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NBEO Part 1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Telecanthus

A

An abnormal large distance between the medical acanthi of the lids

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2
Q

Poliosis

A

whitening of the eyelashes

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3
Q

Madrosis

A

Eyelashes falling out

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4
Q

Trichiasis

A

Turning inward of the lashes

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5
Q

Pthiriasis Palpebrarum

A

An infection of the lashes caused by pthiriasis pubis

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6
Q

Why is the skin layer of the eyelid unique

A

It is the thinnest in the body and contains no fat

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7
Q

Which layer is below the skin layer of the eyelid

A

Subcutaneous areolar layer. Contains the elevator aponeurosis

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8
Q

Orbicularis Layer

A

CN VII. Closes the eye.

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9
Q

Orbital portion or orbicularis

A

Attaches to the orbital margins and extends outward. used in force closure

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10
Q

Palpebral portion of orbicularis

A

Used for spontaneous and reflex blinking. Made up of muscle of riolan and muscles of horners

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11
Q

Muscles of Riolan

A

Pars ciliaris. Most superficial orbicular oculi. Keeps lid margin tightly applied to the globe. May rotate the eyelash inward with eyelid closure.

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12
Q

Gray line

A

Most anterior portion of the muscle of Riolan. Between the eyelashes and the meiobomian glands.

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13
Q

Muscle of Horners

A

Pars lacrimalis. Encircle the canaliculi and help drain tears into the lacrimal sac.

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14
Q

Submuscualar areolar layer

A

Between the orcicularis and the orbital septum. Contains the elevator aponeuris, palpebral portion of main lacrimal gland, and the peripheral and marginal arcades.

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15
Q

orbital Septum

A

Dense irregular connective tissue that serves as a barrier to the orbit. Prevents fat from falling down and keeps infections out.

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16
Q

Periorbita

A

covers the orbital bones. Projects anteriorly to become the orbital septum and posteriorly to fuse the dura of the ON head.

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17
Q

Where does the orbital septum attach

A

Medially to the posterior lacrimal crest (i.e. behind the lacrimal sac)

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18
Q

What inserts in the superior orbital septum

A

levator aponeurosis

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19
Q

Posterior muscular system

A

mullers muscle and Levator.

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20
Q

Superior palpebral levator orgin

A

lesser wing of the sphenoid

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21
Q

How much does it retract the lid?

A

15 mm

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22
Q

Whitnall’s ligament

A

Changes the direction of the Levator and allows it to perform its function.

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23
Q

Levator aponeurosis

A

A fan of the elevator in the eyelid.

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24
Q

Superior palpebral furrow

A

Formed by the elevator aponeurosis sending fibers through the tarsal plate to insert in skin.

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25
Q

Lateral horn of elevator aponeurosis

A

Travels across lacrimal gland and attaches to whitenall’s ligament.

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26
Q

Medical horn of levator aponeurosis

A

Travels medical to medial palpebral ligament

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27
Q

Inferior palpebral furrow

A

formed by indirect attachment of the IR into the skin of the lower eyelid.

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28
Q

Muscle of Muller

A

Innervated by alpha 2 of SNS. Originates from elevator and extends to the tarsal plate.

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29
Q

How much does muscle of muller widen eyelid

A

1-3 mm (minor)

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30
Q

Inferior tarsal msucle

A

original from fascial sheath of the IR and extends into the tarsal plate.

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31
Q

Normal interpalpebral distance in adults

A

10-12 mm

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32
Q

Tarsal Plate

A

Dense irregular CT that provides rigidity to the eyelids. Surrounds the meiobomian glands.

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33
Q

What do the tarsal plates become?

A

The medial and lateral palpebral ligaments.

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34
Q

Where does the medial palpebral ligament attach?

A

maxillary bone

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35
Q

Where does the lateral palpebral ligament attach

A

Whitnall’s ligament (also where lateral horn of Levator aponeurosis)

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36
Q

Layers of palpebral conjunctiva

A

Epithelial and stroma layer

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37
Q

Epithelial layer of the palpebral conjunctiva

A

Extends into the fornices and bulbar conj. Contains the goblet cells that produce the mucin layer of the tears.

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38
Q

where are goblet cells most commonly found

A

infernasal fornix and on bulbar conj temporally

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39
Q

Layers of Stroma of the palpebral conj.

A

Made up of superficial lymphoid layer and deep fibrous layer

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40
Q

Superficial lymphoid layer of the palpebral conj

A

Very immunologically active. Has IGA, macrophages, mast cells, PMNs, eosinophils.

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41
Q

Deep fibrous layer of palpebral conj.

A

Connects the conjunctiva to to underlying structures. Contains the accessory lacrimal glands, nerves, blood vessels of the eyelids. Becomes continuous with tarsal plate.

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42
Q

How many meiobomian glands are there

A

25 on top and 20 on lower

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43
Q

What do meiobomian glands produce and what kind are they

A

The lipid layer of the ear film. Holocene (whole cell shed)

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44
Q

Glands of Zeiss. What kind?

A

Lubricate the eyelashes. Also help with lipid layer. Holocrine.

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45
Q

Glands of Moll

A

Empty contents into lashes, glands of zeiss, and lid margin. Also help with lipid layer. Apocrine.

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46
Q

Glands of Krause

A

Accessory lacrimal glands. Mesocrine. Located in fornices of the conjunctiva (krause in creases).

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47
Q

Glands of Wolfring

A

Accessory lacrimal glands. Mesocrine. Larger and less numbers. In Tarsal conjunctiva.

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48
Q

Holocrine glands

A

Meiobomian and Zeiss. Secrete entire cell.

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49
Q

Apocrine

A

Moll and Goblet. A portion of plasma membrane buds off.

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50
Q

Mesocrine

A

Accessory lacrimal glands. Secrete by exocytosis.

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51
Q

What branch of CN VII controls the lid

A

Zygomatic controls orbicularis oculi

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52
Q

Involuntary motor innervation of the lid

A

Muscle of Muller controlled by SNS

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53
Q

Sensory innervation of the lid

A

Upper eyelid innervated by frontal and lacrimal branches of V1. Lower eyelid innervated by infraorbital and zygomaticofacial branch of V2.

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54
Q

Which innervation supplies both upper and lower lid senstation

A

infratrochlear branch of nasociliary from V1.

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55
Q

Branches of V1

A

Nasociliary, Frontal, Lacrimal

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56
Q

Nasociliary Branches

A

infratrochlear, anterior ethmoid, posterior ethmoid, long ciliary, short ciliary.

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57
Q

Branches of frontal nerve

A

Supratrochlear and Supraorbital

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58
Q

Branches of V2

A

Infraorbital and zygomaticofacial.

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59
Q

What layer are the palpebral arcades located in

A

Submuscular areolar layer

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60
Q

What forms the palpebral arcades

A

Medial palpebral artery (from ophthalmic artery or dorsal nasal artery) and lateral palpebral artery (from the lacrimal artery)

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61
Q

Marginal palpebral arcades

A

near the eyelid margin

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62
Q

Peripheral palpebral arcades

A

Supply the fornices and the posterior conjunctiva. Connect with anterior ciliary arteries which supplies the anterior conj.

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63
Q

What do Anterior ciliary arteries provide

A

Provides circulation to the bulbar conj. and the CB. Why a patient with uveitis can have circumlibal injection.

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64
Q

What external artery branch provides the lids

A

The facial artery

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65
Q

Where do lateral lymphatics drain

A

Parotid (pre auricular) lymph nodes

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66
Q

Where do medial lymphatics drain

A

submanidubular lymph nodes

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67
Q

What is the only type of bacterial conjunctivitis that presents with parotid lymphadenopathy swelling?

