Opthalmology Mcqs Postgraduation entrance preparation: opthalmology eponyms

Showing posts with label opthalmology eponyms. Show all posts

Sunday, March 2, 2008

13 - 151 to 200 important mcqs in opthalmology

151- which type of cataract has high visual morbidity ? posterior subcapsular

152- a person suffered blunt trauma to the right eye with immediate loss of vision , on examination the anterior chamber is deep ? diagnosis ? lens dislocation.

153- IOL is mostly implanted in which chamber ? posterior chamber .

154- good vision in dim light and clumsy vision in day light is a feature of which type of cataract ? nuclear .

155- snow blindness is caused by ? ultravoilet rays .

156- diabetic cataract is due to accumulation of ? SORBITOL .

157- cataract is responsible for what percent of blindness in india ? 75 %

158- subluxation of lens is seen in ? MARFAN'S SYNDROME , MARCHESON'S SYNDROME , HOMOCYSTINURIA . there is no dislocation of lens in lowe syndrome
.
159- in cataract following operation , spectacles are advised after how many weeks of operation ? 6 WEEKS .

160- type of cataract produced by steroids ? posterior subcapsular.

161- cataract can be produced in experimental animals by depriving them of which amino acid? TRYPTOPHAN .

162- lens develops from ? surface ectoderm .

163- intraocular lenses are made up of ? PMMA

164- rider's cataract is seen in ? zonular or lamellar cataract.

165- a 55 year old female comes to the eye casualty with history of severe eye pain , redness and dimunition of vision , on examination the visual acuity is 6/60 ,
there is circumcorneal congesiton , corneal oedema and a shallow anterior chamber , which of the following is the best drug of choice?
a- atropine ointment b- i.v mannitol c-ciprofloxacin eye drops d-betamethasone eye drops .
---------- ans is i.v mannitol ..... as the diagnosis is acute angle closure glaucoma -- the other three drugs are not used in this case . the other drugs used in AACG are
carbonic anhydrase inhibitors ( acetazolamide ), beta blockers( timolol, carteolol, levobetaxolol and levobumolol) , alpha agonists( apvaclonidine brominidine ) ,
opthalmic miotics , steroids and hyperosmotics ( mannitol , glycerine and isosorbide ) .

166- beta blockers are contraindicated in ? hypotension , asthma and depression.

167- the latest technique in cataract surgery is using ? LASER

168- Yttrium laser - after cataract surgery .

169- among the following 4 which is the ideal rehabilitation for aphakia ? a- spectacles b- contact lens c-anterior chamber intraocular lens d- posterior chamber IOL
---------- ans is posterior chamber iol.

170- a child 6 months old , large cornea and photophobia . diagnosis ? CONGENITAL GLAUCOMA . other causes for large cornea like keratoglobus and megalocornea are mostly
asymptomatic except for partial visual impairment seen only in keratoconus . keratoconus is only characterised by hazy cornea due to fragmentation of the bowmans layer .
there is no impairment of vision in megalocornea.

171- drug of choice for acute congestive glaucoma ? 1-2 % PILOCARPINE . ( miotic , muscarinic agonist ,also used in dry mouth and dry throat ( xerostomia )
which can occur as a side effect of radiation therapy to head and neck .as it increases the salivary secretions and sweat secretions . )

172- 100 days glaucoma is seen in ? CENTRAL RETINAL VEIN OCCLUSION.

173- SAFE strategy( WHO VISION 2020 ) is used in the control of ? TRACHOMA .

174- corneal epithelium is ? stratified non keratinised epithelium.

175- cobble stone appearance of the conjuctiva is typically seen with ? SPRING CATARRH

176- tranta's spots alone are seen in vernal kerato conjunctivitis( SPRING CATARRH ) where as the trantas spots and herbert's pits together are seen in TRACHOMA .

177- features of trachoma are - pannus formation , follicles , papillary hypertrophy, herbert's pits and tranta's spots .

178- what is safe strategy ? surgery , antibiotics , facial cleanliness and environment improvement.

179- blindness in a child is most commonly due to ? keratomalacia - vit a deficiency .

180- horner trantas spots - vernal catarrh .

181- the colors best appreciated by the central cones of the fovea - macular region are ? RED AND GREEN .

182- mydriatic used in children for refraction is ? atropine ointment .

183- for refraction in a hypermetropic child , the best drug is ? atropine ointment

184- the term anisometropia indicates refractive error .

185- most sensitive part of the eye ? fovea centralis .

186- what all can be detected by indirect opthalmoscopy ? periphery of the retina , examination of the fovea , examination of the ora serrrata. the base of the vitreous cannot be
viewed by indirect opthalmoscopy .

187- ocular diseases given importance in vision 2020 program ? cataract , trachoma , glaucoma . refractive errors are not given importance .

