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Ocular Anatomy / Physiology Flashcards

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1
Q

a CN X lesion will have what effect in the mouth? How does this compare to a CN XII lesion?

A

CN X: Uvula will pull away from side of lesion

CN XII: Tongue pushes towards the side of lesion

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2
Q

What are the three possible destinations for a ganglion nerve fiber coursing through the optic nerve? What do these destinations control?

A

LGN: Primary visual cortex
Superior Colliculus: Saccades
Pretectal Nucleus: Pupils

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3
Q

What does CN I control?

A

Smell

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4
Q

What does CN II control?

A

Vision

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5
Q

What does CN III control?

A

EOMS (superior rectus, inferior rectus, inferior oblique, medial rectus)
Pupil Size
Accommodation

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6
Q

What does CN IV control?

A

Superior Oblique

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7
Q

What does CN V control?

A

Facial sensation

Mastication

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8
Q

What does CN VI control?

A

Lateral Rectus

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9
Q

What does CN VII control?

A

Facial Expression
Anterior 2/3 taste
Salivation (Submaxillary, Submandibular)
Lacrimation

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10
Q

What does CN VIII control?

A

Hearing

Balance

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11
Q

What does CN IX control?

A

Swallowing
Salivation (Parotid)
Posterior 1/3 taste
Monitor carotid sinus

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12
Q

What does CN X control?

A

Taste (epiglottis)
Palate elevation
Talking
Thoracoabdominal viscera

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13
Q

What does CN XI control?

A

Shoulder movement

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14
Q

What does CN XII control?

A

Tongue movement

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15
Q

The medial longitudinal fasciculus connects what four cranial nerves?

A

CN III, CN IV, CN VI, CN VIII

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16
Q

What sub-nucleus of CN III decussates to innervate the contralateral muscle?

A

Superior Rectus

Sub-nuclei for IR, IO, and MR go to ipsilateral muscle

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17
Q

What is unique about the levator sub-nucleus?

A

There is only ONE sub-nucleus for BOTH levators

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18
Q

What are the divisions of the CN III?

A

Superior - Superior Rectus and Levator, Sympathetic fibers (Muller’s muscle)
Inferior - Inferior Rectus, Inferior Oblique, Medial Rectus

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19
Q

What structures do the fibers of CN III travel with as they course from the sub-nuclei to their respective muscles?

A

Sub-nuclei in Brainstem -> PCOM Artery -> Cavernous Sinus -> Superior Orbital Fissure

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20
Q

Where do sympathetic fibers join CN III? Where do they come from? What division of CN III do they join?

A

Superior division of CN III receives sympathetic fibers from the ICA in the cavernous sinus

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21
Q

Where do parasympathetic fibers join CN III? Where do they come from? What division of CN III do they join?

A

Inferior division of CN III receives parasympathetic fibers from the EW nucleus

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22
Q

What would happen to the eye in a complete CN III palsy?

A

Severe ptosis. Eye would be DOWN and OUT.

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23
Q

Pupil involved CN III palsy is most likely due to ______. Pupil-sparing CN III palsy is most likely due to ______.

A

Pupil-involving CN III palsy -> PCOM and ICA junction (tumor / aneurysm)
Pupil-spring CN III palsy -> Microvascular ischemia (DM / HTN)

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24
Q

What is unique about the course of CN IV?

A

Exits DORSALLY from the midbrain (at the level of the inferior colliculus) and decussates to innervate the CONTRA superior oblique