A

Gonococcal conjunctivitis

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68
Q

What commonly results in pre auricular lymphadenopathy

A

viral infections. (viral conjunctivitis, chlamydia conjunctiviies, and dacryoadentitis)

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69
Q

Frontalis

A

The main elevator of the brows. Originates high on the scalp and inserts near the Superior orbital rim

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70
Q

Corrugator

A

Concentration or sorrow. Medial depressor of the eyelids. Originates at frontal bone and inserts in skin above medial eyebrows.

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71
Q

Procerus

A

Agression. Pull the skin between the eyebrows downward. Originates at nasal bone and inserts on the frontal.

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72
Q

What divides the lacrimal gland?

A

The superior palpebral elevator tendon

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73
Q

How does the lacrimal gland receive parasympathetic innervation

A

From the lacrimal nerve of the pterygopalantine ganglion of CN VII.

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74
Q

How does the lacrimal gland receive sympathetic innervation

A

SNS follows the lacrimal artery to innervate the gland.

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75
Q

Acute dacryoadentitis

A

inflammation of the lacrimal gland. S shaped.

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76
Q

What is responsible for keeping the lacrimal puncta open

A

Lacrimal papilla

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77
Q

Cannaliculi

A

10mm long. Connects the punch to the lacrimal sac. Runs 2mm vertical and then 8mm medially to join the common canaliculus that joins into the lacrimal sac.

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78
Q

What does the muscle of Horners do?

A

During eyelid closure it contracts and assists with tear draining.

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79
Q

What bones form the lacrimal fossa

A

Lacrimal bone and maxillary bone.

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80
Q

How long is the lacrimal sac

A

10-12 mm

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81
Q

What tendon straddles the lacrimal sac

A

Medal palpebral ligament (from the tarsal plates)

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82
Q

Darcyocystitis

A

Infection of the lacrimal sac.

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83
Q

What sinus does the nasolacrimal duct lay adjacent to

A

maxillary sinus.

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84
Q

How long is the nasolacrimal duct?

A

15 mm

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85
Q

Where does the nasolacrimal duct terminate

A

inferior meatus

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86
Q

Valve of hasner

A

At the end of the nasolacrimal duct. Stops back flow

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87
Q

Intraconal Adipose Tissue

A

Within the cone. Separates ON from the EOMs

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88
Q

Extraconal adipose tissue

A

outside of the cone. Between the EOMs and wall of orbit.

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89
Q

The Sheath of the _____ and _____ are connected

A

SR and elevator. Allow lids to go up with upward movement.

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90
Q

Spiral of Tillaux

A

The insertion of the rectus muscles. Medial is closest, then inferior, then lateral, then superior.

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91
Q

MR insertion

A

5.5 mm

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92
Q

IR inserteion

A

6.5 mm

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93
Q

LR insertion

A

6.9 mm

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94
Q

SR insertion

A

7.7 mm

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95
Q

Where do all recti muscle originate

A

CTR

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96
Q

SO origin

A

Lesser wing of sphenoid and CTR.

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97
Q

Physiological origin of SO

A

trochlea

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98
Q

IO origin

A

Only muscle to originate anteriorly. Originates from the maxillary bone.

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99
Q

Muscular artery branches

A

Superior lateral and inferior medial

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100
Q

Superior lateral artery supplies…

A

SR, SO, LR.

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101
Q

Inferior medal artery supplies

A

IR, IO, MR.

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102
Q

Superior division of the CN III supplies what…

A

SR.

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103
Q

Inferior division of the CN III supplies what…

A

MR, IR, IO.

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104
Q

What creates the orbital septusm

A

Orbital fascia

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105
Q

What is in lesser wing

A

Optic canal, elevator starts, So starts

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106
Q

Great wing forms the

A

Lateral wall

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107
Q

Foramen within greater wing

A

Formen rotundum (v2), formane ovale (v3), formane spinosum (middle meningeal artery)

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108
Q

Where is the SOF

A

between the greater and lesser wing.

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109
Q

Annulus of Zinn

A

Common tendinous ring. Orgin of the Rectus muscles

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110
Q

What goes through the CTR and SOF

A

Nasociliarty of V1 (along with sympathetic root), oculomotor nerve, Abducens nerve.

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111
Q

What goes through SOF but above the CTR

A

Superior ophthalmic vein, frontal nerve, lacrimal nerve, trochlear nerve. SOV, FLighT.

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112
Q

What goes through IOF and below CTR

A

inferior ophthalmic vein and occasionally central retinal vein if it hasn’t joined ophthalmic vein)

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113
Q

what goes through carotid canal

A

Internal carotid artery and Sympathetic plexus

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114
Q

what goes through Supraorbital formaen

A

supraorbital n. (V1) and vessels

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115
Q

what goes through Infraorbital formaen

A

infraorbital n. (v2) and vessels

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116
Q

what goes through sylomastoid formen

A

facial nerve

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117
Q

mnemonic for bones that make up the orbit

A

Many Friendly Zebras Enjoy Lazy Summer Picknicks

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118
Q

What makes up the roof of the orbit

A

Front-less. The lacrimal gland is in a fossa in the frontal bone

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119
Q

What makes up the floor of the orbit

A

My Pal gets His Z’s on the floor. Maxillary, palatine, Zygomatic.

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120
Q

what makes up the medial wall

A

SMEL. Body of sphenoid, Maxillary, ethmoid, lacrimal.

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121
Q

Lamina Papyracea

A

Orbital portion of the ethmoid. Very thin. Infectious of sinus can spread

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122
Q

Lateral wall

A

Great Z. Great wing of sphenoid and zygomatic.

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123
Q

Which wall does not have sphenoid

A

inferior

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124
Q

cavernous hemiagnomas

A

most common benign orbital tumors in adults

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125
Q

capillary hemangionomas

A

most common being orbital tumors in kids

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126
Q

Important branches of the external carotid artery

A

Facial artery, superficial temporal artery, and maxillary artery.

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127
Q

Angular artery

A

Terminal branch of the facial artery that supplies medical canthus with the dorsal nasal artery (from ophthalmic artery)

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128
Q

Maxillary artery

A

A terminal branch of external carotid artery. Gives of infraorbital artery that supplies IR and IO and exits orbit and supplies the lower eye lid and lacrimal sac before joining with the angular artery and the dorsal nasal artery

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129
Q

Anastomose of the lacrimal sac

A

infraorbital (ECA), angular (ECA), and dorsal nasal (ICA). DAI.

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130
Q

Superficial temporal artery

A

Branches Ant temporal, zygomatic, transverse.

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131
Q

Which nerve travels closest to the ICA

A

CN VI

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132
Q

Where does the ophthalmic a. branch from

A

Internal carotid

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133
Q

Branches of the ophthalmic artery

A

CRA, Lacrimal A, Muscular, SPCA, LPCA, Supraorbital, Ethmoid. –>Supratrochlear and Dorsonasal.

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134
Q

Lacrimal artery branches

A

Travels along the lateral wall and supplies the lr and lacrimal gland. It terminates as the lateral palpebral artery for lacrimal arcades.

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135
Q

Muscular artery

A

Superior lateral: SO, SR, LR. Inferior Medial: IO, IR, MR

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136
Q

What lawyers are the CRA in

A

NFL and ONL/OPL

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137
Q

Anterior ciliary artery

A

formed by branches of the muscular arteries. Combines with LPCA to form MACI

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138
Q

Short Posterior Ciliary Artery

A

Forms the circle of Zinn to supply optic nerve, posterior choroid, and macula.

