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Neuro 3 > Visual Lectures > Flashcards

Visual Lectures Flashcards

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1
Q

What is the sequence of the horizontal saccadic system?

A

right side of brain’s frontal eye field or superior colliculus —> left paramedian pontine reticular formation (PPRF) –> left nucleus CN 6 –> a. left lateral rectus or b. right CN3 nucleus via MLF –> medial rectus

  • example: looking for keys
  • eyes look left
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2
Q

Where are frontal eye fields found?

A

medial frontal gyrus

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3
Q

Patient presents post-op surgery to remove a nail that was lodged into her parietal lobe. After running tests, it is clear she cannot track well, what are you concerned happened?

A

lesion of parietal lobe –> caused loss of smooth pursuit movements towards the side of lesion; will have no optokinetic nystagmus when tape is moved toward damaged lobe

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4
Q

What Broadmann’s area is the primary visual cortex? another name for the primary visual cortex?

A

17 (above and below calcarine sulcus)

striate cortex

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5
Q

What forms the optic radiations?

A

secondary neurons from the LGN –> go to the lower and upper banks of calcarine sulcus (primary visual cortex)

  • lower quadrant of contra hemifield –> superior bank on cuneus gyrus
  • higher quadrant of contra hemifield –> inferior bank on lingual gyrus
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6
Q

What is the pathway of optokinetic?

A

right parieto-occipital junction (BM 19) –> nuclei of the accessory optic system and nucleus of optic tract–> right pontine nuclei –> left flocculonodular lobe/vestibulocerebellum –> left vestibular nuclei –> right CN 6 –> a. right eye lateral recturs or b. left CN 3 medial rectus via MLF

  • holds image of the target steady on retina during sustained head movement
  • almost exactly the same as smooth pursuit
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7
Q

What are two tests of the vestibular-ocular system?

A

Dolls eye maneuver and COWS

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8
Q

What part of the lateral geniculate nucleus (of thalamus) do temporal fibers come in to? nasal?

A

temporal: 2, 3, 5
nasal: 1, 4, 6

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9
Q

What is the dorsal pathway?

A
  • from primary visual cortex to parietal/frontal cortex
  • association of vision and motor
  • completes motor acts based on visual stimuli
  • passes V3
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10
Q

Lesion ventrolateral LGN fibers

A

superior quadrantanopia (contra eye)

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11
Q

Pt. presents with color blindness. What visual cortex may be involved?

A

V4 - complete processing of color inputs

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12
Q

Pt. presents with insomnia. You worry that a certain cell in their retina may be damaged. What cell are you thinking of, and what is their function?

A

melanopsin ganglion cell - detect light and take their information to the hypothalamus (suprachiasmatic nucleus) to control circadian rhythms

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13
Q

Lesion to optic chiasm

A

bitemporal hemianopia

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14
Q

Pt. presents to your clinic complaining about not seeing colors in her book when she reads over candle light. You tell this is normal because…

A

with dim light, multiple rods are activated and they release glutamate to activate an ON center bipolar cell and an amacrine cell. The amacrine cell will release GABA or Gly to inhibit the cone cells in order to best see. The amacrine cells act as interneurons.

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15
Q

Where do we find vertixal gaze control centers? horizontal?

A
  1. midbrain

2. pons/lower pons

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16
Q

Pt. presents with complaints of difficulty reading. What is a possible mxn causing her near vision problems?

A

her ciliary m. is not contracting, so her suspensary ligaments cant relax and her lens can’t round up

*possibly presbyopia (lens becomes stiffer with aging)

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17
Q

What is the role of the hypothalamus in vision? accessory optic nuclei?

A
  • visual input to the hypothalamus drives the light-dark entertainment of neuroendocrine function and other circadian rhythms
  • advanced visual processing
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18
Q

What is the sequence of the vertical saccadic system?

A

right side of brain’s frontal eye field or superior colliculus –> rostral interstitial nucleus of the MLF –> send fibers through MLF to CNs 3 and 4

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19
Q

Lesion dorsomedial LGN fibers

A

inferior quadrantanopia (contra eye)

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20
Q

What are the three cell types needed for horizontal saccades? where are they found? for vertical?

