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AHNNA > 8. Anatomy Of Eye > Flashcards

8. Anatomy Of Eye Flashcards

1
Q

What are the openings into and out of the orbit?

A

Superior orbital fissure
Optic canal
Inferior orbital fissure

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2
Q

Which bones contribute to the orbit?

A 
Frontal bone
Ethmoid bone
Lacrimal bone
Maxilla
Palatine bone
Zygomatic bone
Sphenoid bone
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3
Q

What are the blood vessels that enter the orbit?

A

Ophthalmic artery and its subsequent branches - including central retinal artery

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4
Q

What are the blood vessels that exit the orbit?

A

Ophthalmic veins (superior and inferior) drain into cavernous sinus, pterygoid plexus and facial vein

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5
Q

Which nerve supplies special sensory vision from retina?

A

Optic nerve

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6
Q

Which nerve supplies general sensory from eye?

A

Ophthalmic division of trigeminal

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7
Q

Which motor nerves supply the muscles of the eye?

A

Oculomotor
Trochlear
Abducens

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8
Q

What are some of the important anatomical relations of the orbit?

A

Paranasal air sinuses (maxillary and ethmoid)
Nasal cavity (nasolacrimal duct)
Anterior cranial fossa

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9
Q

What are the weakest parts of the orbital cavity?

A

Medial wall and floor of the orbit

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10
Q

What his the history of orbital blow out fractures?

A

Sudden increase in intra-orbital pressure (from retro pulse on of eye ball by fist or ball) fractures floor of orbit (maxilla)

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11
Q

What happens to the orbital contents in an orbital blow out fracture?

A

Can prolapse and bleed into maxillary sinus
Fracture site can trap structures such as extra ocular muscle located near orbital floor, and prevents upward gaze on affected side

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12
Q

What are the signs and symptoms of orbital blow out fractures?

A

History of trauma to eye/orbit
Periorbital swelling, painful
Double vision
Numbness over cheek, lower eyelid and upper lip on affected side - branch of maxillary division of CNV

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13
Q

What do the eyelids consist of?

A 
Skin
Subcutaneous tissue
Orbicularis oculi (palpebral part)
Levator palperae superioris 
Tarsal plate
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14
Q

What is the orbicularis oculi innervated by?

A

Facial nerve

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15
Q

What is the role of the orbicularis oculi in the eyelid?

A

Closing of eyelids

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16
Q

What is the levator palpebrae superioris innervated by?

A

Oculomotor nerve

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17
Q

What is the role of levator palpebrae in the eyelid?

A

Retract and elevate eyelid

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18
Q

Which glands contribute to tear film?

A

Meibomian glands

Sebaceous glands associated with lash follicle

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19
Q

What is a stye?

A

Blockage of sebaceous gland on eyelid
Usually caused by staphylococcal infection
Painful, red bump, white head

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20
Q

What is a chalazian?

A

Meibomian gland cyst - blockage

Painless

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21
Q

What is blepharitis?

A

Inflammation of lids (including skin, lashes and meibomian glands)

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22
Q

What is the orbital septum?

A

Thin sheet of fibrous tissue originating from orbital rim periosteum blends with tarsal plates

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23
Q

What do the orbital septum and tarsal players separate?

A

Subcutaneous tissue of eyelid and orbicularis oculi muscle from intra-orbital contents

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24
Q

What is the role of orbital septum?

A

Acts as a barrier against superficial infection spreading from the pre-septal to post-septal space

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25
Q

What is periorbital (pre-septal) cellulitis?

A

Infection occurring within eyelid tissue, superficial to orbital septum
Usually secondary to superficial infections e.g. from bites, wounds
Ocular function remains unaffected (eye movements/vision)

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26
Q

What is orbital (post-septal) cellulitis?

A

Infection within the orbit posterior or deep to the orbital septum

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27
Q

What are the features fo orbital cellulitis?

A

Proptosis/exopthalmous
Reduced/painful eye movements
Reduced visual acuity

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28
Q

Why can orbital cellulitis cause serious complications?

A

Orbital veins drain to cavernous sinus, pterygoid venous plexus and facial veins
Potential route for infection to spread intracranial
- cavernous sinus thrombosis
- meningitis

29
Q

What are the contents of the orbital cavity?

A 
Nerves and blood vessels
Fat
Lacrimal apparatus
Eyeball
Extra-ocular muscles
30
Q

What are the 3 layers of the tear film and what are they produced by?

A

Oily, water, mucus

Meibomian glands, lacrimal glands, goblet cells in conjunctiva

31
Q

What does blinking do?

A

Distributes tear film, rinsing an lubricating conjunctivae and cornea

32
Q

What drains the tear film?

A

Lacrimal canaliculus into the lacrimal sac

33
Q

What is epiphora?