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139
Q

Long Posterior Ciliary Artery

A

Travel between sclera and choroid. Provide the anterior choroid before forming MACI.

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140
Q

What makes up MACI

A

Anterior ciliary arteries (from muscular branches) and LPCA.

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141
Q

Supraorbital artery

A

Provides SR, SO, elevator before going through Supraorbital notch to supply the scalp.

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142
Q

Ethmoid artery

A

Branches supply the sphenoid, frontal, and ethmoid sinuses.

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143
Q

Supratrochlear artery

A

Terminal branch of ICA. Supplies the forehead, scalp, and muscles of forehead

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144
Q

Dorsal nasal artery

A

Supplies lacrimal sac and then joins angular (facial-ECA)

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145
Q

Medial palpebral artery

A

branch of dorsal nasal that form palpebral arcades.

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146
Q

What causes ocular ischemic syndrome?

A

Occlusion of ICA or ophthalmic artery.

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147
Q

Central Retinal Vein

A

Drains blood from the inner 6 layers of the retina that are supplied by the CRA. Exits through the optic nerve and then enters the cavernous sinus, either directly or joining with superior ophthalmic veins first.

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148
Q

Anterior Ciliary Veins

A

Drain the anterior structures. Drain into the superior and inferior ophthalmic veins.

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149
Q

Vortex veins

A

Drains blood from the choroid. Drain into the superior and inferior ophthalmic veins.

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150
Q

Superior Ophthalmic Veins

A

Drains the majority of the eye (muscular=MR and SR) Formed by angular artery (formed by supraorbital and facial). Exits through the SOF and then joins the cavernous sinus.

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151
Q

Inferior ophthalmic veins

A

Drains muscular (MR, LR, IO, IR). Divides into superior and inferior branch

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152
Q

Superior branch of inferior ophthalmic vein

A

Exits through SOF and then drains directly to cavernous sinus or joins with SOV

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153
Q

Inferior branch of inferior ophthalmic vein

A

Exits through IOF and then drains into ptyergopoid plexus to communicate with facial veins

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154
Q

Supraorbital vein

A

Combines with the facial v. to form angular v. –>SOV

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155
Q

Angular vein

A

Becomes the anterior facial vein. Gets blood from pterygoid venous plexus and superior and inferior palpebral veins. Joins with posterior facial vein to form the common facial vein. Common facial vein drains into internal jugular vin.

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156
Q

Infraorbital vein

A

drains the lower face and then drains into the pterygoid plexus

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157
Q

Ptergoid venous plexus

A

The anterior facial vein (from angular), Inferior branch of IOV, and infraorbital all drain into it. Communicates with cavernous sinus with orbital veins and emissary veins of the cranium.

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158
Q

What does the venous plexus form?

A

The maxillary vein

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159
Q

Superficial temporal vein

A

Joins the maxillary vein within the parotid gland to form the posterior facial vein (combines with anterior facial to form form common facial).

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160
Q

Middle temporal vein

A

Drains into the superficial temporal vein. Receives blood from the orbital vein that originates from lateral palpebral venous branches.

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161
Q

Posterior Facial vein

A

Formed by superficial temporal vein and maxillary vein. Divides into an anterior and posterior branch

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162
Q

Anterior branch of posterior facial vein

A

Joins with anterior facial vein to form common facial v. then drains into internal jugular vein.

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163
Q

Posterior branch of posterior facial vein

A

Joins with the posterior auricle vein to form the external jugular vein

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164
Q

Occipital vein

A

Can drain directly to the internal jugular vein or join the posterior auricle to drain into the external jugular vein

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165
Q

External jugular vein

A

Formed by union of posterior facial vein (retromandibular vein) and the posterior auricular vein and drains blood from the superficial face.

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166
Q

Internal jugular vein

A

Continuation of the sigmoid sinus and drains the common facial, occipital, lingual, and superior and medical thyroid veins.

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167
Q

What travels through the Cavernous Sinus

A

V1, V2, III, IV, VI, ICA, post ganglionic sympathetic fibers that travel around ICA, and parasympathetic fibers around CN III

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168
Q

What does not go through the cancerous sinus

A

V3, CN VII (and parasympathetic fibers that travel with CN VIII)

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169
Q

Tolosa Hunt Syndrome

A

Inflammation of SOF or Cavernous sinus. Has painful external othamolpegia and diplopia.

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170
Q

Carotid Cavernous Fistula

A

Abnormal communication between the arterial and venous blood supplies in the cavernous sinus. Associated with painful red eye, ocular bruit, and pulsatile proptosis.

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171
Q

Superior Petrosal Sinus

A

Drains the inferior cerebral and some cerebellar veins. Communicates with cavernous sinus and transverse sinus.

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172
Q

Inferior Petrosal sinus

A

From the posterior inferior cavernous sinus. Exits through the jugular foramen and drains into internal jugular vein

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173
Q

Superior Saggital sinus

A

Located in the falx cerebra. Drains into the right transverse sinus.

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174
Q

Inferior saggital sinus

A

in the inferior fall cerebri. Forms the straight sinus.

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175
Q

Straight sinus

A

Originates at the junction of the falx cerebra and tentorium. Drains into the left transverse sinus.

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176
Q

Occipital sinus

A

Drains into the left transverse sinus.

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177
Q

Transverse sinus

A

Form the sigmoid sinuses.

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178
Q

Sigmoid sinus

A

Exits and becomes the internal jugular vein.

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179
Q

Confluence of the Sinuses

A

Metting point of Superior sagittal, straight, occipital, and transverse sinus. Located on the internal occipital protuberance. SS TOS.

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180
Q

Average axial length

A

24 mm

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181
Q

Why is the cornea able to refract so well?

A

The large difference in n values between the air and tears.

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182
Q

Where is the cornea thicker?

A

The periphery.

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183
Q

Central radius of curvature for the front of the cornea

A

7.8 mm

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184
Q

Central radius of curvature for the back of the cornea

A

6.5 mm (steeper)

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185
Q

Diameter of anterior

A

Horizontal=11.7 Vertical=10.6

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186
Q

Diameter of posterior

A

11.7 horizontal and vertical

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187
Q

What has type 4 collagen in the cornea?

A

BM and descemts.

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188
Q

What forms the epithelium

A

surface ectoderm.

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189
Q

Surface layer of the corneal epithelium

A

2 layers of non-keratizinzed squamous cells. Plasma membrane secretes a glycocalyx and contains micropillae and microvillae.

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190
Q

What is the only layer in the cornea to have ZO

A

epithelium surface layer

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191
Q

Wing cells

A

2-3 layers going by desmosomes

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192
Q

Basal layer of epithelium

A

Only mitotic layer in corneal epithelium. Made up of 1 layer of columnar cells. Basal layer secretes basement membrane. Attaches to basal layer by hemidesmosomes.

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193
Q

Increased chances of RCE

A
  1. poor hemidesomes attachment 2. EMD 3. age related thickening of cornea
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194
Q

Palisades of Vogt

A

Where all stem cells of epithelium are. 1 mm band at the layer of the basal.

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195
Q

Is bowman’s layer a BM?

A

NO

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196
Q

What type of collagen is Bowman’s made up of

A

Type 1. Bones and sclera too.

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197
Q

What makes bowman’s layer

A

Prenatally by anterior stroma.

