (blurred, missing,dim)
Decreased brightness or color vision impaired

Exam:
Vision loss (acuity, field, or both)
Afferent Pupillary Defect (APD)
Color vision loss
Abnormal optic nerve (swelling and bleeding)

10

Afferent pupillary defect

Afferent – prior to synapse in LGN (thalamus)
Detected by swinging flashlight test

11

Symptoms of eye misalignment

Have binocular diplopiac

12

Localizing ocular misalignment

Nerve (3,4,6)
Eye (displaced)
Junction, neuromuscular (myasthenia)
Muscle (thyroid, myopathies)

13

Downbeat nystagmus

1. Localizable to cervical-medullary junction
2. Not a congenital type of nystagmus

Surgical decompression – improved