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FRCOphth Part 1 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Which cranial nerves travel through the lateral wall of the cavernous sinus at the level of the pituitary fossa? (3 things)

A
  • 3
  • 4
  • 5th (V1 + V2)
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2
Q

Which cranial nerve travels through the cavernous sinus?

A

6

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3
Q

What is the supratrochlear nerve derived from?

A

Frontal nerve (branch of Ophthalmic nerve (CN V1))

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4
Q

What does the supratrochlear nerve supply? (2 things)

A
  1. Skin of medial eyebrow
  2. Forehead
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5
Q

Where are goblet cells most abundant in conjunctiva? (2 things)

A
  1. Fornices
  2. Plica semilunaris
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6
Q

What does conjunctival stroma contain?

A

Rich vascular network

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7
Q

What type of cells does conjunctival epithelium contain?

A

MHC class II dendritic cells

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8
Q

How does conjunctival epithelium vary?

A

Stratified squamous to stratified columnar epithelium

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9
Q

What are the anatomical zones of the trabecular meshwork?

A
  1. Innermost uveal meshwork
  2. Corneoscleral meshwork
  3. Outermost cribriform meshwork
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10
Q

Which zone of the trabecular meshwork has the highest resistance to aqueous outflow?

A

Cribriform meshwork (adjacent to Schlemm’s canal)

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11
Q

What is the effect of anterior ciliary muscle contraction on aqueous outflow?

A

Increases outflow by opening trabecular meshwork

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12
Q

What are functions of trabecular meshwork cells? (2 things)

A
  1. Maintain hydration of trabecular connective tissue
  2. Phagocytic capacity
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13
Q

Where does the nucleus of the third cranial nerve (oculomotor nerve) reside?

A

Midbrain

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14
Q

Where does the nucleus of the fourth cranial nerve (trochlear nerve) reside?

A

Midbrain

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15
Q

Where does the nucleus of the sixth cranial nerve (abducens nerve) reside?

A

Pons

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16
Q

What is the correct order of the five layers of Bruch’s membrane (from retina to sclera)? (5 layers)

A
  1. RPE basement membrane
  2. Inner collagenous zone
  3. Elastic layer
  4. Outer collagenous zone
  5. Choriocapillaris basement membrane

(aka elastic sandwich - elastic layer in middle of collagenous zones as “bread” on either side

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17
Q

What are the different parts of Orbicularis oculi muscle?

A

Orbital
Palpebral

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18
Q

Where does the orbital portion of the orbicularis oculi arise from?

A

Medial palpebral ligament.

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19
Q

Where does the palpebral portion of the orbicularis oculi originate from?

A

Medial palpebral ligament.

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20
Q

How do the orbital fibres of the orbicularis oculi run?

A

Circumferentially in an elliptical fashion around the orbital margin.

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21
Q

Where do the palpebral fibres of the orbicularis oculi pass?

A

Within the eyelid, anterior to the orbital septum and tarsal plate.

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22
Q

Where is cerebrospinal fluid (CSF) produced?

A

By the choroid plexus in the:
Lateral ventricles
Third ventricle
Fourth ventricle

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23
Q

What is the pathway of the Oculomotor nerve (CN3) BEFORE the Ciliary ganglion?

A

Pre ganglionic PS fibres → via branch of its inferior division → Ciliary ganglion

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24
Q

What is the pathway of the Oculomotor nerve (CN3) AFTER the Ciliary ganglion?

A

Ciliary ganglion → Post-ganglionic PS fibres via Short Ciliary Nerve

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25
Q

What do the PS fibres of the Oculomotor nerve (CN3) supply) (3 things)

A
  1. Choroid
  2. Ciliary muscle
  3. Sphincter pupillae
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26
Q

What does the INFERIOR division branch of the Oculomotor nerve (CN3) supply? (motor) (3 things)

A
  1. Inferior oblique
  2. Inferior rectus
  3. Medial rectus
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27
Q

What does the SUPERIOR division branch of the Oculomotor nerve (CN3) supply? (motor) (2 things)

A
  1. Superior rectus
  2. Levator palpebrae superioris
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28
Q

What is the Anterio-posterior diameter of the adult eye?

A

23-25mm

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29
Q

Which is the strongest orbital wall?

A

Lateral

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30
Q

Which is the weakest orbital wall?

A

Anterior Medial (Lamina Papyracea)
It’s paper thin

NB: Thin like papyrus

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31
Q

Which is thicker, the Anterior or Posterior Lens Capsule?

A

Anterior

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32
Q

Which has a stronger refractive power, lens or cornea?

A

Cornea
(70% of eyes refractive power)

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33
Q

What are the shapes of the sutures of the lens?