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198
Q

What function may bowman play

A

Maintaining the curvature of the cornea

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199
Q

Band Keratopathy

A

Calcium deposits within bowman’s layer (swiss cheese)

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200
Q

Crocodile Shagreen

A

Gray-white polygonal stroll opacities that may involve bowman’s layer

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201
Q

Keratocytes of the stroma

A

Fibroblasts the produce collagen fibrils and the extracellular matrix

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202
Q

Collagen fibrils of the stroma

A

Uniformly spaced lamellae.

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203
Q

The anterior 1/3 of the storm has a ______ incidence of cross linking

A

Greater

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204
Q

The posterior 2/3 of the storma is _______ organized and has less uniformly lamellae and ____ cross linking

A

more, more

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205
Q

The less cross linking with the posterior stroma results in

A

higher incidence of corneal edema

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206
Q

What is the GAG in the cornea?

A

Keratin Sulfate

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207
Q

What produces Decesments?

A

The corneal endothelium.

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208
Q

What type of collagen is descements?

A

Type 4

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209
Q

Schwalbe’s line

A

The ending of descents at the limbus

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210
Q

Hydrops

A

Occurs in keratoconus as a results of rupture of descements

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211
Q

Haab’s striae

A

Folds in descements with congenital glaucoma

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212
Q

Hassal-Henle bodies

A

small ares of thickened descent’s in the corneal periphery. Increase in number with age and have no visual significance.

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213
Q

Endothelium of the cornea

A

Squamous cells with NA/K ATP pumps that maintain corneal hydration and transparency.

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214
Q

Where does cornea obtain nutrients?

A

Aqueous humor, Limbal conj and episcleral capillary networks, and palpebral conj. vessels.

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215
Q

Main source of O2 in the open eye

A

tear film

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216
Q

Main source of O2 in the closed eye

A

Palpebral conjunctival blood vessels.

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217
Q

What is corneal innervation responsible for

A

wound healing and pain sensation

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218
Q

Where do LPCN’s enter cornea?

A

The midstroma. After traveling 2-4 mm inside stroma, the corneal nerves lose their myelin sheath as they penetrate bowman and are now nocireceptors.

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219
Q

Where are there no nerves in the cornea

A

Endo, descemets, posterior stroma.

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220
Q

Stratified non-keratizined layer of conjunctiva?

A

Made of cuboidal/columnar cells in palpebral and squamous in the bulbar conj. Superficial cells have melamine granules, microvilli, and goblet cells.

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221
Q

Submucosa of the Conj.

A

Outer lymphoid layer has IGA, etc.. Deep fibrous layer has collagen fibrils, fibroblasts, blood, vessels, accessory lacrimal glands.

222
Q

Palpebral marginal conj.

A

Lines the eyelid margins. Submucosa is thin with only a deep fibrous layer.

223
Q

Palpebral tarsal conj.

A

Lines the tarsal plate. Submucosa is thicker. Strongly attached to tarsal plate.

224
Q

Forniceal conj.

A

Lines the fornices. The EOM fascia attach to the forniceal conjunctiva that allow conj to move with eyes.

225
Q

Bulbar conj

A

Submucosa is losely attached under tenon’s capsule until 3 mm from the cornea where it fuses with tenon’s episclera, and sclera.

226
Q

What stops at limbus

A

Bowman’s and descents (continues as Schwalbe’s)

227
Q

What begins at the limbus

A

conj stroma, episclera, and tenon’s capsule.

228
Q

Plica Semilunaris

A

Made of stratified squamous bulbar conj that folds at the medial cants. Allows eye to move and floor of lacrimal lake.

229
Q

Caruncle

A

Conj and skin hybrid with sebaceous glands, sweat glands, and goblet cells. Function is unknown.

230
Q

What drains the bulbar and palpebral conj

A

anterior ciliary veins

231
Q

What supplies blood to palpebral conj?

A

Palpebral arcades

232
Q

What supplies blood to bulbar conj?

A

Posterior supplies to peripheral palpebral arcades and anterior bulbar by anterior ciliary arteries.

233
Q

Anterior lens radius of curvature

A

8-14

234
Q

Posterior lens radius of curvature

A

5-8

235
Q

Lens capsule

A

Transparent basement membrane that surrounds the entire lens and is secreted by the anterior lens epithelium. Zones insert here.

236
Q

What collagen is lens capsule made of

A

Type 4

237
Q

Lens epithelium

A

Single layer of cuboidal cells adjacent to the lens capsule. Joined to together by macular occludences and gap junctions

238
Q

Pre-Equatorial region of the lens

A

Just anterior to the lens equator and known as the germinal zone. Contains mitotic epithelial cells that become secondary lens fibers.

239
Q

Lens cortex

A

70% water and 30% protein (highest in body). Most lens proteins are water soluble.

240
Q

Crystalline in the lens cortex

A

Have alpha, beta, and gamma. Alpha crystalline are in charge and help the others. When we loose them we get cataracts.

241
Q

Index of refraction in the cortex

A

Gradient index highest in the nucleus.

242
Q

Lens Zonules

A

BM of NPCE creates lens zonules. Has no true elastic fibers.

243
Q

Primary lens zonules

A

Attach directly to the lens zone in the pre and post equatorial regions

244
Q

Secondary lens zonules

A

Connect primary lens zonules to one another or the NPCE of the pars plana

245
Q

Tension zonules

A

connect the primary lens zonules to the alleys between the ciliary processes of the pars plicate.

246
Q

Where is the sclera thickest? how thick?

A

posterior pole at 1 mm

247
Q

Where is the clear thinnest? how thin?

A

Under recti tendon insertions. 0.3 mm.

248
Q

Where is the weakest area of the sclera

A

lamina cribosa

249
Q

Is the sclera vascular?

A

NO. Considered avascular. Receives minimal blood supply from episcleral vessels, choroidal vessels, and branches of LPCAs.

250
Q

Layers of the sclera

A

episclera, sclera proper, lamina fusca

251
Q

Episclera

A

Loose CT layer that contains a capillary network for Anterior ciliary arteries. Will get injection with CB or iris inflammation.

252
Q

What is on top of the episclera?

A

Tenon’s capsule

253
Q

Sclera Proper

A

Thick, dense, avascular CT. Irregular collagen bundles that provide strength but no transparency.

254
Q

What is sclera proper a continuation of?

A

Corneal stroma

255
Q

Episclera vs. sclera proper

A

Episclera is loose CT and highly vascular. Sclera proper is dense CT and is relatively avascular.

256
Q

Lamina Fusca

A

The innermost layer of the sclera. Adjacent to choroid and continues elastic fibers and melanocytes.

257
Q

Tenon’s Capsule

A

Thin transparent layer that covers the episclera. Pierced by EOMs, vessels, etc.

258
Q

Layers of the eye from anterior to posterior

A

conj epi, conj. stroma (submuconsa), Tenon’s capsule, episclera, sclera proper, lamina fasca.

259
Q

Anterior sclera foramen

A

Area occupied by the cornea

260
Q

Posterior sclera formaen

A

Are occupied by the ON. Lamina cribosa.

261
Q

Emissaria

A

Channels in the sclera for things to travel.

262
Q

Middle emissaria

A

Vortex veins

263
Q

Posterior emissaria

A

LPCAs, SPCA, LPCN, SPCN.