188- Homonymous hemianopia caused by lesion in ? optic tract , optic radiation and occipital cortex .

189- in paralytic squint - secondary deviation is greater than the primary deviation .

190- nystagmus which is not pathological ? OPTOKINETIC NYSTAGMUS .

191- basal cell carcinoma at inner canthus of eye treatment? WIDE EXCISION AND RECONSTRUCTION .

192- NADPH DEPENDENT ALDOLASE REDUCTASE - enzyme responsible for accumulation of sorbitol in lens in diabetic patients which leads to cataract.

193- causes for pseudo proptosis? bupthalmos , retraction of the upper eyelid and high axial myopia .

194- most common type of lid carcinoma ? basal cell carcinoma .

195- steroid induced cataract is mostly - posterior subcapsular .

196- most common systemic association of scleritis ? RHEUMATOID ARTHRITIS .

197- under the national programme for control of blindness who is supposed to conduct the vision screening of school students ?
--------school teachers .

198- crocodile tears are seen with abnormal facial nerve regeneration.

199- most common allergic manifestation of tuberculosis ? KOEPPE'S NODULES .

200- koeppe's and busaca's nodules are characteristic of - GRANULOMATOUS UVEITIS .

12 - 101 to 150 important mcqs in opthalmology

101- layers of retina from within outwards are : 1- stratum opticum
2- ganglionic layer
3- inner plexi form layer
4- inner nuclear layer ( layer of inner granules )
5- outer plexiform layer
6- outer nuclear layer ( layer of outer granules )
7- layer of rods and cones

102- a patient complains of pain both eyes with congestion , blurrng of vision , photophobia and mucopurulent discharge since one day , many cases
have been reported from the same community , causative agent is a- adeno virus b- entero virus 70 c- herpes simplex d- ECHO virus
----------- answer is entero virus 70 --- because in entero virus there is sudden onset and short duration , where as in adeno virus photophobia and epithelial keratitis
occurs 5 to 14 days after tearing and pain. ( pg- 313- ashish vol 2 )

103- a neonate 30 days old , presented with excessive lacrimatiion and photophobia , he has large and hazy cornea . his both lacrimal duct systems are normal , the diagnosis is ?
a- congenital glaucoma b- keratoconus ( keratoglobus ) c- megalocornea d- hunters syndrome
-----------answer is congenital glaucoma because the symptoms mentioned above are not seen in other three cases . when iop raises in children less than 3 years of age , the size of the globe
increases condition called buphthalmos .( pg 315 - ashish vol 2)

104- HAABS striae - corneal opacities due to rupture in descemets membrane - seen in buphthalmos - congenital glaucoma ( infantile glaucoma ).

105-a 12 year old boy presents with recurrent attacks of conjunctivitis for the last 2 years with intense itching and ropy discharge . the diagnosis is
---------------- VERNAL KERATOCONJUNCTIVITIS ( SPRING CATARRH - cobble stone ) ----- ropy discharge is the clue .

106- 60 year old male patient operated for cataract 6 months back now complains of floaters and sudden loss of vision , the diagnosis is ?
a - vitreous hemorrhage b- retinal detachment c- central retinal artery occlusion d- cystoid mcular edema
---------------answer is retinal detachment , because of all the options only a and b can cause floaters and out of the two vitreous hemorrhage is a acute complication
and the retinal complication is a long term complication .

107- causes of large cornea - keratoconus , megalocornea , bupthalomos ( congenital glaucoma )

108- late post operative complications of cataract surgery? after cataract ( Nd YAG laser ) , retinal detachment , cystoid macular edema , epithelial ingrowth , vitreous touch syndrome .

109- most common late postoperative complication of cataract surgery ? CYSTOID MACULAR EDEMA

110- causes of floaters ? retinal detachment , vitreous hemorrhage , coats disease , eales disease , HTN retinopathy , DM retinopathy , SABE , leukemia , pars planitis, retinal branch vein occlusion, ( LPR )

111- causes of sudden painless loss of vision? CRAO , CRVO , RD , VH , Macular edema due to any cause , anterior ischemic optic neuropathy .

112- a 25 year old lady presents with severe sudden onset of pain , corneal congestion , photophobia and deep anterior chamber in the right eye . the left eye is normal . x ray pelvis shows , sacroiliitis ?
-------------the diagnosis is anterior uveitis . the lady is suffering from ANKYLOSING SPONDYLITIS and the most common ocular manifestation in AS is anterior uveitis . 3 men AS= 1 WOMEN AS.

113- the most common complication of hypermature sclerotic cataract is ? lens dislocation .

