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MB2: Ophthalmology > Anatomy > Flashcards

Anatomy Flashcards

(97 cards)

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1
Q

bones of the bony orbit

A 
frontal 
ethmoid 
zygomatic 
maxilla 
lacrimal 
palentine 
nasa 
sphenoid
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2
Q

where is the optic canal located in relation to the bony orbit

A

posteromedially

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3
Q

what is the gap between the greater/lesser sphenoid wing called and what passes through it

A

superior orbital fissure

cranial nerves III, IV, VI

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4
Q

what bone is the supraorbital notch found on and what is in it

A

frontal

supraorbital neurovascular bundle with supraorbital nerve as a branch of opthalamic branch of trigeminal

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5
Q

what bone is the infraorbital foramen found on and what is in it

A

maxilla

infraorbital neurovascular bundle with infraorbital nerve as a branch of maxillary division of the trigeminal

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6
Q

the bony orbit can be described as a pyramid shape. what is the base of this ‘pyramid’ known as

A

orbital rim

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7
Q

the eyes face ____ and the bony orbit faces ___ and so they do/dont line up

A

anterior
anterolateral
they dont line up

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8
Q

describe how the eye is protected by the bony rim

A

superior overhangs inferior to prevent eye trauma

bones are quite strong

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9
Q

what is a blowout fracture

A

traumatic strike to the bony rim carries energy back to the orbital plates and causes fracture

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10
Q

besides a blowout fracture where else is a fracture common after strike to bony orbit

A

orbit rim sutures

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11
Q

where are the bony plates found

A

frontal bone superior
ethmoid bone medially
maxilla inferiorly

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12
Q

most superficial muscle to the eyelid, function and innervation

A

orbicularis oculi
orbital - tight closing of eye
palpebral part for gentle eye closing
facial nerve CN VII

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13
Q

what muscular thick layer is deep to orbicularis oculi

A

superior and inferior tarsus

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14
Q

function of LPS and attachment

A

elevates superior eyelid
attaches to superior tarsus and superior eyelid
originates from lesser wing sphenoid

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15
Q

function of tarsus gland

A

produces lipids to prevent tears overflowing

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16
Q

describe the flow of lacrimal fluid over the eye and drainage

A

washes over eye lateral to medial and drains through canaliculi to lacrimal puncta, moving to lacrimal sac and nasolacrimal sac
drains to inferior meatus of nasal cavity

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17
Q

rectus muscles of the eye?

A

superior rectus
inferior rectus
lateral rectus
medial rectus

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18
Q

oblique muscles of the eye?

A

superior oblique

inferior oblique

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19
Q

what does the inferior oblique originate from and what does it attach to

A

originates from orbital plate of the maxilla and inserts onto the sclera

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20
Q

innervation to the muscles of the eye

A

LR6 SO4 AO3
lateral rectus is CN IV
Superior oblique is CN IV
all others are CN III

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21
Q

what covers the sclera of the eye

A

conjunctiva

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22
Q

what covers the iris of the eye

A

cornea

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23
Q

true/false - cornea receives nutrient from small conjunctival vessels

A

false - it is avascular and receives its nutrient from lacrimal fluid and aqueous

