022 the eye Flashcards

1
Q

what are the external/visible structures of the eye?

A
  • upper and lower eyelids
  • palpebral fissure between the eyelids (endpoints called medial and lateral cathus)
  • medial canthus = has lacrimal caruncle and plica semilunaris
  • sclera, cornea, iris and pupil
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2
Q

what are the medial and lateral canthus of the eye?

A

end points of the eye

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3
Q

what is the lacrimal caruncle and plica semilunaris of the eye?

A
  • remnants of the ‘3rd eyelid’ which many animals have
  • inner pink part of eye
  • lacrimal caruncle is most inner, then plica semilunaris
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4
Q

what is the conjunctiva?

A
  • thin transparent film that covers inside of eyelids and visible part of sclera (but not cornea/iris)
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5
Q

what is the purpose of the conjunctiva?

A
  • secretes oils and mucous to lubricate eye and keep it clean
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6
Q

what is the anatomical location of the conjunctiva and what is it attached to?

A
  • covers inside of eyelids and sclera, but not cornea/iris
    – attaches on the corneal boundary/limbus
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7
Q

what is the innervation and blood supply of the conjunctiva?

A
  • ophthalmic division of trigeminal nerve
  • ophthalmic artery
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8
Q

what is subconjunctival hemorrhage?

A
  • blood in eye
  • caused by blood vessel bursting between conjunctiva and sclera (not in cornea)
  • can be causing by high blood pressure in head e.g. from coughing, vomiting, sneezing, head injury, lifting heavy things
  • not serious, goes away by itself
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9
Q

what is hyphaema?

A
  • blood in between the cornea and iris
  • often due to trauma, surgery, tumours or vascular anomalies
  • can be serious –> cause vision loss, increased intraocular pressure and atrophy of optic nerve
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10
Q

what is viral conjunctivitis?

A
  • inflammation of the conjunctiva of the eye often due to infection/allergies
  • also called pink eye
  • makes eyes red and itchy and may produce pus
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11
Q

what are the layers of the eyelids?

A

superficial to deep:
- skin
- subcutaneous tissue
- orbicularis oculi muscle
- levator palpebrae and superior tarsal muscle (upper)
- orbital septum
- tarsus / tarsal gland
- sebaceous gland of eyelash
- conjunctiva

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12
Q

what is the orbital septum?

A
  • extension of periosteum into both upper and lower eyelids
  • levator palpebrae superiors and tarsus muscle atatch here
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13
Q

what are the tarsal plates?

A
  • fibrous tissue in the upper and lower eyelids
  • stiffen eyelids
  • the conjunctiva adheres to the deep surface of the tarsal plates and tarsal muscle
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14
Q

what glands are in the eyelids?

A

ciliary = behind the roots of eyelashes (infection of these cause styes)
tarsal = on deep surface of tarsal plates, their ducts open onto lid margin

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15
Q

what is the innervation of the upper eye lid?

A

ophthalmic division of trigeminal nerve

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16
Q

what is the innervation of the lower eye lid?

A

maxillary division of trigeminal nerve

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17
Q

what is ptosis?

A
  • drooping of upper eyelid
  • sometimes called a lazy eye
  • can be unilateral or bilateral
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18
Q

what causes ptosis?

A
  • muscle weakness of the eyelid muscles levator palpebrae and superior tarsal muscle (associated with old age or congenital)
  • oculomotor nerve palsy e.g. stroke
  • Horner’s syndrome
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19
Q

what is Horner’s syndrome caused by?

A
  • usually due to damage of the sympathetic trunk in the neck
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20
Q

what are symptoms of Horner’s syndrome?

A
  • ipsilateral = same side as the side of the sympathetic trunk lesion
  • ptosis, drooping of eyelid due to denervation of superior tarsal muscle
  • miosis, pupillary constriction due to denervation of superior tarsal muscle
  • anhidrosis, absence of sweating due to deneravation of sweat glands
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21
Q

what is the lacrimal apparatus made up of?

A
  • lacrimal gland and its ducts
  • puncta
  • lacrimal canaliculi
  • lacrimal sac
  • nasolacrimal duct
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22
Q

what is the function of the lacrimal apparatus?

A
  • production, movement and drainage of fluid from the surface of the eyeball
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23
Q

what is the location of the lacrimal gland?

A
  • above the eyelid on the lateral side
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24
Q

what is the location of the puncta, lacrimal canaliculi, lacrimal sac, nasolacrimal duct?

A
  • puncta = medial inner pink region of eye, opening through which fluid enters each lacrimal canaliculus
  • the lacrimal canaliculi then join the lacrimal sac which is connected to the nasolacrimal duct
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25
Q

what is the lacrimal gland innervated by?

