Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Neurology - step > Opthamology > Flashcards

Opthamology Flashcards

1
Q

what is the anterior segment of the eye

A

from cornea to the back of the lens

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

what is the posterior segment of the eye

A

lens to back of eye where optic nerve ecxits

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

what is the anterior chamber of the eye

A

between the cornea and the iris/pupil in the anterior segment

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

what is the posterior chamber of the eye

A

between the iris/pupil and the lens in the anterior segment

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

describe the flow of the aqueous humor

A

produced by the ciliary body epithelium with beta receptors on it –> posterior chamber –> pupil –> anterior chamber –> Trabecular meshwork –> canal of schlemm by the corena/scleral junction.

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

what are refractive errors

A

common cause of impaired vision
correct with glasses
refractory power of the lens/cornea does not make image onto the retina

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

what is hyperopia

A

far sightedness (can see far aways)
refractive power pf lens/cornea is not strong enough
image is behind the retina/ eye is too short
correct with biconcave lens?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is myopia

A

near sightedness (can see close ups)
refractive power is too strong
image is infront of the retnia/eye is too long
correct with biconvex lens

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

what si astigmatism

A

abnormal curvature of the cornea - different refractive power at different axes

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

what is presbyopia

A

age related impaired accommodation - trouble focusing on near objects - possible due to decreased lens elasticit
reading glasses

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

what causes presbyopia

A

decreased lens elasticity (farsightedness - image past retina, cannot see close)

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

causes of cataracts

A

most commly - advanced age
diabetes mellitus - osmotic damage
congenital rubella, CMV
corticosteroids

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

painless
often bilateral
opacification of lens

A

cataracts

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

what are RF for cataracts

A 
increased age,
excessive sunlight
prolonged corticosteroid use
classic galactosemia
galactokinase deficiency
diabetes mellitus/sorbitol
trauma
infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is glaucoma

A

optic disc atrophy with characteristic cupping/thinning of outer rim of optic nerve head

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

how does glaucoma present

A

usually with increased IOP and progressive peripheral visual field loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

cupping of optive nerve

A

glaucoma = thinning of outer rim of optic nerve head

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

what is open angle glaucoma

A

primary cause is unclear
secondary - blocked trabecular meshwork due to wbcs @ uveitis, rbc @ vitreous hemorrhage or retinal elements @ retinal detachement

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

risk factors for open angle glaucoma

A

increased age
African American race
family history

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

cxpx of open angle glaucoma

A

painless
most common type in the USA
cupping of optic nerve (Atrophy/thinning of edges)
(usually increased IOP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the cause of primary closed/narrow angle galucoma

A

enlargement or forward movement of the lens against the central iris/pupil margin –> obstrucst normal aqueous flow through pupil – fluid builds up behind the iris – pushes peripheral iris against cornea – impede flow through trabecular meshwork

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the cause of secondary close/narrow angle glaucoma

A

hypoxia from retinal disease (DM ro vein occluisn( that induces vasoproliferation in the iris that contracts angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what can cause vasoproliferation in the iris - contraction of angle - gluacoma

A

diabetes or vein occlusion - hypoxial retina disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what type of glaucaom is associated with diabetes

A

secondary close/narrow angle glaucoma due to vasoproliferation from induced h;ypoxic state int eh iris that closes the angle - fluid buildup and increased IOP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

cxpx of chronic closed/narrow angle glaucoma

A

often asymptomatic with damage to the optic nerve and peripheral vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

describe acute closed/narrow angle glaucoma

A

OPTHALMIC EMERGENCY
increased IOP pushes iris forward - angle closes abruptly

very painful 
red eye
sudden vision loss
halos around lights
rock hard eye
frontal headaches
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is contraindicated in acute closed/narrow angle glaucoma

A

mydriatics - epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q 
very painful
red eye
sudden vision loss
halos around lights
rock hard eye
frontal headaches
A

primary acute close/narrow angle glaucoma

acute is probly usually primary (Secondary due to hypoxia at venous occlusion or dm so those are probly chronic and asxtic with peripheral vision loss and optic nerve damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

optic nerve damage
peripheral vision loss
asxymptomat

A

chornic (probably secondary to dm or vein occlusion) closed/narrow angle glaucoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what is uveitis

A

inflammation of the uvea (iris, ciliary body and choroid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the layers of the eye ball

A

outside - sclera
middle - choroid –> iris
inner - retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is anterior uveitis aka