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25
The ______ connects the sub-nucleus of CN IV to the visual cortex through the _________
The *tectobulbar tract* connects the sub-nucleus of CN IV to the visual cortex through the *superior colliculus*
26
Damage to the LEFT CN IV sub-nucleus will cause a _____ superior oblique palsy and _____ head tilt
Damage to the LEFT CN IV sub-nucleus will cause a *RIGHT* superior oblique palsy and *LEFT* head tilt
27
The anatomical origin of the superior oblique is the _______, the physiological origin is the _______
Anatomical origin - lesser wing of sphenoid | Physiological origin - trochlea
28
What is the Arden Ratio? What value is considered normal?
EOG measurement of the differences in the RPE response under light and dark conditions normal Arden Value = Greater than 1.80
29
What do the waves of an ERG correspond to? A-wave? B-wave? C-wave?
A-wave: Photoreceptors B-wave: Bipolar and Amacrine cells C-wave: RPE
30
How fast will a healthy visual cortex respond to visual stimuli in a healthy patient?
Less than 100 msec
31
Henle's nerve fiber layer in the Macula is another name for what layer in the retina?
Outer Plexiform Layer
32
The synaptic endings of rods are called ______ while the synaptic endings of cones are called ______
Rods - Spherules (smaller are more "sphere"-like) | Cones - Pedicles (larger and flatter like a "pedestal")
33
How long does it take for a demarcation line to become present after a retinal detachment stabilizes?
3 months
34
What is the patellar fossa?
Depression of the vitreous which abuts the posterior surface of the lens
35
What is the name of the additional retinal layer that many nocturnal vertebrate animals posses that functions to enhance visual sensitivity at low light levels?
Tapetum Lucidum
36
Cone photoreceptors are neatly organized in what type of arrangements in the macula?
Hexagonal
37
What are the three photopigment in cones? What are their peak wavelength absorbency?
Erythrolabe - 565 nm Chlorolabe - 535 nm Cyanolabe - 430 nm
38
What branch of the nasociliary nerve carries sympathetic fibers to the dilator muscle of the iris?
Long Posterior Ciliary Nerves
39
Increase intracranial pressure will most likely affect which cranial nerve first?
CN VI
40
Where is the lacrimal artery, lacrimal nerve, and ciliary ganglion in relation to CN VI in the orbit?
Lacrimal nerve and artery - superior to CN VI | Ciliary ganglion - medial to CN VI
41
Why does a CN VI palsy with ipsilateral horner's localize to the cavernous sinus?
ICA aneurysm in the cavernous sinus will compress CN VI and sympathetic fibers
42
What is the difference between the facial manifestations of Bell's Palsy and a stroke?
Bell's Palsy - IPSI LMN lesion -> entire side of face is affected Stroke - CONTRA UMN lesion -> only lower side of face is affected
43
What nerve carries the final parasympathetic innervation to the pupillary sphincter muscle and ciliary body? What nerve carries the final sympathetic innervation to the pupillary dilator muscle?
SPCN - Pupillary sphincter and ciliary body | LPCN - Pupillary dilator
44
Wha is the Canal of Hannover?
Between anterior and posterior lens zonules over the equator. Contains equatorial zonules.
45
What is the Canal of Petit?
Between posterior zonules and anterior hyaloid membrane and ciliary body
46
Iris cysts can develop if there is a separation between what two layers?
Anterior and posterior pigmented iris epithelium. Typically they are joined apex to apex by desmosomes and microvilli.
47
What layer of the ciliary body secretes aqueous humor?
Non-pigmented ciliary body of the pars plicata
48
What are the valley of Kuhnt?
Heavily pigmented areas located between the ciliary processes
49
What produces lens zonules?
Pars Plana
50
_____ produces zonules, which travel through _____ before inserting on the _______
*Pars plana NPCE* produces zonules, which travel through the *Valley of Kuhnt* and insert onto the *lens capsule*
51
What is the Supraciliaris?
Potential space! Outermost layer of the ciliary body that is loosely attached to the underlying sclera
52
What structures must nerves and blood vessels travel through to get from the choroid to the anterior portion of the eye?
Choroid -> Suprachoroid -> Supraciliaris -> Anterior portion of eye *Suprachoroid is continuous with supraciliaris at the ora serrata
53
Where does fluid accumulate in a ciliary body detachment?
Supraciliaris
54
What is the largest intrinsic muscle of the eye?
Ciliary muscle
55
The ciliary muscle is anchored anteriorly by what structure?
Scleral spur
56
What are the Longitudinal muscle fibers of the ciliary muscle also known as?
Longitudinal muscle fibers of Brucke
57
What comprise the largest proportion of CM fibers?
Longitudinal muscle fibers (of Brucke)
