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Neuro III > Orbit Eye > Flashcards

Orbit Eye Flashcards

1
Q

What is the shape of the orbit

A

quadrangular pyramid with base facing anterolateral and apex posteromedial

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2
Q

desribe how the orbital walls are oriented

A

the contralateral medial orbital walls are parallel

the contralateral lateral orbital walls are perpendicular

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3
Q

Describe the orbital axis orientation

A

long axis through orbit

oriented at 45 degrees to one another

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4
Q

describe the optical axes orientation

A

long axis through globe

parallel to medial walls

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5
Q

What bones make up the orbit

A

frontal, maxilla, sphenoid, lacrimal, ethmoid, palatine and sygomatic

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6
Q

describe the apex of the orbit

A

lesser wing of sphenoid surrounding optic canal

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7
Q

describe the base of the orbit

A

orbital margin and orbital opening

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8
Q

what bones form the orbital margin

A

frontal zygomatic and maxillar

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9
Q

what is the function of orbital margin

A

thickened to provide support and protection to eyeball

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10
Q

describe bones of the roof of the orbit

A

frontal and some sphenoid separating orbit from anterior cranial fossa
also contains fossa for lacrimal gland

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11
Q

describe bones that form the floor of the orbit

A

maxilla- separates orbit from maxillary sinus
zygomatic bone
palatine bone

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12
Q

what bones of the orbit form the medial wall

A

ethmoid, lacrimal, maxilla

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13
Q

what is the function of medial wall of the orbit

A

separates orbit from sphenoidal and ethmoidal air sinuses

lacrimal fossa

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14
Q

describe bones that form the lateral wall of the orbit

A

zygomatic

sphenoid- greater wing

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15
Q

What foramina are in the orbit

A 
optic canal
superior orbital fissure
inferior orbital fissure
anterior ethmoidal foramen
posterior ethmoidal foramen
nasolacrimal canal
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16
Q

what runs through the optic canal

A

optic n and ophthalmic a

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17
Q

what runs through superior orbital fissure

A

III IV V1 and VI superior ophthalmic v

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18
Q

what runs through inferior orbital fissure

A

inferior ophthalmic v
infraorbital avn
zygomatic nn

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19
Q

what runs through anterior ethmoidal foramen

A

anterior ethmoidal avn

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20
Q

what runs through posterior ethmoidal foramen

A

posterior ethmoidal avn

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21
Q

What runs in the nasolacrimal canal

A

nasolacrimal duct

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22
Q

What is a blowout fracture

A

fracture of the orbital walls

usually inferior or medial

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23
Q

what can be damaged by a blowout fracture is there is damage to the floor

A

involve maxillary sinus, intraocular fat and bleeding can then spread to maxillary sinus

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24
Q

What are other structures at risk in a blowout fracture

A

inferior rectus m gets trapped and can cause diplopia
exophthalmos due to fat in surrounding spaces of mm entrapment
globe can be damaged(detached retina)

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25
Q

what sinuses can be involved in a medial wall blowout fracture

A

sphenoidal and ethmoidal air sinuses

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26
Q

what are orbital tumors

A

malignant tumors originating in the sphenoidal and ethmoidal sinuses, middle cranial or infratermporal fossa car erodes through the thin walls of the orbit or pass directly through foramina

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27
Q

What can be a sign of an orbital tumor

A

exophthalmos

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28
Q

what fascia lines the bones of the orbit

A

periorbital fascia

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29
Q

what fascia is the periorbital fascia continuous with

A

periosteal dura at optic canal and superior orbital fissure
orbital septum anteriorly
muscular fascias of the EOM

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30
Q

What are the check ligaments of the orbit

A

medial and lateral attach to the orbital walls
limit ADduction and ABduction of the eye
prevent posterior retraction of the eyeball by rectus mm

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31
Q

What is tenon’s capsule

A

the fascial sheath of eyeball

continuous with muscular fascia of EOM

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32
Q

what is the function of orbital fat

A

cushion, lubrication, protection

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33
Q

why do eyes become sunken in in starvation

A

loss of orbital fat

enophthalmos

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34
Q

What are the components of the eyelid

A

skin, loose CT, muscle, tarsal plate and palpebral conjunctiva

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35
Q

what are the mm associated with eyelids

A

orbicularis oculi and levator palpebrae superioris

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36
Q

what is the structure of the tarsal plate in eyelid

A

desnse CT
has orbital septum to contain fat in orbit and to limit spread of infection
has medial and lateral palpebral ligaments

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37
Q

what glands are assoc with the eyelid

A

Tarsal glands (sebaceous)
Glands of Zeis (smaller sebaceous)
Glands of Moll (sweat)

