PBL 3 Flashcards

(48 cards)

1
Q

What are the refractive structures that light passes through to reach to retina?

A
  • Cornea
  • Aqueous Humor
  • Lens
  • Vitrous Humor
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2
Q

Explain what happens in the accommodation reflex for near vision?

A
  • Ciliary muscles contract, ciliary body moves towards lens
  • tension is released is suspensory ligaments
  • lens becomes more spherical
  • rounder shaped lens can refract more light, to focus near image
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3
Q

Explain what happens in the accommodation reflex for distant vision?

A
  • Ciliary muscles relax, ciliary body moves away from lens
  • suspensory Ligaments pull at the lens
  • lens becomes flatter
  • flat shape allows lens to bring in more light from distant objects
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4
Q

What is visual acuity and how is it measured?

A

The ability to distinguish two nearby points

Measured using a snellen eye chart

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5
Q

Name the two layers of the retina

A

Pigmented part - outer layer

Neural part - inner layer

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6
Q

List the order of layers in the neural layer of the retina from outside to the inside

A
  • photoreceptor outer segment
  • outer nuclear layer
  • outer plexiform layer
  • inner nuclear layer
  • inner plexiform layer
  • ganglion cell layer
  • nerve fibre layer
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7
Q

In which layer of the neural layer in the retina are the cell bodies for horizontal and amacrine cells located?

A

Inner nuclear layer

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8
Q

What is the area of the retina where there are only cones present?

What is the structure in the middle of this called?

A

Macula

Fovea

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9
Q

What is the difference between horizontal and amacrine cells?

A

Horizontal - forms network at outer plexiform layer at the level of synapses between photoreceptor and bipolar cells

Amacrine - forms network at inner plexiform layer at the level of synpases between bipolar cells and ganglion cells

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10
Q

What is the role of horizontal and amacrine cells?

A

Facilitate or inhibit communication at the plexiform layers, thereby altering the sensitivity of the retina

Play important role in eye’s adjustment to dim or brightly lit environments

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11
Q

What is the difference in convergence in rod cells and cone cells?

A

Rod cells - high convergence (lots of rod bipolar cells synapse onto one ganglion cell)

Cone cells - low convergence (one cone bipolar cell contacts one ganglion cell)

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12
Q

What is rhodopsin?

What is its structure?

A

Visual pigment present in rod and cones cells
Made up of:
- Opsin: 7 transmembrane G protein coupled receptor
- Retinal: light absorbing chromophore

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13
Q

How does the shape of retinal change when it absorbs light?

A

Converted from 11-cis form to all-trans form

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14
Q

Describe the process of photoreception

A
  • Activation of opsin: due to change in retinal shape
  • Opsin activates transducin
  • Transducin activates phosphodiesterase (PDE)
  • PDE breaks down cGMP to GMP
  • removal of GMP from sodium channels causes inactivation
  • membrane is hyperpolarised as neurotransmitter release declines
  • as photoreceptor is turned off, bipolar cell is turned on
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15
Q

What is bleaching?

A

After a photon has been absorbed by rhodopsin, it has reduced sensitivity to light.

The whole molecule must be broken down and reassembled before it can absorb light again.

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16
Q

What are the 3 forms of opsin in cones and their wavelengths?

A

Blue: 420-550nm (short wavelength)
Green: 450-630nm (medium wavelength)
Red: 480-690nm (long wavelength)

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17
Q

What is the difference between on centre and off centre ganglion cells?

A

On centre ganglion cells - excited by light arriving in the centre of their receptive field
Off centre ganglion cells - excited by light arriving in the edges of their receptive field

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18
Q

What glutamate receptors do on centre bipolar cells have?

Explain how on centre bipolar cells respond in light and dark

A
  • on centre bipolar cells have mGluR6 metatropic receptor which when bound to glutamate, causes hyperpolarisation of the cell
  • In dark: they are inhibited (hyperpolarised) by glutamate
  • In light: they are activated (depolarised) as glutamate release from photoreceptors is terminated
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19
Q

What glutamate receptors do off centre bipolar cells have?

Explain how off centre bipolar cells respond in light and dark?

A

Off centre bipolar cells have ionotropic (AMPA/kainate) glutamate receptors which are depolarised by glutamate

  • In dark: they are depolarised by presence of glutamate
  • In light: they are hyperpolarsied as glutamate is no longer present
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20
Q

What is the difference between M and P type ganglion cells?

A

M type - monitor rods (large receptive field)

P type - monitor cones (specific location monitored due to 1:1 ratio)

21
Q

What two types of occupancy can be seen in colour-opponent ganglion cells?

A

Red vs Green

Blue vs Yellow

22
Q

What happens to the medial (nasal) ganglion fibres when they reach the optic chiasm?

