Neurology eye (delta) Flashcards Preview

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Flashcards in Neurology eye (delta) Deck (68)
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1

Inferior obqlie action

Extorsion
Elevation
Abduction

2

Inferior rectus action

Depression

3

Medial rectus action

Adduction

4

Superior rectus action

Elevation

5

LPS action

Retraction of eyelid

6

Superior oblique action

Incyclotorsion
Depression
Abduction

7

Lateral rectus action

Abduction

8

CNs that originate from midbrain

Oculomotor
Trochelar

9

CNs that originate from pons

Trigeminal
Abducens

10

CNs at cerbellopontine angle

Facial nerve
Vestibulocochlear

11

CNs that originate at medulla

Glossopharyngeal
Vagus
Spinal accessory
Hypoglossal

12

Accomodation

Increase in lens curvature; ciliary muscle contracts leading to relaxation of suspensory ligaments of lens
Constriction of pupils; activation of sphincter pupillae
Eye convergence medially

13

Signs of optic nerve dysfunction

Decrease in VA
Dyschromatopsia; red first
Visual field defects
Diminished contrast sensitivity
RAPD

14

Systemic clinical features of MS

Sensory loss
Motor spinal cord symptoms
Autonomic; bladder, blower and sexual dysfunction
Cerebellar; tremor + dysarthria + ataxia
L'hermitte sign; electrical shock on neck flexion
Uhthoff phenomenon; worsening of symptoms due to increase in temperature

15

Opthalmic features of MS?

Optic neuritis; unilateral pain exacerbated by eye movement, decreased VA (central scotoma), dyschromatopsia, RAPD
INO
Nystagmus

16

What can be seen on ix for MS?

Demyelinated plaques on MRI
Oligoclonal bands in CSF on LP

17

Tx for optic neuritis

IV methylprednisolone followed by PO prednisolone

18

What is neuromyelitis optica?

Demyelinating disorder characterized by bilateral severe optic neuritis and transverse myelitis in 3 or more vertebral columns
Causes muscle weakness, increased tone and spasm

19

What can be seen on investigation of neuromyelitis optica?

IgG antibody against AQP4

20

What is AION?

Damage to optic nerve as a result of ischaemia
Can be non-arteritic or caused by giant cell arteritis

21

Presentation of non-arteritic AION

Less than 50
RF: idiopathic, hypertx, diabetes, sleep apnoea, disc anomaly
Occlusion of short posterior ciliary artery
Sudden, painless, unilateral visual loss
Inferior altitudinal VF defect
Disc swelling
Ix; BP, BG, exclude GCA
Treat cause

22

Presentation of GCA

Older than non-arteritic
GCS of short posterior ciliary artery
Sudden, painful, unilateral severe visual loss
Disc; chalky white, diffusely swollen, optic atrophy
Assoc sy; scalp tenderness, headache, jaw claudication
Ix; ESR, CRP, temporal artery biopsy
Tx; high dose IV methylprednisolone

23

What is papilloedema?

Optic disc swelling due to elevated ICP

24

Clinical features of papilloedema

Elevated ICP sy; headache (worse in morning), N+V, pulsatile tinnitus, deterioration of consciousness
Transient visual loss with a duration of seconds
Enlarged blind spot

25

Signs of papilloedema on fundoscopy

Hyperaemia and blurring of disc margins
Swelling and elevation of optic disc with peripapillary sphincter haemorrhage

26

What is horner's syndrome?

Lesion to symp pathway

27

Hallmarks of horner's syndrome

Ptosis
Miosis
Ipsilateral anhydrosis

28

What causes horner's syndrome

Stroke
Syringomyelia
Pancoast tumour
Carotid aneurysm
ICA dissection
Cluster headache
Cavernous sinus lesion

29

What does a painful horner's syndrome direct you towards?

Carotid/ ICA dissection

30

What can be used to confirm hroner's syndrome?

Apraclonidine; will cause pupillary dilation in the horner's pupil but normal pupil will be unaffected