114- a male patient with a history of hypermature cataract presents with a 2 day history of ciliary congestion , photophobia , blurring of vision and on examination has a deep
anterior chamber in the right eye , the left eye is normal. the diagnosis is - a - phakomorphic glaucoma b- phakolytic glaucoma c- phakotoxic glaucoma d- phakoanaphylactic uveitis
------------------ ans is phacoanaphylactic uveitis ... no symptoms of glaucoma like severe pain , hazy cornea , fixed dilated pupil. - complications caused by hypermature morgagnian type of
cataract are phacolytic glaucoma( leaked proteins blocking the outflow ) and phacoanaphylactic uveitis ( leaked proteins inducing antigen antibody reaction ) .

115- paralytic patient presents with ? diplopia , deviation, confusion

116-nystagmus which is not pathological ? OPTOKINETIC

117-in a child with retinoblastoma , on x ray we can see ? intra orbital calcification , multiple cranial deposits and widening of the optic foramen. intracerebral calcification is not present .

118- one year old male child with cats eye reflex and increased intraocular tension , diagnosis ? RETINOBLASTOMA

119-what is amblyopia ? partial loss of sight in one or both eyes in the absence of opthalmoscopic or other marked objective signs . congenital or acquired . acquired can be organic ( toxic )
or functional. functional amblyopia results from the psychical suppression of the retinal image . it may be anisometric , strabismic or due to stimulus deprivation.

120- what is amblyopia ex anopsia ? amblyopia due to stimulus deprivation .

121- tests done for visual malingering ( one eye blind ) ? 1-convex lens test 2- prism base down test 3- prism base out test 4- snellens coloured types test ( a good eye can read
only red letters thru a red glass .)

122- what is amourosis ? complete loss of sight in one or both eyes in the absence of opthalmoscopic or other marked objective signs . types a- amaurosis fugax - sudden , temporary
and painless monocular visual loss occuring due to a transient failure of retinal circulation . common causes are carotid transient ischaemic attacks , embolization of retinal
circulation , papilledema , giant cell arteritis , raynaud's disease , migraine , as a prodromal symptom of CRAO or carotid artery occlusion , hypertensive retinopathy and venous
stasis retinopathy . b- uraemic amaurosis - sudden , bilateral ,complete loss of sight occuring probably due to the effect of certain toxic materials upon the cells of the visual centre
in patients suffering from acute nephritis , eclampsia of pregnancy and renal failure .visual loss is associated with dilated pupils which generally react to light , the fundi are usually
normal except for the coincidental findings of the hypertensive retinopathy , when associated . usuallly the vision recovers in 12 to 48 hours .

123- saccade - abrupt involuntary rapid eye movements .

124- field defect seen in pituitary adenomas and craniopharyngiomas - BITEMPORAL HEMIANOPIA ( temporal halfs of both sides lost ) . lesion or compression at the optic chiasma .

125- amblyopia shud be corrected within how many years? 5 years

126- visual defect in optic chiasmal lesion ? bitemporal hemianopia .

127- what is homonymous hemianopia ? visual field defect in which in one eye nasal field is visible and in the other eye temporal field is visible .

128- paralysis of the 3rd , 4th and 6 th nerve with the paralysis of the opthalmic division of the 5 th nerve , localises the lesion to ? CAVERNOUS SINUS .

129- A 25 year old male gives a history of sudden painless loss of vision in one eye for the past 2 weeks .no history of trauma . on examination the anterior segment is normal but there is no
fundal glow . what is the diagnosis ? a- vitreous hemorrhage b- developmental cataract c- optic atrophy d- acute attack of angle closure glaucoma-----
--------- answer is vitreous hemorrhage ... development cataract - there is gradual loss , optic atrophy also gradual loss , angle closure glaucoma acute attack is associated with pain.

130- levator palpebrae superioris is supplied by which nerve ? oculomotor nerve

131- UVEITIS associated with VITILIGO and AUDITORY DEFECTS occurs in ? VOGT - KOYANAGI SYNDROME .

132- sympathetic opthalmia is ? BILATERAL NON SUPPURATIVE UVEITIS .

133- most common cause of anterior uveitis associated with arthritis ? ANKYLOSING SPONDYLITIS.

134- the type of synechiae in iris bombe is ? RING TYPE .

135- SALT AND PEPPER FUNDUS IS SEEN IN ? CONGENITAL SYPHILIS .

136- visible retinal artery pulsations are seen in? increased intraocular tension

137-sudden increase in blood sugar in diabetics causes ? myopia

138- black floaters in a biabetic patient indicate ? vitreous hemorrhage .

139- an young adult male presents with sudden painless loss of vision , he recovered spontaneously within 3 months . diagnosis? central serous retinopathy.

140- berlin's edema is due to ? blunt injury .

141- vitreous hemorrhage in young adults indicates ? EALES DISEASE .

