Orbit

Question 1

Anatomy (Dimensions)
Volume of orbital cavity is about —— in an adult
Rim of the orbit measures — mm
horizontally and — mm vertically in an adult
Medial orbital walls are roughly parallel and —mm apart in adults
Lateral orbital walls angles about ——degrees from each other

Answer 1

Anatomy (Dimensions)
Resembles a four sided pyramid
Volume of orbital cavity is about 30 cc in an adult
Rim of the orbit measures 40 mm
horizontally and 35 mm vertically in an adult
Medial orbital walls are roughly parallel and 25 mm apart in adults
Lateral orbital walls angles about 90 degrees from each other

Question 2

Orbital
• Superior orbital rim is formed by the ——— bone
• Inferior orbital rim is formed by —— bone medially and —— bone laterally
© Lateral orbital rim is formed by the ——
• Superior orbital rim contains a notch at its —— and —— 1/3. This is known as ——- notch.
• ——— passes through this notch to the forehead
© Medial portion ofthe rim is formed by the ———

Answer 2

Orbital
• Superior orbital rim is formed by the frontal bone
• Inferior orbital rim is formed by maxillary bone medially and zygomatic bone laterally
© Lateral orbital rim is formed by the zygoma
• Superior orbital rim contains a notch at its medial and lateral 1/3. This is known as supraorbital notch.
• Supraorbital nerve and artery passes through this notch to the forehead
© Medial portion ofthe rim is formed by the frontal process of maxilla

Question 3

Lacrimal fossa

Lodges the ———
This fossa is formed by —— and —— bones
It is bounded by ——- and ——-

Answer 3

Lodges the lacrimal sac
• This fossa is formed by maxillary and lacrimal bones
It is bounded by anterior and posterior lacrimal crests
Anterior lacrimal crest is formed by the maxillary bone
Posterior lacrimal crest is formed by lacrimal bone

Question 4

Lacrimal fossa

Anterior lacrimal crest is formed by the ——— bone
Posterior lacrimal crest is formed by —— bone

Answer 4

Anterior lacrimal crest is formed by the maxillary bone
Posterior lacrimal crest is formed by lacrimal bone

Question 5

Anterior lacrimal crest is formed by the maxillary bone
Posterior lacrimal crest is formed by lacrimal bone

Question 6

Naso lacrimal duct
Connects the ——— to the ——— opening in the ——— of nose
It is—to—mm in diameter
It is about —mm long
All the walls of the duct are covered with
——- bone excepting its —— wall

The medial wall is formed by———inferiorly and ——— superiorly

Answer 6

Naso lacrimal duct
Connects the lacrimal sac to the naso
lacrimal opening in the inferior meatus of nose
It is 3-4 mm in diameter
It is about 12 mm long
All the walls of the duct are covered with
maxillary bone excepting its medial wall
The medial wall is formed by lateral nasal wall inferiorly and descending process of lacrimal bone superiorly

Question 7

Weber’s suture
It lies anterior to the ———
Also known as ————
This suture runs parallel to———
Branches of ——- artery pass through this groove to supply the nasal mucosa
Bleeding occurs from these vessels during lacrimal sac surgeries

Answer 7

Weber’s suture
It lies anterior to t h e lacrimal fossa
Also known as sutura longitudinalis imperfecta
This suture runs parallel to anterior lacrimal crest
Branches of infraorbital artery pass through this groove to supply the nasal mucosa
Bleeding occurs from these vessels during lacrimal sac surgeries
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Question 8

Embryology
The 7 bones forming the orbit are derived from ——- cells
• Ossification of orbit is complete at —— excepting its ——
Excepting ———-, other bones develop by ———- ossification

Answer 8

Embryology
The 7 bones forming the orbit are derived from neural crest cells
• Ossification of orbit is complete at birth excepting its apex
Excepting lesser wing of sphenoid other bones develop by intramembranous ossification
Lesser wing of sphenoid is cartilaginous

Question 9

Embryology

Excepting lesser wing of sphenoid other bones develop by ——— ossification
Lesser wing of sphenoid is ———

Answer 9

Embryology
Excepting lesser wing of sphenoid other bones develop by intramembranous ossification
Lesser wing of sphenoid is cartilaginous

