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NS-1 > Eye and Eye movements > Flashcards

Eye and Eye movements Flashcards

(53 cards)

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1
Q

What are the bones of the orbit?

A

St Louis Zoo Makes Entrance Passes Free

Sphenoid

Lacrimal

Zygomatic

Maxillary

Ethmoid

Palatine

Frontal

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2
Q

What passes through the superior orbital fissure?

A

CNs 3, 4, V1, and 6

opthalamic Vs

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3
Q

What passes through the optic canal?

A

optin n

opthalamic A

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4
Q

What passes through the infraorbital fissure?

A

infraorbital A, zygomatic N (branch of maxillary N = V2)

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5
Q

What are the major paranasal sinuses to know?

A

Frontal = sup to orbit

ethmoid = medial to orbit

maxillary = inf to orbit

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6
Q

How do orbital blow out fractures usually occur and what can happen because of them?

A

usually occurs medial and inferiorly involving the maxillary bone (sometimes ethmoid)

blood and other orbital contents can prolapse –> go to maxillary sinus

can get iplopia, globe ptosis, exophthalmos

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7
Q

How is the eye positioned in relation to the orbit?

A

medial walls of orbit are parallel and in line w/ gaze

lateral walls are at right angles

axes of orbit diverge at 45 degree angles

(lateral side of eyeball is more exposed)

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8
Q

What are intorsion and extorsion and upon what axis do they occur?

A

intorsion = medial rotation

extorsion = lateral rotation

on AP axis

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9
Q

What extraocular Ms are innervated by what nerves?

A

SO4 LR6

occulomotor (CN III) –> levator palpebrae superioris, IO, SR, IR, MR

Trochlear N (CN IV) –> superior oblique

Abducent N (6) –> Lateral rectus

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10
Q

What is the action of superior oblique m?

A

(out and down)

abducts

depresses

medially rotates eye

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11
Q

What is the action of inferior oblique m?

A

laterally rotates

elevates

abducts

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12
Q

What occurs to elevation and depression when the eye is abducted by lateral rectus?

A

only rectus ms can produce elevation and depression

(so looking out and up tests SR, looking out and down tests IR)

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13
Q

What happens to elevation and depression during adduction by medial rectus?

A

only the oblique muscles can produce elevation and depression

(looking in and up tests IO, looking in and down tests SO)

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14
Q

What are the branches of V1 (opthalmic n) in the orbit?

A

first breaks into frontal n, nasociliary n, and lacrimal n

lacrimal n –> lacrimal gland

frontal –> supratrochlear and supraorbital n

nasociliary n –> posterior ethmoidal, anterior ethmoidal, infratrochlear, long ciliary, sensory root of ciliary ganglion

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15
Q

What nerves go through both the superior orbital fissure and the common tendinous n?

A

superior and inferior divisions of occulomotor n

nasociliary n (branch of V1)

abducent n (CN 6)

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16
Q

What structures go through the superior orbital fissure but not the common tendinous ring?

A

trochlear n (4)

superior ophthalmic v

frontal n (V1)

lacrimal n (v1)

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17
Q

How do sympathetics get to the eye and what do they innervate?

A

From T1-T4 –> synapse at superior cervical ganglion

postsynaptic fibers –> to internal carotid plexus –> either on CN 3 or V1 –> either to ciliary ganglion and then short ciliary ns

or on their own to muscles via long ciliary n(5) or CN3

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18
Q

What muscles are innervated by sympathetics in the eye?

A

Levator palpebrae superioris m

dilator pupilae

super and inf tarsal muscles

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19
Q

How do parasympathetics travel to and within the orbit?

A

Travel with CN III –> synapse in ciliary ganglion –> short ciliary n to ms

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20
Q

What eye muscles are innervated by PS?

A

sphincter pupilae

ciliary muscle

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21
Q

What types of fibers are in long ciliary nerves?

A

general sensory

post-synaptic sympathetics

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22
Q

What type of fibers are in short ciliary nerves?

Study These Flashcards
A

general sensory

post-synaptic sympathetic

post-synaptic parasympathetic

23
Q

What eye parts are innervated by general sensory fibers?

Study These Flashcards
A

choroid

iris

cornea

24
Q

What occurs in trochlear palsy?

