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Ocular Phys > Block 12 > Flashcards

Block 12 Flashcards

(101 cards)

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1
Q

When the flow of AH in does not equal the flow of AH out

A

Glaucoma

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2
Q

2 pathways that AH leaves the eye

A

Unconventional path

Conventional path

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3
Q

AH path: through ciliary muscle and other downstream tissues

A

Unconventional path

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4
Q

AH path: through the TM and SC

A

Conventional path

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5
Q

AH path: the major pathway of AH out of eye

A

Conventional path

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6
Q

AH path: not affected by IOP (IOP independent)

A

Unconventional path

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7
Q

AH path: IOP dependent

A

Conventional path

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8
Q

The conventional pathways of AH flow is also called

A

Corneoscleral path

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9
Q

The unconventional path of AH outflow is also called

A

Uveoscleral outflow

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10
Q

2 models of conventional AH outflow path

A
  • bulk flow model

- pumping model

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11
Q

Conventional pathway model: simplest hydraulic model

A

Bulk flow model

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12
Q

Conventional pathway model: a rise in EVP results in a 1:1 ration of increase IOP

A

Bulk flow model

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13
Q

Conventional pathway model: receives power form transient IOP increase

A

Pumping model

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14
Q

With constant very high IOP, what can happen to SC

A

It can collapse on itself and obstruct entry into the venous sys

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15
Q

What 2 structures are the TM between

A

Anterior chamber and SC

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16
Q

The pssr of anterior chamber and SC are different, so what does the TM do

A

Sense the differential and strives to maintain parameters within a homeostatic range

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17
Q

What 2 things can cause outflow obstruction of AH

A

Occlusive angle

Injury to TM

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18
Q

Possible conditions to cause an occlusive angle, obstructing outflow

A 
Diabetes (severe - retinopathy)
Uveitis
Hyphens
Pseudoexfoliative glaucoma
Pigment dispersion glaucoma
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19
Q