Question 10

Orbital roof
The roof is formed by the ——— bone
The posterior —cm of the roof is formed by the ——-
The optic foramen is located in the ———
The optic foramen contains the ——
The optic nerve enters the orbit at an angulation of — degrees
Lacrimal gland is located at the ———
• Trochlear fossa is located in the ————

Answer 10

Orbital roof
The roof is formed by the frontal bone
The posterior 1.5 cm of the roof is formed by the lesser wing of sphenoid
The optic foramen is located in the lesser wing of sphenoid
The optic foramen contains the optic nerve
The optic nerve enters the orbit at an angulation of 45 degrees
Lacrimal gland is located at the lateral end of orbital roof
• Trochlear fossa is located in the anteromedial portion of the roof

Question 11

Medial orbital wall
Is formed by the ———
Thinnest portion of the medial wall is the ———-. It is one of the components of the —— bone
• Infections from ——— sinus can breach this bone thus spreading to the
orbit

Answer 11

Medial orbital wall
Is formed by the frontal process of maxilla, lacrimal bone, ethmoidal bone, and lesser wing of sphenoid bone
Thinnest portion of the medial wall is the lamina papyracea. It is one of the components of the ethmoid bone
• Infections from ethmoidal sinus can breach this bone thus spreading to the
orbit

Question 12

Medial orbital wall (contd)
• The medial orbital wall is thicker posteriorly where the ——— bone is present. It is thicker anteriorly where the ———— is present
• Tumors of the nasal cavity can breach the ——— to involve the orbit
• A ——— line runs between the anterior and posterior lacrimal crests

Answer 12

Medial orbital wall (contd)
• The medial orbital wall is thicker posteriorly where the sphenoid bone is present. It is thicker anteriorly where the posterior lacrimal crest is present
• Tumors of the nasal cavity can breach the lamina papyracea to involve the orbit
• Avertical suture line runs between the anterior and posterior lacrimal crests

Question 13

• Avertical suture line runs between the anterior and posterior lacrimal crests
• If this suture is located anteriorly it indicates predominance of —— bone while a posteriorly located suture indicates the predominance of —— bone in the anatomical relationship

Answer 13

Medial orbital wall (contd)
• The medial orbital wall is thicker posteriorly where the sphenoid bone is present. It is thicker anteriorly where the posterior lacrimal crest is present
• Tumors of the nasal cavity can breach the lamina papyracea to involve the orbit
• Avertical suture line runs between the anterior and posterior lacrimal crests
• If this suture is located anteriorly it indicates
predominance of lacrimal bone while a posteriorly located suture indicates the predominance of maxillary bone in the anatomical relationship

Question 14

Medial wall applied anatomy
Lacrimal bone at the level of ——-is very thin
• This bone can easily be penetrated during ———
If —— component is
predominant, it becomes difficult to perform osteotomy to reach the sac
during endo DCR because——-

Answer 14

MedialIwall applied anatomy Lacrimal bone a t the level of lacrimal
fossa
is very thin
• This bone can easily be penetrated during endoscopic DCR
If maxillary component is
predominant, ti becomes difficult to perform osteotomy to reach the sac
during endo DCR because the maxillary bone is very thick

Question 15

Fronto ethmoidal suture line
This is a very important surgical landmark
This suture line marks the approximate level of ———
Dissection above this line will expose the cranial cavity
——— and ——— foramina are present in this suture line
Anterior ethmoidal foramen is located — mm from the ——— lacrimal crest, while the posterior foramen is located — m m from the ———lacrimal crest
The ——— and ——— arteries pass through these foramina

Answer 15

Fronto ethmoidal suture line
This is a very important surgical landmark
This suture line marks the approximate level of ethmoidal sinus roof
Dissection above this line will expose the cranial cavity
Anterior and posterior ethmoidal foramina are present in this suture line
Anterior ethmoidal foramen is located 24 mm from the anterior lacrimal crest, while the posterior foramen is located 36 m m from the anterior
lacrimal crest
The anterior and posterior ethmoidal arteries pass through these foramina

Question 16

Orbital floor
It is bordered laterally by ——— fissure
Medially it is bound by the ———
The floor is almost entirely formed by the ————, while the ———bone contributes to a small portion posteriorly

Answer 16

Orbital floor
1Floor is the shortest of all its walls
It is bordered laterally by infraorbital fissure
Medially it is bound by the maxillo ethmoidal strut of bone
The floor is almost entirely formed by the orbital plate of maxilla, while the orbital plate of palatine bone contributes to a
small portion posteriorly