Study These Flashcards
A

Trochlear n innervates superior oblique m (abducts, depresses, medially rotates)

so eye is stuck laterally rotated –> head tilts away from affected side to compensate

diplopia worse on downward gaze

25
What occurs in abducens palsy?
CN C innervates lateral rectus m can't look laterally w/ affected eye
26
What are the different types of oculomotor palsy?
down and out eye: loss of occular m innervation, but SO and LR are still intact (I by 4 and 6) complete ptosis: loss of I to levator palpebrae superioris m pupil dilation: loss of PS to pupil
27
What are the 4 steps of the pupillary light reflex?
1. light sensed by **CN 2** --\> synaps in **pretectal nucleus** 2. cells from pretectal nucleus synapse in **edinger-westphal nucleus** 3. **presyn PS** travel w/ **CN 3** --\> synapse at **ciliary ganglion** 4. PS neurons go to **pupillary constrictor m**
28
What is the corneal reflex?
1. receptors in cornea detect touch --\> travel in CN V --\> synapse in trigeminal sensory nucleus or spinal trigeminal nucleus 2. cells from trigeminal nuclei project to facial nucleus 3. neuron in facial n will cause eye to blink via tarsal m
29
What makes up the fibrous layer of the eye?
sclera cornea
30
What makes up the vascular layer of the eye?
choroid ciliary body iris
31
What makes up the inner layer of the eye?
retina = optic n, covered w/ meninges until it goes in eye
32
What are palpebral and bulbar conjuctiva?
palpebral lines innermost part of eyelids bulbar lines the outermost part of the eyeball
33
What innervates the superior tarsal m?
sympathetics keeps eye open
34
What innervates orbicularis oculi and what does it do?
facial N closes eye
35
What is a subconjunctival hemorrhage?
ruptures of vasculature under conjuctiva see red patches in sclera
36
What are the conjuctival fornices?
sac btw bulbar and palpebral conjuctiva
37
What occurs in complete vs partial ptosis?
complete = CN3 lesion, levator palpebrae superioris doesn't work partial = sympathetics issue that won't keep eyelid up via Tarsal muscle, usually horner's syndrome
38
What is papilledema?
caused by increased intracranial pressure see bulging optic disc
39
What is the macula? What is the fovea?
macula = center of vision fovea = area of macula most concentrated by cones \* have blind spot in optic disc
40
The occlusion of what artery will certainly cause blindness?
central retinal artery quick occlusion of any orbital a --\> most likely blindness slow occlusion --\> enough anastomoses that you will be okay
41
What are the 3 main endpoints for venous drainage from the eye?
to cavernous sinus to pterygoid plexus to facial V and internal jugular
42
What occurs in central retinal vein occlusion?
hardening of CRA or HTN can compress --\> backup of blood and hemorrhages dilated veins looks like ketchup on retina
43
What occurs in central retinal artery occlusion?
retina appears white cherry red spot = macula veins and arteries attenuated
44
What innervates the lacrimal gland?
lacrimal n from CN 5 innervates sensory PS innervation from greater petrosal n (CN 7)
45
What does the lacrimal part of orbicularis oculi m do?
contracts --\> opends lacrimal sac to hold more tears
46
What is the general path of tears?
lacrimal gland --\> to lacrimal canaliculi --\> lacrimal sac --\> nasolacrimal duct to nose if tears overflow lacrimal sac --\> cry
47
How are tears produced?
1. greater petrosal n (CN 7) and deep petrosal n from n of pterygoid canal 2. PS fibers synapse in pterygopalantine ganglion 3. travel w/ V2 then w/ zygomatic branch, communicating branch, then lacrimal n of V1
48
What is the ciliary body?
circumferential tissue inside the eye composed of ciliary m and ciliary processes
49
What do ciliary processes do?
secrete aqueous humor --\> fills ant and post chambers
50
What define the anterior and posterior chambers?
part of anterior cavity which is anterior to lens ant chamber = btw cornea and iris/pupil post chamber = btw iris/pupil and lens and ciliary body
51
What can glaucoma in relation to aqueous humor?
schlemm's canal = how aqueous humor drains out of anterior cavity of eye blockage of this canal --\> increased pressure = glaucoma
52
What is hyphema?
blood pooled btw cornea and iris
53
How do the ciliary ms affect vision?
muscles contract --\> loosens suspensory L of lens --\> lens more round --\> near vision muscles loose --\> lens flat --\> far vision

NS-1 (50 decks)

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