A
  • ophthalmic division of trigeminal nerve
  • facial nerve
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26
Q

what are the 3 wall layers of the eye?

A

outer to inner:
- sclera
- choroid
- retina

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27
Q

what is the eye divided into?

A
  • anterior and posterior cavity
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28
Q

what is in the anterior cavity of the eye?

A
  • divided into anterior and posterior chamber
  • anterior chamber = lens
  • posterior chamber = everything in front of the lens : pupil, iris
    -all filled with aqueous humour ( more watery)
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29
Q

what is in the posterior cavity of the eye?

A
  • filled with vitreous humour (more jelly like)
  • behind the lens
  • retina/fovea at back
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30
Q

what is a?

A

sclera

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31
Q

what is b?

A

choroid

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32
Q

what is c?

A

retina

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33
Q

what is d?

A

fovea centralis

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34
Q

what is e?

A

optic disc

35
Q

what is f?

A

optic nerve

36
Q

what is g?

A

central retina artery and vein

37
Q

what is h?

A

hyaloid canal

38
Q

what is i?

A

ora serrata

39
Q

what is j?

A

ciliary process of the ciliary body

40
Q

what is k?

A

ciliary muscle of the ciliary body

41
Q

what is L?

A

lacrimal sac

42
Q

what is m?

A

limbus

43
Q

what is n?

A

scleral venous sinus

44
Q

what is o?

A

suspensory ligament

45
Q

what is p?

A

lens

46
Q

what is q?

A

iris

47
Q

what is r?

A

cornea

48
Q

what is s?

A

pupil

49
Q

what is t?

A

posterior chamber of the anterior cavity

50
Q

what is u?

A

anterior chamber of anterior cavity

51
Q

describe the structure of the cornea

A
  • a transparent layered structure that covers the iris, covered with stratified epithelium epithelium
  • epithelium contains no stem cells, new cells migrate from periphery
  • contains no blood vessels or lymphatics
  • continuous with the sclera
52
Q

what is the function of the cornea?

A
  • refracts light entering the eye
  • responsible for 40 out of 60 diopters refractive power if the eye
  • sensory = corneal reflex
53
Q

what happens if the cornea is misshapen?

A
  • can no longer refract light into the eye properly
  • affect vision
  • vision more blurry
  • need cornea transplant
54
Q

what is the structure of the sclera?

A
  • outermost layer of the eye
  • fibrous connective tissue
  • continuous with the cornea
  • provides shape and support
  • white part of eye
  • attachment for extraocular muscles
55
Q

what is the choroid?

A
  • middle layer of the eye wall
  • part of the vascular layer of the eye
  • supplies the retina with nutrition and gas exchange from ciliary arteries (branch of ophthalmic artery)
    -part of uveal tract (iris, ciliary body, choroid)
  • contains melanin, limits uncontrolled reflection of light
56
Q

what is in the vascular layer of the eye?

A
  • choroid, the ciliary body, iris
57
Q

what is the cornea reflex?

A
  • touching the cornea causing a reflex to blink/shut eyelids
58
Q

describe the pathway of the cornea reflex

A
  • stimulus on cornea –>nasociliary nerve of ophthalmic division of trigeminal nerve (CNVi)
    –> spinal trigeminal nucleus –> interneuron –> facial nucleus
    –> facial nerve –> orbicularis oculi muscles to close eyelids
59
Q

what is the ciliary body?

A
  • 2 parts:
  • ciliary muscle = collection of smooth muscle fibres, radial, longitudinal and circular
  • ciliary processes = longitudinal ridges projecting from the ciliary body, attach ciliary muscle to lens
  • overall control shape of lens for vision and also formation of aqueous humour
60
Q

What is the function of the ciliary muscle?

A
  • change the shae of the lens for focusing vision
61
Q

what is the function of the ciliary processes?

A
  • attach zonular fibres (which forms the suspensory ligament) to the lens of the eye
  • also contributes to the formation of aqueous humour
62
Q

describe accommodation for near vision

A

-ciliary muscle contraction = decreases size of ring formed by ciliary body, which reduces tension on suspensory ligament –> lens becomes more rounded/relaxed = accommodation for near vision
- pupil diameter is also smaller because of this
- both under parasympathetic innervation (CNIII)

63
Q

describe the flow of aqueous humour in the anterior cavity of the eye

A
  • aqueous humour is secreted in the ciliary process in the posterior chamber and flows from their through the pupil into the anterior chamber
  • the posterior limiting lamina of the cornea contains many small openings in the pectinate ligament into the scleral canal/sinus which it drains out of into the episcleral veins
64
Q

what is glaucoma?

A
  • increased pressure in the eye, causing damage to the optic nerve
  • causes blurry/distorted vision and halos around lights
65
Q

what causes glaucoma?