Question 17

The ——- is the shortest of all the orbit walls

Answer 17

Floor

Question 18

Orbital floor (contd)
• Infraorbital groove becomes ——— foramen anteriorly
———— pass through this foramen
- The portion of the floor medial to the infraorbital groove is thin because of the———

Answer 18

Orbital floor (contd)
• Infraorbital groove becomes infraorbital foramen anteriorly
Infraorbital nerve and artery pass through this foramen
- The portion of the floor medial to the infraorbital groove is thin because of the expansion of the maxillary sinus

Question 19

Orbital floor (contd)
• ———— becomes infraorbital foramen anteriorly

• The portion of the floor medial to the infraorbital groove is(thin/thick?) because of the expansion of the maxillary sinus

Answer 19

Orbital floor (contd)
• Infraorbital groove becomes infraorbital foramen anteriorly
Infraorbital nerve and artery pass through this foramen
- The portion of the floor medial to the infraorbital groove is thin because of the expansion of the maxillary sinus

Question 20

Lateral wall
• Lateral wall of orbit is formed by the ————
- ——— and ——— bone contribute in a minor way anteriorly
——— branch of ——-artery is seen in this wall
— to — mm behind the lateral orbital rim and — cm inferior to the fronto zygomatic suture line ——— tubercle is present.

Answer 20

Lateral wall
• Lateral wall of orbit is formed by the greater wing of sphenoid
- Zygoma and zygomatic process of frontal bone contribute in a minor way anteriorly
Recurrent meningeal branch of middle meningeal artery is seen in this wall
4 - 5 mm behind the lateral orbital rim and
1 cm inferior to the fronto zygomatic suture line Whitnall’s
tubercle is
present.

Question 21

Whitnall’s tubercle
• Lies — to — mm behind the ——— rim & — cm inferior to ———— suture
Structures getting attached to this tubercle are:

Answer 21

Whitnall’s tubercle
• Lies 4-5 mm behind the lateral orbital rim & 1 cm inferior to fronto zygomatic suture
Structures getting attached to this tubercle are: 1. Lateral canthal tendon
2. Lateral rectus check ligament
3. Suspensory ligament of lower eyelid (Lockwood’s ligament)
4. Orbital septum
5. Lacrimal gland fascia

Question 22

Lateral wall (contd)
• ———— and ——— bone protect the globe from lateral trauma
• This area is also known as ——— area
• Just behind this facial buttress area the ——— bone and ———bone are thinner. The junction between these two bones are separated by the ——— suture.
This area is the preferred site for ———
Posteriorly lateral wall thickens and meet the —— bone to form the lateral wall of the cranial cavity

Answer 22

Lateral wall (contd)
• Frontal process of zygoma and zygomatic process of frontal bone protect the globe from lateral trauma
• This area is also known as facial buttress area
• Just behind this facial buttress area the posterior zygomatic bone and orbital plate of greater wing of sphenoid are thinner. The junction between these two bones are separated by the zygomatico sphenoid suture.
This area is the preferred site for lateral orbitotomy Posteriorly lateral wall thickens and meet the temporal
bone to form the lateral wall of
the cranial cavity

Question 23

Superior orbital fissure
Lies between the ——— and ——— of ——- bone
Medial to this fissure is the ——— through which ——- passes
-what passes through this fissure
outside the annulus of zinn

Answer 23

Superior orbital fissure
Lies between the greater and lesser wings of sphenoid
Medial to this fissure is the optic foramen through which optic nerve passes
Lacrimal, frontal and trochlear nerves pass
through this fissure
outside the annulus of zinn

Question 24

Optic foramen
• Lies medial to the ———— fissure
• It is present in the —— wing of sphenoid
• ———— passes through it
• It is about —mm in diameter
Optic foramen in both sides is usually
Asymmetrical (T or F) .