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24
Q

what is the conjunctival fornix

A

junction where the conjunctiva is reflected from the sclera to the eyelid

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25
what is the limbus of the eye
corneoscleral junction
26
layers of the eye?
fibrous uvea retina
27
contents of the fibrous layer of the eye
sclera | cornea
28
contents of the uvea
iris ciliary body choroid
29
what is the anterior segment and what can it be subdivided into
segment of eye in front of lens anterior chamber between iris and cornea posterior chamber between iris and suspensory ligaments
30
what is the posterior segment of the eye and what makes it up
behind lens of the eye | made up of vitreous body, jelly like to transmit light and hold the retina in place
31
describe the circulation of aqueous in the anterior segment of the eye
ciliary processes secrete aqueous circulates through posterior chamber and nourishes lens passes into anterior chamber and nourishes cornea reabsorbed by scleral venous sinus at iridocorneal angle
32
describe the venous drainage of the eye
superior/inferior opthalmic veins drain to cavernous sinus through superior orbital fissure central vein drains direct to cavernous sinus some smaller veins frain to the pterygoid plexus
33
what is the danger triangle of the face and why is it possibly dangerous
upper lip to external nose all facial and forehead veins within the danger triangle drain to the cavernous sinus and cranial cavity means superficial infections can spread deep to cranial cavity
34
describe the arterial supply of the eye
internal carotid passes to opthalmic artery and passes optic canal to supply eyeball, lacrimal gland, muscles, forehead, scalp ciliary arteries supply choroid centra artery to retina
35
what is important about the arterial and venous drainage of the retina
they are end arteries/veins so occlusion leads to tissue ischaemia and death
36
what is the fundus
posterior layer where light is focused | optic disk, macula, fovea
37
what is the optic disk
point of CNII formation | only point of entry for blood vessels and axons of CN II
38
true/false - the optic disk is a visual blind spot
true
39
what is the macula
greatest density of cones
40
what is the fovea
centre of macula and area of most acute vision
41
layers of the optic disk and retina?
photoreceptors - posterior and sense light ganglion cells - ant to photoreceptors and synapse photoreceptors for light perception axons of ganglion cells - come together to form optic nerve
42
describe the visual pathway
light enters the nasal and temporal retina of the eye this enters the optic nerve and then enters the optic chiasma nasal visual field crosses over to other side of the chiasm and combines with temporal to form optic canal synapse with genicular bodies to form optic radiation enters visual cortex
43
movement of superior rectus and innervation
can only elevate in abduction | CN III
44
movement of inferior rectus and innervation
when held in abduction can only depress | CN III
45
movement of medial rectus and innervation
can only adduct eyeball | CN III
46
movement of lateral rectus and innervation
can only abduct eyeball CN IV brings line of gaze into path superior and inferior rectus
47
movement of superior oblique and innervation
when in adduction it can only depress | CN IV
48
movement of inferior oblique and innervation
when in adduction can only elevate | CN III
49
describe pure elevation
inferior oblique and superior rectus synergistically elevate eyes antagonistically rotates eyes
50
describe pure depression
superior oblique and inferior rectus synergistically depress eyes and are antagonists to adduct/abduct
51
what muscles mediate bilateral eye movement at the same time
yolk muscles
52
for testing elevation and depression of the eyes, why does the testing of superior and inferior retus need done in abduction
to correctly angle the origin and attachment to allow for accurate true eye movements
53
describe the passage of sympathetic innervation to the orbit
exits T1 and passes up sympathetic chain to superior cervical ganglion enters internal/external carotid nerves and pass on surface of int/ext carotids opthalamic artery carries sympathetic axons to orbit
54
what cranial nerves are parasympathetic
sacral outflow | CN III, VII, IX, X
55
describe parasympathetic innervation to the orbit
parasympathetic, mainly CN III, synapses in ciliary ganglion
56
true/false - sympathetics and sensory fibres also synapse in ciliary ganglion
false - they can pass through it but they dont synapse
57
describe the path of CN III
connects with CNS at pons/midbrain passes through cavernous sinus exits supraorbital fissure splits into superior/inferior division
58
sensory innervation of the opthalmic division trigeminal
``` upper eyelid cornea conjunctiva tip of nose forehead ```
59
sensory innervation of the maxillary division of the trigeminal
lower eyelid and maxilla
60
sensory innervation of the mandibular division of the trigeminal
sensory to mandible and TMJ | motor for muscles of mastication
61
describe the blink reflex
APs conducted from cornea to CN V1, carried to trigeminal ganglion to CN V and then to pons connection to facial nerve motor AP carried down CN VII to ocularis oculi
