1.
Which of the following muscles is NOT involved in eyelid elevation?
A. Levator palpebrae superioris
B. Muller's muscle
C. Frontalis muscle
D. Orbicularis oculi
Correct Answer
D. D
Explanation
Orbicularis Oculi - is the major protractor of the eyelids (closing) it is innervated by CNVII as well
2.
Concerning yoked muscles: Hering's law of _______ innervation.
Correct Answer
Equal
Explanation
Hering's law of equal innervation states that the muscles that are yoked together, meaning they work together to perform a certain movement, receive equal innervation from the nervous system. This means that when one muscle is activated, its yoked muscle will also be activated to the same extent. This ensures smooth and coordinated movement.
3.
Concerning yoked muscles: Sherrington's law of _______ innervation.
Correct Answer
Reciprocal
Explanation
Sherrington's law of reciprocal innervation states that when one muscle is activated, its antagonist muscle is inhibited. This means that the muscles that work together in opposite directions are coordinated to prevent them from contracting at the same time, allowing for smooth and coordinated movement. This reciprocal innervation helps to maintain balance and control in the body.
4.
Which of the following afferent pathways is not paired correctly?
A. Trigeminal (CN V) - Corneal reflex
B. Auditiory ( CN VIII) - auditory and facial reflexes
C. Optic (CN II) - Dazzle, glare and menace reflexes
Correct Answer
B. B
Explanation
Option A; Correct but in addition CNV also controls the facial reflex
Option B: CNVIII - is solely responsible for auditory reflex
5.
Which of the following statements regarding the corneal reflex is FALSE?
A. It has a latency of about 160 msec
B. It is the last reflex lost under general anesthesia
C. It remains in decorticate animals
D. First reflex lost with cerebellar pontine angle tumor
Correct Answer
C. C
Explanation
Option C - refers to the Dazzle reflex
Additional information for the corneal reflex = CL patients adapt to this reflex
6.
Which reflex can normal patients withhold? If a patient cannot withhold this reflex it is known as Myerson's sign.
A. Corneal Reflex
B. Facial Reflex
C. Dazzle Reflex
D. Glare Reflex
Correct Answer
B. B
Explanation
Normal patients can withhold the Facial Reflex. Myerson's sign refers to the inability to withhold the Glabellar Reflex, which is a repetitive blinking response to tapping on the forehead. Therefore, the correct answer is B.
7.
Why is the "contact lens stare" significant?
A. It shows that blinking is not affected by the concentration or excitation level
B. It shows that the blink cycle for secretion, dispersal, evaporation and drainage of tears is not dynamic
C. It shows that blink characteristics can be altered.
D. It is an example of blink suppression
Correct Answer
C. C
Explanation
The "contact lens stare" is significant because it demonstrates that blink characteristics can be altered. This suggests that wearing contact lenses can affect the natural blinking reflex, potentially leading to dry eyes or other discomfort. The stare may indicate that contact lens wearers tend to blink less frequently or have altered blink patterns compared to those who do not wear contact lenses.
8.
Blink suppression affects:
A. Low spatial frequency
B. High temporal frequency
C. Luminance information
Correct Answer
D. All of the above
Explanation
Blink suppression affects all of the above options: low spatial frequency, high temporal frequency, and luminance information. Blink suppression refers to the phenomenon where the visual system suppresses the perception of visual information during eye blinks. This suppression can affect the perception of low spatial frequency information, which refers to the perception of coarse details in an image. It can also affect high temporal frequency information, which refers to the perception of rapid changes or motion in an image. Additionally, blink suppression can also affect the perception of luminance information, which refers to the perception of brightness or intensity of light.
9.
Which of the following statements does NOT apply to the palpebral fissure?
A. Thyroid -associated orbitopathy is a common cause of increased fissure width.
B. Is elliptical in children and already completely developed at birth.
C. There is no difference b/t men and women
D. Upper lid 1.5 - 2mm below superior limbus and lower lid at inferior limbus
Correct Answer
B. B
Explanation
The palpebral fissure refers to the opening between the upper and lower eyelids. Option B states that the palpebral fissure is elliptical in children and already completely developed at birth. However, this statement is incorrect as the palpebral fissure is actually narrower and more rounded in children, and it continues to grow and develop until adulthood.
10.
In reference to the palpebral fissure: which sign results from retraction of the upper lid as a result of excessive sympathetic stimulation of Muellers muscle?