Answer 24

Optic foramen
• Lies medial to the superior orbital fissure
• It is present in the lesser wing of sphenoid
• Optic nerve and ophthalmic artery passes through it
• It is about 6.5 mm in diameter
Optic foramen in both sides is usually
symmetrical. Even slight difference is considered to be pathological

Question 25

Inferior orbital fissure • Lies between the ——— and ——— • It is about — mm long Structures passing through this fissure are:

Answer 25

Inferior orbital fissure • Lies between the lateral wall and floor of orbit • It is about 20 mm long Structures passing through this fissure are: .1 Maxillary division of trigeminal nerve 2. Zygomatic nerve 3. Branches from sphenopalatine ganglion 4. Branches from inferior ophthalmic vein leading on to pterygoid plexus

Question 26

Soft tissues of orbit include:

Answer 26

Soft tissues of orbit • Orbitalseptum • Periorbita • Orbital fat • Extraocular muscles • Lacrimal system

Question 27

Orbital septum It is ——— in origin • Covered anteriorly by ——— muscle

Answer 27

Orbital septum Is the anterior soft tissue boundary of orbit • It acts as a physical barrier against pathogens It is thin and formed by multilayered fibrous tissue It is mesodermal in origin • Covered anteriorly by preseptal orbicularis oculi muscle

Question 28

——— Is the anterior soft tissue boundary of orbit

Answer 28

Orbital septum

Question 29

Periorbita Is the ——— lining of orbital walls Posteriorly the Periorbita is continuous with the ——- ———— provides the cushioning effect to the eye ball

Answer 29

Periorbita Is the periosteal lining of orbital walls It is attached to fissures, suture lines and foramen of orbit Posteriorly the Periorbita is continuous with the optic sheath Fat tissue / orbital fat provides the cushioning effect to the eye ball

Question 30

———Is the periosteal lining of orbital walls

Answer 30

Periorbita Is the periosteal lining of orbital walls It is attached to fissures, suture lines and foramen of orbit

Question 31

Extraocular muscles Arise from ———- These muscles are:

Answer 31

Extraocular muscles Arise from the annulus of zinn • They are responsible for the movements of the globe These muscles are: 1. Lateral and medial rectus 2. Superior and inferior rectus 3. Superior and inferior oblique

Question 32

Lacrimal system Lacrimal gland is located in the ——— portion of orbit It lies in the shallow ——— of frontal bone • It is composed of numerous secretary units called ——-, It measures —mm / —mm A fibrous band incompletely divides the gland in to two lobes, the posterior larger —— lobe and the anterior smaller —— lobe Ducts from the —— lobe will have to pass through the —— lobe to drain Damage to the —— lobe blocks drainage to the entire gland

Answer 32

Lacrimal system Lacrimal gland is located in the supero temporal portion of orbit It lies in the shallow lacrimal fossa of frontal bone • It is composed of numerous secretary units called acini It measures 20mm / 12mm A fibrous band incompletely divides the gland in to two lobes, the posterior larger orbital lobe and the anterior smaller palpebral lobe Ducts from the orbital lobe will have to pass through the palpebral lobe to drain Damage to the palpebral lobe blocks drainage to the entire gland

Question 33

Lacrimal system (contd) The lacrimal excretory system begins at the —— end of each eyelid known as the —— These puncta are directed ——— Punctal opening widens into ———, which is perpendicular to the eyelid margin This makes a sharp turn to drain into the ——— The canaliculi measures —to — mm in diameter • It courses parallel to the ———

Answer 33

Lacrimal system (contd) The lacrimal excretory system begins at the medial end of each eyelid known as the punctum These puncta are directed posteriorly Punctal opening widens into ampulla, which is perpendicular to the eyelid margin The ampulla makes a sharp turn to drain into the canaliculi The canaliculi measures 0.5 - 1 mm in diameter • It courses parallel to the lid margins

Question 34

Lacrimal system (cont) Superior canaliculus is — mm long Inferior canaliculus is — mm long These two canaliculi joint to form a common canaliculi before joining the sac Opening of common canaliculi into nasolacrimal sac is known as —— ———- is present at the junction of the common canaliculus and the lacrimal sac ———— is present at the lower end of nasolacrimal duct at the ——— Congenital nasolacrimal duct obstruction is caused due to imperforate ————

Answer 34

Lacrimal system (cont) Superior canaliculus is 8 mm long Inferior canaliculus is 10 mm long These two canaliculi joint to form a common canaliculi before joining the sac Opening of common canaliculi into nasolacrimal sac is known as internal punctum Valve of Rosenmuller is present at the junction of the common canaliculus and the lacrimal sac Hasner's valve is present at the lower end of nasolacrimal duct at the inferior m e a t s Congenital nasolacrimal duct obstruction is caused due t o imperforate Hasner's valve