264
Q

Anterior emissaria

A

Anything not stated in middle or posterior :)

265
Q

Internal sclera Sulcus

A

Located in the eye and has the cornea sclera junction

266
Q

Becker-Shafter Grade 4

A

Most posterior structure seen is CB

267
Q

Becker-Shafter Grade 3

A

Most posterior structure seen is sclera

268
Q

Becker-Shafter Grade 2

A

Most posterior structure seen is 1/2 to 1/3 TM

269
Q

Becker-Shafter Grade 1

A

Most posterior structure seen is anterior aspect of TM or schwalbe’s line

270
Q

Becker shaffer grade 0

A

no structures seen

271
Q

Van Herick grade 4

A

Anterior chamber is >1/2

272
Q

Van Herick Grade 3

A

Anterior chamber is 1/2 to 1/4

273
Q

Van Herick Grade 2

A

Anterior chamber is =1/4

274
Q

Van Herick Grade 1

A

<1/4

275
Q

Van Herick Grade 0

A

no structures visible

276
Q

What attaches to the Scleral Spur

A

TM and longitudinal muscle fibers of the CB

277
Q

Which layers of the sclera contain elastin

A

Lamina fuscha, lamina cribosa, and SS

278
Q

Which part of the angle typically contains the most pigment

A

inferior

279
Q

Uveoscleral meshwork

A

Innermost 1-5 layers of the TM. Large pores. Does not utilize Schlem’s canal. Aqueous flows between the ciliary muscle fiber bundle, into the suprachoridal space, and then through the sclera or through the anterior ciliary veins, vortex veins, or other routes.

280
Q

What to prostaglandins due

A

Decrease resistance in uveoscleral meshwork.

281
Q

Corneoslceral Meshwork

A

Outer 8-15 layers. Has smaller pores. IOP must be greater than venous pressure.

282
Q

Juxtacanalicular Tissue

A

AKA cribifirm layer. Located closest to schlem’s canal. Much resistance.

283
Q

Schelmm’s Canal

A

A major site of aqueous humor filtration. Inner wall has vacuoles to collect for JXT. Has internal collector chambers to increase the SA.

284
Q

Routes of schelemm’s canal drainage

A

Short efferents->deep scleral venous plexus–>intrascleral venous plexus–>Episcleral venous plexus OR external collector channels (aqueous veins of Ascher)–>episcleral venous plexus.

285
Q

Pupil location

A

Slighting IN.

286
Q

Schwalbe’s contraction furrows

A

At the pupillary margins. Represent variation in thickness of the Posterior pupillary iris.

287
Q

Where is iris thickest?

A

collarette

288
Q

Where is iris thinnest

A

Iris root

289
Q

Collarette

A

Attachment for fetal pupillary membrane and has old fetal vasculature. Divides iris into pupillary and ciliary zones

290
Q

Ciliary zone

A

Contains iris furrows that allows iris to bunch with dilation. Also has radial streaks which are white in color and represent collagen traveling with iris vessels.

291
Q

Pupillary zone

A

Radial streaks are still present but are smaller.

292
Q

Crypts of Fuchs

A

Span the collate into ciliary and pupillary zones

293
Q

Anterior iris stromal leaf

A

Located in ciliary zone. Contains the ABL and a small portion of the iris stroma.

294
Q

Posterior iris stromal leaf

A

Contains most of the iris stroma in the ciliary ABL and all of the iris stroma in the pupillary zone.

295
Q

What determines iris color

A

amount of melanin not amount of melanocytes.

296
Q

Iris crypts

A

columns in ABL that serve as passageway for aqueous humor.

297
Q

Cells of the iris stroma

A

fibroblasts, melanocytes, lymphoctyes, macrophages, mast cells, clump cells.

298
Q

What is the iris stroma continuous with?

A

Ciliary body stroma

299
Q

Nerves of the iris stroma

A

LPCNs and SPCNs.

300
Q

What carries sensory and sympathetic signals to iris stroma?

A

LPCNs and SPCNs

301
Q

What carries parasympathetic signals to iris stroma

A

SPCNs.

302
Q

What is the blood aqueous barrier

A

minor ACI, endo of scheme’s canal, NPCE.

303
Q

MACI

A

Major. Formed by LPCA and ACA. In the CB and extends to the iris root.

304
Q

Minor ACI

A

Located in the iris stroma near pupillary margin and inferior to collarette. Formed by branches of MACI.

305
Q

Radial veins

A

Veins of the iris and parallel the arteries. Drain into CB veins–>choroidal veins–>vortex–>super/inferior SOV.

306
Q

Sphincter muscle

A

Present in the iris stroma.

307
Q

What innervates the sphincter muscle

A

SPCN that travel with CN III

308
Q

Anterior epithelium

A

Lies closest to iris stroma and becomes the pigmented ciliary epithelium. Contains pigment myoepithelial cells which which contain processes at basal surface that extend into iris stroma and attach to sphincter. This forms the dilator muscle

309
Q

Dilator muscle

A

in the anterior epithelium layer. Extends from the iris root and stops at midpoint of sphincter.

310
Q

Posterior Pigments Epithelium of Iris

A

Heavy pigmented single layer of columnar cells.

311
Q

Pupillary ruff

A

PPE of iris extends around pupil.

312
Q

What kind of transillumination defects will see with pigment dispersion syndrome

A

mid peripheral.

313
Q

Iris cysts

A

Develop when there is separation between pigmented anterior layer and pigment posterior epithelium layer.

314
Q

Where is the posterior chamber located

A

Between the iris and anterior vitreous.

315
Q

Posterior chamber proper

A

bound by posterior iris epithelium, Cilliary processes, and the anterior zonules and surface of lens.

316
Q

Canal of Hannover (aka circumlental space)

A

Between the anterior and posterior lens zonules. Hannover=pushover=always in the middle.

317
Q

Canal of petit (aka retrolental space)

A

located between the most posterior lens zonules, anterior hyaloid membrane, and posterior portion of the CB.

318
Q

Function of the CB

A

Aqueous humor production, Accommodation CN III.

319
Q

How is the CB innervated by parasympathetic

A

CN III carry SPCN

320
Q

Pars Plicata

A

Corona Ciliaris. Wide anterior portion that contains 70-80 Ciliary processes. The NPCE of the pars plicate is responsible for the production and secretion of aqueous humor into the posterior chamber

321
Q

Par Plana

A

Orbiularis ciliaris. Flatter, more posterior.

322
Q

Dentate processes

A

The teeth.

323
Q

Oral bays

A

Part of CB. The ovals.

324
Q

Enclosed oral bay

A

neighboring dentate processes joining together

325
Q

Valley of Kuhnt

A

Heavily pigmented areas located between ciliary processes.

326
Q

Where do the lens zonules come from

A

Mostly the NPCE of the pars plans.

327
Q

Course of he lens zonule

A

Produced by the pars plans and then course forward to the valleys of kunt before inserting in the lens capsule.

328
Q

Supraciliaris

A

The outermost layer of the ciliary body. Loosely attached to underlying sclera. It is a potential space. It is continuous with the suprachoriod at the ora errata. Blood vessels and nerves travel here.

329
Q

Where does a ciliary body detachment occur

A

Fluid in Supraciliaris

330
Q

Ciliary Muscle Longitudinal fibers

A

Outermost fibers that are most of the CM fibers. Originate at the SS and TM with legs extending into the chord as stellate shaped terminations (muscle stars)

331
Q

Radial fibers

A

Also extend from SS.

332
Q

Muller’s annular Muscle

A

Smallest CM fibers. Most medical and located near MACI. originates from SS and has same effect as sphincter

333
Q

Ciliary Stroma

A

Contains MACI.

334
Q

Pigmented Ciliary Epithelium

A

The outer cuboidal epithelial layer layer that is attached to the ciliary stroma.

