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OPTM 5004 - Head and Neck > The Orbit (Go OD's Go!) > Flashcards

The Orbit (Go OD's Go!) Flashcards

0
Q

What is a blow-out fracture?

A

Fracture of the orbital floor, usually due to blunt or penetrating trauma

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1
Q

What are the seven bones of the orbit?

A 
Ethmoid
Lacrimal
Palatine
Frontal
Sphenoid
Zygomatic
Maxilla
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2
Q

What bones form the superior wall of the orbit?

A

Orbital part of the frontal bone

Less wing of sphenoid

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3
Q

What bones form the medial wall of the orbit?

A

Orbital plate of ethmoid bone
Frontal process of maxilla
Lacrimal bone
Sphenoid bone

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4
Q

What bones form the lateral wall of the orbit?

A

Frontal process of zygomatic

Greater wing of sphenoid

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5
Q

What bones form the inferior wall of the orbit?

A

Maxilla
Zygomatic
Palatine

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6
Q

Which wall of the orbit is the thickest and strongest wall?

A

Lateral wall

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7
Q

Tell me about the orbital septum

A

A fibrous membrane that becomes continuous with the periosteum of the orbital margins. It is crucial to infection prevention into the orbit

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8
Q

The nasolacrimal duct conveys lacrimal fluid from the __________ to the ___________.

A

Lacrimal sac; inferior nasal meatus

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9
Q 
Levator palpebrae superioris
O:
I:
N:
A:
A

O: lesser wing of sphenoid
I: super tarsus and skin of upper lid
N: CN III - superior division
A: elevation of upper eyelid

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10
Q 
Superior Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anterosup half of eye
N: CN III - superior division
A: elevation, intorsion, adduction

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11
Q 
Inferior Rectus
O: 
I:
N:
A:
A

O: common tendinous rings
I: anteroinf half of eye
N: CN III - inferior division
A: depression, Extorsion, adduction

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12
Q 
Medial Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anteromedial half of eye
N: CN III - inferior division
A: adduction

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13
Q 
Lateral Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anterolateral half of eye
N: CN VI
A: abduction

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14
Q 
Superior oblique
O: 
I:
N:
A:
A

O: body of sphenoid
I: sclera deep to superior Rectus
N: CN IV
A: intorsion, depression, abduction

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15
Q 
Inferior oblique
O:
I:
N:
A:
A

O: anteromedial floor of orbit
I: sclera deep to lateral Rectus
N: CN III - inferior division
A: extorsion, elevation, abduction

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16
Q

The superior oblique, inferior oblique and lateral Rectus hold the eye where?

A

Abducted

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17
Q

How do the SO and IO keep the eye aligned on its axis?

A

Adducting the eye

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18
Q

How do you test the IO and SO using he H test?

A 
Have patient direct eyes medially
Look UP (IO)
Look DOWN (SO)
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19
Q

How do the SR, MR and IR hold the eye?

A

Adducted

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20
Q

How do the SR and IR keep the eye aligned with its axis?

A

By abducting the eye

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21
Q

How can the H test be used to test the SR and IR?

A 
Patient looks laterally
Look UP (SR)
Look DOWN (IR)
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22
Q

What does RADSIN stand for?

A

Recti adduct; superiors intort

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23
Q

What happens to the eye when there is a CN III nerve palsy? What might be the cause?

A

Eye is down and out
Pupil dilated
Complete ptosis
Suspect aneurism (usually in PCA)

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24
What happens to the eye when there is a CN IV nerve palsy? What is a common cause of this?
Eye is hyper Head tilt to opposite side of palsy Congenital or traumatic etiology
25
What happens to the eye in a CN VI palsy? What are the common causes of this?
Eye is deviated toward nose | Common etiology includes trauma, elevated ICP and ischemia from DM
26
Blood supply to the eye comes from where?
The ophthalmic artery which is a branch of the ICA
27
Name the 10 branches of the ophthalmic artery.
``` Lacrimal a Central retinal a Long/short posterior ciliary aa Supra orbital Supra trochlear Medial palpebral aa Ant/post ethmoidal Dorsal nasal ```
28
Where does the lacrimal artery supply blood too?
To lacrimal gland
29
Where does the central retinal artery supply blood to and from what structure does it pierce?
Pierces CN II and perfuses the retina
30
Where does the long posterior ciliary arteries supply blood too?
Ciliary body and iris
31
Where does the short posterior ciliary arteries supply blood too?
Choroid
32
Where do the supra orbital and supra trochlear arteries supply blood too?
Forehead and anterior scalp
33
Where do the medial palpebral arteries supply blood too?
Contribute to arcades in upper and lower eyelids
34
Where does the anterior ethmoidal artery supply blood too?
Ethmoidal air cells Frontal sinus Nasal cavity External nose
35
Where does the posterior ethmoidal artery supply blood too?
Ethmoidal sinuses and nasal cavity
36
Where does the dorsal nasal artery supply blood too?
Terminal branch to root of nose and lacrimal sac
37
What is the venous drainage of the eye?
The superior and inferior ophthalmic veins
38
List the 3 layers of the eyeball and their main components
Fibrous layer: sclera and cornea Vascular layer: choroid, ciliary body, iris Sensory layer: retina
39
What do the superior and inferior ophthalmic veins drain into?
The cavernous sinus
40
Map the pathway of aqueous humor from creation to drainage.
Ciliary processes secrete > posterior chamber > pupil > anterior chamber > trabecular Meshwork > scleral venous channels
41
In what way do dilator pupillae fibers oriented?
A radial manner
42
What is the dilator pupillae innervated by?
By the sympathetic system thus causing mydriasis
43
In what way are the sphincter pupillae fibers oriented?
Circumferentially
44
How is the sphincter pupillae innervated?
It is innervated by postganglionic parasympathetic fibers causing miosis.
45
What is the intraocular lens composed of?
Water and proteins
46
What component of the lens breaks down in cataracts?
Breakdown of the lens proteins
47
The vitreous is mainly composed of what?
Water and collagen
48
What does the vitreous have none of!
BLOOD VESSELS!!!!!
49
What is the anterior chamber located between?
The iris and the cornea
50
How does the central retinal vein drain the eye?
Drains retina > leaves through CN II > drains into sup. ophthalmic vein
51
How do the Vorticose veins drain the eye?
Usually four in number, one for each quadrant of the choroid. Pierced the sclera and drains into the sup and inf ophthalmic veins
52
Map the pathway of lacrimal gland innervation (efferent)
GE fibers travel from CN II > greater petrosal > n of pterygoid canal > pterygopalatine ganglion > hitchhike with v2 branch > infraorbital fissure > lacrimal (v1) > lacrimal gland
53
What happens when the ciliary muscle contracts?
The size of the ciliary body decreases, causing a loosening of the zonular fibers, causing the intraocular lens to thicken for accommodation.
54
What are the three types of tears?
Basal Reflex Emotional
55
What is the purpose/cause of basal tearing?
Lubrication Cleaning Removal of bacteria Normal parasympathetic stimulation
56
What is the purpose/cause of reflex tearing?
Irritation Wash irritants from cornea ``` Afferent = trigeminal Efferent = facial ```
58
What is the purpose/cause of emotional tearing?
Emotional stress | Cause unknown
59
What happens to lacrimation when there is a lesion of CN VII proximal to the geniculate ganglion?
All lacrimation is lost but sometimes the lubrication can be maintained via tarsal, sebaceous and conjunctival glands
60
What will happen to lacrimation when there is a legion at CN V?
Reflex lacrimation is gone

OPTM 5004 - Head and Neck (15 decks)

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