A

They decussate to the opposite side

23
Q

What are the different neurons present in the different layers of the lateral geniculate nucleus?

Which type of ganglion cells do they receive information from?

A

Magnocellular neruons (layers 1+2) - receive information from M type ganglion cells

Parvocellular neruons (layers 3,4,5,6) - receive information from P type ganglion cells

24
Q

What are the two types of pupillary muscles and where are they located in the eye?

Which part of the autonomic nervous system are they controlled by?

A
  • pupillary dilators: located radially (controlled by sympathetic nervous system)
  • pupillary constrictors: form a sphincter around the pupil (controlled by autonomic nervous system)
25
Describe what happens in the pupillary light reflex
- light generates action potentials in the optic nerve which then synpase at the pretectal nucleus - neurons from pretectal nucleus synapse with edinger-Westphal nucleus bilaterally (to affect both eyes) - Occulomotor nerve supplies preganglionic parasympathetic fibres to ciliary ganglion - postganglionic fibres cause contraction of contractor pupillae muscles - pupil decreases in diameter
26
What is the difference between the direct pupillary reflex and the consensual pupillary reflex
Direct - occurs in ipsilateral eye | Consensual - occurs in contralateral eye
27
What are the three types of muscles which contract during the convergence reflex?
Medial rectus muscles Ciliary muscles Constrictor pupillae muscles
28
Layers 1,4 and 6 of the left lateral geniculate nuclei are receiving information from where?
Nasal visual field of right eye
29
Layers 2,3 and 5 of the right geniculate nucleus are receiving information from what part of your visual field
Temporal side of right eye
30
To what degree can you see the 4 quadrants of your visual field: - superior - inferior - nasal - temporal
- superior: 60 degrees above - inferior: 75 degrees below - nasal: 60 degrees medial - temporal: 100 degrees lateral
31
What is homonymous hemianopia? What kind of lesion can it be caused by?
Decreased vision in half the visual field on the same in both eyes Optic tract lesion
32
What is bitemporal hemianopia? What kind of lesion can it be caused by?
Loss of peripheral visual fields Optic chiasm lesion Pituitary tumour
33
What is the difference between myopia and hyperopia?
Myopia (short sightedness) - refracting power is too great, image focuses in front of the retina Hyperopia (long sightedness) - refracting power is too small, image focuses behind the retina
34
What type of lens are gives to correct myopia and hyperopia?
Myopia - concave lens (bring image back onto retina) Hyperopia - convex lens (bring image forward onto retina)
35
What is presbyopia?
- This is the normal ageing of the lens which causes it to loose its elasticity - Problems with near vision as lens is less able to alter its curvature - similar to hyperopia
36
What is astigmatism?
A refractive error where the corneal surface is asymmetric, so multiple focus points occur either in front of the retina or behind it.
37
How can amblyopia lead to blindness?
- one eye is lazy and can't achieve normal visual acuity - this causes persistence interference with the image from one eye but not the other - visual cortex suppresses the image from affected eye, if suppression occurs for too long then vision loss can be permanent
38
What are the 3 main causes of amblyopia (lazy eye)?
1) strabismus amblyopia - due to squint 2) anisometropic amblyopia (refractive amblyopia) - due to uneven refractive errors 3) deprivation - e.g, obstruction by cataract
39
How do you treat amblyopia?
Eye patching of the good eye - this forces the brain to pay attention to the visual input from the bad eye and enable normal vision to occur
40
What is strabismus?
Also known as "squint" - due to an imbalance of the extraocular muscles of the two eyes, so they point in different directions
41
What are the 3 different types of strabismus?
1) Esotopia (convergent squint) - cross eyed 2) Exotopia (divergent squint) - wall eyed 3) Hypertopia - one eye turned up
42
What is Cataract?
Cloudy patches within the lens of the eye
43
What is Glaucoma?
- increased amount of aqueous humor causes an increase in pressure - compresses the retinal blood vessels, causing degeneration of the optic nerve - vision is gradually lost from the periphery inward
44
What are the two types of glaucoma?
Primary open angle glaucoma (POAG) | Acute angle closure (AACG)
45
What happens in primary open-angle Gluacoma?
- anterior chamber angle is normal - reduced outflow of aqueous humor through the trabecular mesh work/canal of schlemm - increased pressure leads to visual loss
46
What happens in acute angle closure glaucoma?
- Closed angle in anterior chamber - Lens pushes the iris forward against the trabecular meshwork/canal of schlemm - aqueous humor cannot drain - increased pressure leads to visual loss
47
Which nerve is responsible for sneezing?
Trigeminal nerve
48
What is the pathophysiology of ACHOO syndrome?
Over stimulation of optic nerve by bright light inappropriately triggers the trigeminal nerve and causes sneezing