142- degree or development of diabetic retinopathy depends on ? duration of disease.

143- lens contains the oldest cells in ? the nucleus

144- the prominent ocular manifestation seen with the marfans syndrome? ectopia lentis .

145- typical glucocorticoids cause ? cataract and glaucoma .

146- commmonest cause of cataract ? age related .

147- retinal detachment is preceded by ? high myopia , trauma, floaters and flashes

148- laser used in the management of after cataracts ? Nd YAG laser .

149- atopic cataract is that which follows skin diseases like eczema .

150- CHRISTMAS TREE CATARACT IS SEEN IN ? MYOTONIC DYSTROPHY.

11 - 51 to 100 important mcqs in opthalmology

51- ropy discharge from the eye is seen in VERNAL KC OR SPRING CATARRH

52- cobble stone arrangement of papillae under the upper eye lid is seen in? SPRING CATARRH

53- tranta's spots are seen in ? SPRING CATARRH

54- fleischer ring characteristic of - CHALCOSIS - copper

55- metabolically active layer of cornea ? endothelium

56- phlycten is due to endogenous allergy

57- ideal treatment for bilateral retinoblastoma ? enucleation

58- in complete third nerve palsy ? eye deviated laterally , superior and inferior recti affected , dilated pupil , ptosis, conversion / accomodation is lost

59- WHEELERS OPERATION ------------------ENTROPION ( inward turning of the eye lid )

BLASCOWICK'S OPERATION--------------PTOSIS ( CONGENITAL ) ( drooping of the upper eyelid )

FASANELLA SERVAT OPERATION ----HORNER'S SYNDROME

60- most common malignant tumour of the eyelids ? basal cell carcinoma

61-most common malignant tumor of the eye - retinoblastoma

62- most common tumor of the orbit ( 1st decade ) ? rhaddomyosarcoma

63- most common intraocular tumor in adult ? metastasis ( check )

64- most common sign of retinoblastoma ? leucocoria

65- for a new born baby with squint surgery shud be done at ? 3- 4 YEARS

66- for a new born baby with congenital cataract surgery ? shud be done before 17 weeks ( 4 months ) or some doctors before 2 months .

67- superior oblique - supplied by 4 th nerve and lateral rectus by 6 th nerve ... all others by the third nerve

68- ptosis results from trauma to which nerve ? oculomotor

69-weakest wall of the human orbit ? floor ( check )

70- most common eye ball tumor ? retinoblastoma

71- ocular manifestation of the sturge weber syndrome ? HEMANGIOMA OF THE CHOROID AND GLAUCOMA .

72- retinoblastoma presenting features are ? leucocoria , squint , glaucoma . the cataract is not a presenting feature of the retinoblastoma

73- proptosis is seen in NEUROBLASTOMA .

74- superior oblique function ? depression with internal rotation ( abduction )

75- ptosis with weakness of the orbicularis oculi is a feature of ? MYASTHENIA GRAVIS

76- plication of the inferior lid retractors operation is done for ? senile entropion

77- tear film is composed of how many layers ? 3 layers

78- blow out fracture of the orbit commonly involves the ? the floor

79- most common second malignancy seen in patients with familial retinoblastoma is ? OSTEOSARCOMA

80- causes of night blindness ? vit a deficiency , retinitis pigmentosa , high myopia

81- which part of the orbicularis oculi is called the horner's muscle ? MULLER'S MUSCLE

82- orbital metastasis is most common in which tumor ? NEUROBLASTOMA

83- visible spectrum - 400 to 700 mu

84- the mother of a one and a half year old child gives history of a white reflex from one eye for the past one month
.ct scan of the orbit showed calcification within the globe . the most likely diagnosis is ? RETINOBLASTOMA

85- type of laser used in capsulotomy ? YAG laser

86- YAG laser is used in the treatment of ? AFTER CATARACT

87- ocular muscle which is commonly involved in thyrotoxic myopathy ? INFERIOR RECTUS

88- most common cause of blindness in children in india ? vitamin A deficiency

89- FRILL'S EXCISION is done for - PAN OPTHALMITIS

90- treatment of choice for carotico cavernous fistula ? balloon embolisation

91- all visual reflexes are developed by ? one year

92- photopthalmia is due to which rays ? ultraviolet rays ( snow blindness )

93- adeno virus causes ? kerato conjunctivitis , diarrhoea , parotid enlargement .

94- in AIDS most common retinitis ? CMV CHORIORETINITIS

95- after cataract is treated by ? Nd YAG laser

96- virus causing eye infections is ? ADENO VIRUS

97- an 18 year old boy comes to the eye casualty with history of injury with a tennis ball . on examination there is no perforation but there is hyphema ,
the most likely source of blood is ? circulus iridis major

98-in retinoblastoma after enucleation , which tissue is sectioned to find out systemic metastasis ? OPTIC NERVE

99- action of the right superior oblique muscle is dextro depression.

