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Opthalmology > Anatomy > Flashcards

Anatomy Flashcards

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1
Q

How much cerebral spinal fluid is circulating in you?

A

400-500mls

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2
Q

Where is CSF produced?

A

Choroid plexus of the ventricles

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3
Q

How is CSF reabsorbed?

A

Through the arachnoid granulations and into the dural venous sinuses

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4
Q

Which level should you do a lumbar puncture?

A

L3/L4

L4/L5 IV disc

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5
Q

Where does the subarachnoid space end?

A

Ends at the level of the S2 part of the sacrum

spinal cord ends at L1/L2

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6
Q

Where is the 3rd ventricle?

A

In the midline within the diencephalon

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7
Q

Where are the left and lateral ventricles?

A

In the cerebral hemisphere

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8
Q

What does the cerebral aqueduct connect?

A

The cerebral aqueduct connects the 3rd and 4th ventricles in the midline

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9
Q

Where is the 4th ventricle?

A

In between the cerebellum and pons

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10
Q

Circulation of CSF

A

1) secreted by choroid plexus
2) Right & left ventricles
3) 3rd ventricle
4) cerebral aqueduct
5) 4th ventricle
6) Mainly subarachnoid space (but some passes into the central canal)
7) reabsorbed from subarachnoid space via the arachnoid granulations
8) into the dural venous sinuses

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11
Q

Sensory supply to the dura mater?

A

CNV

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12
Q

Raised ICP and optic nerve

A

Raised ICP will compress optic nerve

It will also compress central artery and vein of retina

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13
Q

Visual symptoms of optic nerve compression and raised ICP

A 
transient visual obscurations (graying-out of vision), 
transient flickering
blurring of vision
constriction of the visual field
decreased colour perception
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14
Q

Which nerve might be damaged by tentorial herniation?

A

Occulomoter nerve (CNIII)

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15
Q

Which nerve supplies 4 extra-ocular muscles and eyelid and innervates the sphincter of the pupil (controls constriction of the pupil) etc?

A

Oculomotor

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16
Q

What will the eye look like if the oculomotor nerve is damaged?

A

“down and out”

-loose/slowness of pupillary light reflex, dilated pupils, ptosis, eye turned inferolaterally

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17
Q

Name two of the septa produced when the dura mater folds?

A

Falx cerebri

Tentorium cerbelli

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18
Q

Somebody has diploplia when looking down and they can’t move their eye infermedially, which nerve is damaged?

A

The trochlear nerve (CNIV)

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19
Q

Damage to which nerve results in paralysis of the superior oblique muscle?

A

Trochlear nerve (CNIV)

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20
Q

Eye cannot move laterally in horizontal plane (medial deviation of eye)

A

Damage to the abducent nerve

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21
Q

If you fracture your zygoma, what tends to happen to it?

A

It rotates medially

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22
Q

A thick fascial sling that holds the eye just above the floor of the orbit

A

The suspensory ligament of the eye

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23
Q

What lies in the infraorbital canal?

A

The infraorbital NVB

-This can be damaged in a zygoma fractue resulting in general sensory deficit of the facial skin

