Download 2008-2009 Basic and Clinical Science Course: Section 5: by Lanning B. Kline, MD PDF

By Lanning B. Kline, MD

A patient-centered method of the prognosis and remedy of significant neuro-ophthalmic stipulations. targeting very important offering signs, this publication leads the reader during the occasionally sophisticated manifestations of neuro-ophthalmic illness to anatomic localization of lesions and definitive prognosis. additionally contains an outline of the anatomy of the visible pathway, directions for accomplishing the neuro-ophthalmic exam and acceptable use of diagnostic imaging reviews.

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Additional resources for 2008-2009 Basic and Clinical Science Course: Section 5: Neuro-Ophthalmology (Basic and Clinical Science Course 2008-2009)

Example text

This additional tonic input is provided by integrating the velocity signal provided by the burst neuron activity. For horizontal eye movements, integration takes place in the nucleus prepositus hypoglossi (NPH) located adjacent to the medial vestibular nucleus at the pontomedullary junction, with input from the cerebellum. Neural integration for vertical eye movements involves the INC in addition to the cerebellum. Pathology affecting this neural integrator (often metabolic, associated with alcohol consumption or anticonvulsant medication) results in failure to maintain eccentric gaze, recognized clinically as gaze-evoked nystagmus.

Luee.! = middle cerebral artery; PCA = posterior cerebral artery. (Illustration CHAPTER Figure 1-10 Venous drainage of the orbit. adjacent plexus. 8, Anterolateral view. A, Lateral 1: Neuro-Ophthalmic view of venous drainage Anatomy. of the orbit (Continues) 21 and 22 . Neuro-Ophthalmology Figure 1-10 C. Superficial venous structures of the eyelid. Key: acv = anterior collateral vein; afv = anterior facial vein; av = angular vein; crv = central retinal vein; cs = cavernous sinus; iopv = inferior ophthalmic vein; iov = infraorbital vein; ipv = inferior palpebral vein; ir = inferior root of superior ophthalmic vein; Iv = lacrimal vein; mb = muscular branch; mcv = medial collateral vein; mopv = medial ophthalmic venous vein; nb = nasal branch; pp = pterygoid plexus; psav = posterior superior alveolar vein; sopv = superior ophthalmic vein; sov = supraorbital vein; spv = superior palpebral veins; sr = superior root of superior ophthalmic vein; stv = supratrochlear vein; vv = vena vorticosa (superior lateral and medial vorticose veins; inferior lateral and medial vorticose veins).

The myelin investment is part of the membrane of oligodendrocytes that join the nerve posterior to the sclera. The intraorbital optic nerve extends approximately 28 mm back to the optic canal. The extra length of the intraorbital optic nerve allows unimpeded globe rotation as well as axial shifts within the orbit. The central retinal artery and vein travel within the anterior 10-12 mm of the optic nerve. The central retinal artery supplies only a minor portion of the optic nerve circulation; most of the blood supply comes from pial branches of the surrounding arachnoid, which is in turn supplied by small branches of the ophthalmic artery.

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