100- RETINOBLASTOMA IS BILATERAL IN 30 % CASES.

10 - 50 important mcqs in opthalmology

1- other name of lowe's syndrome ? oculo- cerebral - renal syndrome .

2- etiology of lowe's syndrome ? rare inborn error of amino acid metabolism .

3- features of lowe syndrome ? ocular- congenital cataract and glaucoma , systemic features - mental retardation , dwarfism , osteomalacia , muscular hypotonia , and frontal prominence .

4- snow flake cataract is seen in ? diabetes mellitus .

5- sunflower cataract is seen in ? wilson's disease ( hepatolenticular degeneration )

6-most common ocular feature of wilson's disease ? kayser fleischer ring ( KF ring ) seen in the cornea .

7-most common type of congenital cataract ? zonular or lamellar cataract

8- powdery appearance of the lenticular opacity is seen in? cataract centralis pulverulenta

9- munson's sign is seen in ? KERATOCONUS

10- normal anterior chamber depth ? 2 to 3 mm ( 2.5 mm )

11-protanopes have difficulty in identifyin which colour ? RED

12- colour blindness is hereditary , not age related , occurs only in males and cannot be treated .

13- treatment of presbyopia ? convex lens

14- distance used in direct distant opthalmoscopy ? 25 cms

15- causes of amaurotic cats eye reflex ( leucokoria ) ?
a- fungal endophthalmitis ( toxocara ) ,
b- retinoblastoma
c- retinal detachment
d- retrolental hyperplasia ( retinopathy of prematurity )
e- congenital cataract
f- persistent hyperplastic primary vitreous
g- inflammatory deposits in eye
h- coloboma of choroid
i - tuberculoma of choroid
j-exudative retinopathy of COATS
k- cyclitic membrane

16- presbyopia is not a refractive error

17- commonest cause of low vision in india ? uncorrected refractive errors

18- commonest cause of blindness in india ? cataract

19- constantly changing refractory error is seen ? DIABETIC CATARACT

20- infant eye at birth is ? hypermetropic of 2 dioptres .

21- total diopteric power of eye ? 60 diopters

22- presbyopia is caused by ? loss of accomodation

23- the graph of the movement of eye is called ? electronystagmogram .

24- keratometer is used to assess the curvature of the cornea .

25- snellens chart is used to test ? vision

26- the nerves tested in the pupilllary reflex ? the optic nerve and the oculomotor nerve ( second and the third ) .

27- angle of the anterior chamber is visualised by ? slit lamp examination and gonioscopy .

28- in a patient of 20 years presenting with moving floaters .. diagnosis is done by ? INDIRECT OPTHALMOSCOPY

29-length of the eye ball - 24 mm

30- commonest type of colour blindness ? PROTANOPES ( RED DEFECT )

31- indirect opthalmoscope -

a- image is real and inverted
b- details of the fundus can be seen even with slightly hazy media
c- magnification less than direct opthalmoscope
d- used for seeing the periphery of the fundus

32- best method for examination of the periphery of the retina ? BINOCULAVIN INDIRECT OPTHALMOSCOPE

33- magnification of the direct opthalmoscope ? fifteen times . 15

34- image formed in direct opthalmoscope ? VIRTUAL AND ERECT .

35- in flourescein angiography of retinal vessels the dye is injected into which vessel ? ANTERIOR CUBITAL VEIN ( ante cubital vein )

36- in cerebral angiography the dye is injected into which vessel ? CAROTID ARTERY

37 - indirect opthalmoscopy is done for
a- PERIPHERY OF RETINA , b- centre of retina , c- sclera , d- angle of the anterior chamber

38-gonioscopy is used to study ? angle of the anterior chamber of the eye

39-flourescein angiography is used to identify lesions in all except ? LENS ( because it is avascular )

40- periphery of retina is visualised by indirect opthalmoscopy

41- ulcer serpens is caused by - PNEUMOCOCCUS

42- the extra ocular muscle which is served by a contralateral brain stem subnucleus ? SUPERIOR RECTUS

43- twilight vision is by? rods

44- commonest cause of keratitis in soft contact lens user ? acanthamoeba

45- chalcosis is seen with ? COPPER

46- contraindications of topical beta blockers which are normally used in the treatment of the acute angle closure glaucoma ? asthma , hypotension and depression.

47- patient suffered blunt trauma to the eye and after that he developed sudden loss of vision with deep anterior chamber , most likely cause is ? lens dislocation

48- keratoconus - munson's sign , thinning of cornea in center , distortion of corneal reflex in the center , no hypermetropia seen.

