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Ophthalmology > Innervations and reflexes > Flashcards

Innervations and reflexes Flashcards

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1
Q

How many nerves are involved with the eye?

A

8

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2
Q

What are the 8 nerves involved with the eye?

A 
Facial CNVII
Abducens CNVI
Trochlea CNIV
Oculomotor CNIII
Short ciliary nerve
Optic nerve CNII
Trigeminal Ophthalmic nerve CNV1
Sympathetic motor/Long ciliary nerve
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3
Q

What four nerve types are present in the eye?

A

Autonomic sensory
Autonomic parasympathetic
Autonomic sympathetic
Somatic motor

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4
Q

Which two nerves provide sensory input from the eyes?

A

Optic nerve CNII

Trigeminal ophthalmic nerve CNV1

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5
Q

What type of stimuli does the optic nerve (CNII) sense?

A

Light

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6
Q

What type of stimuli does the ophthalmic nerve sense?

A

Mechanical

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7
Q

What nerve supplies sensory information from the face?

A

Trigeminal

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8
Q

What to branches of the trigeminal nerve are important for sensing the eye?

A

V1

V2

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9
Q

What area of the face does the CNV1 nerve cover?

A

Forehead, upper eyelid, cornea, conjunctiva, bridge of nose.

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10
Q

What area of the face does the CNV2 nerve cover?

A

Lower eyelid, maxilla, upper lip and side of nose

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11
Q

How is the parasympathetic outflow described?

A

Craniosacral

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12
Q

What cranial nerves provide the cranial outflow of the parasympathetics?

A

CNIII
CNVII
CNIX
CNX

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13
Q

Which cranial nerves are parasympathetic?

A

CNIII
CNVII
CNIX
CNX

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14
Q

Where do parasympathetic fibres synapse from presynaptic to postsynaptic?

A

Near their target organ

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15
Q

Describe sympathetic axons

A

Presynaptic sympathetic spinal nerves exit SC between T1 and L2 where they synapse in the sympathetic chain next to the SC. From here postsynaptic splanchnic nerves go to organs and body wall.

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16
Q

What are spinal nerves made up of?

A

Anterior and posterior rami

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17
Q

Where are the sympathetic chains located?

A

Parallel to the SC

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18
Q

What do splanchnic nerves do?

A

Supply the organs

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19
Q

What does splanchnic mean?

A

Relating to viscera

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20
Q

What happens at the cervical ganglia?

A

Postsynaptic splanchnic nerves to organs of the head branch off.

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21
Q

Where do the postsynaptic splanchnic nerves to organs of the head branch off?

A

Cervical ganglia

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22
Q

What are the postsynaptic splanchnic nerves to the organs of the head called?

A

Internal and external carotid nerves

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23
Q

Where do the internal and external carotid nerves run?

A

Along the internal and external carotid arteries

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24
Q

What do the internal and external carotid nerves form?