Question 35

Nasolacrimal sac Resides in the ——— Measures about — - — mm vertically — to —mm anteroposteriorly • Drains via the ———duct into the ———

Answer 35

Resides in the lacrimal fossa Measures about 12 - 15 mm vertically 4-8mm anteroposteriorly • Drains via the nasolacrimal Lacrimal duct into the inferior meatus

Question 36

Development of orbit Develops from mesenchyme by —— — th to — th week laying down of bones starting with —— bone around the Optic vesicle During this time optic vesicle —degree apart rotates anteriorly

Answer 36

Development of orbit Develops from mesenchyme by ossification 6 th to 7 th week laying down of bones starting with maxilla bone around the Optic vesicle During this time optic vesicle 170 degree apart rotates anteriorly

Question 37

Craniosfacial dysostois / Crouzon’ syndrome features:

Answer 37

Proptosis – shallow orbits Hypertelorim - wide separation of orbits V pattern exotropia

Question 38

Oxycephaly-syndactlye / Apert’ syndrome features

Answer 38

Oxycephaly-syndactlye / Apert’ syndrome : Flattened occiput , steep forehead , supra orbital ridge Midfacial hypoplasia , parrot beak nose

Question 39

Orbital apex syndrome/ Tolosa - hunt syndrome : Damage to structures at ——— Symptoms :

Answer 39

Orbital apex syndrome / Tolosa - hunt syndrome : Damage to structures at apex 2 nd, 3 rd, 4 th ,6 th nerves Symptoms : visual loss, ophthalmoplegia periorbital & facial pain

Question 40

———— Lesion anterior to orbital apex excluding optic nerve pathology

Answer 40

Superior orbital fissure syndrome / Rochon – Duvigneaud syndrome : Lesion anterior to orbital apex excluding optic nerve pathology

Question 41

Contents of orbit include

Answer 41

Contents of orbit  Eye ball  Orbital fat  Connective tissue system  Blood vessels  Nerves  Extraocular muscles

Question 42

Connective tissue system include

Answer 42

Connective tissue system  Periorbita Orbital septum Tenon’s capsule

Question 43

Which of the facial system is incompletely formed

Answer 43

Posterior facial system

Question 44

Anterior fascialsystem Formed by condensation of fibrous septa:

Answer 44

Anterior fascialsystem Formed by condensation of fibrous septa: Lockwood lig, whitnall sup susp lig Lacrimal lig Intermuscular septum

Question 45

Surgical spaces in orbit :

Answer 45

Surgical spaces in orbit : Subperiosteal space  Peripheral space  Central space  Tenon’s space

Question 46

Optic nerve Intra orbital part = — mm out of — cm Enclosed in three ——— sheaths At apex surrounded by ——— , ———— pierces optic nerve 1.25 cm behind optic nerve

Answer 46

Optic nerve Intra orbital part = 25 mm out of 4 cm Enclosed in three meningeal sheaths At apex surrounded by recti muscles , Central retinal artery and vein pierces optic nerve 1.25 cm behind optic nerve Relations: superiorly: ophthalmic artery, sup ophthal vein Interiorly: nasociliary nerve, nerve to medial rectus

Question 47

Oculomotor nerve Divides at anterior part of ——— before entering ———— Sup division supplies :——— Inf division supplies: And motor root relay at ciliary ganglion supplies:———

Answer 47

Oculomotor nerve Divides at anterior part of cavernous sinus before Entering sup orbital fissure Sup division Sup rectus LPS Inf division Medial rectus Inf rectus Inf oblique And motor root relay at ciliary ganglion sphincter pupillae , ciliary muscle

Question 48

Trochlear nerve Runs medially from lateral wall of ——— Above Levator palpebral sup Then supplies orbital surface of ———muscle

Answer 48

Trochlear nerve Runs medially from lateral wall of cavernous sinus Above Levator palpebral sup Then supplies orbital surface of Superior oblique

Question 49

Trigeminal nerve Three terminal branches of ophthalmic division: ——— nerve which gives off—— ——— nerve; Sensory and secretomotor fibres to ———through ——— nerve ——— nerve: branches include