A

iritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is posterior uveitis aka

A

choiroiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

clinical presentation of uveitits

A

hypopyon - pus in the anterior chamber (between cornea and iris of the anterior segment)
conjunctival redness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

hypopyon

conjunctival redness

A

uveitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

eye complication of sarcoidosis, ulcerative colitis and ankylosing spondylitis, juvenile idiopathic arthritis, HLA-B27s, rheumatoid arthritis

A

uveitis
hypopyon
conjunctival rednesss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is uveitis a complication of

A 
systemic inflammatory diseases:
rheumatoid arthritis
HLA B27s - ankylosing spondylitis
juvenile idiopathic arthritis
ulcerative colitis
sarcoidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

describe age related maculodegeneration

A

degeneration of the macula/cenral area of the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

describe dry age related macular degeneration

A

non exudative, accoutns for > 80 % of all cases
deposition of yellowish extracellular material (DRUSEN) beneath the BRUCH membrane (between retina and choroid) and the retinal pigment epithelium

presents with a gradual decrease in vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

elderly individual

gradual decrease in vision

A

age related macular degeneration

DRY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

how do you prevent progression of dry age related macular degeneration?

A

multivitamins and antioxidant suppliments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

describe wet age related macular degeneration

A

exudative, 10-15% of all cases
bleeding secondary to choirodal neovascularization
rapid vision loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

elderly individual

rapid vision loss

A

wet age related macular degeneration (choroidal neovascularization bleeding; exudative)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

how to treat wet age related macular degeneration

A

anti VEGF: ranibizumab/bevacizumab

or laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

what causes damage in diabetic retinopathy

A

hyperglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

describe nonproliferative diabeti retinopathy

A

damaged capillaries leak blood - lipid and fluid seep into retina - hemorrhage and macular oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

how to treat nonproliferative diabetic retinopathy

A

blood sugar control

macular laser

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

describe proliferative diabetic retinopathy

A

chronic hypoxia results in new blood vessel formation with resultant traction on the retina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

what can proliferative diabetic retinopathy cause

A

hemorrhage - wet age related macular degeneration OR chronic acute angle glaucoma (chronic hypoxia - retinal damage)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

how to treat proliferative diabetic retinopathy

A

periperahl retinal photocoagulation

anti VEGF - bevacizumab/ranibizumatab (same as wet age related macular degeneration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

desecribe retinal vein occlusion

A

blockade of central or branch retinal vein due to compression from nearby arterial atherosclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what does retinal look like in retinal vein occlusion

A

retinal hemorrhage
venous engorgement
edema
BLOOD and THUDNER

53
Q

blood and thunder

A

retinal vein occlusion

54
Q

cxpx of rential vein occlusion

A

sudden, painless,s unilateral vision loss
swelling of optic disk
engorgement of retinal veisn with hemorrhage

55
Q

what can casue retinal vein occlusion

A

hypercoagubale states ie polycythemia

compression by nearby arterial atherosclerosis

56
Q

describe retinal detachment

A

separation fo neurosensory late of retina the one with the rods and cones from the outermost pigmented epitlieum (normal roel is to shield excess light and support retina) – degeneration of photoreceptprs - vision loss

57
Q

what can cause retinal detachment

A 
diabetic traction (proliferative)
retinal breaks
inflammatory effusions
58
Q

how does retinal detachment look on fundoscopy/

A

splaying and paucity of retinal vessels

59
Q

how else can you visualize retinal detachment

A

cross sectional optical ultrasound

60
Q

who is more common to get retinal breaks

A

those with high myopia (myopia - nearsightedness, image is in front of the retina, refractive power is too strong)

61
Q

cxpx of retinal detachment

A

pt with high myopia/nearsightedness
posterior vitreous detachemt occurs first - flashes and floares
monocular loss of vision eventual that is like a ‘‘curtain drawn down’’
SURGICAL EMERGENCY

62
Q

pt with high myopia
expierences flashes and floaters
loss on monocular vision like a curtain drawn down