A

Periarterial sympathetic plexus

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25
What vessel carries the sympathetic nerve input to the orbit?
Ophthalmic artery
26
What two tissues related to the eye receive sympathetic input?
Levator Palpebrae Superioris | Dilator pupillae
27
How does the dilator pupillae receive its sympathetic input?
Long ciliary nerve
28
What flows through the centre of the optic nerve?
Central artery and vein of the retina
29
Where does the ophthalmic nerve enter the orbit?
Superior orbital fissure
30
Where does the optic nerve exit the orbit?
Optic canal
31
What three nerves supply somatic motor innervation to the eye?
Oculomotor CNIII Trochlea CNIV Abducens CNVI
32
What does the abducens CNVI innervate?
Lateral rectus
33
What does the trochlea CNIV innervate?
Superior oblique
34
What does the oculomotor CNIII innervate?
Superior, inferior and medial rectus Inferior oblique Levator Palpebrae Superioris Ciliary ganglion
35
In addition to somatic motor what other fibres does the oculomotor CNIII carry and where to?
Parasympathetic to ciliary ganglion
36
What arises from the ciliary ganglion?
SHort ciliary nerve
37
What does the short ciliary nerve innervate?
Ciliary muscles | Sphincter pupillae
38
Is the short ciliary nerve sympathetic or parasympathetic?
Parasympathetic
39
What nerves synapse, arise and pass through the ciliary ganglion?
Synapse- CNIII Arise- SHort ciliary Pass through- Long ciliary
40
In addition to the CNIII/Short ciliary nerve what other parasympathetic nerve is involved with the eye?
Facial CNVII nerve
41
What does the facial CNVII nerve innervate?
Orbicularis oculi | Lacrimal gland
42
Where does the oculomotor CNIII enter the orbit?
Superior orbital fissure
43
What two features does the oculomotor (CNIII) nerve pass through to reach the eye?
Cavernous sinus | Superior orbital fissure
44
How many divisions does the oculomotor nerve have?
2: Superior Inferior
45
Which divisions of the oculomotor nerve (CNIII) supply which muscles?
Superior- SR and LPS | Inferior- IR, MR, IO and ciliary muscles
46
Where does the CNIII (Oculomotor) arise?
Between pons and midline
47
Where is the pons found?
Brainstem
48
What does pons mean?
'Bridge'
49
What do ciliary nerves do?
Control iris and ciliary muscles
50
What do ciliary muscles do?
Control lens focus
51
What do iris muscles do?
Control aperture
52
Where do all ciliary nerves pass through or arise from?
Ciliary ganglion
53
What two types of ciliary nerve are there?
Long ciliary nerve | Short ciliary nerve
54
Are long ciliary nerves sympathetic or parasympathetic?
Sympathetic
55
Are short ciliary nerves sympathetic or parasympathetic?
Parasympathetic
56
Where does the trochlear nerve CNIV enter the orbit?
Superior orbital fissure
57
What does the trochlear nerve pass through?
Cavernous sinus
58
Where does the abducens nerve CNVI enter the orbit?
Superior orbital fissure
59
What does the abducens nerve pass through?
Cavernous sinus
60
Which nerves enter the orbit through the superior orbital fissure?
Oculomotor CNIII Trochlear VNIV Ophthalmic CNV1 Abducens CNVI
61
Which nerves pass through the cavernous sinus?
Oculomotor CNIII Trochlear VNIV Ophthalmic CNV1 Abducens CNVI
62
Where does the optic nerve pass in relation to the cavernous sinus?
Superiorly
63
Where does the facial CNVII nerve arise from?
Pons (in brain stem)
64
Where does the abducens CNVI nerve arise from?
Pons/medulla junction
65
Where does the trochlear CNIV nerve arise from?
Dorsal brain stem
66
Where does the trigeminal CNV nerve arise from?
Pons
67
Where does the optic nerve arise from?
Forebrain
68
Which nerves are involved in the blink reflex?
CNV1 CNV CNVII
69
Describe the blink/corneal reflex
Adverse stimuli activates CNV1 fibres in cornea CNV1 pass to trigeminal ganglion where they become CNV fibres CNV fibres integrate in pons in brainstem Pons activates CNVII fibres which cause closure of eyelid.
70
Where is the ciliary ganglion located?
Posterior orbit
71
Which nerve innervates the SR, IR, MR, IO, LPS and ciliary ganglia?
CNIII
72
What nerve innervates the SO?
Trochlear
73
What nerve innervates the LR?
Abducens
74
What does the sphincter pupillae muscle do and what innervates it?
Constricts iris | Parasympathetic short ciliary nerve
75
What does the dilator pupillae do and what innervates it?
Dilates iris | Sympathetic long ciliary nerve
76
Describe the pupillae muscles?
Sphincter pupillae fibres form central ring round pupil | Dilator pupillae fibres radiate out like spokes
77
What is a non-physiological dilation of the iris called?
Mydriatic
78
What is a non-physiological constriction of the iris called?
Miotic
79
is the facial CNVII nerve sympathetic or parasympathetic?
Parasympathetic
80
What does the orbicularis oculi muscle do?
Closes the eye
81
What do the ciliary muscles do?
Adjust the focus on the lens allowing for focus
82
What happens when the ciliary muscles are relaxed?
The lens is stretched- good for distance vision
83
What happens when the ciliary muscles are contracted?
The lens thickens- good for near vision
84
What innervates the ciliary muscles?
Parasympathetic short ciliary nerve
85
Can the ciliary muscles be actively relaxed?
No, can be actively contract but must wait for parasympathetic innervation to stop before can dilate
86
What are the 6 reflex arcs it is important for us to know?
``` Maximal eyelid opening Pupil contraction/dilation Lens focusing Lacrimation Vestibulo-ocular reflex Blink reflex ```
87
When is maximal eyelid opening useful and what nerves control it?
Fight or flight | Somatic motor CNIII and sympathetic input
88
What is pupil contraction/dilation used for and what nerves control it?
Regulate the amount of light entering the eye | Parasympathetic short ciliary nerve and sympathetic long ciliary nerve
89
What is lens focusing used for and what nerve controls it?
Focusing on object at different distances | Parasympathetic short ciliary nerve
90
What is lacrimation used for and what nerve controls it?
Lubricate, clean and protect the eyes | Parasympathetic CNVII
91
What is the vestibulo-ocular reflex used for?
Eyes go opposite direction to head to keep them focused as head moves
92
What is a pinpoint pupil and what can it be a sign of?
Fixed constricted pupil. | Opiate use
93
What is a 'Blown' pupil and what can it be a sign of?
Fixed dilated pupil | CNIII damage
94
What is accommodation?
When eyes converge the lens thickens and pupils constrict.

Ophthalmology (10 decks)

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