6: Papilloedema Flashcards Preview

Ophthalmology Week 2 2017/18 > 6: Papilloedema > Flashcards

Flashcards in 6: Papilloedema Deck (17)
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1
Q

Does “swollen optic disc” mean papilloedema?

A

No

Swollen discs have many causes (e.g CRVO, ischaemic optic neuropathy…)

Papilloedema is a swollen optic disc secondary to raised ICP

2
Q

All patients with bilateral optic disc swelling should be suspected of having what?

A

Space occupying lesion in brain

3
Q

How is CN II examined?

A

Visual acuity

Pupil exam

Visual field assessment

Colour vision

swinging light test

4
Q

Why does raised ICP affect the optic nerve?

A

CN II is an extension of the brain and so is found in the subarachnoid space, so it can be compressed by increased ICP

5
Q

What space does ICF circulate in?

A

Subarachnoid space

6
Q

What does the subarachnoid space surround?

A

Optic nerve

7
Q

Why do the optic discs become swollen in papilloedema?

A

Raised ICP causes swelling of subarachnoid space, compressing VEINS

8
Q

What is the Monro-Kellie hypothesis?

A

Brain, blood and CSF make up the volume of the brain

If one volume increases, the others DECREASE (and thus pressure INCREASES inversely)

9
Q

Can the cranial vault change its volume?

A

No, fixed

10
Q

Which hole in the cranial floor does the brainstem pass through?

A

Foramen magnum

11
Q

Why can an increased ICP cause you to die?

A

Compression of respiratory centres of brainstem

12
Q

What type of hypertension can cause optic disc swelling?

A

Malignant hypertension

13
Q

What should be investigated in all patients with optic disc swelling?

A

Head scan for space occupying lesions

Blood pressure for malignant hypertension

Lumbar puncture if suspected inflammation / infection of CNS

14
Q

Where is CSF produced?

What is its path?

Where does it drain?

A

Choroid plexus of lateral ventricles

Lateral > 3rd > Cerebral aqueduct > 4th ventricle > Subarachnoid space > Arachnoid granulations

Dural venous sinuses

15
Q

What aspects of CSF cause raised ICP?

A

Obstruction of drainage

Overproduction

16
Q

What is the investigation used to diagnose problems to do with the CSF?

A

Lumbar puncture

17
Q

Why must optic disc swelling be treated?

A

Eventually turns atrophic and pale

=> LOSS OF VISION