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PRIYA OPTHALMOLOGY > summary factoids > Flashcards

summary factoids Flashcards

(130 cards)

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1
Q

describe the circulation of aequous

A 
ciliary body
posterior chambre
pupil
norishes cornea
aqeuous reabsorped into scleral venous sinus (canal of schlemm) at iriocorneal angle (angle involved in glaucoma)
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2
Q

what does the inferior oblique do

A

when in addction, IO can only elevate

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3
Q

what does the superior oblique do

A

when in adduction, SO can only depress

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4
Q

which muscles can do pure elevation

A

SR and IO,

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5
Q

which muscles can do pure depression

A

SO and IR

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6
Q

what is the shape of the orbit

A

pyramidal with apex at optic canal posteriorly, base is anteriorlateral

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7
Q

what is the infraorbital nerve responsible for?

A

sensation in the mid face region

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8
Q

what does orbicularis oris do

A

external muscle of eye - CN7

orbital and palpebral

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9
Q

orbital orbicularis oris

A

tight closure of eye

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10
Q

orbicularis palpebral

A

dircectly on eyelid, gentle closure of eye

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11
Q

what does orbital septum do

A

helps prevent spread of infection from superfiical to deep

a tough layer of connective tissue

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12
Q

what is the tendon of LSP

A

attaches to tarus
mullens muscle (widens eye)
elevates upper eyelid

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13
Q

what does the tarsal gland do

A

secretes lipids + stops tears from flowing over eyes

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14
Q

describe the lacrimal apparatus

A

lacrimal gland > lacrimal fluid > medial angle > little hole > caniculi > lacrimal sac > nasolacrimal duct > nasal cavity > inferior nasal meatus > runny nose

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15
Q

what is the corneal reflex

A

blinking

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16
Q

sensory afferent limb of corneal reflex

A

sensory afferent via CN VI branches -> trigemial ganglion > CN V > pons

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17
Q

motor efferent limb of corneal reflex

A

AP conducted by CN VII to eyelid part of orbicularis oris

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18
Q

what is the vestibuloocular reflex

A

turns eye in opposite direction to head movement

stabilises gaze on object

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19
Q

what is the occulocardiac reflex

A

reflex bradycardia in respone to tension on extraocular muscles on pressure on eye

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20
Q

what happens in sympathetic reflex

A

wider
more light in
far objects

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21
Q

what happens in parasympatehtic reflex

A

less light in
nearer objects
reflex lacrimation

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22
Q

what happens when the eyes open wider

A

post synaptic sympathetic fibres travel via

  • superior cervical sympahtetic ganglia
  • internal carotid nerve
  • internal carotid plexus
  • axons carried on the ophtelamic artery
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23
Q