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38
Q

What happens if glands of eyelid become inflamed or obstructed

A

chalazion (meibomian cast)

hordeoum (cyst of eyelash glands)

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39
Q

describe action and inn orbicularis oculie

A

sphincter m of eyelid

VII

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40
Q

what happens with VII impairment

A

eyelid that cannot close completely

inferior eyelid tends to fall away from eyeball and result in dryness and irritation of cornea and sclera

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41
Q

What is the origin and insertion of levator palpaebrae superioris

A

origin: lesser wing of sphenoid
insertion: skin of superior eyelid

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42
Q

what is the function and inn of levator palpebrae superioris

A

elevates superior eyelid

CN III

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43
Q

where does the superior tarsal portion of levator palpebrae superioris attach

A

superior tarsal plate

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44
Q

What can impairment of CN III lead to

A

inability to open upper eyelid (ptosis)

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45
Q

What is horners syndrome

A

loss of SANs to head

ptosis, miosis and anhydrosis

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46
Q

What is the palpebral conjunctiva

A

epithelium of internal eyelid

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47
Q

what is the bulbar conjunctiva

A

outer epithelium of sclera

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48
Q

what is the conjunctival sac

A

between palpebral and bulbar conjunctiva

opens at palpebral fissure

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49
Q

what are the conjunctival fornices

A

formed where bulbar and palpebral conjunctiva are continuous

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50
Q

What are the components of the lacrimal apparatus

A

lacrimal gland
lacrimal cannaliculi
lacrimal sac
nasolacrimal duct

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51
Q

where is the lacrimal gland

A

compound tubuloalveolar gland

located in lacrimal fossa in superolateral orbit

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52
Q

what does the lacrimal gland secrete

A

watery serous secretion into conjunctival sac

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53
Q

what is the function of lacrimal fluid

A

keeps sclera and cornea moist and contains an antibacterial agent for protection

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54
Q

where are the lacrimal canaliculi

A

located in medial angle of eye

begin at lacrimal papilla (punctum is opening)

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55
Q

what is role of lacrimal sac

A

receives fluid from lacrimal cannaliculi

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56
Q

describe flow of tears

A

lacrimal gland to conjunctival sac to surface of eye to lacrimal papillae with punta to cannaliculae to lacrimal sac to nasolacrimal duct

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57
Q

What are the 3 tunics of eye

A

external cornea-scleral
middle uveal
inner neural

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58
Q

describe the sclera

A

tough opaque fibrous layer covering posterior 5/6 globe

provides structural support and mm attachment

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59
Q

describe the cornea

A

avascular, dehydrated,
provides most eyes refractile capabilities
numerous pain R located here

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60
Q

What is corneal neovascularization

A

blood vessels grow into corneal stroma secondary to hypoxia

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61
Q

Describe the components in the uveal layer

A

choroid, iris and ciliary body

62
Q

describe the choroid of eye

A

highly vascularized
loose CT
vascualr supply to fibrous layers and outermost layers of retina
contain melanocytes which produce melanin to absorb photons of light

63
Q

describe the iris

A

central aperture forms pupil which controls amount of light

64
Q

What are the mm of the iris

A 
sphincter pupillae (closes pupil) miosis PANs CN III
dilator pupillae (opens pupil) mydriasis SANs
65
Q

What are the ciliary processes

A

Finger like extensions from ciliary body
secrete aqueous humor into posteiror chamber
suspensory ligaments extend from ciliary proccesses to the lens

66
Q

what inn the ciliary m

A

PANs CN III

67
Q

what is the role of the ciliary mm

A

accommodation
distant it is relaxed
focused on nearby it is contracted to make lens more round

68
Q

What is the ora serrata

A

anterior termination of retina

69
Q

what is the macula lutea of eye

A

pigmented zone 2.5mm lateral to optic disk

70
Q

what is the blood supply to retina

A

central retinal a supplies neural portion of retina except photoR
choroid vessels supplies pigmented epithelium and photoRlayer

71
Q

What is retinal detachment

A

when pigmented epithelium separates from the underlying rods and cones layer
can cause blindness

72
Q

Describe the characteristics of the lens

A

transparent, refractile, flexible, biconvex disk located posterior to iris

73
Q

What is the function of the lens

A

refraction and accommodation

74
Q

what is presbyopia

A

refers to hardening of lens

inability to accommodate and focus on near objects

75
Q

what are cataracts

A

proteins of lens aggregate

produce opaque lens

76
Q

Where is the anterior chamber?

posterior?

