Neurology Exam Prep Podcast Episode 70 - The Pupil
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Aug 1, 2024 In this enlightening discussion, neurology expert Harry Sutherland and pupil function specialist Jeremy Moeller dive into the intricacies of pupillary anatomy and disorders. They explore the pupillary light reflex, detailing the roles of retinal cells and various brain nuclei. The duo also examines cranial nerve complexities, highlighting symptoms of oculomotor palsy alongside Horner's syndrome. With insights on diagnostic approaches and clinical implications, they provide invaluable knowledge for medical professionals navigating pupil assessments.
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Moeller's Resident Review Journey
- Jeremy Moeller shared how writing a review on the dilated pupil as a resident deeply enhanced his understanding.
- He also considered neuro-ophthalmology for its intricate anatomy and clinical exam magic.
Bilateral Nature of Pupillary Reflex
- The pupillary light reflex elicits a bilateral pupil response due to fibers from the pretectal nucleus synapsing on both Edinger-Westphal nuclei.
- This bilateral connection occurs via the posterior commissure in the midbrain.
Visual Pathways' Complex Anatomy
- The lateral geniculate nucleus (LGN) and superior colliculi lie in a tightly packed brainstem and thalamic neighborhood.
- Visual fibers diverge to LGN, the superior colliculus, and pretectal nuclei for image, gaze, and pupillary reflex functions respectively.