A

Anterior: Y shaped suture
Posterior: Inverted Y shaped suture

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34
Q

Which Lens capsule has lens epithelium under it?

A

Anterior ONLY
(NOT posterior)

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35
Q

What 2 arteries does the Trochlear Nerve (CN 4) pass OVER and UNDER?

A

OVER: Superior Cerebellar Artery
UNDER: Posterior Cerebral Artery

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36
Q

At what angle are nerve fibres in the Optic tract rotated?

A

90 degrees

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37
Q

Where does the muscle belly of Levator Palpebrae Superioris pass in relation to Superior Rectus?

A

Forward + Above

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38
Q

What does the Medial Horn of the Aponeurosis of the Levator Palpebral Superioris become?

What does it insert into?

A

Becomes: Medial Palpebral Ligament

Inserts into: Frontolacrimal Suture

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39
Q

What is on the inferior aspect of the Levator Palpebrae Superioris?

A

Muller’s Muscle

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40
Q

What nerve branch is the Levator Palpebrae Superioris supplied by?

A

Superior division of Oculomotor Nerve (CN 3)

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41
Q

What spiral shows the distances of the insertion of the EO muscles from the limbus?

A

Spiral of Tillaux

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42
Q

What is the distance from Limbus to Medial Rectus Muscle?

A

5.5mm

(Spiral of Tillaux)

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43
Q

What is the distance from Limbus to Inferior Rectus Muscle?

A

6.5mm

(Spiral of Tillaux)

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44
Q

What is the distance from Limbus to Lateral Rectus Muscle?

A

6.9mm

(Spiral of Tillaux)

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45
Q

What is the distance from Limbus to Superior Rectus Muscle?

A

7.7mm

(Spiral of Tillaux)

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46
Q

What are the different types of glands around the eye? (3 things)

A
  1. Eccrine glands
  2. Apocrine glands
  3. Holocrine glands
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47
Q

What is an example of Eccrine glands?

A

Sweat gland

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48
Q

What is an example of Apocrine glands?

A

Moll’s glands
(associated with hair follicles)

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49
Q

What are examples of Holocrine glands? (3 things)

A
  1. Meibomian glands
  2. Sebaceous glands
  3. Glands of Zeis
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50
Q

Where in the nose does the Nasolacrimal duct open?

A

Through an ostium partially covered by a mucosal fold (Valve of Hasner)

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51
Q

Where does the Nasolacrimal duct drain?

A

Inferior nasal meatus
(under inferior turbinate)

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52
Q

What is the Vitreous most firmly attached to?

A

Vitreous base

(Recall Q)

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53
Q

Where does the Lateral Geniculate Nucleus send most of its fibres to?

A

Visual cortex (aka Area 17)

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54
Q

What month of gestation does myelination of Optic Nerve begin?

A

7th month

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55
Q

When does myelination of Optic Nerve complete?

A

1 year after birth

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56
Q

Where does Myelination of the Optic Nerve terminate anatomically?

A

@ Lamina Cribrosa

(So optic disc + retina not myelinated)

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57
Q

What cells are responsible for myelination of optic nerve?

A

Oligodendrocytes

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58
Q

What is the Cornea permeable to?

A

Lipid soluble subtances

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59
Q

What is the Refractive Index if Descemets Membrane the same as?

A

Corneal endothelium RI

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60
Q

How does Descemet’s Membrane change with age?

A

Thickens

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61
Q

Where does Cornea get majority of its nutrition?

A

Aqueous

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62
Q

Where does Cornea get 10% of its nutrition from?

A

Limbal capillaries + Tear film

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63
Q

Remember the diagram of the Intracanalicular portion of Optic Nerve?

A

Yes

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64
Q

What is the Optic Nerve accompanied by in the Intracanalicular portion? (2 things)

A

Ophthalmic artery
Sympathetic nerves

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65
Q

What does the Optic Nerve have in its orbital portion?

A

S shaped bend

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66
Q

Where does the subarachnoid space terminate around the Optic Nerve?

A

Posterior surface of Sclera

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67
Q

The optic nerve passes through the ______ ring near the _______

A

Tendinous
Orbital apex

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68
Q

The optic nerve passes through the ______ ring near the _______

A

Tendinous
Orbital apex

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69
Q

What is the pterygopalatine fossa?

A

Distribution centre for main vessels and nerves of middle third of face

70
Q

What are the contents of the pterygopalatine fossa? (3 things)

A
  1. Maxillary artery
  2. Maxillary nerve (CN V2)
  3. Pterygopalatine ganglion (PS)
71
Q

What cells of the Choroid Plexus produces the CSF?

A

Modified ependymal cells

72
Q

Blockage of what can cause communication hydrocephalus in terms of CSF?

