Orbit Overview Flashcards

1
Q

What does the orbit socket contain?

A

the globe, connective tissue,
extraocular muscles (EOMS),
orbital nerves, blood vessels,
and fat

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2
Q

What three coats (tunics) does the globe
consist of?

A

Outer fibrous layer (cornea &
sclera), middle vascular layer
(iris, ciliary body, choroid), and
inner neural layer (retina)

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3
Q

What three chambers are filled with fluid in
the globe?

A

Anterior, posterior, and vitreous

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4
Q

What is the sheet of dense connective tissue
that covers the sclera?

A

Tenon’s capsule (Bulbar fascia)

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5
Q

Describe the attachment of Tenon’s capsule

A

Anteriorly merges with sclera/
conjunctiva at the limbus.
Posteriorly is continuous with
the dural sheath of the optic
nerve.

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6
Q

What is the purpose of Tenon’s capsule?

A

-provides a strong barrier
-separates the globe from
contents of orbit
-prevents orbital infections
from entering the globe

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7
Q

What is the transition between the cornea
and tenon’s capsule/sclera referred to?

A

Limbus

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8
Q

Why is Tenon’s capsule continuous with
dura sheath posteriorly?

A

The optic nerve must pierce
sclera and tenon’s capsule to enter the globe

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9
Q

Sheet of dense connective tissue that extends
the entire rim of the orbit to the tarsal
plate

A

Orbital septum (Palpebral fascia)

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10
Q

Describe the attachment of the orbital septum

A

Continuous with the periosteum
at the superior and inferior
orbital rim

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11
Q

What is the purpose of the orbital septum?

A

Anterior barrier of the orbit
-separates the eyelids and
lacrimal sac from the orbit and
keeps the orbital fat in place

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12
Q

What does the orbital septum prevent from
entering the orbit?

A

Facial/eyelid/nasolacrimal
system infections

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13
Q

Rim where the orbital septum originates

A

Arcus margins

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14
Q

Sheet of dense connective tissue that covers
the bones of the orbit

A

periorbital (orbital fascia, periosteum)

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15
Q

Describe the attachment of periorbita

A

anteriorly- continuous with the
periosteum of facial bones
and orbital septum
posteriorly- continuous with
dural sheath of the ON and
forms the common tendinous
ring

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16
Q

Cranial nerve II

A

optic nerve

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17
Q

cranial nerve III

A

oculomotor

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18
Q

cranial nerve IV

A

Trochlear

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19
Q

cranial nerve V and its branches

A

Trigeminal
-V1 ophthalmic
-V2 maxillary
-V3 mandibular

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20
Q

cranial nerve VI

A

abducens

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21
Q

What blood vessels are in the orbit?

A

-Ophthalmic artery and its
branches
-superior and inferior ophthalmic
vein and its branches

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22
Q

Transverse dense connective tissue located
in the superior orbit and courses from
lateral orbital wall to medial orbital wall

A

Whitnall’s ligament

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23
Q

What is the function of Whitnall’s ligament?

A

Provides support and maintains
spatial movement between
anatomic structures in
the superior orbit

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24
Q

How is the Whitnall’s Ligament formed?

A

By condensation of the levator
muscle and is the point where
the levator muscle fibers end
and the levator aponeurosis
begins