A

anterior is located between cornea and iris

posterior is located between iris and lens

77
Q

where is the drainage from venous sinuses

A

vorticose and anterior ciliary vv

78
Q

What causes glaucoma

A

excess aqueous humor in anterior and posterior chambers
decreased outflow of aqueous humor
or increased production of aqueous humor

79
Q

What is the vitreous body

A

between lens and posterior surface eye

filled with vitreous humor- transparent refractile jelly-like substance

80
Q

What are the 3 sources of the eye in development

A

neural ectoderm (optic vesicles)
surface ectoderm
mesenchyme

81
Q

What is neural ectoderm derived from

A

evaginations of the forebrain neuroectoderm

82
Q

What forms the optic cup

A

optic vesicles invaginate on themselves
optic cup retains connection of forebrain at optic stalk
choroid fissure forms on central surface of optic cup- carries hyaloid vessels

83
Q

what does the neural ectoderm become

A

retina, optic nerve

84
Q

what does the surface ectoderm become

A

lens placode–>lens vesicle

85
Q

what does the mesenchyme of the eye become

A

fibrous (sclera, cornea) and vascular (choroid, iris, ciliary body) layers

86
Q

Which layer of the optic cup is pigmented

A

outer

87
Q

when does the choroid fissure close

A

7th week

88
Q

what causes congenital retinal detachment

A

inner and outer layer of optic cup fail to fuse

89
Q

What is the choroid derived from

A

vascular layer of mesenchyme surrounding optic cup

90
Q

The outer portion of the iris is derived from what

A

vascular mesenchyme surrounding optic cup

91
Q

the inner potion of the iris is derived from what

A

optic cup

92
Q

when do melanocytes migrate to the anterior iris

A

first 6-10 months

93
Q

What is the iridopupillary membrane

A

vascular structure which originally separates anterior and posterior aqueous chambers

94
Q

when does the iridopupillary membrane degenerate

A

15th week

95
Q

What will happen if the iridopupillary membrane fails to degenerate

A

congenital atresia of the pupil

96
Q

What is coloboma

A

failure of choroid fissure to fuse in 7th week

97
Q

What layer of mesenchyme are the sclera and cornea derived from

A

fibrous layer of the mesenchyme surrounding optic cup

98
Q

how do the aqueous and vitreous chambers of the eye form

A

eye chambers form in areas of cell death within eyeball

vitreous humor is likely derived from neural crest cells

99
Q

what is the lens derived from

A

lens vesicle

100
Q

what is congenital aphakia

A

agenesis of lens placode

101
Q

what are the extrinsic eye mm formed from

A

mesoderm of myotomes

102
Q

What are the branches of the ophthalmic a

A 
central retinal
short posterior ciliary
long posterior ciliary
anterior ciliary
lacrimal
supraorbital
posterior ethmoidal
anterior ethmoidal
medial palpebral
supratrochlear
dorsal nasal
103
Q

where do the short posterior ciliary aa go? long?

A

short pierce sclera near optic n and supply choroid

long pierce sclera anteriorly to supply ciliary body and iris

104
Q

describe venous drainage of orbit and eyeball

A

central retinal v to cavernous sinus
vorticose vv to choroid, ciliary body and iris
superior and inferior ophthalmic vv to the cavernous sinue and pterygoid venous plexus

105
Q

How can thrhomophlebitis of cavernous sinus lead to vision loss

A

can clot the central retinal v

106
Q

What can causes retinal edema

A

occlusion of the central retinal v

107
Q

What are the movements of the eye

A 
ADduction
ABduction
eleveation
depression
extortion
intortion
108
Q

what is extortion/intortion

A

extortion is the superior pole of eyeball rotates laterally

intortion is the superior pole of the eyeball rotates medially

109
Q

What is the origin and insertion action inn medial rectus

A

origin: common tendinous ring
i: medial surface eyeball
inn: CN III
ADduction

110
Q

o i action inn lateral rectus

A

o: common tendinous ring
i: lateral surface of eyeball
ABducts
CN VI

111
Q

what is the o i action inn of superior rectus

A

o: common tendinous ring
i: superior surface of eyeball
eleavtes, ADducts and intorsion
CN III

112
Q

what is the o i action inn inferior rectus

A

o:common tendinous ring
i: inferior surface of eyeball
depresses ADducts and extorsion
CN III

113
Q

o i action inn inferior oblique

A

o: anterior portion of floor of orbit
i: inferior surface of eyeball, posterior to vertical axis
elevates ABducts and extorsion
CN III

114
Q

how do you test for loss of inferior oblique m

A

weakness of elevation

loss of elevation when eye is fully ADducted

115
Q

o i action inn superior oblique

A

o: common tendinous ring
i: superior surface eyeball, posterior to vertical axis
depresses ABdcuts and intorsion
IV