A 
1. Burst - PPRF
Tonic - Nucleus prepositus hypoglossi
Pause - omnipause cells of Raphe Nuclei
2. Burst - Rostral interstitial nucleus of MLF
Tonic - Interesitial nucleus of Cajal
 Pause omnipause cells of Raphe Nucleus
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21
Q

What is the role of the pretectal area?

A

pupillary light reflex

*fibers from optic tract, LGN, and suprachiasmatic nucleus

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22
Q

Pt. presents with inability to name an object. You check to see if they are able to copy objects. Why did you do this?

A

because copying and naming objects are housed in different parts of the temporal region, so one can be damaged without affecting the other

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23
Q

What do we see with damage to CN 2? damage to optic tract? CN 3 nucleus/nerve?

A
  1. no direct or consensual constriction with light in abnormal eye; both present with light in normal eye
  2. diminished direct and consensual in both eyes
  3. direct/consensual lost for abnormal eye, but other eye is always okay
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24
Q

Visual areas 1-5

A 
V 1 - primary visual cortex (17)
V 2 - greater part of 18
V 3 - narrow strip of 18
V 4 - 19 
V 5 - middle temporal area (part of 19)
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25
What Brodmann areas surround the striate cortex? what do they compose?
18 and 19 --> visual association cortex (extrastriate cortex)
26
What are the functions of the LGN?
1. control motion of eyes to converge on point of interest 2. control focus of eyes based on distance 3. Determine relative position of objects to map them in space 4. Detect movement relative to an object
27
What receptor do we find in the depolarizing parts of bipolar cells? hyperpolarizing?
- glutamate R is a GPCR that closes cGMP gated ion channels --> sign change - non-NMDA (AMPA or kainate) --> no sign change
28
# Define the following: 1. Saccadic 2. Smooth pursuit 3. Vestibularocular 4. Vergence
1. rapid eye movement that brings image of object onto fovea 2. keeps moving image centered on fovea 3. holds image steady on fovea with head movements 4. keeps image on fovea when object is moved near *all are conjugate, except 4
29
What type of saccades are seen by the frontal eye field? superior colliculus?
a. voluntary (ex. looking for keys | b, reflex (ex. look to see what caused a loud sound)
30
What is the pathway for the vestibular-ocular system?
right semicircular duct --CN 7--> vestibular nuclie --> left CN 6 nucleus --> a. left CN 6 lateral rectus or b. MLF CN 3 to medial rectus * vertical uses 3 and 4 * eyes move in opposite direction of head movement
31
OFF center cell | Day and Night
Day - less glutamate --> less AMPA --> hyperpoliarze Night - more glutamate --> more AMPA --> depolarize *tell us where things end --> excited by dark spot
32
What is the main function of VI?
identify edges and countours of objects
33
Pt. presents with inability to look upward. You worry about?
a pineal tumor or tumor pressing the superior midbrain, which would compress the cells controlling vertical gaze (found near superior colliculus and posterior commissure) --> leads to selective palsy of vertical gaze upward
34
Why do we have a blindspot? where is it?
medial to the macula lutea, we have the optic disc which is where retinal axons leave as the optic nerve we don't have photoreceptors here--> blind spot
35
What is the ventral pathway?
- primary visual cortex to inferior temporal cortex | - interpreting images and complex patterns
36
What are abnormal results of a saccadic movement test?
1. Destructive lesion: transient conjugate eye deviation toward side of lesion (difficult to look away from lesion) 2. Seizure activity: eyes deviate away from firing gaze center
37
Pt. presents with superior visual field loss after a gun shot would to the temporal lobe. What was hit?
Meyer's loop
38
What is the role of layers 1-3? 4? 5 and 6?
a. networking between VI and other areas of cortex b. input from LGN c. output to LGN, thalamus, subcortical regions
39
Pt. presents with "weird pupils", He admits to having multiple sexual partners, being an anti-vaccer, and rarely using protection. What is the dx?
Argyll-Robertson pupil - neurosyphilis absent light reflex, but pupil constricts in near reflex testing
40
Pt. presents with inability to constrict pupil, What are the possible steps that went wrong to cause this?
