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Ophthalmology > Anatomy 2- Orbital Autonomics > Flashcards

Anatomy 2- Orbital Autonomics Flashcards

1
Q

Where does CNV1 supply?

A

Upper eyelid, cornea, conjunctiva, skin of the root/bridge, tip of nose

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2
Q

Where does CNV2 supply?

A

Skin of the lower eyelid, maxilla, ala of nose, upper lip

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3
Q

Where does CNV3 supply?

A

Skin over the mandible and TMJ joint

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4
Q

What supplies the angle of the mandible?

A

C2/3 spinal nerves

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5
Q

The supra/infraorbital nerves are branches of what?

A

Supraorbital- CNV1, infraorbital- CNV2

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6
Q

In the blink reflex, something touches the cornea, and APs are conducted via what nerves to where?

A

From the cornea to the trigeminal ganglion via CNV1 branches. Then along CNV to the pons.

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7
Q

In the blink reflex, central connections are made at the CNS between what two nerves?

A

CNV and CNVII

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8
Q

In the blink reflex, what happens after connections have been made at the CNS?

A

APs are conducted via CNVII to the palpebral part of orbicularis oculi

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9
Q

In the skin, what type of innervation is found in the arterioles, sweat glands and arrestor muscles?

A

Sympathetic

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10
Q

Does the brain have motor function?

A

No

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11
Q

The anterior surface of the eyes are sensitive to touch. What nerve is responsible for this?

A

CNV1

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12
Q

Where do sympathetic axons originate from and where do they pass to?

A

Originate from autonomic centres in the brain and pass down the spinal cord

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13
Q

Where do sympathetic axons exit the spinal cord and where do they pass to?

A

They exit at T1-L2 spinal nerves (thoracolumbar outflow) and pass into the sympathetic chain

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14
Q

Where do sympathetic axons pass into from the sympathetic chain?

A

All spinal nerves (anterior and posterior rami) and then into splanchnic nerves to supply all organs

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15
Q

All anterior and posterior rami will have what 3 types of innervation?

A

Somatic motor, somatic sensory and sympathetics

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16
Q

Where do presynaptic sympathetic axons from the CNS synapse? What do they then become?

A

They synapse at the superior cervical ganglion to become postsynaptic sympathetic axons

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17
Q

How do postsynaptic sympathetic axons get to the orbit?

A

They enter the internal/external carotid nerves and then pass onto the internal/external carotid arteries where they are carried to the organs of the head. The ophthalmic artery carries them into the orbit.

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18
Q

Where do parasympathetic axons leave the CNS?

A

Cranial nerves III, VII, IX and X and via sacral spinal nerves (craniosacral outflow)

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19
Q

What do parasympathetics supply?

A

Internal organs

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20
Q

Where in the head receives parasympathetic supply?

A

Eye, lacrimal gland and salivary glands

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21
Q

What does the vagus nerve supply?

A

Organs of the neck, chest and abdomen as far as the midgut

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22
Q

Sacral spinal nerves carry parasympathetic nerves to where?

A

Hindgut, pelvis and perineum

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23
Q

What is CNIII?

A

Oculomotor nerve

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24
Q

Where does CNIII attach with the CNS?

A

The junction between the midline and pons and passes through the cavernous sinus

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25
Q

Where does CNIII exit the skull?

A

Superior orbital fissure

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26
Q

The oculomotor nerve supplies somatic motor supply to where?

A

Superior, medial, inferior rectus muscles, inferior oblique and LPS

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27
Q

The oculomotor nerve supplies presynaptic parasympathetic axons to where?

A

Ciliary ganglion

28
Q

Where does the superior division of CNIII supply?

A

SR and LPS

29
Q

Where does the inferior division of CNIII supply?

A

MR, IR, IO and ciliary ganglion

30
Q

Ciliary nerves supply autonomic axons to do what?

A

Control the diameter of the iris and refractive shape of the lens

31
Q

What fibres do long ciliary nerves contain?

A

Sympathetic, somatic sensory

32
Q

What fibres do short ciliary nerves contain?

A

Sympathetic and parasympathetic

33
Q

What is the accommodation reflex?