A

retinal detachment

watch out for in diabetics, retinal breaks and inflammatory effusions

63
Q 
acute
painless
mononuclear vision loss
cloudy retina
cherry red spot @ fovea
A

central retinal artery occlusion

64
Q

how does optic disc appear in central retinal artery occlusion

A

paalle

with box car segmentation of blood in retinal veins

65
Q

what causes central retinal artery occlusion

A

embolus from carotid or ophthalmic artery

giant cell temporal arteritis involving the ophthalmic artery

66
Q

giant cell arteritis

emboli

A

central retinal artery occlusion

67
Q

what is retinitis pigmentosa

A

inherited retinal degeneration

68
Q

painless
progressive vision loss
starts with night blindness

A

retinitis pigmentosa

69
Q

what does retina look like in retinitis pigmentosa

A

bone spicule-shaped deposits around the macula

70
Q

what is retinitis

A

retinal oedema and necrosis – leads to a scar

71
Q

what is retinitis associated with

A

immunosuppression

72
Q

what is retinitis usuallyc aused by

A

viruses
CMV
HSV
HZV

73
Q

how do you differentiate CMV from HZV retinitis

A

CMV - ADIS with > 50 CD4/mm and usually painless

HZV - usually painful.

74
Q

what is papilledema

A

optic disc swelling
usually bilateral
due to increased icp

75
Q

fundoscopy of papilledema

A

enlarged blind spot and elevated optic disc with blurred margin

76
Q

retina looks like –> and you think: drusen deposits yellow blobs all over the place between the bruch membrane and retinal pigment epi

A

dry age related macular degeneration

77
Q

retina looks like –> and you think: hemorrhages, macular edema, new blood vessels and traction

A

diabetic non and proliferative retinopathy

78
Q

retina looks like –> and you think: retinal hemorrhage and venous engorgement and oedema (Reb blobs everywhere)

A

retinal vein occlusion

79
Q

retina looks like –> and you think: splaying and paucity of retinal vessels

A

retinal detachement

80
Q

retina looks like –> and you think: cloudy retina with attenuated vessels and cherry red spot at fovea

A

central retinal artery occlusion

81
Q

retina looks like –> and you think: bone spicule-shaped deposits around macula

A

retinitis pigmentosa

82
Q

retina looks like –> and you think: retinal oedema and necrosis

A

retinitis - scar

83
Q

retina looks like –> and you think: enlarged blind spot and elevated optic disc with blurred margins

A

papilloedema

84
Q

describe the pathway for miosis

A

constriction = parasympathetic
edinger westphal nucleus to the ciliary ganglion via CN III
short ciliar nerves to the pupillary sphincter muscles

85
Q

describe how the pupillary light reflex works

A

CN II from the retina – to bilateral pretectal nuclei – stimulate the edinger westphal nuclie bilaterall – send message via CN III to the ciliary ganglion – short ciliary out to the pupillary sphincter muscles M3

86
Q

where is the pretectal nuclei

A

midbrain

87
Q

list the order o the ganglion/nuclei involed int he pupillary light reflex

A

bilateral pretectal nuclie
bilateral edinger-westphal nuclei
ciliary ganglion

88
Q

describe the physiology of mydrasis

A

dilation via sympa
first neuron: hypothalamus to ciliospinal centre of Budge at C8-T2
second neuron: exits at T1 to the superior cervical ganglion with the cervical sympathetic chain near the lung apex and subclavian vessles
third neuron: pleusx along the internal carotid - through cavernouso sinus - enters the orbit as long ciliary nerve to pupillary dilator mucles.

89
Q

what do sympathetic fibres do in the eye

A

long ciliar nere to pupillary dilator muscles
smooth muscle of the minor retractors
sweat gland of forehead and face

90
Q

what are marcus gunn pupils related to pathos wise

A

multiple sclerosis

optic nerve damage or severe retinal injuery

91
Q

what tis a marcus gunn pupil

A

an afferent pupil defect - damage to optic nerve or severe retinal injury - decreased bilateral pupillary constrinction when light is shone in affected eye relative to unaffected eye

92
Q

how do you test marcus gunn pupil

A

swinging flashlight test

93
Q

slight droppig of eyelid
absence of sweating
flushing
pupil constriction

A

horner syndrome
anhidrosis
ptosis
miosis

94
Q

what causes horner syndrome

A

sympathetic denervation of face

95
Q

muscle responsible for slight ptosis in horners

A

superior tarsal

96
Q

what syndromes are associated with horners?