what does mitotic mean

A

constricted

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24
Q

eye symptoms of horners syndrome

A

mitotic

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25
what does myadratic mean
enlarged
26
how are dilator pupillae aranged
radially
27
where do director pupillae attach to and from
originate around external circumference of iris (fixed) | insert around internal circumference of iris (mobile)
28
4 neurone chain of pupillary light reflex retinal ganglion cells pass via ipsilateral optic nerve synapse in pretechtal nucleus synapse in EW (location of cell bodies of parasympathetic axons of CN3) pass from EW via CNS then its inferior division synapse in ciliary ganglion course in short ciliary nerves to sphincter papillae muscle
1. reintal ganglion cells > pass via ipsilateral optic nerve > synapse in pretectal nucleus to next synapse in EW nucleus (location of cell bodies of parasympathetic axons of CN3) 2. located entirely within midbrain + connect pretechtal nucleus to next synapse in EW nucleus (locataion of cell bodies of para axons of CN3) 3. pass from EW nucleus via CN 3 then its inferior division, to synapse to ciliary ganglion 4. course in short ciliary nerves to sphincted papillae muscles
29
basal tears
``` corneal health contain lysozone (hydrolyses bacteiral cell walls) ```
30
reflex tears
in response to mechanical or chemical sitmulation afferent - CN V1 from cornea efferent - parasympathetic axons from CN VII
31
treatmnet for bacterial conjunctivitis
chloramphenicol QTD
32
how not to treat herpetic keratitis
steroids - causes corneal melt
33
feature of herpetic keratis
dendritic ulcer
34
feature of adenoviral keratitis
subepithelial infiltrates
35
features of fungal keratitis
hypopyon
36
how to treat fungal keratiits
topical antifungal eg natamycin
37
what causes keratitis in contact lenses
acanthamoedema
38
what is oral cellulitis
direct extension from sinus | extension from orbital infection eg infection chalazion, dacrocystitis
39
what bug causes endophalamitits
staph epidermis
40
how to treat endophalamitis
intraviteal ameakin inflam of intraocuar fluids
41
how to treat toxoplasmosis
clindamycin / azithryomycin + steroids
42
what can toxocara form
granulomas
43
how does chloramphenicol work
inhibits peptidyl transferase enzyme (therefore stops bacterial proteins being made)
44
when is chloramphenicol bacteriocidial
strep + haemophilus
45
when is chloramphenicol bacteriostatic
staph
46
side effects of chloramphenicol
allergy irreversible aplastic anaemia grey baby syndrome
47
which antibiotics inhibits the cell wall synthesis
penicillins + cephalosporins | beta lactam ring inhibits enzyme which make bacteriocidal cell wall (without cell wall, bacteria die)
48
which antibiotics inhibit nuclei acid synthesis
quinolones eg ofloaxin (inhibits DNA gyrase, an enzyme that compresses bacterial DNA into supercoils) inhibition of DNA gyrase leads to unwinding of supercoils + cell death
49
how to treat bacterial keratitis
A-4 quinolone (ofloxacin) - treats gram neg | gentamicin and cefuromime (treats gram neg and positive
50
how to treat chlamydial conjunctiivits
oxytetracycline | via single median aparture and paired lateral appertures
51
pathway of CSF
ventircles > subarachnoid pace > absorped into venal circulation
52
when is the neural canal formed
at 3 weeks
53
which areas dont have a BBB
circumfrencicular organs + pineal glands
54
where are colloid cysts found
at interventricular foramen
55
where do ependymomas arise from
ependymal cells lining the ventricles
56
what is a epidermal haematoma
arterial bleed between the skull + dura
57
what is a subdural haematoma
venous bleed between dura + arachnoid
58
what is a hydrocelphaus
accumualtion of CSF
59
what does rhodopsin do when light hits
light converts 11-cis-retinal to all trans-retinal (activated form)
60
what is the dark current
opens in the dark permeable to Na+ keeps photoreceptor Vm more positive than most neurons steady release of neurotransmitter
61
which cells function in normal day light
cones
62
what does lysozome do
destroys bacterial cell wall
63
what are tear lipids antibacterial to
cell membranes
64
what does secretory IgA do
prevent attachment
65
what is the principle APC of the external eye
langerhans cell
66
what are langerhans cells rich in
MHC class 2
67
where are langerhan cells abundant
corneoslceral limbus
68
where are langerhan cells absent
from central 1/3rd of cornea
69
which part of the eye is the only part with lymphatic drainage
conjunctiva
70
what are the APC cells in the conjunctiva
dendritic cells
71
which area of the eye has MALT
conjunctiva
72
what unique function does the cornea and sclera have
down regulated the immune environment
73
what is ACAID
protects eyes + visual axis from collateral damage of an immune repsone to an ifnection by surpressing the response
74
do corneal cells have MHC class 2
no
75
primary mediators of sympathetic opthalamia
T cells
76
eg of immediate hypersensitivity (1)
acute allergic conjunctivitis