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25
What is the function of levator aponeurosis?
moves the eyelid
26
Transverse dense connective tissue located in the inferior orbit and courses from lateral orbital wall to medial orbit wall
Lockwood's ligament
27
What is the function of Lockwood's Ligament?
-provides support and maintains spatial relationships between anatomic structures in the inferior orbit -contributes to the formation of the capulopalpebral fascia
28
What is the function of the capulopalpebral fascia?
dense connective tissue that acts as a muscle to move the lower eyelid
29
Transverse dense connective tissue that is an expansion of the sheath of the medial rectus and attaches to the lacrimal bone
Medial check ligament
30
What is the function of medial check ligament?
Prevents overaction of the medial rectus
31
Transverse dense connective tissue that is an expansion of the sheath of the lateral rectus and attaches to the zygomatic bone
Lateral check ligament
32
What is the function of the lateral check ligament?
prevents overaction of the lateral rectus
33
Which ligaments come together to form the supporting hammock-like structure for the globe?
-Whitnall's -Lockwood's -Medial check -Lateral check
34
Web of interconnecting connective tissue septa that organizes the orbital space surrounding the globe
Orbital septal system
35
What is the function of the orbital septal system?
Anchors and supports EOMS (muscles), nerves, and blood vessels
36
What are the extraocular muscles?
-Recti muscles: medial, lateral, superior, and inferior -Oblique muscles: superior and inferior
37
What muscles play a role in eyelid retraction?
levator palpebrae, Müller's muscle (Tarsal), capsulopalpebral fascia (not actually a muscle)
38
Space not occupied by orbital structure and filled with adipose tissue
orbital fat
39
What is the purpose of orbital fat (adipose)?
-surrounds the ON and separates it from the EOMs -separates muscles in the orbit from the orbital walls
40
In the anterosuperior orbit, what 2 pads are anterior to the levator aponeurosis?
nasal, central
41
What 3 fat pads are posterior to the orbital septum and anterior to the capsulopalpebral fascia?
nasal, central, temporal
42
hole or opening in bone that allows entrance and exit of nerve and vessels in and out of the orbit
foreamen
43
long, narrow opening in bone that allows entrance and exit of nerves and vessels in and out of the orbit
fissure
44
shallow depression in bone that contains anatomical structures
fossa
45
What are the foramen of the orbit?
optic foramen (canal), supraorbital foramen, supratrochlear foramen, and infraorbital foramen
46
What are the fissures located in the orbit?
superior and inferior orbital fissure
47
What fossa are located in the orbit?
two lacrimal fossa
48
Where is the optical canal?
-lies between the lesser wing and body of sphenoid -at the orbital apex
49
What is the function optical canal?
opening between the orbit and cranial cavity that allows CN II and ophthalmic artery to pass through
50
What is the common tendinous ring (annulus of zinn)?
band of connective tissue that lies anterior to optic canal
51
What is the function of annulus of zinn?
origin for the 4 EOMs (muscles)
52
If a patient has an orbital infection, why must they be treated immediately?
Because the optic canal connects the orbit and cranial cavity so the infection can easily spread to brain
53
Where is the superior orbital fissure?
-Lies between the greater and lesser wings of the sphenoid -inferior portion at the orbital apex
54
What nerves pass through the superior orbital fissure through the annulus of zinn?
-Superior and inferior division of oculomotor nerve (CN III) -nasociliary nerve (CN V1) -abducens nerve (CN VI)
55
What nerves and vessels pass through the superior orbital fissure and above the annulus of zinn?
-superior ophthalmic vein -trochlear nerve (CN IV) -lacrimal nerve (CN V1) -frontal nerve (CN V1)
56
Which cranial nerve provides sensory of touch that results in discomfort when you touch your superior orbit?
CN V -trigeminal
57
Where is the inferior orbital fissure (infraorbital fissure)?
Lies between the floor of the orbit and lateral wall
58
What nerves and vessels pass through the inferior orbital fissure?
-inferior ophthalmic vein -zygomatic nerve (CN V2) -infraorbital nerve (CN V2), artery, and vein
59
Where do the infraorbital nerve (CN V2), artery, and vein go after passing through the inferior orbital fissure?