335
Q

NPCE

A

Responsible for controlling aqueous

336
Q

What supplies the CB with blood

A

MACI

337
Q

What drains CB

A

Vortex veins

338
Q

Innervation of the CB

A
  1. CN III carry parasympathetic fibers from SPCNs. 2. SNS travels with SPCNs and LPCNs for arteries 3. Sensory nerves from V1 travel with LPCNs.
339
Q

Where is the choroid thickest

A

posterior pole 0.2 mm

340
Q

Where is choroid thinnest

A

Ora serrata 0.1 mm

341
Q

Suprachoroid

A

potential space between the sclera and choroid vessels. Passage of LPCN and SPCN occurs here

342
Q

Where do you see LPCN in BIO

A

3 and 9

343
Q

Who does the suprachorid layer belong to (lamina fuscha)

A

Both choroid and sclera. If there is a seperation part will stick to choroid and part to sclera.

344
Q

Choroidal stroma

A

Have choroidal blood vessels, nerves, and melanin. Innervated by the sympathetic NS which causes construction. The high density of bv and melanocytes gives the chance for nevus to occur.

345
Q

Haller’s Layer

A

Posterior layer of choir formed by SPCAs. Composed of large vessels that branch into smaller vessels in settler’s layer.

346
Q

Sattler’s layer

A

More anterior and smaller vessels that branch to form a capillary bed.

347
Q

Choriocapillaries

A

Composed of large fenestrated capillaries that are most concentrated in the macula. Nourishes the outer layers of the retina.

348
Q

Pericytes

A

surround blood vessels and regulate flow.

349
Q

Bruch’s Membrane

A

Thin innermost layer of choroid. Represents the fusion of the RPE and Choriocapillaris.

350
Q

Layers of bruch membrane

A

BM of choriocapillairis, Outer collagen layer, elastic layer, innercollegent layer, Bm of RPE.

351
Q

Functions of bruch membrane

A

allow passage of nutrients from choroid to Retina, Waste products pass to choroid, phosolipids accumulate with age and cause drusen and stop transport.

352
Q

What conditions have angoid streaks

A

PEPSI. Psuedoxanthoma elasticum, Ehlers-dahlos, Pagets, Sickle cells, Idiopathic

353
Q

What conditions cause neovacsularization

A

CH BALA. Choroid rupture, hitso, Bests, Angoid, Lacquer, ARMD.

354
Q

Innervation of the choroid

A

Sympathetic fibers cause vasoconstriction, CN VII parasympathetic from ptergyopalantine cause vasodilation, CN III parasympathetic have unknown function, CN V1 provides sensory information.

355
Q

Patellar fossa

A

Anterior depression of the vitreous due to the lens

356
Q

What type of collagen is the vitreous

A

Type II

357
Q

Where do most of the changes in vitreous with age occur?

A

Central vitreous

358
Q

Halocytes

A

The predominate cell type in the vitreous and are only found there. Synthesize HA and have phagocytic properties.

359
Q

Hyaluronic acid

A

The gag in the vitreous.

360
Q

Fibroblasts in the viterous

A

Predominately in the base and synthesize collagen.

361
Q

Virtual attachment from strongest–>weakest

A

Vitreous base, posterior lens, optic disc, macula, BV.

362
Q

Vitreous cortex

A

Outer region of the vitreous adjacent to the retina that extends to ora errata. High density of collagen fibrils, cells, proteins, a mucopolysaccharide filler substance.

363
Q

Anterior Hyaloid

A

Extends from the vitreous base to attach to the lens.

364
Q

Hyaloideocapsule ligament of Weiger

A

Strong circular adhesion between the anterior vitreous, posture zonules, and the posterior capsule of the lens.

365
Q

Berger’s space

A

Potential space between anterior hyaloid and the posterior lens capsule that is located in the central non-attachment area of Weiger.

366
Q

Posterior hyaloid

A

From vitreous base to ON.

367
Q

Cloquet’s canal

A

AKA hyaloid channel or retrolental tract. A normal remnant of primary vitreous in the middle of the vitreous. Low density liquid fluid surrounded by high density. The former sight of the hyaloid artery.

368
Q

What happens to the hyaloid artery

A

After birth it regresses to the optic disc where it becomes the CRA.

369
Q

Area of Martegiani

A

The posterior end of cloquet’s canal that is in contact with the OD.

370
Q

Epicapsular star

A

On anterior lens capsule. It is the embryological remnant of the former connection between the tunica vasculosa lentil and the posterior hyaloid artery.

371
Q

Mittendorf’s dot

A

Embryological remnant of the hyaloid artery on the posterior lens capsule

372
Q

Bergmeister’s papillae

A

Embryological remnant of the hyaloid artery on the optic disc.

373
Q

Function of RPE

A

Phagocytosis of Phot outer segments, Transfer of ions, water, and metabolites, Vitamin A storage, Blood retinal barrier, Absorbs light, produces growth factor.

374
Q

Inner segment of photoreceptors

A

Produce photopigments that are transported to outer segment.

375
Q

Myoid

A

The inner layer of inner segment. Makes protein.

376
Q

Ellipsoid

A

The outer layer of inner segment. Packed with mito for energy.

377
Q

Cilium

A

Connects the outer and inner segment.

378
Q

Outer Segment

A

Stacks of membrane discs that contain photopigments.

379
Q

OS of rods vs. cones

A

Disc membranes are continuous with disc in cones but are not in rods. (free floating)

380
Q

Where is the rod density greatest

A

5 mm (20 degrees) from the fovea in an area known as the rod ring.

381
Q

What wavelength does rhodopsin absorb maximally

A

507 nm

382
Q

What do rods terminate in

A

Sphericals

383
Q

Cyanolabe (blue)

A

440

384
Q

Chlorolabe (green)

A

535

385
Q

Erythrolabe (red)

A

565

386
Q

Where is the fovea

A

5 mm temporal and 0.4 mm inferior.

387
Q

ELM

A

Not a true membrane. Formed by mueller cels and inner segments of the photoreceptors

388
Q

ONL

A

Contains the cell bodies of rods and cones

389
Q

OPL

A

Synapses between Photo, horizontal, Bipolar.

390
Q

Rod Spherule

A

Can synapse with 1-4 rod bipolar cell dendrites and horizontal

391
Q

Con pedicule

A

Can form a synaptic triad (3 horizontal or 2 horizontal and one bipolar).

392
Q

Who can cone pedicure synapse with

A

Midget, flat, or diffuse flat bipolar cells.

393
Q

Henley’s layer

A

The OPL in the macula

394
Q

Where does OPL get is blood

A

booth choroid and retina.

395
Q

Who does CRA supply

A

NFL, GCL, IPL, INL, OPL

396
Q

Where does retinoschisis occur

A

OPL

397
Q

Where are hard exudates located

A

OPL

398
Q

INL

A

Cell bodies of bipolar, horizontal, interplexiform, amacrine, mueller cells.

399
Q

Midget bipolar cells

A

Connect to only one cone and one ganglion. Resolve fine detail. Found in the fovea.

400
Q

Flat bipolar cells

A

Connect with several photoreceptors

401
Q

Diffuse flat bipolar cells

A

Connect with numerous cone receptors (more than flat)

402
Q

Horizontal cells

A

Carry information laterally within the retina through synapse of photoreceptors, bipolar and other horizontal cells. Give inhibition.

403
Q

Interplexiform cells

A

Rely information between the IPL and OPL

404
Q

Amacrine cells

A

Connect bipolar, interplexiform, ganglion, and amacrine.

