The Retina and Central Visual Pathways Flashcards Preview

2.4.1. Nervous System > The Retina and Central Visual Pathways > Flashcards

Flashcards in The Retina and Central Visual Pathways Deck (28):

Describe the structure of the retina?

Pigmented layer = melanin stops light refracting too much, anchors photoreceptive cells (rods/cons)

Neural layer = contains nerves and blood vessels


Rods are responsible for what type of vision?

Black and white, low level lighting


Cons are responsible for what type of vision?

Colour, high definition vision


Outline the pathway from the retina to the optic N

Photoreceptor cells – rods and cons

Bipolar cells (like first order neurones)

Axons of ganglion cells

Converge to form optic N


Outline the role of horizontal cells

Lateral inhibition

Stop the receptors next to the point of the highest light intensity from sending any confusing info

= emphasising contrast


What is the role of the macula?

Fovea = highest density of con cells = more defined vision

Thinner layer of retinal axons


What structures can be seen on fundoscopy?



Optic disk = raised ICP present with bulging blurred outline (papilloedema)

Central retinal vein/artery = can see occlusions – amaurosis fugax

Retinal venules/arterioles


Give an overview of the central visual pathway


Optic nerve

Optic chiasm

Optic tract

Lateral geniculate nucleus

Optic radiation

Primary visual cortex (occipital lobe)


What 2 fibres are present in the visual pathway?

Nasal fibres = temporal field of vision, cross at optic chiasm

Temporal fibres = nasal field of vision, run ipsilateral


How do lesions present when they are located before the optic chiasm?

Signs are unilateral and ipsilateral


How do lesions present when they are at or after the optic chiasm?

Signs are bilateral

Site of crossing over


How do lesions present when they are after the optic chiasm?

Signs are contralateral

As the pathway has crossed over so will be seen on the opposite side


Outline monocular blindness

Lesion of the optic N

Lesion to the optic N is on the same side as the blindness (remember it hasn’t crossed over yet)

Children = optic N glioma, retinoblastoma

Middle aged = optic stealth meningiomas


Outline bitemporal hemianopia (tunnel vision)

Lesion at optic chiasm

Affects both nasal fibres = temporal fields lost

Causes = growth of pituitary, aneurysm of anterior communicating artery


Outline left homonomous hemianopia

Lesion of R optic tract = R temporal and L nasal fibres affected

Lose L temporal + R nasal vision

Causes = vascular stroke most common


Outline right homonomous hemianopia

Lesion of L optic tract = L temporal and R nasal fibres affected

Lose R temporal and L nasal vision

Causes = vascular stroke most common


What is macular sparing?

Occipital lobe has dual blood supply = posterior cerebral A + middle cerebral A

Stroke affecting posterior cerebral A = most of occipital lobe lost

However middle cerebral A supplies occipital pole = macula = macular function spared (central vision)


Explain optic radiations

Superior radiations = inferior field of vision (project into parietal lobe)

Inferior radiations = superior field of vision (project into temporal lobe)

Quadrantanopias – loss of a quarter of the visual field


Outline the pupillary light reflex

Afferent = CN II optic N

Synapse with pretectal nucleus – send signals to Edinger Westphal nuclei bilaterally

Efferent = parasympathetic CN III oculomotor N

(BOTH stimulated = direct and consensual pupillary constriction)


Outline the accommodation reflex

Required for near vision

1) eye converge (medial rectus)

2) pupillary constriction (constrictor pupillae)

3) convexity of lens (ciliary muscle) = increase refractory power

Afferent = retina CN II optic N

Synapse lateral geniculate nuclei – projects to visual cortex (processes finger getting closer to the face)

Communicates this back to the midbrain – Edinger Westphal and Oculomotor nuclei

Efferent = parasympathetic CN III oculomotor N


The lateral geniculate nucleus projects to which lobe?

Occipital lobe


The optic nerve has no photoreceptors so is referred to as what?

The blind spot


Outline the layers of the retina

1) retinal pigment ep = contain melanin, stop excessive reflections, maintain photoreceptor cells

2) rod and cons = photoreceptors

3) horizontal cells = lateral inhibition

4) bipolar neurone = can think of as 1st order neurones

5) ganglion = can think of as 2nd oder neurones

6) optic N


What is retinal detachment?

Most common form = photoreceptors separate from the underlying pigment ep (neural retina detaches from the pigment layers)

= fluid build up between

Presents = sudden blurring, stars, visual artefacts


What is amacrosis fugax?

Sudden transient loss of vision = emboli blocks ophthalmic A

‘Curtain coming down over vision’


If the L and R visual fields are generated in each hemispheres how do we see a complete image?

Commissural fibres of corpus callosum connecting the 2 visual cortex


What does the medial longitudinal fasciculus contain with regards to the eyes?

Connections between: oculomotor, abducens, trochlear nuclei to coordinate eye movements

Vestibular nuclei are also attached = maintain a level horizon

All are connected to the spinal cord = enabling generation of compensatory movements


Describe Internuclear ophthalmoplegia

Paralysis of the eyeballs caused by loss of connection between the cranial nuclei