62
what is the vestibulo-ocular reflex and what nerves mediate it
turning of eye in opposite to head movement on focusing on object to stabilise gaze CN VIII, CNIII, IV, VI
63
hat is the oculocardiac reflex and what nerves mediate it
reflex bradycardia in response to tension on extraocular muscles or pressure on eye mediated by CN V1 and CNX
64
parasympathetic actions on the eye
less light into eyes focus on near objects reflex lacrimation to wash away foreign stimuli and clean cornea
65
sympathetic actions on the eye
opens eye wider | more light into eyes
66
what is muellers muscle and what innervates ir
elevates eyelid marginally | small slip of smooth muscle off LPS that has sympathetic innervation
67
describe pupillary constriction
parasympathetics constrict by sphincter pupillae muscles
68
describe pupillary dilation
sympathetic widens pupil by activating dilator pupillae muscles
69
origin and insertion of dilator pupillae muscles?
radially arranged fixed onto external iris mobile on the internal circumference of iris
70
what is a mydriatic pupil
non-physiologically enlarged pupil
71
what may cause mydriatic pupil
mydriatic drugs
72
what is a miotic pupil
non-physiologically constricted pupil
73
what may cause a miotic pupil
horners syndrome
74
what may cause a blown pupil
CN III pathology
75
what may cause fixed pin point pupils
opiate drugs
76
describe the path of the pupillary light reflex
bright light is shone into eye and this interpretation is taken by optic nerve to ipsilateral pretectal nucleus in the brain stimulates BOTH edinger westphal nuclei in the midbrain CN III carries motor function to pupils to cause bilateral constriction in stimulated and consensual eye
77
describe lens accommodation in far vision
parasympathetic innervation causes relaxation of the ciliary body to lead to tightening of the suspensory ligaments and flattening of the lens to accommodate farther light as it requires less refraction
78
describe lens accommodation in close vision
sympathetic innervation causes contraction of the ciliary body leading to slackening of suspensory ligaments and the rounding of the lens this leads to more accommodation of closer objects in vision as they require more refraction
79
what are the function of basal tears
corneal health cleans/nourishes and hydrates cornea contains lysozyme
80
what are the function of reflex tears and what are the afferent/efferent nerves controlling
extra tears in response to mechanical/chemical stimuli afferent is CN V1 efferent is facial VII
81
what are the types of tears
reflex basal emotional
82
describe reflex lacrimation in response to ANS innervation
parasympathetic facial nerve carries APs through internal acoustic meatus passes through synapse with geniculate ganglion and branch that goes through pterygoid canal to enter pterygopalentine ganglion joins with CN V1/2- these dont have lacrimal innervation
83
what provides sensory supply to dura mater
trigeminal nerve
84
what sinuses are enclosed in the dura mater
dural venous sinuses
85
what is found in the subarachnoid space
CSF and blood vessels
86
where is the subarachnoid space accessed in a lumbar puncture and when does it end
L3/4 or L4/5 | S2
87
describe CSF production and circulation in the brain
produced in choroid plexus in lateral and third ventricles passes from R/L lateral ventricles to midline third then through cerebral aqueduct to 4th then subarachnoid space and central canal reabsorbed by subarachnoid granulations into dural venous sinuses
88
what is the monro-kellie hypothesis
describes how pressure within the intracranial cavity must remain constant
89
what may cause raised ICP
any condition causing swelling of the brain or increased pressure surrounding the brain
90
true/false - most patients with raised ICP have visual problems
true
91
what does ICP normally sit around and what level requires intervention
5-15 | >20
92
what is papilloedema
raised ICP causing compression on the optic tracts/nerves | this leads to bulging/swelling of optic disk as well as compression of the central artery/vein of the retina
93
visual symptoms associated with papilloedema
transient visual obscuration flickering blurred vision decreased colour perception
94
what are the dura septae and why are they clinically relevant in raised ICP
brain can herniate through these folds of dura mater in raised ICP and cause cord compression or cranial nerve compression/stretch
95
what may raised ICP do to CN III and how may this present
compression/stretch oculomotor if medial lobe herniates through temporal notch paralysis of sphincter pupillae slow/lost pupillary light reflex, dilated pupil, ptosis, inferolaterally turned eyelid
96
what may raised ICP do to CN IV and how may this present
prone to trauma as winds around midbrain and stem paralysis of SO so eye cannot move inferomedially diplopia when looking down eye may be more fixed upwards due to IO
97
what may raised ICP do to CN VI and how may this present
susceptible to damage by petris ridge of temporal bone | paralysis of LR muscle so eye cannot move laterally or may be medially deviated

MB2: Ophthalmology (8 decks)

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