Reflexes of the Eye Flashcards

(48 cards)

1
Q

What division of the trigeminal nerve does the supraorbital nerve belong to?

A

CN V1 = ophthalmic

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2
Q

Where does CN V1 supply on the face?

A

Upper eyelid, cornea, conjunctiva

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3
Q

Where does CN V2 supply on the face?

A

Skin of lower eyelid and over the maxilla

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4
Q

Where does CN V3 supply on the face?

A

Skin over mandible and TMJ (except the angle of the mandible)

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5
Q

What is the sensory limb of the blink reflex?

A

Action potentials conducted from the cornea via CN V1 branches to the trigeminal ganglion, then along CN V to pons

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6
Q

What nerves are the central CNS connections between in the blink reflex?

A

CN V and CN VII

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7
Q

What is the motor limb of the blink reflex?

A

Action potentials conducted via CN VII to eyelid part of orbicularis oculi

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8
Q

What are the autonomic reflexes of the eye?

A

Wide eye opening of fight/flight, pupillary light reflex, accommodation reflex, lacrimation reflex, vestibulo-ocular reflex, oculocardiac reflex

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9
Q

What is the vestibulo-ocular reflex?

A

Turns eye in opposite direction to head movement and stabilises gaze on object during head movement

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10
Q

What nerves are involved in the vestibulo-ocular reflex?

A

CNS connections between CN VII and CN III/IV/VI

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11
Q

What is the oculocardiac reflex?

A

Reflex bradycardia in response to tension on extra-ocular muscles or pressure on eye

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12
Q

What nerves are involved in the oculocardiac reflex?

A

CNS connections between CN V1 and CN X

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13
Q

What are the sympathetic reflexes of the eye?

A

Opens eyes wider, get more light in, focus on far objects, emotional lacrimation

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14
Q

What are the parasympathetic reflexes of the eye?

A

Get less light in (protect retina from bright light/when asleep), focus on near objects, reflex lacrimation (to clean eye)

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15
Q

Which muscles opens the eye wider?

A

Levator palpebrae superioris = contains skeletal and smooth muscle, Mueller’s muscle, sympathetic innervation

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16
Q

What do post-synaptic sympathetic fibres travel via to open the eyes wider?

A

Superior cervical sympathetic ganglion, internal carotid nerve, internal acoustic meatus, axons carried on ophthlamic artery and on its branches to orbital structures

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17
Q

What nerves modality constricts the pupils during rest and digest, and in bright light?

A

Parasympathetic system

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18
Q

What is a non-physiologically constricted pupil classed as?

A

A miotic pupil (e.g Horner’s syndrome)

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19
Q

Are fixed pin point or dilated pupils normal?

A

No = are often serious pathological signs (ie of opiates or CN III pathology respectively)

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20
Q

Which structure is responsible for constricting the pupils?

A

Sphincter pupillae fibres = encircle pupil around the internal circumference of the iris

21
Q

Which nerve modality is responsible for pupillary dilation?

A

Sympathetic system

22
Q

What is a non-physiologically dilated pupil classed as?

A

A mydriatic pupil (e.g mydriatic drugs)

23
Q

What structure is responsible for dilating the pupils?

A

Dilator pupillae fibres = radially arranged, originate around external circumference of iris (fixed) amd insert around internal circumference of iris (mobile)

24
Q

What is the special sensory limb of the pupillary light reflex?

A

Ipsilateral CN II

25
Where do the CNS connections for the pupillary light reflex occur?
In the midbrain
26
What is the motor limb of the pupillary light reflex?
Bilateral CN III
27
How does the stimulation of the eye affect the pupillary light reflex?
Direct light reflex occurs in stimulated eye | Consensual light reflex occurs in non-stimulated eye
28
How many neurons make up the chain in the pupillary light reflex?
4
29
What is the first neuron in the pupillary light reflex?
Retinal ganglion cell = pass via ipsilateral optic nerve, decussate in optic chiasm, synapse in pretectal nucleus in midbrain
30
What is the second neuron in the pupillary light reflex?
Bilateral = located entirely in midbrain and connect pretectal nucleus to next synapse in Edinger-Westphal nucleus
31
What is the Edinger-Westphal nucleus?
Location of cell bodies of parasympathetic axons of CN III
32
What is the third neuron in the pupillary light reflex?
Bilateral = pass from Edinger-Westphal nucleus via CN III then its inferior division to synapse in ciliary ganglion
33
What is the fourth neuron of the pupillary light reflex?
Bilateral = course in short ciliary nerves to sphincter pupillae muscles
34
What do the suspensory ligaments of the lens connect?
The circumference of the lens and the ciliary body
35
What is the ciliary body?
Both muscular and vascular = smooth muscle like sphincter around circumference
36
What happens to the ciliary muscle during far vision?
Relaxes = no parasympathetics, ligament tightens and lens flattens to focus on object in distance
37
What happens to the ciliary muscle during near vision?
Contracts = parasympathetic control, ligament relaxes and lens becomes spherical to focus on near objects
38
What does the lens accommodation reflex occur in response to?
Near vision
39
What are the three elements of the lens accommodation reflex?
Bilateral pupillary constriction Bilateral convergence of both eyes towards midline Bilateral relaxation of lens
40
What nerve innervates all three aspects of the lens accommodation reflex?
CN III
41
What causes bilateral pupillary constriction during the lens accommodation reflex?
Parasympathetic constrictor of sphincter pupillae
42
What causes the bilateral convergence of both eyes towards the midline during the lens accommodation reflex?
Medial rectus muscle
43
What causes the bilateral relaxation of the lens during the lens accommodation reflex?
Contraction of ciliary muscles
44
What is the purpose of basal tears?
Corneal health = cleans/nourishes and hydrates avascular cornea, contains lysozyme (hydrolyses bacterial cell walls)
45
What causes reflex tears?
Chemical or mechanical stimulation
46
What is the sensory limb of reflex tears?
CN V1 from the cornea and conjunctiva
47
What is the motor limb of reflex tears?
Parasympathetic axons from CN VII
48
What emotions can cause lacrimation?
Happiness, fear or sadness