A

Arachnoid granulation

73
Q

How does the Ventricular system communicate with the subarachnoid space?

A

Via roof of 4th ventricle

74
Q

What is the main route of absorption of CSF?

A

Through Arachnoid Granulations in Superior Sagittal Sinus

75
Q

Where does CN4 (Trochlear) enter orbit via?

A

Superior Orbital fissure

SO4

76
Q

What is the innervation of the different Extraocular muscles?

A

Lateral Rectus: 6
Superior Oblique: 4
Others: 3

LR6 SO4 O3

77
Q

What is the innervation of the different Extraocular muscles?

A

Lateral Rectus: 6
Superior Oblique: 4
Others: 3

LR6 SO4 O3

78
Q

Know the EO muscles

A
79
Q

Know the EO muscles and nerves from posterior view

A
80
Q

What does paralysis of Orbicular Oculi muscle result in?

A

Widening of palpebral fissure

81
Q

What muscle is responsible for frowning?

A

Procerus

82
Q

Which muscle is responsible for vertical glabellar wrinkles?

A

Corrugator

83
Q

Which muscle is responsible for vertical glabellar wrinkles?

A

Corrugator

84
Q

Why is lateral brow ptosis more common in elderly?

A

Frontalis is deficient laterally

85
Q

What layer is Outer Capillary Plexus of Retina contained in?

A

Inner Nuclear Layer

86
Q

What side is the nucleus that innervates each of the EO muscles?

A

Levator Palpebrae Superioris: Fused

Superior Rectus + Superior Oblique: Contralateral

All others: Ipsilateral

87
Q

What epithelium lines Nasolacrimal duct?

A

Stratified columnar ciliated

88
Q

What is the line at the termination of Descemets membrane?

A

Schwalbe’s line

89
Q

Where is the cornea thicker?

A

Periphery

90
Q

Where is the cornea thicker?

A

Periphery

91
Q

Where is the cornea thicker?

A

Periphery

92
Q

What are the muscles of facial expression innervated by?

A

Facial nerve CN 7

93
Q

What are the muscles of mastication innervated by?

A

Trigeminal nerve CN 5

94
Q

What are the muscles of mastication? (2 things)

A

Temporalis
Masseter

95
Q

What is the suspensory ligament of Lockwood?

A

Hammock-like ligament supporting the globe

96
Q

What structures make up the suspensory ligament of Lockwood? (4 things)

A
  1. Inferior rectus sheath
  2. Inferior oblique sheath
  3. Medial check ligament
  4. Lateral check ligament
97
Q

What are longer, rods or cones?

A

Rods

98
Q

What layer is closest to the RPE microvilli?

A

Photoreceptor outer segments

99
Q

What bone is the Cribriform plate part of?

A

Ethmoid bone

100
Q

What nerves run through Cribriform plate?

A

Olfactory nerve (CN 1)

101
Q

Where does the Trochlear Nerve (CN 4) pass in relation to tendinous ring?

A

Through Superior Orbital Fissure but ABOVE tendinous ring

102
Q

Where does the Lacrimal Nerve (branch of CN V1) pass in relation to tendinous ring?

A

Through Superior Orbital Fissure but ABOVE tendinous ring

103
Q

Where does the Frontal Nerve (branch of CN V1) pass in relation to tendinous ring?

A

Through Superior Orbital Fissure but ABOVE tendinous ring

104
Q

What structures travel within Superior Orbital Fissure but ABOVE tendinous ring? (4 things)

A
  1. Lacrimal Nerve
  2. Frontal Nerve
  3. Superior Ophthalmic Vein
  4. Trochlear Nerve
105
Q

What are the divisions of contents of the Tendinous Ring? (2 things)

A
  1. Optic canal contents
  2. Superior Orbital Fissure contents
106
Q

What are the contents of the Tendinous ring in the Optic canal? (2 things)

A
  1. Optic nerve (CN 2)
  2. Ophthalmic artery
107
Q

What are the contents of the Tendinous ring in the Superior Orbital Fissure? (4 things)

A
  1. Sup division of Oculomotor Nerve (CN 3)
  2. Nasociliary Nerve (branch of CN V1)
  3. Inf division of Oculomotor Nerve (CN 3)
  4. Abducens Nerve (CN 6)
108
Q

What is the only structure in the Superior Orbital Fissure that is BELOW the Tendinous ring?

A

Inferior Ophthalmic vein

(also found in inferior orbital fissure)

109
Q

What are the contents of the Inferior Orbital Fissure? (6 things)

A
  1. Inferior Ophthalmic vein
  2. Ganglionic branches (from Pterygopalatine ganglion to Maxillary Nerve)
  3. Infra orbital Nerve (branch of CN V2)
  4. Infra orbital Artery
  5. Infra orbital Vein
  6. Zygomatic Nerve (branch of CN V2)
110
Q

What EO muscle does intortion?

