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Study guide 17 MlJ I STUDY GUIDE normal The color of the fundus is brown or orange A slight ly dark spo t in the middl e is the macula At the portion degrees nasall y from the ce nter on the hor izontal axis there is th papilla of the optic nerve whic h i

MlJ I STUDY GUIDE normal The color of the fundus is brown or orange A slight ly dark spo t in the middl e is the macula At the portion degrees nasall y from the ce nter on the hor izontal axis there is th papilla of the optic nerve whic h is circ ular or slightly elliptical shaped and has a slightly brighter tinge The border betwe en the papilla and the surro undi ng retina is clearly de ?ned Th e center o f the pa pilla is indented and bright er than the periph ery excavati o pap illae and appea rs pale yellow The area o f the inde ntation is less than of the tota l area of the papilla and the retinal arteries and veins ex tend upward and downwa rd nasally and aura lly from the pap illa's nasal side On the nas al side they run straight The ?ne arter ies and vei ns ru nni ng from the papill a to the macu la run stra ight The arteries are brigh t red and the ve ins are darker and in the center of the arteries ap pears a wh ite linear re ection abou t or of the artery in width The di ameter of the art ery is from to that of the vei n hypertensive retinopathy Arter ial vasoco nstriction grade ar terios cleros is gra de hemorrh age s co tton wool spo ts and simp le vei n concealment The dia meter of the constricted arteries is irre gular and less than hal f that of the correspo nding veins Spotty hemorrha ge s are scattered Soft ex uda tes co tto n-wo ol patches exhibit localized insu ?cie nt b lood supp ly of the op tica l nerve tissue Simpl e ve in concea lment appea rs at the crossings o f ar tery and vein simple background diabetic retinopathy m icroaneu rysms hemorrh ages and hard exu dates Spotty hemorrhages arc scattered aro und Th e extremely small red dots are microaneurysms an d the ha rd exu dates are also apparen t papilledema chronic phase Ca used by ch ronically inc reased intracranial press ure Th e papilla of the optic nerve swe lls and protrudes in to the vitreous bod y Th e ap ical inde nta tion of it ex cavatio pa pillae disapp ears and the boundary betwee n the papill a and surrounding retina becomes uncl ear But in contrast to the acu te phase the amo unt of bleeding and ex udation is smaller and the degr ee of venou s engorge men t is less papilledema acute phase Generally occ urs as a result of increased intracr anial pre ssure Th e papill a swells and protru des into the vit reo us bo dy Th e ap ical indentation excavatio papill ae disapp ears The boundary between the pap illa and the surrounding retin a