Answer 49

Trigeminal nerve Three terminal branches of ophthalmic division: Frontal nerve supratrochlear supraorbital .Lacrimal nerve Sensory and secretomotor fibres to lacrimal gland tru zygomaticotemporal nerve Nasociliary nerve: 3. Communicating branch to sensory root of ciliary ganglion 4. Long ciliary nerves - dilator pupillae 5. Posterior and anterior ethmoidal branches 6. Infratrochlear nerve

Question 50

Orbit is made up of 7 bones : -

Answer 50

Made up of 7 bones : -Ethmoid -Frontal -Lacrimal -Maxillary -Palatine -Sphenoid -Zygomatic

Question 51

By— to —th month laying down of bone starting with ———

Answer 51

By 6 -7 th month laying down of bone starting with maxillary process

Question 52

Embryology of orbit During this time optic vesicles which are 170 ͦ apart are rotated ——.

Answer 52

During this time optic vesicles which are 170 ͦ apart are rotated anteriorly.

Question 53

Gross anatomy  Dimensions  Depth ≈ —mm along medial wall ≈ — mm along lateral wall  Intraorbital width – distance between medial margins of both orbits ≈ —mm  Extraorbital width – distance between lateral margins of both orbits ≈ — mm  Orbital index = (height / width) ×100 >— – megasenes (orientals) — to — – mesosenes (caucasian) < — – microsenes (nigros)  Volume ≈ —ml -volume of orbit : volume of eyeball = — :—  Angulations – Between lateral wall & sagital plain ≈ — ̊ - Between visual axis & orbital axis ≈ — ̊ other - Medial wall of both orbits are —— to each - Lateral wall of both orbits bears an angle of — ̊

Answer 53

Gross anatomy  Dimensions  Depth ≈ 42 mm along medial wall ≈ 50 mm along lateral wall  Intraorbital width – distance between medial margins of both orbits ≈ 25 mm  Extraorbital width – distance between lateral margins of both orbits ≈ 100 mm  Orbital index = (height / width) ×100 >89 – megasenes (orientals) 83 – 89 – mesosenes (caucasian) < 83 – microsenes (nigros)  Volume ≈ 30ml -volume of orbit : volume of eyeball = 4.5:1  Angulations – Between lateral wall & sagital plain ≈ 45 ̊ - Between visual axis & orbital axis ≈ 23 ̊ other - Medial wall of both orbits are parallel to each - Lateral wall of both orbits bears an angle of 90 ̊

Question 54

What is the shape of the medial and inferior wall, superior, lateral

Answer 54

Medial- quadrangular Inferior- triangle Superior- triangle Lateral- triangle

Question 55

 Base of orbit: - bounded by ——— i.e. ring of compact bone which gives attachment to orbital septum. - Divided into 4 margin:

Answer 55

 Base of orbit: - anterior open end of orbit. - bounded by orbital margins i.e. ring of compact bone which gives attachment to orbital septum. - Divided into 4 margin Superior, lateral, inferior, medial

Question 56

) Superior orbital margin: - Formed by —— bone. - —— 2/3 is sharp & —— 1/3 is rounded. - At this junction lies ——— notch transmiting ———— nerves & vessels. - About — mm medial to supraorbital notch is ——— groove transmitting ——— nerve & artery.

Answer 56

) Superior orbital margin: - Formed by frontal bone. - Lateral 2/3 is sharp & medial 1/3 is rounded. - At this junction lies supraorbital notch transmiting supraorbital nerves & vessels. - About 10 mm medial to supraorbital notch is supratrochlear groove transmitting supratrochlear nerve & artery.

Question 57

ii)Lateral orbital margin: -Strongest/weakest? -Formed by ———- bone & ———- bone.

Answer 57

ii)Lateral orbital margin: -Strongest -Formed by zygomatic process of frontal bone & zygomatic bone. -It does not reach as anteriorly as medial margins.