116
Q

how do you test for loss of superior oblique

A

weakness of depression

loss of depression when eye is fully ADducted

117
Q

What type of info is CN III carrying

A

GSE and GVE-P

118
Q

what mm does the superior division of CN III inn

A

levator palpabae superioris and superior rectus

119
Q

what mm doe sthe inferior division of CN III inn

A

medial rectus, inferior rectus and inferior oblique

120
Q

What other fibers are carried in the inferior division of CN III

A

preganglionic PANs to ciliary ganglia

121
Q

What are signs of occulomotor nerve palsy

A 
ptosis
diplopia
eye will be ABducted and depressed
dilation of pupil
loss of accomodation
122
Q

What type of info is carried in CN IV

A

GSE to superior oblique

123
Q

What are signs of trochlear n palsy

A

diplopia
eye is slightly elevated and ADducted
loss of depression when eye if fully ADducted

124
Q

What type of info is carried in CN CI

A

GSE to lateral rectus m

125
Q

what are signs of abducens n palsy

A

diplopia and loss of eye ABduction

126
Q

What type of infor is carried in CN II

A

SSA vision

127
Q

what meninges cover the optic n

A

dura, arachnoid and pia

128
Q

where do the optic n fibers exit the sclera

A

lamina cribosa

129
Q

What type of info is carried in ophthalmic V1

A

GSA

130
Q

what are the branches of V1

A

nasociliary
frontal
lacrimal

131
Q

what type of info do the short ciliary nn have

A

postganglionic SAN PAN and sensory fibers

arise lateral to optic n

132
Q

what type of info do the long ciliary nn have

A

postganglionic SANs and sensory

arise medial to optic n

133
Q

what are the branches of the nasociliary branch of V1

A

short ciliary, long ciliary, posterior ethmoidal, anterior ethmoidal, infratrochlea

134
Q

what does the infratrochlear n inn

A

sensory skin at root of nose, eyelids, palpebral conjunctiva and lacrimal sac

135
Q

what are the branches of the frontal n off V1

A

supratrochlear and supraorbital

136
Q

what info is in the lacrimal branch of V1

A

sensory to lacrimal gland and lateral portion superior eyelid
postganglionic PAN and SAN to lacrimal gland

137
Q

Where is the ciliary ganglion located

A

between lateral rectus and optic n

138
Q

what type of cell bodies are in ciliary ganglion

A

postganglionic PANs

139
Q

what are the 3 roots that enter ciliary ganglion

A

sensory from nasociliary
PAN motor from CN III
SAN from internal carotid plexus

140
Q

Where are the preganglionic cells for the sphincter pupillae and cliliary m

A

edinger westphal nucleus

141
Q

what n do postganglionic PAN run with

A

short ciliary nn to sphinter pupillae and ciliary m

142
Q

Where are the preganglionic SAN cell bodies for dilator pupillae and superior tarsal m

A

T1-T2

143
Q

describe path of postganglionic SAN to dilator pupillae and superior tarsal m

A

pass through ciliary ganglia without synapsing and distribute via long and short ciliary nn

144
Q

Where are the preganglionic cell bodies for PAN to lacrimal gland and what n do they travel with

A

salivatory nucleus in brainstem

travel with greater petrosal n from VII

145
Q

where are the postganglionic cell bodies for PAN to lacrimal gland and what nn do they travel with

A

pterygopalatine glanglia

zygomaticV2 and lacrimalV1 nn

146
Q

where are the preganglionic cell bodies for SAN to lacrimal gland and what nn do they run with

A

T1-T4

enter sympathetic chain and ascend

147
Q

Where are the postganglionic cell bodies for SAN to lacrimal gland and what nn do they run with

A

superior cervical ganglia, some distrbute on deep petrosal and merge to form n of pterygoid canal
others go with zygomatic V2 and lacrimal V1

148
Q

what is the result of SAN stimulation to lacrimal gland

A

more watery lacrimal fluid

vasomotor

149
Q

Describe componentes of pupillary light reflex

A

function to protect eye from excessive light exposure
afferent CN II
efferent CN III

150
Q

describe components corneal reflex

A

afferend CN V1
efferent CN VII oribuclaris oculi
puff of air stimulates V1 and blink from VII

151
Q

describe accommodation reflex

A

afferent II

efferent III

152
Q

what are the 3 events in accommodation reflex

A

ciliary mm contract lens rounds CN III GVE-P
pupils constrict CN III GVE-P
eyes adduct CN III GSE

Neuro III (10 decks)

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