49- thickness of cornea is measured by - PACHYMETER

50 - spring catarrh is otherwise called ? VERNAL KERATOCONJUNCTIVITIS .

Saturday, February 16, 2008

7 - seidel's test

Seidel

Seidel's test = a test which uses 2% sodium
fluorescein to check for leaks such as
post corneal trauma or post-trabeculectomy.

Positive Seidel's test from from a punctured
corneal wound.

6 - stargardt's disease - karl bruno stargardt

Karl Bruno Stargardt

German ophthalmologist, born 4th December, 1875, Berlin; died 2nd April, 1927, Marburg.

Stargardt's disease = The most frequently encountered juvenile onset macular degeneration characterised by multiple pisciform subretinal yellowish lesions.

Biography:
Karl Bruno Stargardt attended the universities of Heidelberg, Erlangen, and Berlin, and obtained his doctorate from the University of Kiel in 1899. He trained in ophthalmology in Kiel under professor Karl Völkers (born 1836), becoming assistant, respectively head physician at the university eye clinic. He then worked in the eye clinic at Strasburg and became head of ophthalmology at Bonn. In 1923 he succeeded Max Bielschowsky (1869-1940) in the chair of ophthalmology at the University of Marburg. Shortly afterwards, however, he developed nephritis and cardiac complications, and died in 1927.

Bibliography:

Über Epithelzellveränderungen beim Trachom und andern Conjunctivalerkrankungen.

Diagnostik der Farbensinnstörungen. Berlin, 1912.

4 - sherrington's law - charles scott sherrington

Charles Scott Sherrington

English neurophysiologist, born 27th November, 1857, London, died 4th March, 1952, Eastbourne, Sussex.

Sherrington's law = The law of reciprocal innervation: when one set of muscles is stimulated, muscles working against the activity of the first will be inhibited.

Sir Charles Scott Sherrington's research, spanning more than 50 years, laid the foundations for modern neurophysiology. He maintained that the most important function of the nervous system in higher animals is the coordination of the various parts of the organism. Although best known for his long series of studies on spinal reflexes, he made equally great strides in the physiology of perception, reaction, and behaviour. He was the first to adequately study the synapse and originated the term. He also introduced the term exterioceptor, proprioceptor and viscerocepter. In 1932 he shared the Nobel Prise in Physiology or Medicine with Edgar Douglas Adrian.

Sherrington was the son of Anne Brookes and James Norton Sherrington, of Caister, Great Yarmouth, a country physician who died when he was quite young. His mother married Caleb Rose, Jr., of Ipswich, a physician of wide cultural interests and a noted archaeologist. The Rose home, a gathering place for artists and scholars, helped to shape Sherrington's broad interest in science, philosophy, history, and poetry. One of his schoolmasters, Thomas Ashe, was a poet of considerable distinction.

After attending the Ipswich Grammar School from 1870 to 1875, Sherrington, encouraged by his stepfather, began medical training at St. Thomas’s Hospital in London. He passed the primary examination of the Royal College of Surgeons in 1878, and a year later the primary examination for the Fellowship of that College.

In 1879 he went to Cambridge as a noncollegiate student studying physiology under the “father of British physiology”, Sir Michael Foster (1836-1907), and in 1880 entered Gonville and Caius College there. During the years 1881-1885 he worked chiefly under two of Forster's pupils who were already becoming world famous – John Newport Langley (1852-1925) and Walter Gaskell (1847-1914). Langley and Gaskell imparted to him their dominant interest in how anatomical structure reflects, or is expressed in, physiological function.

In 1881 he attended a medical congress in London at which Sir Michael Foster discussed the work of Sir Charles Bell and others on the experimental study of the functions of nerves that was then being done in England and elsewhere in Europe. At this congress controversy arose about the effects of excisions of parts of the cortex of the brains of dogs and monkeys done by David Ferrier (1843-1928) and Friedrich Leopold Goltz (1834-1902) of Strasbourg. Subsequently, Sherrington worked on this problem in Cambridge with Langley, and with him published, in 1884, a paper on it. In this manner Sherrington was introduced to the neurological work to which he afterwards devoted his life.

In 1883 Sherrington became Demonstrator of Anatomy at Cambridge under Professor Sir George Humphrey, and during the winter session of 1883-1884 at St. Thomas's Hospital he demonstrated histology.

From 1884 to 1887 Sherrington completed his medical courses. After graduation he worked with Langley, studying the anatomical changes in the cord and brain stem of decorticate dogs which had first been exhibited by Friedrich Goltz at the International Congress in 1881. This led to the first of many visits to Goltz' laboratory in Strassburg.