Steps of constricting -- could be any of these: 1. Retinal Retinal axams terminate in the olivary pre-tectal nucleus 2. Fibers are sent to b/l Edinger-Westphal nucleus 3. Autonomics travel via CN3 to ipsi ciliary ganglion 4. Postganglionic short ciliary nerves travel to innervate the pupillary m. and ciliary m.
41
What is the role of the columns? blobs?
1. respond to angles - ex. vertical angles respond to trees, while horizontal respond to tables 2. respond to varying wavelengths to detect color (need red, blue, and green cones to properly detect color)
42
What is the purpose of the crossing nasal fibers?
allows depth perception (stereoscopic vision)
43
Pt. presents with inability to look down. You worry about?
a tumor just medial/dorsal to the Red Nucleus --> selective palsy of vertical gaze downward
44
Pt. Presents with weak adduction of right eye, and abduction nystagmus of left eye. What is the dx and what caused it?
Internuclear Ophthalmoplegia lesion to MLF in pons or midbrain
45
Pt presents with a lesion to the upper cuneus and lingual gyrus. What would be their deficits?
superior and inferior visual loss with macula sparing (so center of visual field is in tact)
46
Pt. presents with difficulty seeing at night, What cell may be damaged and what can you suggest to correct it?
Rod; have her use her peripheral vision to focus on what she wants to see
47
What is the pathway of smooth pursuit?
right parieto-occipital junction (BM 19) --> right pontine nuclei --> left flocculonodular lobe/vestibulocerebellum --> left vestibular nuclei --> right CN 6 --> a. right eye lateral recturs or b. left CN 3 medial rectus via MLF * eyes look right * vertical is the same except you use CN 3 and 4
48
What forms the lateral geniculate nucleus (of thalamus)?
the ventral portion is the optic tract, and lateral/dorsal portions come from optic radiations
49
Pt. presents with compalins of difficulty seeing while running. They have a hard time focusing on objects, and it is making running quite dangerous. What system may be affected?
vestibular-ocular system
50
What is the difference between Magnocellular layers and Paracellular layers?
1, Magno a. . layers 1 and 2 b. rods c. moving stimuli d. large receptive fields e. rapidly conducting axons 2. Para a. layers 3-6 b. cones c. stationary stimuli (high acuity color) d. small receptive fields e. slowly conducting axons *part of LGN
51
Where is the macula represented in the occipital lobe?
most posterior
52
Optic Tract =
nasal from contra + temporal from ipsi
53
Pt. presents and is having trouble noticing when things are moving. She just notices the aftermath.YOu worry that she is having problems with?
V3a - motion identification - narrow strip 18
54
Pathway of near reflex
optic nerve --> LGN --> primary visual cortex --> visual association cortex --> superior colliculus and/or pretectal plate --> Edinger-Westphal (CN 3; gives convergence) --> Medial rectus ms. and dilation of pupils *bypasses MLF, which is why some lesions you can still have convergence
55
What causes homonymous hemianopia?
cut optic radiations
56
Pt. presents and is having difficulty placing objects on tables. You worry that she is having problems with?
V2 - depth perception - greater partof 18
57
Pt. presents with inability to focus on an object even when looking for it. For example, she may hear a loud sound, and not be able to identify the location. What cell type may be involved?
tonic cells of either the Nucleus prepositus hypoglossi or Interesitial nucleus of Cajal
58
What are the requirements of near vision?
1. Ciliary m. contraction 2. Convergence of eyes on point of focus (accommodation) 3. Constriction of pupil *3 Cs
59
What is anisocoria? mydriasis?
- uneven pupil size | - dilation of pupil
60
Pt. presents after a MVA, and is pronounced to have a grave sign. What was seen in the pt?
dilated, unresponsive pupil in an unconscious person
61
Pt. presents with inability to name an object, but can use the object correctly. What is their dx?
Associate Visual Agnosia *infarction of the left occipital lob and posterior corpus callosum due to PCA occlusion
62
ON center cell: | Day and Night
Day - less glutamate --> less Gi --> depolarize Night - more glutamate --> more Gi _ hyperpolarize *tell us where something is --> excited by bright spot
63
What is the superior colliculus' role in vision?
- spatially directs head movements and visual reflexes | * fibers from the optic tract bypass the LGN/MGN to form the brachium of the SC
64
Where is an object of interest centered in the eye?
fovea centralis, which is in the macula lutea

Neuro 3 (8 decks)

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