Pupil response
동공 반응(pupil response)은 자극에 대한 동공 크기의 반응이다.
- 경로: optic nerve로 들어가 Edinger-Westphal nucleus를 거쳐 oculomotor로 나온다.
- 축동(Miosis): pupil constriction, PNS에 의해 circular muscle이 수축
- 산동(Mydriasis): pupil dilation, SNS에 의해 radial muscle이 수축
Pupillary light reflex
- optic nerve 손상시: 직접 반사 X, 간접 반사 O
- oculomotor nerve 손상시: 직접 반사 X, 간접 반사X
축동의 원인
- Horner's syndrome
- Hemorrhage into pons (intracranial hemorrhage)
- Opioids such as fentanyl, morphine, heroin and methadone (the notable exception being demerol/pethidine)
- Imidazolines such as clonidine, naphazoline, Oxymetazoline and Tetrahydrozoline
- Antipsychotics, including risperdal, haloperidol, thorazine, olanzapine, quetiapine and others *Cholinergic agents such as acetylcholine
- Pilocarpine Eye drops and all other parasympathomimetics
산동의 원인
- Anticholinergics: atropine, hyoscyamine, scopolamine
- Alkaloids
- Antidepressants: SSRIs, SNRIs, MAOi