A

Focussing the lens on near and far

34
Q

Describe the vestibulo-ocular reflex? It involves CNS connections between where?

A

Turns the eyes in the opposite direction to a head movement. Involves CNS connections between CNVIII and CNs III, IV and VI

35
Q

Describe the oculocardiac reflex? It involves CNS connections between where?

A

Reflex bradycardia in response to tension on extra ocular muscles or pressure on the eye. Involves CNS connections between CNV1 and CNX

36
Q

What nerve fibres are involved in opening the eyes really wide?

A

Sympathetic

37
Q

What nerve fibres focus on far objects? (dilate pupil)

A

Sympathetic

38
Q

What nerve fibres focus on near objects? (constrict pupil)

A

Parasympathetic

39
Q

What nerve fibres are involved in reflex lacrimation?

A

Parasympathetic

40
Q

What muscle is involved in opening the eyes in fight or flight response?

A

Smooth muscle part of the LPS

41
Q

What is a mydriatic pupil?

A

A non-physiologically enlarged pupil e.g. due to mydriatic drugs

42
Q

What muscle is responsible for dilating the pupil?

A

Dilator pupillae

43
Q

Where does the dilator pupillae muscle originate and insert?

A

Originates around the external surface of iris (fixed) and insert around the internal surface of the iris (mobile)

44
Q

What is a mitotic pupil? Give an example of a syndrome where this is seen.

A

A non-physiologically constricted pupil- can be seen in Horner’s Syndrome

45
Q

A fixed pin point pupil can be a serious pathological sign of what?

A

Opiate drug use

46
Q

A fixed dilated ‘blown’ pupil can be a serious pathological sign. It can indicate pathology in what cranial nerve?

A

CNIII

47
Q

In the pupillary light reflex, what is the sensory afferent limb?

A

Ipsilateral optic nerve

48
Q

In the pupillary light reflex, where do CNS connections occur?

A

Midbrain

49
Q

In the pupillary light reflex, what is the motor efferent limb?

A

Bilateral oculomotor nerve

50
Q

In the pupillary light reflex, a direct light reflex occurs in which eye?

A

Stimulated eye

51
Q

In the pupillary light reflex, a consensual light reflex occurs in which eye?

A

Non-stimulated eye

52
Q

The pupillary light reflex involves a how many neurone chain?

A

4

53
Q

What are the 1st neurones involved in the pupillary light reflex?

A

Retinal ganglion cells

54
Q

The 2nd neurones in the pupillary light reflex are located entirely within where?

A

The midbrain

55
Q

The 3rd neurones in the pupillary light reflex exit the midbrain to synapse where?

A

Ciliary ganglion

56
Q

The 4th neurones in the pupillary light reflex have a course in the short ciliary nerves to act on which muscles?

A

Sphincter pupillae muscles

57
Q

The suspensory ligament of the lens connects what?

A

The circumference of the lens and ciliary body

58
Q

What type of muscle is the ciliary body?

A

Smooth

59
Q

What happens to the ciliary muscles, suspensory ligament and lens in far vision?

A

Ciliary muscles relax, the ligament tighten and the lens flattens

60
Q

What happens to ciliary muscles in near vision? What nerve fibres are responsible for this?

A

The contract- parasympathetics

61
Q

What happens to the suspensory ligament and lens in near vision?

A

Ligament relaxes and the lens becomes spherical

62
Q

What does lysozyme do?

A

Hydrolyses bacterial cell walls

63
Q

What is the afferent limb in reflex tears?

A

CNV1 from cornea/conjunctiva

64
Q

What is the efferent limb in reflex tears?

A

CNVII

65
Q

What are the main symptoms of Horner’s syndrome?

A

Ipsilateral mitosis, ptosis, anhydrosis, increased warmth and redness

66
Q

What causes Horner’s syndrome?

A

Impaired sympathetic innervation to the head and neck from compression of the cervical sympathetic trunk

67
Q

Name 5 causes of Horner’s syndrome?

A

Root of neck trauma, carotid dissection, internal jugular vein engorgement, deep cervical node metastases, pancoast tumour

Ophthalmology (12 decks)

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