Neuro-Ocular Exam (F) Flashcards Preview

III. Ocular Neurology > Neuro-Ocular Exam (F) > Flashcards

Flashcards in Neuro-Ocular Exam (F) Deck (24)
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1
Q

If the oculocephalic response is intact in a patient with limited eye movements, what does it suggest?

A

supranuclear disorder

2
Q

What is the neutral density filter method for grading relative afferent pupillary defect?

A
increase filter in front of normal eye until APD disappears
Grade 1 – ND 0.4
Grade 2 – ND 0.7
Grade 3 – ND1.1
Grade 4 – ND 2.0
3
Q

What aspects of the facial nerve (VII) need to be assessed?

A
  1. motor function
  2. taste
  3. tear function
  4. blink
4
Q

What is the cerebellar test that asks the patient to alternately point from his or her nose to the examiner’s finger and the examiner typically moves their finger to different locations?

A

Finger-nose-finger test

5
Q

What are the aspects of the patients history that should be addressed in a neuro-ocular exam?

A
  1. age and gender
  2. chief complaint
  3. Associated symptoms, neuro and general
  4. review of systems and past ophthalmologic and medical history
  5. family history
  6. social history
6
Q

What should be noted about motor function of the facial nerve (VII)?

A

facial asymmetry, blink pattern, forehead wrinkling, lagophthalmos, and facial emotional response and response to command, and orbicularis strength

7
Q

What can the Photostress Test (Glare Recovery) be useful in detecting?

A

macular disease more likely to impair glare recovery than optic nerve disease

8
Q

What are the different types of pathological processes that can cause a dyschromatopsia?

A
  1. macular
  2. retinal
  3. chiasmal
  4. retro-chiasmal
  5. optic nerve
9
Q

What type of VA charts are best for repeatability, consistency, and testing with relatively poor vision?

A

LogMAR

10
Q

What do color tests help differentiate?

A

congenital from acquired

11
Q

What do diseases of the corticobulbar tracts tend to spare regarding facial nerve motor function? 1. Basal ganglia? 2

A
  1. emotional facial responses

2. voluntary movements

12
Q

How is LPS function determined? 1. What is normal? 2. When is it reduced? 3

A
  1. Measure upper lid margin position in downgaze, then in upgaze with brow fixed.
  2. Normal is 12 mm or greater change
  3. ptosis from Myasthenia Gravis, myopathies, III palsy, and congenital ptosis, but normal in Horner Syndrome or LPS dehiscence.
13
Q

What often presents with dissociation between spontaneous and voluntary facial movement with preservation of forehead wrinkles and brow?

A

supranuclear VII palsies

14
Q

What is the number-plus system for grading relative afferent pupillary defect?

A

1+:initial constriction, but early redilation
2+:no initial movement of the pupil, then dilation
3+:immediate redilation
4+:amaurotic pupil

15
Q

What is the cerebellar test that asks the patient to stand, feet together with eyes closed and arms at sides? 1. What is a positive of this? 2

A
  1. Romberg test

2. loss of balance occurs

16
Q

Why do supranuclear lesions result in weakness of the lower face only?

A

upper face innervate by both hemispheres

17
Q

When should exophthalmometry be used?

A
  1. proptosis

2. enophthalmos

18
Q

What is the cerebellar test that asks the patient to run the heel of one foot along the shin of the opposite leg and then other leg?

A

Heel-to-shin test

19
Q

What is Kollner’s rule for acquired dsychromatopsias?

A
  1. Outer retina = B/Y defects

2. Inner retina, optic nerve, and visual pathway = R/G defects

20
Q

What is a method to test CN I? 1. CN VIII? 2. CN IX and X? 3. CN XI? 4. CN XII? 5

A
  1. test each nostril with coffee
  2. discern fingers rubbing?
  3. is voice hoarse?
  4. head turning and shoulder shrugging
  5. tongue protrusion
21
Q

What can Amsler grid be useful in detecting?

A

macular disease and other visual field defects

22
Q

What does testing contrast sensitivity help in diagnosing?

A

optic neuropathies

23
Q

What is the distance between the upper eyelid edge and the corneal light reflex called? 1. Lower eyelid to corneal light reflex? 2

A
  1. Marginal reflex distance (MRD1)

2. MRD2

24
Q

What is an APD without vision loss suggestive of?

A

lesion between optic tract and pretectal area