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Ophthalmology Week 1 2017/18 > 10: Anatomy - clinical > Flashcards

10: Anatomy - clinical Flashcards

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1
Q

How wide is the eye in diameter?

A

2.5 cm

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2
Q

Which eyelid is the most important one clinically?

A

Upper eyelid

Lower eyelid has very little function in comparison

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3
Q

Which type of gland is found within the tarsal plates and releases an oily substance which stops the tear film from evaporating?

A

Tarsal gland

or Meibomian gland

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4
Q

What muscles open the upper eyelid?

A

Levator palpebrae superioris

AND

Mueller’s muscle

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5
Q

Which type of fibres innervate Mueller’s muscle so it can help levator palpebrae superioris with opening the upper eyelid?

A

Sympathetic

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6
Q

Which cranial nerve innervates levator palpebrae superioris?

A

CN III

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7
Q

What is the function of orbicularis oculi?

Which cranial nerve supplies it?

A

Closes the eyelids

CN VII (remember it’s a muscle of facial expression)

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8
Q

Which part of orbicularis oculi is responsible for blinking?

A

Palpebral part

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9
Q

What are the three main symptoms of Horner’s syndrome?

A

Miosis (constricted pupil)

Ptosis (droopy eyelid)

Anhidrosis (lack of sweating)

unilaterally

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10
Q

What lung tumour can cause Horner’s syndrome by compressing the superior cervical ganglia?

A

Pancoast tumour

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11
Q

What is the purpose of the orbital septum?

A

Prevents transmission of pathogens/debris etc. into bony orbit

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12
Q

What is an infection of the orbit which is sight and life-threatening and must be treated immediately?

A

Orbital cellulitis

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13
Q

What does orbital cellulitis look like?

A

Puffy inflamed eye

Fever

Rigors

Pupillary disorders

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14
Q

Where in the orbit is the lacrimal gland found?

A

Superolaterally

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15
Q

Where are the Meibomian glands found?

A

Tarsal plates

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16
Q

Lacrimal fluid is swept from the ___ to ___ sides of the eye.

A

temporal to nasal

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17
Q

What is the function of the Meibomian glands?

A

Add oil to tear film to stop it from evaporating

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18
Q

Through which structures does lacrimal fluid enter the superior and inferior lacrimal papillae?

A

Puncta

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19
Q

What carries lacrimal fluid from the lacrimal sac to the nose?

A

Nasolacrimal ducts

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20
Q

What symptom may be produced by a blind-ended lacrimal sac?

A

Watery eyes

which AREN’T red (no inflammation)

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21
Q

Which type of weather dries out the eyes?

What symptom does this lead to?

A

Cold weather

Watery eyes - reflex lacrimation overcompensates

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22
Q

Which cranial nerves control the

a) sensory
b) motor parts of reflex lacrimation?

Is this sympathetic or parasympathetic?

A

a) CN V1

b) CN VII

Parasympathetic

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23
Q

Why do people with uncontrolled diabetes develop corneal ulcers?

A

Neuropathy

CN V1 doesn’t detect dryness

So reflex lacrimation doesn’t occur

So cornea dries out and ulcerates

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24
Q

Which enzymes are found in the tear film and give it antibacterial properties?