Continue along the infraorbital groove to pass through the infraorbital canal and infraorbital foramen
60
Where is the lacrimal fossa (for lacrimal gland) located?
located in the frontal bone temporally
61
Where is the lacrimal fossa (for the lacrimal sac) located?
-medially -formed by the lacrimal bone (posterior lacrimal crest) and the frontal process of maxillary bone (anterior lacrimal crest)
62
Which canal extends from the maxillary bone from the lacrimal fossa to open into the nasal cavity?
nasolacrimal canal (nasolacrimal duct within this canal)
63
Why is the lacrimal fossa (for the lacrimal sac) not consider apart of the orbit?
It is considered medial to the orbit because it is separated by the orbital septum
64
How does an infection spread when it occurs within the lacrimal sac?
Can spread to nasal cavity but not the orbit because of the barrier protection from orbital septum
65
Where is the superior orbital (supraorbital) foramen/ notch located?
Located in the frontal bone medially
66
Why can the supraorbital foramen also be called a notch?
Varies among individuals, could be a notch or hole
67
What is the function of the supraorbital foramen?
-opening between the orbit and facial surface -supratrochlear nerve (CN V1), artery, and vein pass through
68
Where is the inferior orbital (infraorbital) foramen located?
maxillary bone
69
What is the function of the infraorbital foramen?
opening between orbit and facial surface -infraorbital nerve (CN V2), artery, and vein pass through
70
skeleton of head
skull
71
What two parts make up the skull?
-cranium -face
72
Bones meet at _______________________, a seam-like immovable joint
suture
73
Exception to bones forming sutures
movable temporomandibular junction (TMJ)
74
Air-filled cavities within several of the skull bones
sinuses
75
What are the bones of the cranium?
frontal, parietal, temporal, occipital, sphenoid, ethmoid
76
Bone that forms the anterior portion of the cranium, anterior floor, and superior part of the face
frontal
77
Bone that forms the roof of cranium and lateral sides of skull skull
parietal
78
Bone that forms the floor of cranium and lateral sides of skull
temporal
79
Bone that forms the posterior portion of the cranium and posterior floor of cranium
occipital
80
Where is the foramen magnum located?
inferior aspect of the occipital bone
81
Bone that forms the floor of cranium
sphenoid
82
What are the three portions of sphenoid bone?
-body -lesser wing -greater wing
83
What is housed in the sella turcica of the body of sphenoid?
Pituitary gland
84
What are the four parts of the ethmoid bone and what are their functions?
-Vertical (perpendicular) plate forms nasal septum -horizontal (cribriform) plate allows olfactory nerves to pass through -Labyrinths (2) house ethmoidal sinuses
85
What are the bones of the face?
frontal, palatine, lacrimal, nasal, inferior conchae, vomer, zygomatic bone (2), maxillary (2), and mandible
86
Bone that forms the forehead and orbital roof
frontal
87
Bone that extends from the hard palate at the of the mouth to the orbital floor
palatine
88
Bone that forms the bridge of the nose
nasal
89
Bone that is located along the lateral wall of nasal cavity
inferior conchae
90
Bone that forms the posterior part of nasal septum
vomer
91
Bone that forms the lateral part of cheekbone and the lateral wall and floor of orbit
zygomatic
92
Bone that forms the upper jaw, cheek, hard palate, lateral wall of nasal cavity, and floor of orbit
maxillary
93
Bone that forms the moveable lower jaw
mandible
94
What does the orbit contain?
Globe, connective tissue, EOMs, orbital nerves, blood vessels, fat
95
What is the shape of the orbit?
Shaped like a 4-sided pyramid with the apex posteriorly and the base anteriorly
96
Where is the apex of the orbit located?
slightly nasal
97
What are the dimensions of the orbit?
40 mm (width) x 35 mm (height) x 45 mm (depth) 3 cc (volume)
98
What bones form the orbit?
frontal, palatine, lacrimal, zygomatic, maxillary, sphenoid, ethmoid
99
What bones form the orbit roof?
frontal bone and lesser wing of sphenoid
100
What bones form the floor of the orbit?
palatine, zygomatic, and maxillary bones
101
Why is the floor of the orbit the weakest wall?
-infraorbital groove/canal in maxillary bone -maxillary sinus below floor
102
What are symptoms of patient that break floor of orbit?