405
Q

Mueller cells

A

Found from ILM to ELM. Provide structural and nutritional support.

406
Q

Which cells in the retina are inhibitory

A

Horizontal and amacrine

407
Q

Layers the receive blood from the CRA

A

NFL and INL

408
Q

Inner Plexiform Layer

A

Amacrine cells synapse with self, bipolar, and ganglion.

409
Q

Bipolar vs. amacrine cells

A

opposite effects

410
Q

Ganglion Cell layer

A

Each ganglion cells has a single axon that travels and terminates in the lgn.

411
Q

P-cells

A

Type of ganglion cells. Deal with color and fine detail.

412
Q

Where in LGN do parvo axons go

A

3,4,5,6

413
Q

P1 cells

A

Midget ganglion cells. Most common. Have only one dendrite that synapses with one midget bipolar cell that synapse with one cone in fovea.

414
Q

P2 cells

A

Larger than P1 with multiple dendrites. Less common.

415
Q

M-Cells

A

Type of ganglion cell. Sensitive to dim changes in illumination and motion.

416
Q

What layer in LGN cells project

A

1,2,

417
Q

NFL

A

Composed of the axons that collectively form the ON

418
Q

Where is the ON thickest?

A

ISNT.

419
Q

Papillomacular bundle

A

NFL fibers that extend from the temporal macula and to the ON.

420
Q

CWS

A

(soft exudates) Located in the NFL

421
Q

Splinter hemorrahges

A

(dance hemes) are in NFL. Occur with normotensive glaucoma

422
Q

Flame hemorrhages

A

Within the NFL. Associated with retinal vascular pathology.

423
Q

Dot blot hemes

A

Within the NFL

424
Q

ILM

A

Formed by Muller cells.

425
Q

ILM over disc

A

Astrocytes take over for muller.

426
Q

Epiretinal membranes

A

Occur in the ILM and are commonly located in the macula.

427
Q

Mueller Cells

A

Located in ILM to ELM. Provide structural and nutritional support. Aid in glycogen metabolism (store so photoreceptors always have nutrients), act as a buffer, and absorb and recycle metabolic waste products.

428
Q

Fiber baskets

A

Although mueller not found within photo layer microvilli of the cells may extend and form a fiber basket

429
Q

Astrocytes

A

Help form the ILM at the optic disc. Similar functions as mueller cells

430
Q

Microglial cells

A

phagocytic cells that respond to inflammation or injury. Found everywhere.

431
Q

Role of neuroglia cells in Retinal processing

A

NONE

432
Q

Capillary networks in the retina

A

NFL and INL.

433
Q

cilioretinal artery

A

Branch from the SPCAs of the choriocapillaris that supplies the inner layer of the retina. Present in 15-20% of population.

434
Q

AV crossings

A

A and V share a common adventitia at crossings. Damage to the arterial wall results in venous wall compression and thrombus formation.

435
Q

Macula diameter

A

5.5 mm or 18 degrees

436
Q

Fovea

A

1.5 mm diameter (1DD).

437
Q

How much of fovea is avascular

A

0.4-0.5 mm.

438
Q

Foveala

A

0.35 mm in diameter and 0.13 mm in thickness. Has only photoreceptors.

439
Q

What photoreceptors are not in the foveala

A

No blue cones or rods

440
Q

Parafovea

A

0.5 mm zone that surround the fovea. Has all retinal layers. Thickest area of the retina.

441
Q

Clivus

A

In parafovea. Sloping of the retinal layers.

442
Q

Perifovea

A

1.5 mm zone. Occurs when ganglion cell layer becomes 4 cells thick. Boundary between perifovea and periphery occurs when ganglion cell is 1 cell thick.

443
Q

CN V

A

Trigeminal. Sensation and mastication.

444
Q

CN 8

A

Sensory. Hearing and balance.

445
Q

CN 9

A

Glossopharyngeal. Both. Post 1/3 taste, swallowing, salivation, monitors carotid sinus.

446
Q

CN 7

A

both. Facial expressions, lacrimation, salivation, ant 2/3 taste.

447
Q

CN 10

A

Vagus. Both. Taste, swallowing, palate elevation, talking, thoracoabdominal viscera.

448
Q

CN 11

A

Accessory. Motor. Head turn, shoulder shrug

449
Q

CN 12

A

Hypoglossal. Motor. Tongue movement.

450
Q

Where will the tongue devaiate

A

Towards the lesion

451
Q

Where will the uvula deviate?

A

Away

452
Q

What visual field does the optic tract carry

A

Information from the same side of the visual field.

453
Q

What destinations does CN II Have

A
  1. LGN 2. pretectcal nucleus (pupils) 3. Supeior colliculus (saccades)
454
Q

MLF

A

Connect CN III nucleus to CN IV, VI, and CN VIII.

455
Q

Which nucleus in CN III are ipsilateral?

A

MR, IR, IO

456
Q

Which nucleus in CN III are contralateral?

A

SR

457
Q

How many nucleus are there for the elevator?

A

ONE

458
Q

Where doe CN III travel close to

A

Posterior communicating artery

459
Q

Superior devision of CN III

A

SR, levator. Sympathetic fibers for mueller also comes.

460
Q

Inferior division of CN III

A

Innervates the MR, IR, IO, iris sphincter, and ciliary muscle. Has parasympathetic fibers from the EW

461
Q

Lesion of CN III

A

Eye down and out.

462
Q

A CN III that contains the pupil

A

Suspicious of aneurysm.

463
Q

What likely causes a pupil sparing CN III lesion

A

ischemia of the small blood vessels that nourish the inner fibers of CN III.

464
Q

Which is the longest and skinniest CN

A

CN IV.

465
Q

Where is CN IV located

A

At the midbrain by the inferior colliculus.

466
Q

What is unique about CN IV’s Path

A

ONLY cranial nerve to leave the dorsal side of the brain steam and cross to innervate the contraleral oblique.

467
Q

SOURS

A

SO tilt to unaffected side. SR to same side.

468
Q

Does CN IV go through the annulus of Zinn?

A

NO. It is superior.

469
Q

Which are the only two muscles that receive innervation from the contralateral nucleus

A

SO and SR.

470
Q

Division of the VI

A

Nasociliary, Frontal, Lacrimal

471
Q

Nasociliary division of V1

A

Includes Infratrochlear, LPCA, SPCA, and ethmoid.

472
Q

Frontal Nerve

A

Includes the supraorbital and supratrochlear.

473
Q

Lacrimal Nerve of V1

A

Provides sensory feedback to the lacrimal gland.

474
Q

Parasympathetic innervation to the lacrimal gland

A

The zygomatic (V2) carries parasympathetic fibers from CN VII from the ptergyopalantine ganglion to the lacrimal nerve of V1.

475
Q

V2 Maxillary Division

A

Includes the infraorbital and the zygomatic nerve.

476
Q

How does V2 enters the skulls

A

Foramen rotundum.

477
Q

V3

A

Mandibular devision. Provides sensory innervation to lower face and motor innervation for mastication.

478
Q

How does the abducens nerve travel?

A

Makes a tight bend over the petrous ridge of the temporal bone.

479
Q

What can cause CN VI palsy

A

increased ICP or Internal carotid artery anurysm

480
Q

Who travels closest to the internal carotid artery

A

CN VI

481
Q

Course of CN VII

A

Starts in frontal lobe, travels to the pons, go through the internal auditory canal and through the geniculate ganglion and then branches into the greater petrosal nerve and the chords tympanic nerve and the others go to the face.