58
What is Muller's annular muscle?
Most medial portion of the ciliary muscle. Has a similar action as pupillary sphincter of iris.
59
What are the two routes aqueous can take once it reaches schlemm's canal?
SC -> short efferents -> deep scleral venous plexus -> intrascleral venous plexus -> episcleral venous plexus OR SC -> veins of Ascher -> episcleral venous plexus
60
Schwalbe's line represents the termination of what structure?
Descemet's Membrane
61
Name the structures seen on gonioscopy from most posterior to most anterior
``` "I Can't See This Stupid Shit, Seriously" Iris Ciliary Body Band Trabecular Meshwork Scleral Spur Schwalbe's Line Sampolesi's Line ```
62
What is the internal scleral sulcus?
Fancy name for the angle: the cornea-slcera junction
63
What is the Becker-Shaffer grading system?
``` Grade 0 - No structures visible Grade 1 - Anterior aspect of TM Grade 2 - 1/2 to 1/3 of TM Grade 3 - Scleral Spur Grade 4 - Ciliary body ```
64
What are the only two parts of the sclera that contain elastin?
Scleral Spur | Lamina Cribosa
65
The TM is triangular in shape, with the base of the triangle abutting the _____ and the apex pointing towards the _____
The TM is triangular in shape, with the base of the triangle abutting the *scleral spur* and the apex pointing towards the *cornea*
66
What portion of the angle typically has the greatest amount of pigment?
Inferior TM
67
Aqueous is transported from the JXT to schlemm's canals through ______
Giant vacuoles?
68
Schlemm's canal often contains multiple channels formed by CTT septae that increase the surface area for aqueous filtration. These channels are known as _______
internal collector channels
69
Posterior Embryotoxin represents an anteriorly displaced _______
Schwalbe's line
70
The pupil is not in the center of the iris. How is it displaced?
Inferior and nasal to center
71
What are Schwalbe's contraction furrows?
Variations in the thickness of the posterior pigmented iris epithelium
72
Where is the iris thickest?
Collarette
73
What are the Crypts of Fuchs?
Depressions / openings near the collarette of iris
74
What zone of the iris is expected to have radial streaks? What are these radial streaks? What color are they?
The ciliary zone of the iris has radial streaks that are white and represent collagen traveling along iris vessels
75
Which is bigger.... The anterior iris stromal leaf or the posterior iris stromal leaf?
Posterior Iris Stroma Leaf
76
Is Aniridia bilateral or unilateral? What condition is it mostly associated with? What other conditions is it associated with?
Bilateral Associated with Glaucoma Also a/w foveal hypoplasia, nystagmus microcornea, lens subluxation, optic nerve hypoplasia
77
What makes an eye blue?
Thin anterior border layer | Melanocytes contain a small amount of melanin
78
What is the only condition characterized by a lack of pigment within the iris epithelial layers?
Oculocutaneous albinism
79
The non-pigmented CB epithelium is continuous with what layer of the iris?
The non-pigmented CB epithelium is continuous with the posterior pigmented iris epithelium
80
Keratic Precipitates are made of what two types of cells?
Macrophages | Epithelioid Cells
81
The ciliary body is triangular in shape and its apex points towards the _______
ora seratta
82
What is Vossius's Ring? What can cause this?
Annular ring of iris pigment on the anterior lens capsule. | Trauma, Posterior Synechiae
83
What is the difference between Dalen-Fuchs, Busacca, Koeppe, and Berlin Nodules?
Koeppe Nodules - Pupillary border Busacca Nodules - Mid-Iris border Berlin Nodules - Anterior Angle Dalen-Fuchs Nodules - Chorioretinal lesions
84
What vitamin interferes with vitamin A absorption?
Vitamin E
85
What is Salus's sign? Bonnet Sign? Gunn Sign? What are they all indicative of? What grade do they represent?
Salus's sign - venule changes course due to arteriolar hardening. Grade 2. Bonnet sign - banking of the venule around the arteriole. Grade 3. Gunn sign - tapering of the venule around a hardened artery. Grade 3.
86
What is HYPERfluorescent on FFA?
Neovascularization (retinal, CNVM), CME, Central Serous, PED, RPE dropout
87
What is the classic "triad" of Retinitis Pigmentosa?
Arteriolar Attenuation, Waxy ONH pallor, Bone-Spicule Pigmentation
88
What is the most likely place that a Hollenhorst plaque comes from?
ICA | Order Carotid-Doppler ultrasound
89
What layers of the LGN contain Magno fibers? What layers contain Parvo fibers?
Layers 1 and 2 = MAGNO | Layers 3, 4, 5, 6 = PARVO
90
The cornea gets the majority of its glucose from ______
Aqueous
91
What bone of the orbit is the thinnest? What bone is the weakest?
Thinnest - ethmoid | Weakest - maxillary

Boards Part 1 (5 decks)

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