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24
Q

Infraorbital nerve

A

Large branch of V2

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25
Supraorbital nerve
Large branch of V1
26
What does the superior oblique muscle do?
Intorsion of the eye Depression in adduction Abduction (weak)
27
Head tilt
CNIV
28
Painful third nerve palsy
Aneursym!!
29
What does the medial longitudinal fasciculus do?
It connects CNIII, CNIV and CNVI and carries information about which ways the eye should move
30
Which nerves supply the angle of the mandible?
CN2, CN3 spinal nerves
31
CNV1 and the eye
The upper eye lid Cornea The conjunctivae The skin at the root/bridge/tip of the nose
32
CNV2 and the eye
the skin of the lower eyelid the skin over the maxilla the skin of the ala of the nose the skin/mucosa of the upper lip
33
CNV3 and the eye
supplies: the skin over the mandible and temporomandibular joint (apart from the angle of the mandible – supplied by C2,3 spinal nerves)
34
The blink (corneal reflex)
CNV1 --> tigeminal ganglion --> trigeminal nerve (CNV) --> pons Action potentials --> CNVII --> eyelid part of orbicularis oculi
35
Which nerve innervates the anterior surface of the eye so that it is sensitive to touch?
CNV1
36
Ciliary body
Helps the lens to focus
37
Which level do the presynaptic sympathetic axons leave the CNS?
exit the spinal cord in T1 spinal nerve and then… ascend within the sympathetic trunk and then… synapse in the superior cervical sympathetic ganglion
38
Which artery carries sympathetic axons into the orbit?
The opthalmic artery (an intracranial branch of the internal carotid artery) carries sympathetic axons into the orbit
39
Stellate ganglion
Inferior cervical ganglia and the 1st thoracic ganglia sometimes fuse to form the Stellate ganglion
40
CNIII
eye
41
CNVII
Submandibular and sublingual salivary gland
42
CNIX
Parotid salivary gland
43
CNX
the vagus nerves supply parasympathetic axons to the organs of the neck/chest & abdomen as far as the midgut
44
Where do the sacral spinal nerves carry parasympathetic axons to?
The sacral spinal nerves carry parasympathetic axons to the hindgut, PELVIS and perinium
45
Which nerve carries presynaptic parasympathetic axons to the ciliary ganglion?
CNIII (somatic) motor to superior (SR), medial (MR) & inferior rectus (IR) and inferior oblique (IO) (somatic) motor to levator palpebrae superioris (LPS) presynaptic parasympathetic axons to the ciliary ganglion
46
Where does CNIII connect with the CNS?
connects with the CNS near the midline at the junction between the midbrain and the pons
47
What do the ciliary nerves supply?
The ciliary nerves supply autonomic axons to control the diameter of the iris (&pupil) and the refractive shape of the lens -The long ciliary nerve forms the first part of the afferent limb of the blink (corneal) reflex
48
Vestibuloocular reflex
- turns the eyes in the opposite direction to a head movement (to stabilise the gaze on an object during head movements) - CNS connections between CN VIII & CNs III, IV & VI
49
Purpose of the suspensory ligament of the lens?
connects the circumferences of the lens & the ciliary body
50
How do sympathetic axons course from the CNS to the organs of the head region?
Cell body of presynaptic neurone in the CNS --> ganglion of the cervical part of the sympathetic trunk --> post synaptic axon to ganglion
51
Which level of the spinal cord do the presynaptic sympathetic axons leave from?
Leave from T1 spinal nerve and then ascend within sympathetic trunk and then synapse in the superior cervical sympathetic ganglion ..Then the postsynaptic sympathetic axons enter the internal and external carotid arteries etc...
52
Which nerve supplies the lacrimal gland?
CNVII | also supplies submandibular and sublingual salivary glands
53
Which nerve supplies the submandibular and sublingual salivary glands?
CNVII (also lacrimal gland)
54
Parasympathetic axons to hindgut, pelvis and perineum?
Sacral spinal nerves
55
parasympathetic axons to the organs of the neck/chest & abdomen as far as the midgut
Vagus nerve
56
(somatic) motor to superior (SR), medial (MR) & inferior rectus (IR) and inferior oblique (IO) (somatic) motor to levator palpebrae superioris (LPS) presynaptic parasympathetic axons to the ciliary ganglion
CNIII (the oculomoter nerves)
57
Which nerves pass through the superior orbital fissure? | Pneumonic : Lazy French Tarts Sit Nakedly In Anticipation
