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Neuroanatomy
2nd ppt
46
Other
Graduate
10/26/2011

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Term
Which nerve innervates the lateral rectus of the eyeball?
Definition
CN6
Term
Which nerve innervates the superior obliques of the eyeball?
Definition
CN4
Term
Which nerve innervates the superior, inferior, and medial recti and the inferior oblique of the eyeball?
Definition
CN3
Term
What is the name for a drooping eyelid?
Definition
ptosis
Term
What cranial nerve innervates the levator palpebrae?
Definition
CN 3
Term
What is accommodation?
Definition
the constriction or relaxation of ciliary muscles causing the lens to flatten or become more spherical, respectively. Helps the eye to change focus from distant to near objects
Term
What is the most common reason for diabetic retinopathy?
Definition
microangiopathy
Term
parasympathetic fibers to the eyeball are carried through which cranial nerve?
Definition
CN 3
Term
What is the function of the superior oblique?
Definition
Depression while adducting
Term
What is the function of the inferior oblique?
Definition
elevation while adducting
Term
What is the function of the superior rectus?
Definition
elevation while abducting
Term
What is the function of the inferior rectus?
Definition
depression while abducting
Term
Disorders of which of the cranial nerves can cause diplopia? What are three causes of diplopia?
Definition
-3, 4, and 6
-Mechanical (orbital fracture), disorders of the EOM's, myasthenia gravis (loss of muscle tone)
Term
In testing a patient for diplopia, if it does NOT go away when you cover one eye it is called what?
Definition
Monocular diplopia
Term
What are three causes of the monocular diplopia?
Definition
-opthalmological disease
-visual cortex disorders
-psychiatric conditions
Term
What is a possible cause of a visual cortex disorder?
Definition
blunt trauma to the back of the head
Term
When testing for diplopia, if it goes away when covering one of the patient's eyes, what is it called?
Definition
- it is a disorder of eye movement
Term
In complete occulomotor palsy (CN III), you lose function of all but what two EOM's? Which way does this cause the eyeball to settle at rest? What are two other indicators?
Definition
-lose all but the superior oblique and the lateral rectus
-causes the eye to go down and out at rest
-complete ptosis (levator palpebrae lost)
-pupil dilated and unresponsive to light (parasympathetic component, fibers originating from the edinger westphal)
Term
What are 6 causes of oculomotor palsy?
Definition
-diabetic neuropathy
-compression of 3rd CN by aneurysm
-head trauma
-herniation of medial temporal lobe
-ophthalmoplegic migraine
-stroke in midbrain
Term
If diabetic neuropathy is the cause of oculomotor palsy, is the pupil spared or involved?
Definition
spared
Term
If compression of the third nerve is the cause of occulomotor palsy, is the pupil spared or involved?
Definition
involved, bc parasympathetic fibers to pupil are located near the surface of the nerve
Term
Trochlear (CN 4) palsy is characterized by what? What muscle involved
Definition
-hypertropia (vertical deviation of the eye)
-vertical diplopia--> when you try and read a book the effected eye will look up
-superior oblique
Term
Abducens nerve (CN6) palsy is characterized by what?
Definition
Weak abduction
Term
Abducens nerve palsy can be an early sign of what?
Definition
increased intracranial pressure (bc of its long course)
Term
What are 4 subjective symptoms of increased intracranial pressure and one objective?
Definition
S: headache, impaired alertness, nausea, double vision
O: blurred disc margins (papilledema), bilateral 6th nerve palsy
Term
What is a mnemonic to remember the subjective symptoms of increased intracranial pressure?
Definition
HIND (headache, impaired alertness, nausea, double vision)
Term
What does the radial muscle of the iris do when it contracts? Is it sympathetic or parasympathetic innervation?
Definition
dilates the pupil when it is contracted. sympathetic
Term
What does the circular muscle of the iris do when it contracts? is it sympathetic or parasympathetic innervation?
Definition
Constricts the pupil, parasympathetic
Term
What does the circular muscle of the iris do when it contracts? is it sympathetic or parasympathetic innervation?
Definition
Constricts the pupil, parasympathetic
Term
What CN is a efferent parasympathetic pathway from the edinger-westphal nucleus to the pupillary constrictor muscle? A lesion of this nerve causes what consequence to the pupil?
Definition
-CN3
-Lesion causes impaired pupillary constriction, unilaterally dilated pupil
Term
What is Horner's syndrome caused by?
Definition
a lesion anywhere along the sympathetic pathway
Term
What are three characteristics of Horner's syndrome?
Definition
-ptosis- from loss of innervation to Muller's muscle of upper lid
-miosis- from loss of sympathetic innervation to pupillary dilator muscle
-anhidrosis, inability to sweat properly (due to loss of sympathetic innervation)
Term
What is benign anisocoria?
Definition
pupillary asymmetry, seen in 20% of population
Term
What effect do opiates have on the pupils?
Definition
pinpoint pupils
Term
What effect do barbituates have on the pupils?
Definition
small pupils
Term
What is Adie's myotonic pupil?
Definition
degeneration of the ciliary ganglion which causes a mid dilated pupil that reacts poorly to light
Term
Which two muscles control opening of the eye?
Definition
-levator palpebrae superior (CN3)
-muller's smooth muscle (sympathetic)
Term
What muscle causes closure of the eye?
Definition
orbicularis oculi (CNVII, the facial nerve)
Term
What are doll's eyes?
Definition
WHen the eyes go in the opposite direction that the head is turned
Term
What are 4 possible causes of ptosis?
Definition
-horner's syndrome
-CN 3 palsy
-myasthenia gravis
-pseudoptosis (Bells palsy causes widened palpebral fissure, may think opposite eye has ptosis)
Term
What is nystagmus?
Definition
involuntary rhythmic movements of the eye
Term
What is pendular nystagmus?
Definition
oscillations equal in rate in both directions (central vision lost early in life)
Term
what is jerk nystagmus? How is the direction named?
Definition
movements alternate between a slow and fast component. named by the fast component (nystagmus to the left)
Term
What can optokinetic nystagmus be related to?
Definition
watching a moving train
Term
Define exotropia, esotropia, and hypertropia
Definition
-exotropia: abnormal lateral deviation of one eye
-esotropia: abnormal medial deviation of one eye
-hypertropia: vertical deviation of one eye
Term
What is dilantin? WHo is it prescribed to? What are two side effects?
Definition
-anti epileptic drug given to epileptic patients
-patient's gums are swollen, can cause nystagmus
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