A

Overflow of tears over lower eyelid due to obstruction in lacrimal sac

34
Q

What maintains the position of the eyeball?

A

Suspension ligament - like a sling
Extra-ocular muscles
Orbital fat

35
Q

What are the 3 layers of the eye?

A

Outer - sclera
Middle - choroid
Inner - retina

36
Q

What is iritis?

A

Anterior uveitis

Painful, red eye, photosensitive

37
Q

What produces the aqueous humour?

A

Ciliary body

38
Q

What is the vitreous humour?

A

Firm, clear gel-like fluid
Fills large portion of globe of eye
Pushes up against retina but not stuck to it

39
Q

What is the anterior surface of the eyeball covered with?

A

Conjunctival membrane - reflects onto inner safe of eye lids

40
Q

Which blood vessel is the retina supplied by?

A

Central retinal artery (branch of ophthalmic artery) but also draws supply from underlying choroid layer

41
Q

Where does the choroid layer get its blood supply from?

A

Ciliary arteries feed extensive capillary bed within choroid layer

42
Q

What are the branches of the ophthalmic artery?

A 
Central retinal artery
Posterior ciliary
Anterior ciliary
Supra-orbital
Supratrochlear
43
Q

What happens in central artery occlusion?

A

Ischaemia of retina - pale

44
Q

What refracts light to bring it into focus?

A

Tear film, cornea, lens (and aq. and vitrous humour)

45
Q

What happens in the accommodation reflex?

A

Pupil constricts
Eyes converge
Lens becomes more biconvex by contraction of ciliary muscles

46
Q

Why do eyes converge in accommodation reflex?

A

To ensure image remains focused on same point of retina in both eyes

47
Q

What happens to the lens with age?

A

Becomes stiffer and less able to change shape - presbyopia

48
Q

What is the ciliary muscle?

A

A ring of muscle surrounding the lens, can pull it tight or let it relax

49
Q

What is a flat, thin lens good for?

A

Looking at distant objects

50
Q

What are rods?

A

Active at low light levels, do not mediate colour vision

Abundant in peripheral parts of retina

51
Q

What are cones?

A

High definition, colour vision - active at high light levels
Concentrated within macula of the retina
Fovea = only cones

52
Q

What converts light signals into action potentials?

A

Photoreceptors

53
Q

How are action potentials propagated?

A

Via retinal ganglion cells
RGC axons oldest in area of optic disc forming optic nerve
Action potentials propagated along visual pathway to occipital lobe for interpretation

54
Q

What is the optic disc?

A

No photo receptors (blind spot)

55
Q

What can decrease visual acuity?

A

Pathology affecting:

  • transparency of structures anterior to retina e.g. cataract
  • refractive ability of structures anterior to retina e.g. astigmatism, presbyopia
  • retina or optic nerve e.g. retinal detachment, age-related macular degeneration, optic neuritis
56
Q

What is astigmatism?

A

Irregularity of corneal surface

57
Q

What is presbyopia?

A

Reduced ability of lens to change shape

58
Q

If someone’s visual acuity is corrected with pin-hole testing, what is the diagnosis?

A

Errors of refraction

59
Q

If someone’s visual acuity is not corrected with pin-hole testing, what is the diagnosis?

A

Indicates pathology involving retina or optic nerve

60
Q

Why does pin-hole testing work in errors of refraction?

A

Light entering directly perpendicular to the cornea/lens does not require refraction to be focused onto macula

61
Q

What is the most common cause of blindness in the UK?

A

Age-related macular degeneration

62
Q

Describe the production and drainage of aqueous humour

A

Secreted by ciliary processes within ciliary body
Flows from posterior chamber, through pupil into anterior chamber
Nourishes lens and cornea
Drains through iridocorneal angle (between iris and cornea)
Via trabecular mesh work into canal of Schlemm

63
Q

What is the canal of Schlemm?

A

Circumferential venous channel draining into venous circulation

64
Q

What is glaucoma?

A

Optic nerve damage secondary to raised intraocular pressure

65
Q

What causes rise in intraocular pressure?

A

Drainage of aqueous humour from anterior chamber blocked

66
Q

What is chronic/open-angle glaucoma?

A

Trabecular mesh work deteriorates as age
Many asymptomatic
Increased IOP leading to increased optic disc cupping
Gradual loss of peripheral vision

67
Q

What is acute/closed-angle glaucoma?

A

Narrowing of iridocorneal angle

Ophthalmological emergency

68
Q

What are the signs and symptoms of acute closed angle glaucoma?

A 
Acutely painful red eye
Irregular oval-shaped pupil
Blurring of vision
Halos around lights
Nausea and vomiting
Medical then surgical treatment

AHNNA (18 decks)

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