75% of the resistance to AH outflow is localized to what structure

A

TM

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20
Q

2 conditions that may injure the TM, obstructing outflow

A

Fuch’s heterochromic irits

Glaucomatocyclitic crisis

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21
Q

3 long term influences of IOP

A

Genetic
gender
refractive error

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22
Q

The older we get, which gender has higher IOP

A

Women

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23
Q

Which will typically have a higher IOP, myopic or hyperopic patients

A

Myopic

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24
Q

The peak IOP is when during the day

A

Morning hours

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25
Higher IOP with pt is sitting or laying
Laying
26
What gaze is there an increase in IOP
Up gaze
27
Thicker corneas cause readings of IOP to be
Artificially high
28
Pts with HIV or pts pregnant will have higher or lower IOP
Lower
29
Corticosteroids may cause your IOP to
Increase
30
largest organ of the eye
Vitreous
31
How much of light does the vitreous transmit
90%
32
How is the vitreous attached to the ILM
By anchoring fibrils and the membrane limitans itnerna (MLI)
33
The the MLI is composed of
- fusing point of the anchoring fibrils - lamina dense - lamina Lucinda
34
Where is the vitreous base
Ora serrata
35
What is the strongest vitreal attachment
Vitreous base
36
Located between the posterior lens and anterior vitreous
Wieger’s ligament
37
The only vitreal attachment to not decline with age
Base
38
Which attachment is of medium strength
Peripapillary adhesion
39
Vitreal adhesion around the edge of the optic disc
Peripapillary adhesion
40
What is the weakest vitreal attachment
Macular/peripheral retinal attachment
41
What composes the majority of the vitreous
Water
42
Main collagen type in vitreous
Type 2
43
What are the 4 major composers of the vitreous
Water Type 2 collagen Vitreal cells Vitamin C
44
The gel structure of the vitreous results from
Arrangement of collagen fibrils suspended in HA
45
3 main vitreal cells
Hyalocytes Fibroblasts Macrophage
46
Majority of vitreal cells are which type
Hyalocytes
47
4 main functions of vitreous
Support retina Diffusion barrier Metabolic buffer Transparency
48
Pathology associated with the support function of the vitreous
PVD | Macular edema
49
Major cause of macular edema
Retinal ischemia
50
The metabolic buffer function of the vitreous serves as a reservoir of what
Glucose/glycogen Potassium VITAMIN C
51
Pathology associated with the diffusion barrier and metabolic buffer functions of the vitreous
nuclear sclerotic catract (NSC) Reduced neovascularization of retina Neovascular glaucoma
52
Pathology associated with the transparency function of the vitreous
Synchisis scintillations | Asteroid hyalosis
53
Protects against oxidative stress | Protect the retina from metabolic and light induced free radicals
Vitamin C
54
T/F: the vitreous provides a transparent medium
True
55
T/F: the vitreous cushions the globe
True
56
T/F: the vitreous stores ions and nutrients for the retina and lens
True
57
A common disorder of the tear film caused by tear deficiency or excessive tear evaporation
Dry eye syndrome
58
3 main functions of the tear film
- Smooth refractive surface - maintain corneal and conj health - act as first line of defense against microbial infection
59
Layers of the tear film starting at the corneal epithelium
Mucous layer Aqueous layer Lipid layer
60
Main component of the mucous layer of the TF
Mucin
61
High molecular weigh glycoproteins that are heavily glycosylated
Mucin
62
2 types of mucins
Membrane associated mucins | Secretory mucins
63
Which type of mucin acts as a dense barrier to pathogen penetrance
Membrane associated mucins
64
Which type of mucin act as a cleaning crew
Secretory mucin
65
4 functions of the mucus layer of the TF
- maintain water on the surface of eye - Lower surface tension, stabilizing the TF - lubrication for eyelid movement - traps exploited surface cell, foreign particles and bacteria
66
Sources of the mucus layer
Goblet cells and squamous cells of cornea and conj
67
Major components of the aqueous layer of the TF
``` Water Electrolytes Protein Peptide growth factors Vitamins ```
68
4 main electrolytes in the aqueous layer of the TF
Sodium Chloride Potassium Calcium
69
2 electrolytes that are the main contributors to osmolarity of tear film
Sodium and chloride
70
Does osmolarity inc or dec with dry eye
Increase
71
What 2 electrolytes are important for maintaining corneal epithelium health
Potassium and calcium
72
What do the electrolytes in the aqueous layer of the TF do
Act as buffer to maintain a constant pH and contribute to maintain epithelial integrity of the ocular surface
73
What pH range can the eye handle, due to the buffering system
3.5 to 10.5
74
During sleep, what happens to the pH
Decrease
75
What happens to the pH in dry eye
Increases due to osmolarity increases
76
2 glands that help make the aqueous layer of TF
Main lacrimal glands | Accessory lacrimal glands
77
Which glands are responsible for reflex and emotional tearing
Main lacrimal glands
78
Which glands are responsible for maintenance tearing
Accessory lacrimal glands
79
The lipid layer of the TF is composed of
Meibomian oil
80
2 phases that compose the lipid layer
``` Polar surfactant phase Nonpolar phase (overlaid polar phase) ```
81
4 main functions of the lipid layer of TF
- Barrier to evaporation - stability to TF through interaction with aqueous-mucin phase - smooth surface for cornea - barrier against foreign particles
82
Main resource for lipid layer of TF
Meibomian glands | + zeis and moll sebaceous glands
83
Largest category of dry eye
Tear deficient dry eye
84
Occurs because of a disorder in lacrimal gland function
Tear deficient dry eye
85
Lacrimal gland function is normal, but another tear abnormality exits that leads to increased tear evaporation
Evaporative dry eye
86
Major barrier to evaporation form ocular surface
Lipid layer of TF
87
Test for tear secretion
Schirmer (1 and 2) Phenol red thread test Meinscometry
88
Test for tear film stability
TBUT Ocular protection index Videokertography Tear turnover
89
Test for tear film osmolarity
TF osmolarity Tear forming Tear evaporation
90
Test for lipid layer evaluation
Interferometry | Meibometry
91
Test for ocular surface evaluation
Fluorescein Rosa Bengal Lissamine Green
92
How does B-lysine function in terms of destroying a pathogen
Acts as a detergent | - pokes holes in cell and causes rupture, reducing membrane integrity
93
3 ways that a defensin functions
- bind to microbial membrane - embed into membrane - act as a detergent (for a pore in membrane and lose ions)
94
Are defensins easily synthesized; what are synthetic defensins called
Yes; mimetics (drugs that act like defensins)
95
What do lysozymes do
Cleaves linkages between sugars
96
What type of bacteria do lysozymes target
Gram + bacteria | - causes them to rupture
97
What areas are affected by lysozymes
Areas where there is a lot of air (surface)
98
Which will affect peptidoglycan
Lysozyme
99
Lactoferrin binds to what
Iron
100
What is enzyme is associated with breast cancer
Lactoferrin
101
Levels of what enzyme are lower in dry eye diseases and diseases like Sjögren’s syndrome
Lactoferrin

Ocular Phys (5 decks)

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