482
Q

Greater petrosal nerve

A

Caries parasympathetic innervation to the lacrimal grand. Greater petrosal joins deep petrosal to form the vidian nerve that then goes to pterygopalantine ganglion and then join zygomatic branch that then communicates with V1.

483
Q

Chords tympani n.

A

Carries taste fibers from the anterior 2/3 of the tongue and para to submandibular and sublingual glands.

484
Q

Facial expression nerves

A

Main root of CN VII enters the parotid gland and divides into five branches to supply the muscles of the facial expression

485
Q

Temporal branch of facial expression

A

Supplies procures, corrugated, occipital frontal, and orbicularlis oculi

486
Q

Zygomatic branch of facial expression

A

Orbicularis occult.

487
Q

Does CN VII innervate the parotid gland?

A

No the glossopharyngeal does. It just divides in there

488
Q

What happens in the parotid gland

A

CN VII splits and the superficial temporal vein joins with the maxillary vein to form posterior facial vein.

489
Q

Stroke

A

supra nuclear. Contralateral impaired innervation to he contralateral muscles of the lower face.

490
Q

Bell’s palsy

A

Lower motor neuron. Ipsilateral. Impaired innervation of upper and lower.

491
Q

Where does parasympathetic innervation come from?

A

CN III and CN VII

492
Q

Sympathetic innervation to the eyes?

A

Travels with ICA. Can branch to CN III for mueller, CN V1 to travel with LPCNs or SPCNs to iris dilator or choroidal and conj blood vessels, or blood vessels of the lacrimal n. by the vidian nerve.

493
Q

1st order sympathetic fibers

A

Begin in hypothalamus and decent in C8-T2 to synapse in ciliospinal center of Budge

494
Q

2nd order sympathetic fibers

A

leave the ganglion and travel around the clavicle an across the apex of the lungs before entering the superior chain ganglion

495
Q

Post ganglionic fibers

A

Come from the superior chain ganglion and travel with ICA through carotid canal.

496
Q

Where is the CSF?

A

subarachnoid.

497
Q

Intraorbital potion of ON

A

surrounded by pia, arachnoid, and dura.

498
Q

What surround the intracranial portion of the ON?

A

Only the pia mater.

499
Q

Why do we get papilledema?

A

CSF fluid spreads into the ON.

500
Q

What provides myelination after the lamina cribosa?

A

oligodendrocytes

501
Q

Why is there pain on eye movement with lamina cribosa?

A

The SR and MR shares an optic sheath with the ON.

502
Q

Can the optic nerve auto regulate?

A

Yes!

503
Q

Where is the ON located

A

15 degrees from fixation

504
Q

Is the On larger vertically or horizontally

A

vertically

505
Q

What is the ILM for the ON

A

Astrocytes (not mueller)

506
Q

How long is the ON

A

50-60 mm

507
Q

Pre-laminar ON

A

Anterior to lamina cribosa. No myelin.

508
Q

Intermediary tissue of Kuhnt

A

Separates ON tissue from rest of retina.

509
Q

Border tissue of Jacoby

A

Separates the ON from the choid

510
Q

Border tissue of elsching

A

Sclera collagen fibers surround glial tissue around the ON.

511
Q

Intraorbital portion

A

30 mm. From lamina cribosa to exiting the skull. S-shaped. Myelinated.

512
Q

Intracanalicular

A

6-10 mm. Through the optic canal in the cranium.

513
Q

Intracranial

A

10-16 mm. Portion of the optic nerve extending from the optic canal to the optic chasm.

514
Q

Anterior knees of wilbrand

A

Inferior nasal fibers that loop anterior into the contralateral track. AIC.

515
Q

Posterior knees of wilbrand

A

Superior nasal fibers that loop posteriorly into the ipsilateral optic tract before crossing through the optic chasm. PIS.

516
Q

Optic Track

A

Superior are medial side, Inferior are lateral. Macular are middle.

517
Q

LGN layers

A

At the thalamus. Mango layers 1,2. Parvocellular 3-6. Koniocellular are between.

518
Q

Uncrossed fibers of the optic synapse in

A

2,3,5

519
Q

Crossed fibers of the optic synapse in

A

1,4,6

520
Q

The orientation of different fibers

A

Superior are medial. Inferior are lateral.

521
Q

Optic radiation inferior

A

Inferior radiations-fibers travel through the temporal lobe and around the lateral ventricle into the parietal lobe and form meter’s loop

522
Q

Optic radiation superior

A

Superior radiation-Course directly through inferior parental lobe and terminate in occipital lobe.

523
Q

Optic radiation mnemonic

A

SPIT(M).

524
Q

Calcimine fissue

A

Divides occipital lobe into anterior and posterior

525
Q

Cuneus gyrus

A

Superior fibers terminate here

526
Q

Lingual gyrus

A

Inferior terminate here

527
Q

SCIL

A

Superior cuneus, inferior lingual.

528
Q

Macula in V1

A

Project to the outer surface of the apex of the occipital lobe. Superior to cuneus and inferior to lingual.

529
Q

Summary of inferior retinal fibers

A

lower fibers course laterally in optic tract to form milers loop and end in lingual gyrus.

530
Q

Layer 4 of V1

A

Synapses between optic radiations and neurons in cortex. Sent to higher cortical area for processing

531
Q

Layer 5 of V1

A

Send to superior colliculus

532
Q

Layer 6 of V1

A

Provide feedback to lgn.

533
Q

Ocular dominance columns

A

in V1. fibers from only one eye

534
Q

Blood supply to optic chiasm

A

Circle of willis and branches of ICA

535
Q

Blood supply to the optic tracts

A

Anterior choroidal branch of the middle cerebral artery

536
Q

LGN blood supply

A

Suppled by anterior choroidal and posterior cerebral arteries

537
Q

Optic radiation blood suply

A

Suppled by anterior choroidal, middle cerebral, and posterior cerebral

538
Q

V1 blood supply

A

posterior cerebral artery and middle cerebral artery

539
Q

Post chasmal lesion

A

Homonymous visual field defects on the same side.

540
Q

Most posterior a post chasmal lesion is located the more ______ the defect is

A

congruous

541
Q

Temporal lobe defects

A

Defect for inferior eye–>superior VF defect. Pie in the sky.

542
Q

Parental lobe defects

A

Defects of superior eye–>pie on the floor.

543
Q

Which VF results in asymmetrical OKN response?

A

Parietal

544
Q

Is visual acuity affected in post chasmal lesions

A

No. Unless bilateral lesions are present. Only if both blood supplies to V1 are obstructed and that is rare.

545
Q

Macular sparing homonymous hemianopsia

A

most commonly a stroke that affected middle or posterior cerebral but not both.

546
Q

Macula only homonymous hemianopsia

A

Most likely a tumor that has compresses both blood supplies to the macula cortex.

547
Q

Bitemperoal hemianopis

A

Pituitary gland tumor

548
Q

Junctional scotoma

A

Optic chiasm lesion that gets central vision loss in one eye and anterior knee of wilbrand.

549
Q

Vf defects that respect the horizontal midline

A

Lesions anterior to the chiasm

550
Q

What are most homonymous hemianopsia due to ?

A

Strokes. (except macula only homonomoys hemianopsia)

551
Q

ON lesions

A

Asymmetrical. Typically respect the horizontal median.

552
Q

Retinal lesions

A

Asymmetrical. Will not respect any midline.

NBEO Part 1 (17 decks)

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