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neuro exam 2 > eye and orbit > Flashcards

eye and orbit Flashcards

(145 cards)

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1
Q

general orbit

A

depth 2x width
shaped like a quadrangular pyramid w/base facing anterolateral and apex posteromedial
contralateral medial walls parallel
contralateral lateral walls perpendicular

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2
Q

orbital axis

A

long axis thru orbit oriented 45 degrees to one another

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3
Q

optical axis

A

long axis thru globe parallel to medial walls of orbit

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4
Q

bones of orbit

A 
frontal
maxilla
sphenoid
lacrimal
ethmoid
palatine
zygomatic
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5
Q

apex of orbit

A

lesser wing of sphenoid surrounding optic canal

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6
Q

base

A

formed by the orbital margin and orbital opening

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7
Q

orbital margin

A

frontal
zygomatic
maxilla
thickened to provide support and protection to eye

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8
Q

roof of orbit

A

frontal bones and some spehnoid
separated orbit from ant cranial fossa
has fossa for lacrimal gland

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9
Q

floor of orbit

A

maxilla bone- separated orbit from maxillary sinus
zygomatic
palatine

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10
Q

medial wall of orbit

A 
separates orbit from sphenoid and ethmoidal air sinuses
ethmoid
lacrimal
maxilla
lacrimal fossa
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11
Q

lateral wall of orbit

A

zygomatic bone

sphenoid- greater wing

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12
Q

optic canal

A

II, ophthalmic a

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13
Q

superior orbital fissure

A

III, IV, V1, IV

superior ophthalmic v

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14
Q

inferior orbital fissure

A

inf opthalmic v
infraorbital a,v,n
sygomatic nn

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15
Q

ant ethmoidal foramen

A

ant ethmoidal a, n, v

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16
Q

post ethmoidal foramen

A

post ethmoidal a,n,v

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17
Q

nasolacrimal canal

A

nasolacrimal duct

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18
Q

blowout fracture- inferior

A

can involve maxillary sinus
inf rectus m trapped -> diplopia
enophthalmos due to fat

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19
Q

blowout fracture- medially

A

enophthalmos due to fat

can involve sphenoidal and ethmoidal air sinuses

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20
Q

blowout fracture-roof

A

can involve ant cranial fossa

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21
Q

orbital tumors

A

tumors in sphenoidal or ethmoidal sinuses or middle cranial or infratemporal fossas can erode thin walls of orbit or pass thru foramen
exopthalmos

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22
Q

periorbital fasica

A

lines bones of orbit
continuous w/periostreal dura at optic canal and superior orbital fissue
continuous w/orbital septum anteriorly
continuous w/muscular fascias of extraoccular eye mm

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23
Q

fat and fascias of orbit

A 
periorbital fascia
mm fascias
check ligaments
fascial sheath of eyeball
orbital fat
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24
Q

check ligaments

A

medial and lat
attach to med and lat orbit walls
limit abduction and adduction
prevent post retraction of eyeball by rectus mm

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25
fascial sheath of eyeball
aka tenons capsule or fascia bulbi thin membrane surrounding eyeball external to sclera continuous w/muscular fascia of extraoccular eye mm separates eyeball from orbital fat
26
orbital fat
cushion lubrication protection w/anorexia eyes become sunken
27
eyelids
moveable folds of skin and CT which cover eye to protect spread lubrication over cornea
28
structure of eyelid
``` skin loose CT orbicularis oculi and levator palpebrae superioris mm tarsal plate palpebral conjuctiva ```
29
tarsal plate
dense CT for structural support of eyelid orbital septum medial and lateral palbebral ligaments
30
orbital septum
part of tarsal plate fibrous membrane connecting tarsi to margins of orbit fnx to contain orbital fat w/in orbit limit spread of infection btwn face and orbit
31
medial palpebral lig
connects tarsi to medial wall of orbit
32
lateral palpebral lig
connects tarsi to lateral wall of orbit
33
glands associated w/eyelid
tarsal/sebaceous glands galnds of Zeis (smaller sebaceous) glands of Moll (sweat)
34
glands become obstructed
can get chalazion or hordeoum cysts
35
orbicularis oculi
sphinchter m of eyelid VII therefore damage to VII cannot close eyelid completely
36
levator palebrae superioris
``` lesser wing of sphenoid skin of sup eyelid elevates sup eyelid III sup portion attaches to sup tarsal plate innervated sympathetically ```
37
III lesion
ptosis
38
horners syndrome
ptosis due to loss of sympathetics to superior tarsal portion of LPS
39
palpebral conjunctiva
epi of internal eyelid
40
bulbar conjunctiva
outer epi of sclera
41
conjunctiva sac
btwn palebral and bulbar conjunctiva | opens at palpebral fissure
42
conjunctival fornices
sup and inf | formed where bulbar and palpebral conjuctiva are continuous
43
lacrimal apparatus
lacrimal gland lacrimal cannaliculi lacrimal sac nasolacrimal duct
44
lacrimal galnd
compound tuboalveolar gland located in lacrimal fossa in superolateral orbit secretes lacrimal fluid into conjunctival sac lubrication and antibacterial
45
lacrimal cannaliculi
located in medial angle of eye begin at lacrimal papilla lacrimal punctum is opening
46
lacrimal sac
receives fluid from lacrimal cannaliculi
47
nasolacrimal duct
drains lacrimal fluid to nasal cavity
48
flow of tears
lacrimal glans -> conjunctical sac-> surface of eye -> lacrimal papillae w/puncta -> cannaliculae -> lacrimal sac -> nasolacrimal duct
49
eye
3 tunics lens vitreous and aqueous chambers
50
external fibrous tunic
sclera | cornea
51
sclera
tough opaque fibrous layer covering post 5/6 of globe | provides structural support for eye and mm attachment
52
cornea
avascular, dehydrated, transparent layer covering ant 1/6 of globe provides most of eyes refractile capabilities numerous pain receptors w/in cornea
53
corneal neurovascularization
blood vessels grow into corneal stroma secondary to hypoxia
54
middle vascular tunic
``` aka uvea choroid iris ciliary body ciliary m ```
55
choroid
highly vascualrized, loose CT, located deep to sclera provides vascular supply to fibrous layers and outermost layers of retina contains melanocytes which produce melanin to absorb photons
56
iris
central aperature forms pupil controls amount of light entering pupil sphincter pupillae m dilator pupillae
57
sphincter pupillae
reduces diameter of pupil (meiosis) | parasympathetic via III
58
dilator pupillae
increases diameter of pupil (mydriasis) | sympathetics
59
ciliary body
ciliary processes | ciliary m
60
ciliary processes
finger like extensions from ciliary body secretes aqueous humor into post chamber suspensory ligaments extend from ciliary processes to lens
61
ciliary m
parasympathetics via from III | accommodation- control of lens thickness via suspensory ligaments
62
accommodation- distant
when looking at distant objects the ciliary m relaxed w/tension on suspensory ligaments ciliary processes pull on lens to stretch and thin it default
63
accommodation- near
ciliary m contracts pulling ciliary body med and ant to reduce tension on suspensory ligs lens round and thick due to parasympathetics from III
64
inner neural tunic
``` visual portion of retina contains rods/cones contains ganglion cells which form optic n ora serrata optic disc macular lutea fovea centralis ```
65
orra serrata
ant termination of retina
66
optic disc
blind spot located on post pole of globe site of entry of II and central retinal a, v
67
macula lutea
yellow pigmented zone located about 2.5mm to lat optic disc
68
fovea centralis
oval depression in center of macula | site of greatest visual acuity due to density of cone cells
69
blood supply of retina
central retinal a for neural portion except rods and cones | choroid vessels for pigmented epi and rod/cone layer
70
retinal detachement
occurs when pigmented epi separated from underlying rods/cones can cause blindness due to loss of blood supply
71
cataracts
proteins of lens aggregate producing opaque lens
72
eye chambers
``` aqueous chambers (ant, post) vitreous body ```
73
anterior aqueous chamber
btwn cornea and iris
74
post aqueous chamber
btwn iris and lens
75
aqueous humor
fill ant and post chambers produced in post chamber by ciliary processes flows into ant via pupil drains to venous system via sclera venous sinus
76
sclera venous sinus
at iridocorneal angle covered by trabecular meshwork (endothelial lines spaces) drains to vorticose and ant ciliary vv
77
glacoma
due to excessive aqueous humor most often due to decreased drainage, but can be due to increased production caused increased ocular pressure which can lead to blindness
78
vitrous body
btwn lens and post surface of eye | filled w/vitreous humor
79
neural ectoderm
aka optic vessels derived from evaginations of forebrain neuroectoderm meninges carried along w/eye optic vessels invaginate to forme double walled optic cup cup maintains connection to forebrain at optic stalk choroid fissure forms on ventral surface of cup forms retina and optic n
80
choroid fissure
hyaloid vessels | closes wk 7
81
surface ectoderm
lens placode -> lens vesicle -> lens
82
mesenchye
fibrous - sclera and cornea | vascular- choroid, iris, ciliary body
83
retina and optic n
outer layer of cup- pigmented layer of retina inner layer of cup- all neural layers of retina nerve fibers from retina migrate thru chorioid fissure to form II
84
congential retinal detachement
inner and outer cup layers fail to fuse
85
chorioid
derived from vascular layer of mesenchyme surrounding optic cup
86
iris and ciliary body
outer portion from vascular mesenchyme surrounding optic cup inner portion derived form optic cup melanocytes migrate in first 6-10 months
87
iridopupillary membrane
vascular structure which originally separates the ant and post chambers degenerates around wk 15
88
congenital atresia of pupil
due to failure of iridopupillary membrane to degenerate
89
coloboma
failure of choroid fissure to fuse during the 7th wk of development may also involve the retina
90
sclera and cornea
are derived from fibrous layer of mesenchyme surrounding optic cup
91
aqueous and vitreous chambers
form in areas of cell death | vitreous humor is likely derived from neural crest cells
92
lens
derived from lens vesicle
93
congenital aphakia
agenesis of lens placode
94
extrinsic eye m
from mesoderm of myoderms
95
ophthalmic a
from internal carotid | enters orbit via optic canal
96
brr of ophthalmic a
``` central retinal a short post ciliary long post ciliary ant ciliary aa lacrimal supraorbital post ethmoidal ant ethmoidal medial palpebral supratrochlear dorsal nasal ```
97
central retinal a
``` pierces optic sheath and runs within optic n supplies retina (except rods/cones and pigmented epi layers) ```
98
short post ciliary a
pierce sclera near optic n to supply choroid
99
long post ciliary a
pierce sclera anteriorly to supply ciliary body and iris
100
ant ciliary aa
arise from mm brr to cliary body and iris
101
lacrimal a
to lacrimal gland and lat portions of eyelids
102
supraorbital a
to forehead and scalp
103
medial palpebral a
medial eyelids
104
supratrochlear
to forehead and scalp
105
dorsal nasal
supplies dorsal surface of nose
106
vv of orbit and eyeball
central retinal v vorticose vv sup and inf ophthalmic vv
107
central retinal v
usually drains directly to cavernous sinus
108
vorticose vv
drain choroid, ciliary body, and iris
109
sup and inf ophthalmic vv
drain to cavernous and pterygoid venous plexuses respectively
110
thrombophlebitis of cavernous sinus
may send clot to central retinal v and cause blindness
111
extortions
superior pole of eyeball rotated laterally
112
intortion
superior pole of eyeball rotated medially
113
medial rectus
``` common tendinous ring medial surface of eyeball adducts eye III if damaged lose adduction, eye 'stuck' in abdcution ```
114
lateral rectus
``` common tendinous ring lateral surface of eyeball adducts eye VI if damaged lose abduction, eye 'stuck' in adduction ```
115
superior rectus
``` common tendinous ring sup surface of eyeball elevated, adducts, intorsion III if damaged loss of elevation when eye is fully abducted ```
116
inf rectus
``` common tendinous ring inf surface eyeball depress, adduct, extorsion III loss of depression when eye fully abducted ```
117
inf oblique
``` ant portion of floor of orbit inf surface of eyeball, post to equator elevates, abducts, extorsion III loss of elevation when eye fully adducted ```
118
sup oblique
common tendinous ring sup surface of eyeball, post to equator mm passes thru trochea ad changes direction to attach to eyeball depress, abducts, intorsion IV loss of depression when eye fully addcuted
119
III
GSE, GVE-P
120
superior division of III
levator palpebrae superiorsis and sup rectus
121
inf division of III
medial rectus, inf rectus, inf oblique | pre-ganglionic parasympathetics to ciliary ganglia
122
oculomotor n palsy
ptosis or complete closure of eye due to loss of levator diploplia eye will be abducted and depressed (down and out) dilation of pupil (due to loss of sphincter ) loss of accommodation (due to loss of ciliary m)
123
IV
GSE | sup oblique m
124
trochlear n palsy
diploplia eye slightly elevated and adducted loss of depression when eye fully adducted
125
VI
GSE | lateral rectus m
126
abducent n palsy
diplopia | loss of eye abduction
127
II
SSA- vision covered in meninges axons of ganglion cell layer of retina which pass thru optic disc then exit via lamina cribosa of sclera posterior
128
V1 bbr
GSA nasociliary frontal lacrimal
129
nasociliary n
``` sensory root to ciliary ganglia short ciliary nn long ciliary nn post and ant ethmoidal nn iinfratrochlear n ```
130
short ciliary nn
arise from ciliary ganglia on lat side of optic n | carry postganglionic sympathetics, parasympathetics, and sensory
131
long ciliary nn
arise from nasociliary n on medial side of optic n | carry postganglionic sympathetics, and sensory fibers
132
posterior ethmoidal n
to ethmoidal air cells and dura
133
ant ethmoidal n
ethmoidal air cells, nasal cavity, dura | terminates as external nasal n
134
infratrochlear
exits orbit at medial angle, sensory to skin at root of nose, eyelids, palpebral conjunctiva, lacrimal sac
135
frontal n brr
supratrochlear n | supraorbital n
136
lacrimal n
sensory to lacrimal gland, lateral portion of superior eyelid carries postganglionic parasympathetics and sympathetic fibers to lacrimal gland
137
ciliary ganglion
located btwn lateral rectus m and optic n | contains postganglionic parasympathetic cell bodies
138
ciliary ganglion recieves
sensory root from nasociliary n parasympathetic motor root from III sympathetic motor root from internal carotid plexus
139
parasympathetics to intraoccular mm
preganglionics in edinger-westphal nucleus preganglionic fibers travel w/III postganglionics in ciliary ganglion postganglionic fibers then distribute via short ciliary nn to sphincter pupillae and ciliary mm
140
sympathetics to intraoccular mm
preganglionic cells T1-2 -> superior cervical sympathetic ganglion -> from here postganglionics travel w/internal carotid plexus -> gives a motor root to ciliary ganglion-> postganglionics pass thru ciliary ganglion w/o synapsing and distribute via long and short ciliary nn to dilator pupillae and superior tarsal mm
141
parasympathetics lacrimal gland
preganglionic in salivatroy nucleus in brainstem travel w/greater petrosal n (VII) to pterygopalatine ganglia where they synapse postganglionics then travel with zygomatic (V2) and lacrimal (V1) nn increase lacrimal secretions
142
sympathetics lacrimal gland
T1-4 -> superior cervical sympathetic chain ganglion -> leave as postganglionics via deep petrosal n -> greater and deep petrosal nn merge to form n of pterygoid canal -> zygomatic (V2) and lacrimal (V1) nn vasomotor and more watery lacrimal fluid
143
pupillary light reflex
fnx- protect eye from excessive light exposure afferent-II efferent- III
144
corneal reflex
protect eye from objects afferent- V1 efferent- VII
145
accommodation
``` afferent- II efferent- III (GSE and GVE-P) 1. ciliary mm contract -> rounding of lens III GVE-P 2. pupils constrict III GVE-P 3. eyes adduct III GSE ```

neuro exam 2 (11 decks)

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