Question 58

)Inferior orbital margin: -Formed by laterally by—— bone medially by ——— bone - Medially it continues with ———— - — to —cm below orbital margin in line with supraorbital notch lies —— foramena transmitting ——— nerve & vessels

Answer 58

)Inferior orbital margin: -Formed by laterallyzygomatic bone medially  maxilla - Medially it continues with anterior lacrimal crest. - 4-5cm below orbital margin in line with supraorbital notch lies infraorbital foramena transmitting infraorbital nerve & vessels

Question 59

Medial orbital margin: - Formed below by ——- -above by ——— bone

Answer 59

Medial orbital margin: - Formed by below anterior lacrimal crest (maxilla) abovefrontal bone

Question 60

Appertures at the base of orbit: -. - These fascial expansions & sup and inferior oblique muscles bound 5 ——- between them & ——— . -These are the communications between ——— & deep portion of ———. - Through them —— & —— passes out of orbit . Further spread in lid is prevented by ———

Answer 60

Appertures at the base of orbit: - Base of orbit is closed partly by globe , extraocular muscles & their fascial expansions. - These fascial expansions & sup and inferior oblique muscles bound 5 orifices between them & orbital margins . -These are the communications between orbital cavity & deep portion of eyelid. - Through them blood & pus passes out of orbit . Further spread in lid is prevented by orbital septum.

Question 61

i) superior apperture: -———shaped -lies between —— & upper surface of —— - —— from ———- lobe may herniate through this apperture. ii) Superomedial apperture: -Vertically —— shape -Lies between reflected tendon of ——— & ——— -It transmits  ,   -Heniation of fat through this space is common cause of ——— in old people. iii) Inferomedial apperture: -Vertically —— shape -lies between ——— & ———and———. iv) Inferior apperture: -——— in shape -Bounded by ——— , arcuate expansion of ——— & ——— v) InferoLateral apperture: -Vertically —— shape -Lies between arcuate expansion of ——— ,——— muscle & ———

Answer 61

i) superior apperture: -comma shaped -lies between roof & upper surface of LPS -Fat from superomedial lobe may herniate through this apperture. ii) Superomedial apperture: -Vertically oval -Lies between reflected tendon of superior oblique & medial check ligament -It transmitsInfratrochlear nerve , dorsal nasal artery angular vein. -Heniation of fat through this space is common cause of lobulated prominence in old people. iii) Inferomedial apperture: -Vertically oval -lies between medial check ligament & inferior oblique and Lacrimal sac. iv) Inferior apperture: -Triangular -Bounded by inferior oblique , arcuate expansion of inf oblique & floor of orbit. v) InferoLateral apperture: -Vertically oval -Lies between arcuate expansion of inf oblique ,Inf oblique muscle & Lateral check ligament.

Question 62

 Apex of orbit: - Posterior end of orbit. - Has 2 orifices:

Answer 62

Optic canal Superior orbital fissure

Question 63

 Apex of orbit: -Posterior end of orbit. -Has 2 orifices i)Optic canal: - Connects orbit to —— cranial fossa. -Transmits —— nerve & surrounding meninges, ——— artery. -Normal adult dimensions are attended by — to—yrs. -Length ≈ — to— mm -Orbital end is vertically —— shaped Centre is ——- in shape Cranial end is horizontally —— shaped - Optic nerve glioma & meningioma causes ———-

Answer 63

 Apex of orbit: -Posterior end of orbit. -Has 2 orifices i)Optic canal: - Connects orbit to middle cranial fossa. -Transmits Optic nerve & surrounding meninges Ophthalmic artery. -Normal adult dimensions are attended by 4-5 yrs. -Length ≈ 6-11mm -Orbital end is vertically oval Centre is circular Cranial end is horizontally oval - Optic nerve glioma & meningioma causes unilateral enlargement of optic canal.

Question 64

Superior orbital fissure: -———shaped -Bounded by ——— & ——- of ——- bone -Fissure is divided into upper middle & lower part by ————— .

Answer 64

Superior orbital fissure: -Comma shaped -Bounded by greater & lesser wing of sphinoid. -Fissure is divided into upper middle & lower part by common tendinous ring .

Question 65

-In optic canal dural sheath is adherant to ———-.

Answer 65

-In optic canal dural sheath is adherant to periorbita.

Question 66

————: -thickened periorbita at orbital margins -gives attachment to orbital septum.

Answer 66

Arcus marginale

Question 67

Lacrimal fascia: - periorbita at ——— splits into 2 layers reunits at ———- to enclose Lacrimal sac.

Answer 67

Lacrimal fascia: - periorbita at post lacrimal crest splits into 2 layers reunits at anterior lacrimal crest to enclose Lacrimal sac.

