iris and pupils NBEO.txt

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cjensen20
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296393
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iris and pupils NBEO.txt
Updated:
2015-02-20 19:30:01
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Iris pupils NBEO optometry
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Iris and pupils NBEO optometry
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  1. Where is the pupil located relative to the iris?
    Nasal and inferior to iris center
  2. Where is the pupil thickest?
    In the collarette
  3. What zones do the collarettes divide?
    • Pupillary zone
    • Ciliary zone
  4. Where is the thinnest part of the iris?
    The iris root, located in the ciliary zone
  5. What does the iris root do?
    Attaches the ciliary zone of the iris to the ciliary body
  6. What part of the iris is continuous with the stroma of the ciliary body?
    Iris stroma
  7. Where is the major circle of the iris located?
    In the ciliary body
  8. Where is the minor circle of the iris located?
    In the iris stroma, at the level of the collarette
  9. What innervates the Iris sphincter muscle?
    Parasympathetic fibers
  10. What innervates the iris dilator muscle?
    Sympathetic fibers
  11. What chemical receptors are found on the dilator muscle?
    A1 receptors
  12. Where is the iris sphincter muscle located within the iris?
    Iris stroma
  13. Where is the iris dilator muscle found within the iris?
    Anterior epithelium
  14. What forms the pupillary ruff?
    Pigmented posterior epithelium
  15. What causes iris color?
    Due to the amount of pigmentation of melanocytes in the anterior border layer of the iris
  16. What forms the blood aqueous barrier?
    • Iris vessels
    • Endothelium of Schlemm's canal
    • Non-pigmented ciliary epithelium
  17. How is uveitis related to the blood aqueous barrier?
    Uveitis occurs due to a breakdown of the BAB
  18. What type of pupillary defects are afferent?
    • APD
    • Light-near dissociation
  19. What should you consider if anisocoria is worse in the dark?
    • Horner's syndrome
    • Posterior synechiae
    • Argyll Robertson
  20. What 3 things is Argyll Robertson pupil associated with?
    • Neurosyphilis
    • DM
    • Alcoholism
  21. Where would there be a lesion found in Argyll Robertson pupil?
    Tectotegemental tract
  22. What does the tectotegemental tract do?
    Carries information from the pretectal nucleus to Edinger-Westphal nuclei
  23. What pupil disorder presents with anisocoria worse in the dark but has normal accommodative response?
    Argyll Robertson pupil
  24. What should you consider if anisocoria is worse in light conditions?
    • Adie's Tonic pupil
    • Something involving CN3
  25. If you suspect Adie's Tonic pupil, but it constricts after 0.125% pilocarpine, what should you consider?
    CN3 involvement
  26. Where would a lesion be located in Adie's Tonic pupil?
    Ciliary ganglion
  27. What condition would you suspect if there was anisocoria worse in the light together with poor light/near response?
    Adie's Tonic pupil
  28. If you suspect Adie's tonic pupil, but it fails to constrict with pilocarpine what should you consider?
    • Due to trauma of sphincter muscles
    • Due to pharmacologic agent
  29. What are 3 the typical signs seen in Horner's syndrome?
    • Mitotic pupil (anisocoria) worse in dim illumination
    • Anhydrosis
    • Ptosis
  30. Where is the most common location of a lesion in Horner's syndrome?
    Pancoast tumor in the apex of the lung
  31. What chemical agents are used to diagnose Horner's syndrome?
    Cocaine or apraclonidine
  32. What chemical agent is used to determine location after Horner's syndrome has been diagnosed?
    Hydroxyamphetamine
  33. If a Horner's pupil dilates with hydroxyamphetamine where should you suspect a lesion?
    Preganglionic, 1st or 2nd order
  34. If a Horner's pupil does not dilate with hydroxyamphetamine, where should you suspect a lesion?
    Postganglionic, 3rd order
  35. What is the 1st order sympathetic pathway of the eye?
    Preganglionic fibers begin at hypothalamus and descend and synapse at ciliospinal center of budge
  36. What is the 2nd order sympathetic pathway of the eye?
    Preganglionic fibers from the ciliospinal center of budge course across the apex of the lung, ascend, and synapse in the superior cervical ganglion
  37. What is the 3rd order sympathetic pathway of the eye?
    • Postganglionic signal from the superior cervical ganglion ascend the internal carotid and innervates:
    • Muller's muscle on the upper eyelid
    • Iris dilator and ciliary muscle via the LPCN
    • Choroidal and conjunctival blood vessels via SPCN
    • Vasoconstriction of lacrimal gland via petrosal nerve
  38. How are CSR and the sympathetic system related?
    CSR is believed to be a hyperactivity of sympathetic system localized in the retina, causing bruch's membrane damage
  39. Where is the near pupil reflex controlled?
    Frontal eye fields
  40. What part of the pupillary pathway is used for pupil constriction?
    • Edinger-Westphal nuclei
    • Ciliary ganglion

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