A

Lysozymes

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25
Which **types** of **conjunctiva** line a) the sclera of the eyes b) the inner surface of eyelids? **What are the folds which form when these two types make contact?**
**a) Bulbar conjunctiva** **b) Palpebral conjunctiva** Conjunctival fornix
26
The **palpebral conjunctiva** lines the \_\_\_. The **bulbar conjunctiva** lines the \_\_\_.
**inner eyelid** **sclera**
27
Which type of conjunctiva is **more vascular**?
**Palpebral conjunctiva**
28
What can be seen on the **palpebral conjunctiva**?
**Follicles** **Papillae**
29
What does **a) bacterial** **b) viral** conjunctivitis look like?
**a) Pus, red eye** **b) Watery, pink eye**
30
**Viral conjunctivitis** commonly accompanies which type of infection?
**URTI**
31
Which **lymph nodes** may be enlarged in conjunctivitis?
**Pre-auricular lymph nodes**
32
Conjunctivitis is highly **\_\_\_**.
**contagious**
33
**Follicles** may be seen on the inner eyelid in which types of infection?
**Bacterial** - esp. chlamydia ## Footnote **Viral**
34
**Papillae** are commonly seen on the inner eyelid in ___ reactions.
**allergic**
35
What percentages of total refractive power do the **a) cornea** **b) lens** have?
**a) 2/3rds** **b) 1/3rd**
36
The **epithelium** of the cornea **(regenerates / can't regenerate)** and has loads of **nerve endings.**
**epithelium regenerates**
37
What is the **endothelium** of the cornea like? Does it regenerate?
**Single layer of cells** Doesn't regenerate
38
What disease causes the cornea to bulge into a **cone shape** and causes visual disturbance?
**Keratoconus**
39
The **anterior surface** of the lens is \_\_\_. The **posterior surface** of the lens is \_\_\_.
**anterior surface is FLAT** **posterior surface is CURVED**
40
What disease causes the lens to become yellow and difficult to see through?
**Cataracts**
41
How are **cataracts** treated?
**Implant artificial lens**
42
Which muscles control the **shape of the lens**?
**Ciliary muscles**
43
**Sympathetic stimulation** causes: ciliary muscles to **CONTRACT / RELAX** the lens to **FLATTEN / BULGE** **NEAR SIGHT / FAR SIGHT**
**Sympathetic:** ciliary muscles **RELAX** lens **FLATTENS** (to be CONCAVE) **FAR SIGHT**
44
**Parasympathetic** stimulation causes: ciliary muscles to **CONTRACT / RELAX** lens **FLATTENS / BULGES** **NEAR SIGHT / FAR SIGHT**
**Parasympathetic:** ciliary muscles **CONTRACT** lens **BULGES** (to be CONVEX) **NEAR SIGHT**
45
What structures are in the **vascular layer** (uvea)?
**Iris** **Ciliary body** **Choroid**
46
The **choroid** supplies ___ to the other layers of the uvea.
**nutrition**
47
The uvea is ___ to help with light capture.
**pigmented**
48
Where is **aqueous fluid** produced? Where can it be **reabsorbed** from?
**Ciliary body** **Bloodstream**
49
What colour is **aqueous fluid**?
**Transparent**
50
Aqueous fluid has a **(high / low)** protein content.
**low protein content** so it can be transparent to see through
51
Why might the aqeuous fluid become hard to see through?
**Uveitis** - full of floating inflammatory cells Treat with **steroids**
52
Aqueous fluid is produced by the ___ \_\_\_, fills the **(anterior / posterior)** chamber and then drains where?
**ciliary body** **anterior chamber** **iridocorneal angle**
53
The **iridocorneal angle** is found at the **(superior / inferior)** part of the cornea.
**superior**
54
What is the normal range of **intraocular pressures**?
**12 - 22 mmHg**
55
In which disease is **intraocular pressure** raised?
**Glaucoma**
56
What is the path that nerve impulses take in the **pupillary light reflex**?
**Optic nerve** **Optic chiasm** **Optic tract** **Optic radiation** **Pretectal nucleus** of **visual cortex** **EW nucleus** **Short ciliary nerve** **Sphincter pupillae**
57
Once they have come off the spinal cord at L2, how do **sympathetic** **nerves** reach the eye?
Sympathetic chain ## Footnote **Superior cervical ganglia** **Internal carotid artery** **Ophthalmic artery** **Long ciliary nerves** **Dilator pupillae**
58