A

lesion fo spinal cord above T1

pancoast tumor
brown sequard
late state syringomyelia

97
Q

describe the pathway, along which any disruption can be made to creat horners

A

hypothalamus - synapse in lateral horn in the ciliospinal center of Budge at c8-t1 –> along the cervical sympathetic chain to the superior cerical canglion at T1 –> plexus along the internal carotid - cavernous sinus - long ciliary to the puplliary dilateor msuceles - alpha 1

98
Q

describe innervation of the EOMs

A

CN III: IO, MR, IR, SR
CN VI: SO
CN VI: LR

99
Q

what does the superior oblique do

A

abducts
intorts
depresses when adducted

100
Q

how to test superior oblique

A

adduct eye (Towards nose) and depress :)

CN IV testin

101
Q

when is the motor output to ocular muscles of CN III affected

A

central in nerve
affected primarily by vascular disease
ie diabetes mellitus

102
Q

what are signs of motor output compromise to ocular muscies of CN IIII

A

ptosis

down and out presentation

103
Q

describe the pathophys of motor output compromise in CN III

A

vascular disease (ie diabetes mellitus sorbitol accumulation) –> decreased diffusion of oxygen and nutrients to the interior fibres from compromised vasculature that resides on outside of nerve

104
Q

when does the parasympathetic output of CN III become affected?

A

fibres are on the periphery so are first to be affected by compression

105
Q

when does CN III become compressed

A

uncla hernation

pstoerior communicating anuerysm

106
Q

what are signs of parasympathetic output compromise in CN III?

A

diminished or absent pupillary light reflex
blown pupil
often with down and out

107
Q

describe the diff between CN III motor vrs parasympathetic compromise

A

motor – down and out and ptosis

parasympathetic - absent light reflex and blown pupil (can have down and out too)

108
Q

presentation of CN IV damage

A

eyes move upwar with contralateral gaze ie adducted (loss of superior oblique)
will also have head tilt towards the side of the lesion

109
Q

if person has problem going down stairs and has compensatory head tilt in opposite direction you think

A

CN IV
head tilt opposite for stairs
head tilt same side for stare

110
Q

CN VI presentation if damaged

A

medially directed eye that cannot abduct

LR gone-zo

111
Q

lesion @ right optic nerve

A

right anopia

112
Q

lesion @ otpic chiams

A

bilateral hemoanopsia

113
Q

lesion @ left optic tract

A

right homonymous hemianopia

114
Q

lestion @ left parietal lobe

A

right lower quadrantic anopia

115
Q

lesion @ right temporal lobe

A

left upper quadrantic anopia

116
Q

lesion at right visual cortex

A

left hemianopia with macular sparing

117
Q

what causes left hemianopia with macular sparing

A

MCA provides supply to macular region/occipital pole when PCA is occluded causing hemanopia to rest of visual field

118
Q

what does image appear in primary visual cortex compared to real world

A

upside down

opposite L-R orientation

119
Q

what causes a central scotoma

A

macular degemenration

120
Q

what causes central scotoma and metamorphopsia

A

age related macular degeneration
distortion - metamorphopsia
loss of central visual field - central scotoma

121
Q

describe Meyer’s Loop

A

inferior retina/upper visual field

loops around inferior horn of lateral ventrcile

122
Q

what is the dorsal optic radiation

A

superior retina/lower visual field

takes shortest path via internal capsule

123
Q

what is the medial lemniscus fasciculus

A

a pair of tracts on the ispilateral side of CN III njuclie and opposite of PPRf and CNVI nuclei that allows for cross talk or CN VI and CN III nuclei

ie coordinates lateral gaze

124
Q

what permits the MLF to communicate very quickly betteen nuclei of CN III and IV

A

highly meylinated

125
Q

when are bilateral MLF lesions commonly seen

A

multiple sclerosis - bilaera internuclear opthalmoplegia

126
Q

what is internuclear opthalmoplegia

A

lesion in MFL
causes conjugate horizontal gaze paralysis
lack of communication so that when CN VI is activated to contract the ipsilateral lateral rectus, the contralateral CNII does not receive stimulation from the MLF (lesioned) to contract the MR by CN II and will instead gaze straight ahead.

127
Q

what happens in internuclear opthalmoplegia when try to abduct eye

A

get nystagmus bc CN VI is overfiring to stimulate CN III

frustrated and shaking it around. angry.

128
Q

what happens when looking left :)

A

CN VI on left is firing to contract the LR on the left. also stimulates the contralateral MLF that then stimulates the CN III to contract MR to look left as well aka adduct

129
Q

what does right INO mean

A

the right eye is paralyzed and right MLF damaged

will notice when looking left

Neurology - step (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions