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OPTM 5032 - Ocular Physiology > Eyelids > Flashcards

Eyelids Flashcards

(79 cards)

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1
Q

What are the 6 structures of the eyelids?

A

Skin

Subcutaneous layer

Muscles

Submuscular areolar layer

Fibrous layer

Palbebral conjunctiva

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2
Q

Three characteristics of skin

A
  1. Thin
  2. Elastic
  3. Fat Free
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3
Q

How often should people where sunglasses?

A

After 20 minutes or more in the sun

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4
Q

Blepharochalasis

A

Orbital fat herniation

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5
Q

Basal cell carcinoma is related to ____ _____ exposure

A

Ultraviolet radiation (UVR)

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6
Q

Are benign growths of the eyelid evenly or unevenly distributed between upper and lower lids?

A

evenly

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7
Q

Where are malignant tumors more common (upper or lower lid) ?How much more common?

A

4 times more common in the lower lid

(Eyebrow protects upper eyelid from sun)

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8
Q

Which muscle elevates the upper lid?

A

Levator Palpebrae Superioris

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9
Q

Which muscle closes the eyelids?

A

Orbicularis Oculi

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10
Q

What do the Müeller muscle fibers do?

A

Modulate position of lids of the open eye

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11
Q

What marks the insertion of the levator on the eyelids?

A

A fold of skin separating the palpebral from the orbital portion of the lid

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12
Q

The orbicular is is striated/unstriated and voluntary/unvoluntary

A

Striated Voluntary

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13
Q

What is the function of the orbicular is oculi?

A

helps hold the lid tightly against the eye, which assists in spreading tears and flushing away waste products

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14
Q

Which nerve innervates the orbicularis oculi?

A

CN VII (Facial)

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15
Q

What happens with damage to the CN VII in the orbicularis oculi?

A

leads to dry eye condition, lagophthalmus, dut to inability to close eyelids

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16
Q

Levator palpebrae superioris is striated or unstraited

A

striated

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17
Q

Where does the levator become tendinous?

A

At the “aponeurosis of the legator” - where it enters the lid

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18
Q

Which nerve innervates the Levator?

A

CN III (Oculomotor nerve)

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19
Q

Where is the tarsal muscle, superior and inferior (Muller) found?

A

Found in the upper and lower lids, lines the levator internally

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20
Q

What happens when sympathetic innervation is damaged?

A

Droopy lid

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21
Q

Where is the submuscular areolar tissue and what is it?

A

Loose connective tissue between muscle and tarsal plate - fat free

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22
Q

What is the fibrous layer of the eyelid?

A

dense fibrous tissue that gives firmness and shape to the eyelids - known as the tarsal plate

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23
Q

Where is the collagen more developed (upper or lower) lid?

A

upper lid - allows lid to be everted

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24
Q

Upper eyelids are _____ and easily ____

A

flaccid everted

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25
Floppy Eyelid Syndrome symptoms
* patients present with burning and irritation of eyes * Contact between eye and pillow during sleep poor apposition of eyelid to globe * Meibomian gland dysfunction
26
How many Cilia in upper and lower lids?
100-150 upper 50-75 lower
27
What is the life span of the cilia?
3-5 months
28
How long does it take for forcibly removed cilia to regrow?
~2 month
29
What is the chief secretion of the eyelid?
Sebum - oily material secreted by the meibomian glands
30
The sebum forms which layer in the eye?
The superficial layer over the pre corneal tear film - slows evaporation of aqueous component
31
\_\_\_\_\_ on the glands will cause sebum to be excreted from the openings of the glands at the lid margins
Pressure
32
What secretes sebum and how many of them?
Meibomian glands ~30 glands
33
Which other glands are found in the lids?
Accessory lacrimal gland tissue Glands of Krause Glands of Wolfring
34
Arterial supply to the eyelids
Facial system (from external carotid artery Orbital system (from internal carotid artery)
35
Venous drainage of the eyelids
Superficial (pre-tarsal) system Deep (post-tarsal) system
36
Lymphatics of the eyelids are dived into which two systems?
Superficial or pre-tarsal plexus Deep or post-tarsal plexus
37
Paralysis of CN 7 can cause the brow to be?
lower on the affected side
38
Paralysis of CN 3 can cause what versus weakness
Paralysis - complete closure of the upper lid Weakness - ptosis of the upper lid
39
Sympathetic paralysis can cause
minor ptosis One of the components of Horner's syndrome
40
Strong or weak solutions of epinephrine applied topically will cause reversal of ptosis in sympathetic ptosis
Weak
41
Function of the corrugator supercilli
pulls eyebrows together (frown)
42
What happens in Bell's phenomenon?
globe turns upward as the eyelids are forced closed
43
What is reflex blinking?
rapid closure movement of short duration
44
What causes reflex blinking?
External stimuli: 1. Strong lights 2. Approaching objects 3. Loud noises 4. Cornel, conjunctival, or ciliary touch
45
What quantifies the corneal reflex?
an aesthesiometer
46
In CL wearers the tactile corneal reflex is _______ slightly
dimished
47
Two examples of blink reflexes
Dazzle reflex Menance reflex
48
The reflex blink is a \_\_\_\_\_-speed response to _____ and ______ stimuli
High Tactile Proprioceptive - detects motion
49
What is blepharospasm
slow, sustained closure to nociceptive (pain) stimuli
50
What can changed the regular basis of spontaneous blinking?
Level of visual activity Emotional states Environmental conditions (computer users)
51
Spontaneous blinking is (high or low) in infants
low or absent
52
Is spontaneous blinking present in blindness?
Yes; does not depend on optic stimulation
53
What does the lower lid do during spontaneous blinking?
Remain almost stationary (most movement is done by upper lid)
54
Spontaneous blink rates is?
~15 times per min
55
What is the duration of the blink?
300-400 msec
56
average time between blinks is?
2.8 sec
57
obscuring visual input up to ____ msec is barely detectable but obscuring it greater than ____ msec is easily detectable
3 msec 30 msec
58
What can give you temporary relief for blepharospasm? How long does it last?
Botulinum-A (botox) ~3 months
59
Blepharospasm (raises or lowers) IOP?
raises
60
What is myokymia
Fibrillary twitched of the eyelids
61
What causes myokymia
fatigue thyrotoxucosis physical stress
62
What is lagophthalmos?
incomplete closure of the eyes during sleep
63
What is the result of lagophthalmos?
desiccation and excessive exposure of the lower portion of the cornea
64
Ectropion is what?
a falling away of the lower lid away from the globe
65
What causes ectropion?
weakness of the orbicularis
66
What is the result of ectropion?
Epiphora or poor blink closure
67
What is senile ectropion?
Loss of tone and loss of orbital fat deep to the eye with age
68
Entropian vs. Ectropian
Entropian - lid turns toward the eye (contact between lashes and corneal surface) Ectropian - turns away from the eye
69
In which diseases is entropian a symptom?
Trachoma and ocular pemphigus
70
The palbebral fissure is usual how wide and how long?
8-11 mm wide 27-30 mm long
71
A large eye within a shallow orbit will appear as a?
prominent globe with a wider fissure
72
Proptosis
forward movement of the globe within the orbit
73
What will proptosis cause?
a widening of the palpebral fissure on the side
74
In which disease is exophthalmos found?
Thyroid disease
75
What is exophthalmos?
retraction of the upper eyelids (causes a widening of the palpebral fissure)
76
The principal component in the apparent exophthalmos os thyroid eye disease is?
The degree of lid retraction (measurement of vertical palpebral fissure may be more important measurement than exophthalmometry)
77
Exophthalmometry measurements range from ____ to ____ mm in normal subjects (mean of ____ mm) and ____ to _____ mm (mean of ____ mm in thyroid eye disease subjects
12-21 mm 16 mm mean 12-24 mm 18 mm mean
78
What is Collier's Sign of Thyroxicosis?
retraction of the upper lid(s)
79
What is Von Grafe's Sign of Thyroxicosis?
Delay of movement of the upper lid when shifting gaze from up to down; causes staring expression

OPTM 5032 - Ocular Physiology (9 decks)

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