By Linda Wilson-Pauwels; Elizabeth J. Akesson; Patricia A. Stewart; Sian D. Spacey
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Additional resources for Cranial Nerves in Health and Disease, Second Edition
Very bright light damages the retina. The pupillary light reflex evolved to control the amount of light entering the eye. In dim light the pupil is dilated to allow maximal entry of light, however, as the light gets brighter the pupil gets smaller. The pupillary light reflex involves two cranial nerves: the optic nerve (cranial nerve II) forms the afferent limb by carrying the sensory signal to the central nervous system, and the oculomotor nerve (cranial nerve III) forms the efferent limb by carrying motor signals to the pupillary constrictor muscle.
46 Cranial Nerves CLINICAL TESTING Examination of the optic nerve involves four procedures: 1. Visualization of the fundus 2. Measurement of visual acuity 3. Testing of visual fields 4. ) Visualization of the Fundus Visualization of the fundus (Figure II–16) involves the use of an ophthalmoscope. The examination is performed in a dimly lit room so that the patient’s pupils are maximally dilated. Ask the patient to focus on an object in the distance. This helps to keep the eyes still and allows for better visualization of the fundus.
The emergency physician was concerned that Werner might have experienced a subarachnoid hemorrhage. A computed tomography (CT) scan of his head was done, and this demonstrated blood in the subarachnoid space. A cerebral angiogram was done, which demonstrated a dilated aneurysm of the right posterior communicating artery. Werner subsequently underwent neurosurgery to have the aneurysm clipped. ANATOMY OF THE OCULOMOTOR NERVE As its name implies, the oculomotor nerve plays a major role in eye movement (Table III–1).
Cranial Nerves in Health and Disease, Second Edition by Linda Wilson-Pauwels; Elizabeth J. Akesson; Patricia A. Stewart; Sian D. Spacey