A. Von Graefe's sign
B. Collier's sign
C. Pseudo Von Graefe's sign
Correct Answer
A. A
Explanation
Von Graefe's sign is the correct answer. This sign refers to the retraction of the upper eyelid due to excessive sympathetic stimulation of Muellers muscle. It is commonly seen in patients with Graves' disease, an autoimmune disorder that affects the thyroid gland. The excessive sympathetic stimulation causes the eyelid to retract, resulting in a widened palpebral fissure. This sign is named after the German ophthalmologist, Carl Ferdinand von Graefe, who first described it. Collier's sign refers to a different condition, which is the absence of the upper eyelid crease. Pseudo Von Graefe's sign is not a recognized term.
11.
In reference to the palpebral fissure: which sign is caused by an increased tonus of the levator?
A. Von Graefe's sign
B. Collier's sign
C. Pseudo Von Graefe's sign
Correct Answer
B. B
Explanation
Collier's sign: The increased tonus is due to a lesion of CN III at the posterior commissure. Unlike Von Graefe's is is NOT a result of thyroid disease. We also see nucleus damage at the intersitial nucleus of Cajal and Darkschewitz (spelling ?).
12.
In reference to the palpebral fissure: which sign occurs after recovery from a CN III paralysis?
A. Von Graefe's sign
B. Collier's sign
C. Pseudo Von Graefe's sign
Correct Answer
C. C
Explanation
Pseudo Von Graefe's sign: Remember that CN III is capable of regeneration, Levator and MR are typically affected. In Adducted gaze - ptosis will disappear due to lid retraction.
13.
What pathophysiology is commonly observed in CN VII nerve palsy, MG or trauma?
A. Ectropion
B. Entropion
C. Bitot spot
D. Ankyloblepharon
Correct Answer
A. A
Explanation
Option D; fusion of the lids/ risk no orbit is present behind the lids
14.
Which of the following statements in regard to the Meibomian glands is FALSE?
A. The glands are oriented parallel to the lid margin
B. There are roughly 30 glands in each lid
C. The oil is the top layer of the tear film that helps to prevent the evaporation of tears
D. Each gland has one central duct on the lid margin
Correct Answer
A. A
Explanation
Areas of oily tissue are adjacent to the duct (acini)
15.
Which of the following terms are paired incorrectly?
A. Accessory lacrimal glands = Krause and Wolfring
B. Acessory oil glands = Zeiss and Moll
C. Internal hordeolum = inflammation/ blockage of the meibomian gland.
D. Meibomitis = bilateral inflammation of the lid margins
Correct Answer
D. D
Explanation
Correct: Meibomitis = chronic, painful, bilateral inflammation of the meibomian glands
Marginal blepharitis = bilateral inflammation of the lid margins
Option C = aka chalazion
16.
Finish the sentence: Blepharochalasis...
A. Results in false positives for defects in superior visual field
B. Is the result of repeated bouts of edema of the lid tissue
C. Is commonly associated with weak superior rectus muscle
D. Is the generalized narrowing of the palpebral fissure
Correct Answer
B. B
Explanation
Option A; Refers to Dermatochalasis
Option C: refers to congenital ptosis
Option D: Refers to Blepharophimosis
17.
Which of the followingtypes of ptosis is not paired/defined with the proper fact:
A. Mechanical - fat deposits and edema cause the levator to have difficulty elevating the lid
B. Myogenic - the most common form is involutional
C. Cicatrial - use of neostigmine results in paralysis of the LPS
D. Neurogenic - CN III nerve or sympathetic lesion
Correct Answer
C. C
Explanation
Option C: Cicatrial = scar tissue that results in ptosis
18.
Which of the following would NOT be a suggested treatment for GPC?
A. Steroids
B. Vaso-constrictors/antihistamines
C. Neostigmine
D. MC stabilizers
Correct Answer
C. C
Explanation
Neostigmine: is given to patients with acquired ptosis from MG. It enhances the activity of the LPS
19.
Of the following choices, which is has the best prognosis?
A. Squamous cell carcinoma
B. Basal cell Carcinoma
C. Malignant Melanoma
Correct Answer
B. B
Explanation
Option B: Only non-metastatic option listed. Make up 95% of lid carcinomas
He also showed the cutaneous horns in lecture but that was purely a cosmetic issue.
20.
What are the characteristics of a lid lesion that would cause you to refer to a specialist (not a general OMD)?
21.
The purpose of treatments for GPC is to suppress the immune response not eradicate it.
Correct Answer
A. True
Explanation
The purpose of treatments for GPC (Giant Papillary Conjunctivitis) is to suppress the immune response, not eradicate it. This means that the goal of the treatments is to reduce the symptoms and inflammation caused by the immune response, rather than completely eliminating the immune response itself. By suppressing the immune response, the treatments can provide relief for the patient and improve their overall eye health.