L: lacrimal nerve F: frontal nerve (a branch of the ophthalmic nerve) T: trochlear nerve (CN IV) S: superior division of the oculomotor nerve (CN III) N: nasociliary nerve (a branch of the ophthalmic nerve) I: inferior division of the oculomotor nerve (CN III) A: abducens nerve (CN VI)
58
Which nerve supplies the superior rectus and LPS?
Superior branch of CNIII
59
Which nerve supplies the lateral rectus?
CNVI | abducens
60
Which nerve supplies the MR, IR and IO? & Ciliary ganglion?
The inferior branch of CNIII
61
Where does CNIII connect with the CNS?
Junction between the pons and midbrain
62
What type of fibres does the long ciliary nerve contain?
Sympathetic motor and somatic sensory | -form the first part of the afferent limb of the blink reflex
63
What type of fibres are contained in the short ciliary nerve?
Parasympathetic and sympathetic
64
What do the ciliary nerves do?
Control the diameter of the iris (&pupil and the refractive shape of the lens)
65
The autonomic reflexes of the eye
-VESTIBULO-OCULAR REFLEX -THE OCULOCARDIAC REFLEX Maximal eyelid elevation Pupillary light reflex The accomodation reflex Lacrimation
66
Pupillary light reflex
Adjusting light entry
67
The accomodation reflex
Far and near vision
68
The vestibulo-ocular reflex
ocular reflex - turns the eyes in the opposite direction to a head movement (to stabilise the gaze on an object during head movements) - CNS connections between CN VIII & CNs III, IV & VI
69
The oculocardiac reflex
reflex bradycardia in response to tension on the extraocular muscles or pressure on the eye - CNS connections between CN V1 & CN X
70
Open eyes wider (get more light into the eye) Focus on far objects Emotional lacrimation
Sympathetic function
71
Allow orbicularis oculi to work?
Parasympathetic function
72
Get less light into the eye, focus on near objects, reflex lacrimation -Allow orbiculairs oculi to work
Parasympathetic function
73
How do postsynaptic fibres reach levator palpebrae superioris?
levator palpebrae superioris via: the superior cervical sympathetic ganglion the internal carotid nerve the internal carotid plexus axons carried on the ophthalmic artery… and on its branches to the orbital structures
74
Non-physiologically dilated pupil?
Mydriatic pupil
75
The mobile insertion of the radially arranged dilator pupillae fibres?
Internal surface of the iri
76
The fixed origin of the radially arranged dilator pupillae fibres?
External circumference of the iris
77
part of Horner's syndrome?
non-physiologically constricted pupil (miotic pupil)
78
Non-physiologically constricted pupil?
Miotic pupil
79
Drugs which might cause a pin point pupil?
Opiates
80
Fixed dilated pupil is a sign of which nerve pathology?
CNIII pathology | -inhibiting the pupillary constricting action of the parasympathetic axons in the ciliary nerve
81
Nerves in pupillary dilatation?
Dilator pupillae fibres
82
Nerves in pupillary constriction?
Sphincter pupillae fibres
83
Direct light reflex and consensual light reflex?
The sensory afferent limb of the reflex is the ipsilateral CNII (optic nerve) The motor limb of the reflex is bilateral VIA CNsIII (OCULOMOTOR NERVES)
84
Where are the bodies of the parasympathetic CNIII axons located?
Edinger Westphal nucleus
85
What kind of muscle is contained in the levator palpebrae superioris?
Skeletal PLUS smooth muscle
86
The accommodation reflex ---> response to the near
1) bilateral pupillary constriction (CNIII) 2) bilateral convergence (medial rotation of both eyes: CNIII) 3) Bilateral relaxation of the lens, the lens becomes spherical due to contraction of the ciliary muscles) (CNIII)
87
The ciliary muscles in far/near vision?
The ciliary muscles relax in far vision and contract in near vision
88
What do basal tears contain?
Lysosome
89
Nerves involved in reflex tears? (extra tears in response to mechanical or chemical stimulation)
(the ophthalmic nerve) from the cornea/conjunctiva | the efferent limb is parasympathetic axons originating from CN VII (the facial nerve)
90
How do CNVII axons reach the lacrimal gland?
branches of V1 and V2 carry the axons to the lacrimal gland
91
Primary headache syndrome
No obvious underlying cause for the headache
92
Secondary headache syndrome
Where the headache is a symptom of an underlying medical problem

Opthalmology (10 decks)

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