blurred vision and lose of feeling in cheek because CN V2 (infraorbital nerve) goes through infraorbital foramen in maxillary bone
103
What bones for the medially (nasal) wall of orbit?
ethmoid, maxillary, lacrimal, and body of sphenoid bones
104
Why is the medial wall the thinnest wall of the orbit?
Because lamina papyracea of ethmoid bone is filled with sinuses
105
What is the disadvantage of the medial wall being the thinnest wall?
Ethmoid sinus infections can spread to the orbit
106
What bones make up the lateral (temporal) wall of the orbit?
zygomatic and greater wing of sphenoid bone
107
Why is it important for the lateral orbital rim to be the strongest area of the orbit?
Most exposed to possible injury
108
What is the purpose of paranasal sinuses?
Reduce the weight of the skull and filter air we breathe
109
What are the four paranasal sinuses?
maxillary, frontal, ethmoid, sphenoid
110
Where is the maxillary sinus in regards to the orbit?
inferior
111
Where is the sphenoid sinus in regards to the orbit?
posterior and medial
112
Where is the ethmoid sinus in regard to the orbit?
medial
113
Where is the frontal sinus in regards to the orbit?
superior
114
Infection in the air cavities is called
sinusitis
115
If a patient comes in and says that their eye hurts due to pressure around the eye, what does that mean?
infection in sinus
116
Why is the eye called a globe?
hollow structure that encloses cavity filled with fluid
117
Components of outer fibrous layer of globe
Sclera and cornea
118
Characteristics of sclera
-85% of fibrous portion -opaque white color
119
Functions of sclera
-provides protection for the structures within -maintains the shape of globe
120
Sclera is divided into:
sclera and episclera
121
What is the sclera covered by?
-tenons capsule -conjuctiva
122
Characteristics of cornea
-15% of fibrous portion -transparent to allow light rays to enter the eye
123
What are the functions of cornea?
refraction occurs here, helps to bring light rays into focus on the retina
124
Location where the cornea transitions to sclera/Tenon's capsule/conjuctiva
limbus
125
Vascular layer (Uvea) is composed of
iris, ciliary body, and choroid
126
Characteristics of iris
-anterior layer of the uvea -gives eye color -hole in the center called the pupil
127
What are the two muscles of the iris?
Iris dilator and iris sphincter
128
iris muscle that contractions dilate the pupil (during dimmer times so allow more light in eye)
iris dilator
129
iris muscle that contractions constrict the pupil (during bright light to let less light in)
iris sphincter
130
Middle layer of the uvea and continuous of iris
ciliary body
131
What does the ciliary body consist of?
ciliary muscle and ciliary processes
132
What is the function of the ciliary muscle?
Contracts and relaxes to regulate the thickness of the lens and allow accommodation for near and far vision
133
What at the zonules?
suspensory ligaments that attach the ciliary muscle to crystalline lens
134
What is the function of ciliary processes?
produce and secrete aqueous humor (clear fluid that provide nutrients to structures of the eye like the lens)
135
Posterior layer of uvea (continuous of ciliary body)
choroid
136
What is the function of choroid?
network of blood vessels that provide nutrition to the outer 1/3 of retina
137
What does the inner neural layer consist of?
retina
138
What is the function of the retina?
Neural tissue that converts light energy into an electrical signal that can be transmitted to the brain
139
Retina creates electrical signal that exits the eye and enters the brain via the
optic nerve
140
Anterior portion of the optic nerve is called the
optic disc or optic nerve head
141
Small area at the center of the retina responsible for central vision
macula
142
located in the center of the macula and provides highest visual acuity
fovea
143
Interior of the eye is made up 3 chambers filled with fluid:
anterior, posterior, and vitreous chamber
144
Where is the anterior chamber?
between cornea and iris
145
Where is the posterior chamber located?
between ciliary body and lens
146
The anterior and posterior chamber are continuous of one another through the:
pupil
147
Anterior and posterior chamber contain:
aqueous humor (produce by ciliary body and provide nourishment for surrounding structures)
148
Where is vitreous chamber located?
between the ciliary body and reina
149
Vitreous chamber contains a gel-like substance that maintains the shape of the eye called
vitreous humor