Between 1884 and 1887 he turned his attention to bacteriology. In 1885 Sherrington went, as a member of a Committee of the Association for Research in Medicine, to Spain to study an outbreak of cholera, and in 1886 he visited the Venice district also to investigate the same disease. In Spain he met Santiago Ramón y Cajal (1852-1934) and later persuaded him to lecture in England. He also went to Berlin to have the cholera material examined under the supervision of Rudolf Virchow (1821-1902), who later sent Sherrington to Robert Koch (1843-1910) for a six weeks' course in technique. Sherrington stayed with Koch to do research in bacteriology for a year. Thus he gained a superb grounding in physiology, morphology, histology, and pathology.

He obtained his M.R.C.S. in 1884 and in 1885 a First Class in the Natural Sciences Tripos at Cambridge with distinction. During this year he published a paper of his own on the subject of Goltz's dogs. In 1885 he also took his M.B. degree at Cambridge and in 1886 became a Licentiate of the Royal College of Physicians.

In 1887 Sherrington was appointed lecturer in physiology at St. Thomas’s medical school in London, where he continued to investigate the spinal tract. From 1891 to 1905 he served as physician-superintendent of the Brown Institution, a centre for human and animal physiological and pathological research, succeeding Sir Victor Alexander Haden Horsley (1857-1916). Here he was able to observe animals with chronic spinal lesions.

In 1895 Sherrington was appointed Holt Professor of physiology in Liverpool, where he did much of his best work. From 1913 until his retirement in 1935 he held Waynflete chair of physiology at Oxford, succeeding Francis Gotch (1853-1913).

Research
Working on cats, dogs, monkeys and apes that had been bereaved of their cerebral hemispheres, he found that reflexes must be considered integrated activities of the total organism, not just the result of the activities of the so-called reflex-arcs, a concept then generally accepted. The proofs supporting "total integration" were his demonstration during the years 1895 to 1898 of reciprocal innervation of muscles, also known as Sherrington's law: when one set os muscles is stimulated, muscles working against the activity of the first will be inhibited.

He developed the theory of transmission at the synapse being in one direction, decerebrate rigidity was then a background in which the presence of reciprocal inhibition was lost and these findings and theories resulted in his publication in 1906 a monograph entitled Integrative action of the nervous system which remains a classic.

In this classic of modern neurology, he summed up his years of experiments and observations on the nervous system and the reflexes and developed a theory that has had a far-reaching and profound influence on modern neurophysiology and clinical neurology. Briefly, his theory was that the nervous system acts as the coordinator of various parts of the body and that the reflexes are the simplest expressions of the interactive action of the nervous system, enabling the entire body to function toward one definite end at a time. Shared the Nobel prize with Adrian for their work on the nervous system.

He established the nature of postural reflexes and their dependence on the anti-gravity stretch reflex and traced the afferent stimulus to the proprioceptive end organs which he had already shown to be sensory in nature.

Most of his work occurred after he had been appointed professor of physiology at Liverpool on 1895.

The man
Sherrington married Ether Wright of Suffolk, England, on August 27, 1891; their only child, Carr E. R. Sherrington, was born in 1897

In physique Sherrington was a well-built, but not very tall man with a strong constitution which enabled him to carry out prolonged researches. During the First World War, as Chairman of the Industrial Fatigue Board, he worked for a time in a shell factory at Birmingham, and the daily shift of 13 hours, with a Sunday shift of 9 hours, did not, at the age of 57, tire him. From his early years he was short-sighted, but he often worked without spectacles.

Besides his scientific work Sherrington was a man of wide interests and accomplishments: biographer, medical historian, poet, and book collector – and sportsman. As a boy and a young man Sherrington was a notable athlete both at Queen Elizabeth's School, Ipswich, where he went in 1871, and later at Gonville and Caius College, Cambridge, for which College he rowed and played rugby football; he was also a pioneer of winter sports at Grindelwald, Switzerland.

Sherrington always had a love for classics and poetry and in 1925 published a volume of collected verse, The Assaying of Brabantius and other Verse.

Following his retirement he published Man on his Nature, which centres round the life and views of the 16th century French physician Jean Fernel , and in 1946 The Endeavour of Jean Fernel.

He was elected President of the Royal Society of Physicians in 1920 and held this chair of honour for five years. Other honours included the Knight Grand Cross of the British Empire (1922) and the Order of Merit (1924). At his death he was an honorary fellow, member, or associate of more than forty academies, and he had received honorary degrees from twenty-two universities.

In 1932 Sir Charles Scott Sherrington shared the Nobel Prise in Physiology or Medicine with Edgar Douglas Adrian, 1st Baron Adrian (1889-1977). The received the prize "for their discoveries regarding the function of neurons."

From 1941 onwards he developed a painful arthritis which remained with him until he died. Right until the end he maintained his mental alertness and was an entertaining conversationalist.