Question 68

————-:- Thickened periorbita at orbital apex which gives attachment to 4 recti muscles.

Answer 68

Tendinous ring of zinn:- Thickened periorbita at orbital apex which gives attachment to 4 recti muscles.

Question 69

————-Thin connective tissue membrane lining various intraorbital structures.

Answer 69

Orbital fascia

Question 70

——— Envelopes globe from from limbus to optic disc.

Answer 70

Fascia bulbi :

Question 71

Fascia bulbi : -Envelopes globe from from limbus to optic disc. -Outer surface lies in contact with ——— posteriorly & ———anteriorly with which it merges at limbus. -Tenon’s capsule is seperated from sclera by ———— -Lower part of fascia bulbi is thickened forming a sling on which the globe rest k/a suspensory ligament of ———-_. which extends from ———— to ———-

Answer 71

 Orbital fascia: -Thin connective tissue membrane lining various intraorbital structures. -Described under following structures i)Fascia bulbi : -Envelopes globe from from limbus to optic disc. -Outer surface lies in contact with orbital fat posteriorly & subconjunctival tissue anteriorly with which it merges at limbus. -Tenon’s capsule is seperated from sclera by Episcleral space / tenon’s space . -Lower part of fascia bulbi is thickened forming asling on which the globe rest k/a suspensory ligament of lockhood. which extends from posterior lacrimal crest to lateral orbital wall.

Question 72

Surgical spaces in orbit:

Answer 72

1.Subperiosteal space. 2. Peripheral orbital space. 3.Central orbital space. 4. Subtenon’s space

Question 73

1. Subperiosteal space: -Lies between ——— bone & ———.

Answer 73

1. Subperiosteal space: -Lies between orbital bone & periorbita.

Question 74

Peripheral orbital space: - Lies between - ——— at periphery - ———- internally - ———- anteriorlly. -Posteriorly it merges with ————

Answer 74

Peripheral orbital space: - Lies between - periorbita at periphery - extraocular muscles & their intermuscular septa internally - orbital septum anteriorlly. -Posteriorly it merges with central space. - ContentsPeriorbital fat SO , IO , LPS  Lacrimal , frontal , trochlear, ant & post ethmoidal nerve. superior & inferior ophthalmic vein  Lacrimal gland & Lateral 1⁄2 of lacrimal sac.

Question 75

Central orbital space: . - Bounded by - anteriorly ——— -posteriorly by ———- - In posterior part ,space becomes continuous with ——— space.

Answer 75

Central orbital space: - k/a muscle cone / retro-orbital space / posterior space. - Bounded by - anteriorly tenon’s capsule -posteriorly by 4 recti & intermuscular septa - In posterior part ,space becomes continuous with peripheral space.

Question 76

Subtenon’s space: - Space around eyeball between ——— & ———

Answer 76

Subtenon’s space: - Space around eyeball between sclera & tenon’s capsule - Pus collection in this space is drained by incision on tenon’s capsule through conjunctiva.

Question 77

Orbital fat & reticular tissue: -It is divided by intermuscular septa into

Answer 77

1. Central part 2. Peripheral part: superomedial inferomedial  superotemporal inferotemporal

Question 78

The orbit develop around ———

Answer 78

Eyeball

Question 79

Orbital walls are derived from ——— which expand to form ——— process and ——— process

Answer 79

Cranial neural crest cells Frontonasal process Maxillary process

Question 80

Development Lateral nasal process and maxillary process forms which walls of the orbit

Answer 80

Medial, inferior, lateral

Question 81

The ———- forms the orbital roof

Answer 81

Capsule of the forebrain

Question 82

Development The bones differentiate during the during the — month and later undergo ——- or ——- ossification

Answer 82

3rd month Endochondrial and membranous ossification

Question 83

Endochondrial and membranous ossification,———- bone Intramembranous ossification, ——,——,—— bones

Answer 83

Sphenoid (Frontal,Maxillary ,Palatine)

Question 84

Although eyeball reaches adult size around age—, the orbit undergoes considerable changes till———

Answer 84

3 Puberty

Question 85

Periorbita is innervated by

Answer 85

CN 5

Question 86

How many mm behind the sclerocorneal joint do the following muscles insert; Superior rectus Inferior rectus Medial rectus Lateral rectus

Answer 86

7.7 6.5 5.5 6.9