What is the **accommodation reflex**?
**Eyes focus on object coming towards you in the midline**
59
Which **three actions** allow for the **accomodation reflex** and which muscles control them?
**1. Adduction of eyes by medial rectus** (CN III) **2. Constriction of pupils by sphincter pupillae** **3.** **Flattening of lens by ciliary muscles**
60
What is **myopia**?
**Short sightedness**
61
What causes **myopia**?
**Eye is too wide so light isn't focused onto retina correctly**
62
**Myopia** (short sightedness) increases your chances of what?
**Retinal detachment**
63
Which extraocular muscles does **CN III** control?
**Medial rectus** **Superior rectus** **Inferior rectus** **Inferior oblique** **Levator palpebrae superioris**
64
What sort of eye movement does a **CN III palsy** cause?
**DOWN AND OUT** because **lateral rectus** (abduction) and **superior oblique** (depression) are the only muscles still working
65
What sort of eye movement problems does **CN IV palsy** cause?
**UP AND IN** with a head tilt required to see properly
66
What might a person with **CN IV palsy** have trouble doing?
**Walking down stairs** due to diplopia **(double vision)**, they can't look down properly
67
**CN IV palsy** produces symptoms in the **(ipsilateral / contralateral)** eye.
**contralateral eye** because they arise from the brainstem and then cross over
68
What does **CN V1** supply?
**Forehead** **Upper eyelid** **Eye** **TIP OF NOSE**
69
What is a sign that **ophthalmic zoster** may affect the cornea?
**Hutchison's sign** Rash on **tip of nose** (which is supplied by CN V1)
70
Why do people with **viral keratitis** have **dendritic** ulcers?
**Virus tracks along CN V1**
71
What eye movement does **CN VI palsy** cause?
**Medial squint** because CN VI supplies lateral rectus only
72
What is the common origin for all the extraocular muscles?
**Common tendinous ring**
73
The **common tendinous ring** is part of the sheathe for which nerve?
**Optic nerve**
74
What nerve problem causes **pain on eye movement?**
**Optic neuritis** because common tendinous ring is part of nerve sheathe
75
What type of fracture can trap **inferior rectus**?
**Orbital blowout fracture**
76
How would a suspected orbital blowout fracture be investigated?
**CT head** because CT is good for bones
77
An orbital blowout fracture can breach which wall of the bony orbit? What is a complication of this?
**Medial wall** Transmission of bacteria into maxillary sinus \> meningitis
78
Where in the retina are a) rods b) cones found?
**a) Rods - peripheral** **b) Cones - central (macula/fovea)**
79
Which type of photoreceptor is good for detecting **movement**?
**Rods** high sensitivity (see other lectures)
80
Where exactly is the **blind spot**?
**15 degrees temporal** from centre
81
What does someone mean when they say the retina is **inverted**?
**Light passes through the blood vessels, ciliary axons / ganglia** to reach the **photoreceptors** Then the nerve impulses travel anteriorly through all that to the optic nerve
82
What are the end arteries of the eye?
**Central artery of the retina** | (ophthalmic artery)
83
What do **veins** look like through an ophthalmoscope?
**Thick and dark** because they have no muscle
84
What do **arteries** look like through an ophthalmoscope?
**Thin, tubular, lighter** because they have muscular walls
85
What are the **3 Cs** to look for when describing the optic disc?
**CUP** - inner ring (like a donut) **COLOUR** - should be pink/orange **CONTOUR** - should be well-defined
86
What colour does the a) whole fundus b) fovea turn in a **central retinal artery occlusion**?
**a) Milky white** **b) Cherry red / black**
87
Where does a) CN III, IV and VI enter the orbit b) the superior ophthalmic vein exit the orbit?
**Superior orbital fissure**
88
Where do the **ophthalmic veins** drain after exiting the bony orbit?
**Cavernous sinus**
89
What does the fundus look like in a central retinal vein occlusion?
**Pizza**

Ophthalmology Week 1 2017/18 (10 decks)

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