77
eg of direct cell killing (2)
ocular cicatricial pemphigoid
78
eg of immune complex mediated (3)
autoimmune corneal melting
79
eg of delayed (4)
corneal graft rejection
80
monro kellie hypothesis
maintain balance of brain, blood and CSF
81
what CN supplies dura matter
V
82
how to acess subarachnoid space
L3/L4 or L4/L5
83
when does subarachnoid space end
S2
84
what is glaucoma
increased pressure of eye dye to increase in humour - blockage of trabecular meshwork / canal of schlemm
85
what are primary open anled glaucoma
most common poor drainage throuh trabecular meshwork slow onset
86
what is closed angle glaucoma
patent drainage 1/3 emergency visual loss headaches
87
scleritis
rare pain on movement underlying autoimmune aetiology
88
genetics of scelritis
HLA B27
89
ARMD
accumulation of drusen
90
dry ARMD
no significant vascular proliferation
91
wet ARMD
vascualr proliferation neovascularisation in choroid, mediated by VEGF new vessels are small and leaky
92
what type of vision loss is seen in wet ARMD
rapid central visual loss
93
treatent of wet ARMD
monoclonal antibodies to VEGF
94
what kind of pupil is seen in diabetes
prostitie | argyll robertson
95
what causes cataracts
conversion of glucose to sorbiol in lens
96
is epithelium lipophilic or phobic
philic
97
is the stroma lipophilic or phobcic
phobic
98
does cholarmphenicol have lipophilic or phobic properties
both
99
when is prednisolone acetate used
post op | good penetration in uninflammed cornea
100
is prednisolone phosphate hypodrophic or philic
philic
101
what drug is used to lower IOP in glaucoma
0.03%
102
when are steroids used
post op cataracts uveitis to prvent corneal grat rejection
103
what is the glaucoma medication
``` prostaglandins eg latanoprost beta blockers carbonic anhydrase inhibitors alpha adrenergic agonists parasympathetic mimetics ```
104
what is fluroscein used for
to show corneal abraisons and dendritic ulcers
105
eg of myadratics and what they do
tropicamide + cyclopentolate pupil dilation by blocking para block to MS cause cytoplasgie (stops lens from foccusing)
106
what are sympathomimetics and give eg
act on sympa system to dilate pupil optic neuropathy - ethambutol maculopathy - chloroquine
107
what happens in diabetic retinopathy
glycosylation of protein / basement membrane > loss of pericytes > microaneurysms = leakage and ischaemia
108
what happens in hypertensive retinopathy
``` attenuated blood vessels cotton wool spots hard exudates retinal haemorrhages optic disc oedema ```
109
symptoms of corneal retinal arteyr occlusion
``` sudden painless loss of vision cherry red spot RAPD pale oedematous retina threadlike reintal vessels ```
110
what causes corneal retinal artery occlusion
carotid artery disease + emboli from heart
111
what causes cherry red spot in corneal retinal artery occlusion
retinal nerve fibre layer becomes swollen except at foeva
112
symptoms of central retinal vein occlusion
``` sudden painless visual loss associaated with diabetes, hypertension + cancer retinal haemorrhages dilated tortourous veins disc swelling + macular swelling ```
113
symptoms of branch vein occlusion
painless disutbance in visual field
114
sympotms of giant cell arteritis
``` middle sized arteritis headache jaw claudication malaise raised PV blinding condition ```
115
what is GCA associated with
polymyalgia rheumatic
116
signs of sjorgens
keratoconjunctivitis sicca xerostomia RA infiltration of lacrimal glands
117
sympoms of RA eye disesase
keratoconjunctivitis sicca
118
sympyoms of SJ syndrome
symniblepharon occlusion of lacrimal glands corneal ulcers
119
3 types of retinal artery occlusion
branch amarosis fugax (curtain coming down, 5 mins) ION
120
what is ION (ischaemic optic neuropathy)
can be caused by temporal arteiits posterior cilliary arteries affected (walls become so infamed that the lumen becomes occluded) blood doesnt flow properly to optic nerve sudden loss of vision
121
what cuases sudden vision loss in ION
occlusion of optic nerve head circulation | occlusion of posterior ciliary arteries
122
signs of vitreous haemorrhage
loss of vision floaters loss of red reflex
123
signs of retinal detachment
painless loss of vision | sudden onset floaters
124
signs of closed angle glaucoma
cupped disc (loss of retinal ganglion cells)
125
types of cataracts
nuclear posterior subscapular cataract christmas tree - polchroatic congenital cataract
126
what happens in refractive error
``` eye cant focus myopia (short sighteD) hypermenopia (long sighted) astigmatism - irregular corneal curvature presbyopia - age related ```
127
painful 3rd nerve palsy
aneurysm
128
4th nerve palsy
congenital trauma
129
6th nerve palsy
cranial pressure
130
what is optic neuritis
progressive visual loss (unilateral ) pain behind eye on movement occular desaturation central scotoma - depressed vision at point of fixiation - suggests a lesion between optic nerve head and chiasm ( can be caused by MS)

PRIYA OPTHALMOLOGY (7 decks)

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