Paradoxical though it may sound, the more skilfully a demonstration experiment is performed the less from it do some students learn.
Mammalian Physiology, Preface.

"It is as if the Milky Way entered upon some cosmic dance. Swiftly the brain becomes an enchanted loom, where millions of flashing shuttles weave a dissolving pattern, always a meaningful pattern though never an abiding one; a shifting harmony of subpatterns."
The Integrative Action of the Nervous System

Men think themselves free, because they are conscious of their volitions and of their desires and are oblivious to the causes which dispose them to desire and to will.
Man On His Nature, page 163

Swiftly the head-mass becomes an enchanted loom where millions of flashing shuttles weave a dissolving pattern, always a meaningful pattern though never an abiding one; a shifting harmony of sub-patterns. Now as the waking body rouses, subpatterns of this great harmony of activity stretch down into the unlit tracks of the stalk-piece of the scheme. Strings of flashing and travelling sparks engage the lengths of it. This means that the body is up and rises to meet its waking day.
Man On His Nature, page 178

The mind is a something with such manifold variety, such fleeting changes, such countless nuances, such wealth of combinations, such heights and depths of mood, such sweeps of passion, such vistas of imagination, that the bald submission of some electrical potentials recognizable in nerve-centres as correlative to all these may seem to the special student of mind almost derisory. It is, further, more than mere lack of corresponding complexity which frustrates the comparison.
Man On His Nature, page 228

If as you say thoughts are an outcome of the brain we as students using the energy-concept know nothing of it; as followers of natural science we know nothing of any relation between thoughts and the brain, except as a gross correlation in time and space. In some ways this is embarrassing for biology.
Man On His Nature, page 229

We have to regard the relation of mind to brain as not merely unresolved but still devoid of a basis for its very beginning.
Man On His Nature

The eye sends, as we saw, into the cell-and-fibre forest of the brain, throughout the waking day continual rhythmic streams of tiny, individually evanescent, electrical potentials. This throbbing streaming crowd of electrically shifting points in the spongework of the brain bears no obvious semblance in space-pattern, and even in temporal relation resembles but a little remotely the tiny two-dimensional upside-down picture of the outside world which the eyeball paints on the beginnings of its nerve-fibres to the brain. But that little picture sets up an electrical storm .... A shower of little electrical leaks conjures up for me, when I look at him approaching, my friend's face, and how distant he is from me they tell me. Taking their word for it, I go forward and my other senses confirm that he is there.
Man On His Nature, page 128-129

Reference:

On the regulation of the blood supply.

Notes on the arrangement of some motor fibres in the lumbo-sacral plexus.

Further experimental note on the correlation of antagonistic muscles.

The Central Nervous System. In volume III of Michael Foster, A Textbook of Physiology. 7th edition. London 1897.

The Mammalian Spinal Cord as an Organ of Reflex.

Experiments in Examination of the peripheral Distribution of the fibres of the Posterior Roots of Some Spinal nerves.

Decerebrate Rigidity and Reflex Co-ordination of Movements.

On the Spinal Animal (The Marshall Hall Lecture).

The Parts of the Brain Below the Cerebral Cortex.

Cutaneous Sensations.

The Muscular Senze.

The Correlation of Reflexes and the Principle of the Common Path.

On the proprio-ceptive system, especially in its reflex aspect.

The integrative action of the nervous system.

Reflex Inhibition as a Factor in the Co-ordination of Movements and Postures.

A manual of school hygiene.

Mammalian physiology. Oxford and London, 1919.

Some Aspects of Animal Mechanism. Presidential Address. British Association for the Advancement of Science.

Reflexes in response to stretch (myotatic reflexes).

The Assaying of Brabantius and Other Verses. Oxford, 1925.

Remarks on Some Aspects of Reflex Inhibition.

Numbers and Contraction-values of Individual Motor-units Examined in Some Muscles of the limb.

The Reflex Activity of the Spinal Cord.

Inhibition as a Co-ordinative Factor. Stockholm, 1932.

The Brain and Its Mechanism. Cambridge, 1933.

Man on His Nature.

The Endeavour of Jean Fernel. Cambridge, 1946.

Marginalia. In E. A. Underwood, editor: Science, Medicine, and History, II. Oxford, 1954: 545-553.

Edgar D. Adrian:

The Analysis of the Nervous System: Sherrington Memorial Lecture.

John F. Fulton:

Sir Charles Scott Sherrington, O. M.

Historical Reflections on the Backgrounds of Neurophysiology: Inhibition, Excitation, and Integration of Activity. In Chandler M. Brooks and P. F. Cranefield, editors, The Historical Development of Physiological Thought. New York, 1959.

Judith P. Swazey:

Sherrington’s Concept of Integrative Action.

Opthalmology Mcqs Postgraduation entrance preparation