A
  • blockage of the drainage of aqueous humour out of the eye
    = increased eye pressure and damage the optic nerve
66
Q

describe the structure of the iris

A
  • circular structure with an opening in the centre (pupil)
  • 2 rings of muscles, outer dilator ring and inner sphincter ring
  • coloured part of eye
67
Q

describe how the iris constricts the pupil

A
  • circularly arranged sphincter muscle of the iris receives innervation from parasympathetic nerves from CNIII to contract muscle and constrict pupil
    = short ciliary nerves
68
Q

describe how the iris dilates the pupil

A
  • radially arranged dilator muscle of the iris receives innervation from sympathetic nerves from superior cervical ganglion through CNVi
    = long ciliary nerves
69
Q

what is the structure/attachment of lens?

A
  • avascular and a-sensory
  • onion like lamella structure
  • suspended behind iris from the ciliary process and muscle via the suspensory ligament
  • resting lens is flat and long = long vision
70
Q

what is cataracts?

A

when the lens in the eye becomes opaque
- due to old age, too much UV exposure, trauma
- can easily be replaced with artificial lens

71
Q

what is the sympathetic pathway supply to the eye?

A
  • originate in hypothalamus –> down into upper thoracic cord (T1,2) (thoracic trunk)
    –> back up into superior cervical ganglion –> carotid plexus –> long ciliary nerves via CNVi = dilate pupil
72
Q

what is the parasympathetic pathway supply to the eye?

A
  • originate in midbrain –> ciliary ganglion –> short ciliary nerves via CNIII= constrict pupil and accommodate for short distance vision
73
Q

what are the 4 parasympathetic ganglia of the head and neck?

A
  • ciliary ganglion = eye (1)
  • submandibular ganglion = salivary glands of mandible (2)
  • pterygopalatine ganglion = lacrimal glanfs of eye and nasal glands (3)
  • otic ganglion = parotid gland (4)
74
Q

describe common features of the parasympathetic ganglia of the head and neck

A
  • autonomic
  • paired
  • non-terminal
  • all have a motor root which synapses within the ganglia to the postsynaptic fibres to the postsynaptic fibres to the target organs
  • all receive postsynaptic sympathetic fibres via a sympathetic root which pass through (don’t synapse)
  • all receive a sensory root which also just pass through ( no synapsing) for general sensory
75
Q

describe the structure of the retina

A
  • inner most wall layer of the eye
  • 2 cellular layers:
    - neural layer = consists of photoreceptors, located posteriorly and laterally (optic part)
    - pigmented layer = lies beneath neural layer, attached to choroid layer, supports neural layer and continues around the whole inner surface of the eye (non-visual part)
  • ora serrata = junction between the optic part and the non-visual part of the retina
  • also have optic disc, macula lutea, fovea centralis and rod and cone cells
76
Q

what is the macula lutea?

A
  • centre of retina
  • has a depressed area where the fovea centralis lies
  • yellow in colour and highly pigmented
  • area of maximal retinal resolution power (most accurate vision)
  • vulnerable to degeneration as it is mainly avascular to have more rod and cone cells
77
Q

what is the fovea centralis?

A
  • depression in the macula in the retina at the back of the eye
  • high concentration of cone and rod light detecting cells
  • lower concentration of rod cells and higher concentration of cone cells
77
Q

what is the fovea centralis?

A
  • depression in the macula in the retina at the back of the eye
  • high concentration of cone and rod light detecting cells
  • lower concentration of rod cells and higher concentration of cone cells
78
Q

what is the function of rod cells?

A
  • light senstitive receptor cell
  • function in dim light
  • insensitive to colour
    ( black and white, night vision)
79
Q

what is the function of cone cells?

A
  • light sensitive receptor cells
  • function in bright light
  • sensitive to colour
    (colourful, day time)
80
Q

what is the optic disc?

A
  • where the optic nerve leaves the retina in the back of the eye
  • no light-sensitive receptor cells here, so called ‘blindspot’
81
Q

what is the distribution of rod and cone cells?

A
  • rod cells = high density across retina except dramatic decrease at the fovea
  • cone cells = low density across the retina and a dramatic increase at the fovea
82
Q

what is ophthalmoscopy?

A
  • using an ophthalmoscope to look at the back of the eye (fundus), including retina, optic disc, choroid and blood vessels
83
Q

what can you find using an ophthalmoscope?

A
  • any conditions or diseases affecting the back of the eye
  • e.g. high blood pressure = enlarged retinal vessels
  • diabetes = ‘cotton wall spots, microaneurysms and neovascularization
  • tumours
  • papilloedema ( swelling of optic disc)
  • ruptured blood vessels