Anatomy Of The Eyelids

Question 1

What are the functions of the eyebrows?

Answer 1

Emotion (facial expression)
Protection

Question 2

What are the muscles of facial expression?

Answer 2

Frontalis elevates eyebrow
Orbital portion of the orbicularis oculi lowers eyebrow and closes the lid
Innervated by 7 (facial nerve)

Procerus depresses medial eyebrow
Corrugator supercilii pulls eyebrow medially
(Fast puppies obtain chocolate)

Question 3

What is facial nerve palsy?

Answer 3

Problem with 7th cranial nerve
Eyes cannot close and dry out

Question 4

What are the functions of the eyelids (palpebrae)?

Answer 4

Protect eye from injury
Protect eye from excessive light
Spread tears

Question 5

Locate the anatomy of the eyelid.

Answer 5

Orbital portion
Tarsal portion
Superior palpebral sulcus
Inferior palpebral sulcus
Palpebral fissure (9-10mm)
Lateral canthus
Medial canthus

Question 6

What is the anatomy of the medial canthus?

Answer 6

Caruncle
Pelican semilunaris
Papilla
Lacrimal punctum
Pores of meibomian gland
Cilia

Question 7

What are the dimensions of the lid margin?

Answer 7

30mm in length
2mm in width

Question 8

Describe the cilia on the lid margin.

Answer 8

In anterior lamella
2 rows superior
1 row interior

Question 9

Describe the puncta on the lid margin.

Answer 9

Superior and inferior in canthal region
Opening within lacrimal papilla

Question 10

Describe the mucocutaneous junction of the lid margin.

Answer 10

Junction between skin an palpebral conjunctiva

Question 11

Gray line

Answer 11

Surgical landmark separating anterior and posterior lamella

Question 12

Clinical correlates of lid margin?

Answer 12

Trichiasis
Epicanthic folds

Question 13

What is the anatomy of the anterior lamella (lid anatomy)?

Answer 13

Eyelid skin
Orbicularis muscle
Lashes
Glands
Levator aponeurosis
“Even old Larry got lit”

Question 14

What is the anatomy of the posterior lamella (lid anatomy)?

Answer 14

Tarsal (meibomian glands)
Palpebral conjunctiva
Accessory lacrimal glans
Muller muscle

“The pig ate mud”

Question 15

What are the muscles of the eyelid and their functions?

Answer 15

Orbicularis oculi (lid closure, tear maintenance)
Levator (raises lid)
Muller’s muscle (superior tarsal muscle) assists levator
Inferior tarsal muscle (depresses the inferior lid)

Question 16

What are the parts of the orbicularis oculi? What nerve innervates it?

Answer 16

Orbital – voluntary: closes the lids and lowers the brow
Palpebral – involuntary: blink
Lacrimal (Horner’s muscle) – moves tears
Ciliary (muscle of Riolan) – maintains lid apposition (next to eye)

7th (facial) nerve

Question 17

What are the glands of the anterior lamella?

Answer 17

Glands of Zeiss- sebaceous
Glands of Moll- Sweat

Question 18

What are the glands of the posterior lamella?

Answer 18

Meibomian glands- sebaceous
Accessory lacrimal glands- aqueous portion of tears

Question 19

Describe sensory innervate on to eyebrow and eyelids.

Answer 19

Through CN5
V1 innervates upper eyelids, nose, medial forehead
V2 innervates lateral eyelid, cheek, upper lip
V3 innervates lateral forehead, part of ear, lower cheek, lower lip

Question 20

Arterial lid vasculature

Answer 20

Peripheral arcade- ICA
Marginal arcade- ECA
Highly vascularized supplies by internal and external

Question 21

Venous lid vasculature

Answer 21

Outer- jugular
Inner- ophthalmic, cavernous sinus

Question 22

Superfical lid lymphatics

Answer 22

Drain skin and orbicularis

Question 23

Deep lid lymphatics

Answer 23

Drain tarsal plate and conjunctiva

Eventually drains into superfical parotid nodes and submandibular nodes

Question 24

Motor lid innervation

Answer 24

Open lid – III to levator
Close lid – VII to orbicularis

Question 25

Sensory lid innervation

Answer 25

V1 to upper lid (lacrimal, supra-orbital, supratrochlear) V1 (lacrimal) and V2 (infraorbital) to lower lid V1 (infratrochlear) to medial commissure

Question 26

Autonomic lid innervation

Answer 26

Open lid – sympathetic to Muller muscle

Question 27

What is the purpose of the structure surrounding the eyeball?

Answer 27

Maintains eye position keeping it controlled as you look around.

Question 28

Describe tenon’s capsule (fascia bulbi).

Answer 28

Envelope of connective tissue Protection Attachment of EOM’s Fuses with optic nerve sheath posteriorly Intermuscular septum anteriorly

Question 29

Describe what surrounds the eyeball from the outside in.

Answer 29

Outer Bulbar conjunctiva Tenon’s capsule (from optic nerve to limbus) Episclera Sclera Inner

Question 30

What are the purposes of check ligaments and the suspensory ligaments?

Answer 30

Check ligaments prevent eyeball from overshooting Suspensory ligaments expends from lateral to medial check ligaments, prevent the eyeball from uncontrollable movement.

Question 31

Describe the orbital septum.

Answer 31

Supports the lid Membranous fibrous sheet Separates the lid and the fat that fills the orbit

Question 32

Describe the tarsal plates.

Answer 32

Maintains firmness and shape of lid Dense fibrous connective tissue Superiorly 10-11mm; inferiorly 5mm