A

Superior Oblique

111
Q

What EO muscle does extortion?

A

Inferior Oblique

112
Q

What is Medial Orbital Wall composed of? (4 things)

A
  1. Maxilla
  2. Lacrimal
  3. Ethmoid
  4. Sphenoid

MLES

113
Q

What is the order of the components of Medial Orbital Wall from Anterior to Posterior?

A
  1. Maxilla
  2. Lacrimal
  3. Ethmoid
  4. Sphenoid

MLES

114
Q

What is Inferior Orbital Wall composed of? (3 things)

A
  1. Maxilla
  2. Zygomatic
  3. Palatine
115
Q

What is Superior Orbital Wall composed of? (2 things)

A
  1. Frontal
  2. Lesser wing of Sphenoid
116
Q

What is Lateral Orbital Wall composed of? (2 things)

A
  1. Zygoma
  2. Greater wing of Sphenoid
117
Q

What are the different types of Ciliary Muscle? (3 things)

A
  1. Longitudinal (external) (aka Brucke’s)
  2. Radial (middle)
  3. Circular (internal) (aka Muller’s)
118
Q

What ciliary muscle attaches to Scleral Spur?

A

Longitudinal (external)

119
Q

What ciliary muscle attaches to Corneoscleral trabeculae?

A

Radial (middle)

120
Q

How does the inner circular muscle of ciliary body run?

A

Runs around ciliary body like a sphincter

121
Q

What are the Apices of RPE in closest approximation?

A

Photoreceptor outer segment

122
Q

What is the Embryological origin of Corneal stroma?

(Recall)

A

Neural crest

123
Q

What is corneal stroma mostly comprised of?

(Recall)

A

Type 1 collagen

124
Q

Which layer of corneal stroma has greater mechanical strength? Anterior or deeper?

Why?

(Recall)

A

Anterior stroma

Because anterior lamellae thinner + more interwoven

125
Q

How is arrangement of fibrils in Corneal stroma different to that of Sclera? (3 things)

(Recall)

A

Corneal stroma:
1. Highly organised
2. Regular spacing
3. Parallel lamellae
= All contribute to transparency

(Sclera less regularly organised)

126
Q

Trochlear nerve (CN 4) pierces dura to enter what wall of cavernous sinus? (easy one)

A

Lateral

127
Q

What is the Tentorium cerebelli?

A

Dural fold separating cerebrum + cerebellum

128
Q

What is Trochlear nerve (CN 4) in relation to Tentorium cerebelli?

A

CN4 travels anteriorly and below free edge of Tentorium cerebelli

129
Q

What is the centre for visual fibre synapses?

A

Lateral geniculate body

130
Q

What is difference between Congruous and Incongruous hemianopia?

A

Congruous: symmetrical visual field loss in both eyes

Incongruous: Asymmetrical visual field loss in both eyes

131
Q

What causes Congruous vs Incongruous hemianopia?

A

Congruous: Lesion in Optic radiations / occipital cortex

Incongruous: Lesion in Optic tract / Lat geniculate nucleus

132
Q

Where is the main visual centre?

A

Calcarine sulcus

(sulcus @ medial aspect of occipital lobe)

133
Q

Which colliculi are involved in light reflex?

A

SUPERIOR colliculi

(midbrain structure)

134
Q

What artery supplies most of Posterior visual pathway?

A

Posterior cerebral artery

135
Q

What artery supports the Retina + Extracranial Optic Nerve in Visual pathway?

A

Ophthalmic artery

136
Q

What artery supports the Intracranial Optic Nerve + Optic chasm in Visual pathway? (3 things)

A
  1. Anterior cerebral artery
  2. Anterior communicating artery
  3. Superior hypophyseal artery
137
Q

What artery supports the Intracranial Optic Tract in Visual pathway? (2 things)

A
  1. Posterior communicating artery
  2. Anterior choroidal artery
138
Q

What artery supports the Lateral Geniculate Nucleus in Visual pathway? (2 things)

A
  1. Anterior choroidal artery
  2. Posterior choroidal artery
139
Q

What artery supports the Optic radiation in Visual pathway? (2 things)

A
  1. Middle cerebral artery
  2. Posterior cerebral artery
140
Q

What artery supports the Primary visual cortex in Visual pathway?

A

Posterior cerebral artery

141
Q

Where is mitotic activity most in Lens epithelium?

A

Equatorial region (aka germative zone)

142
Q

What cell type is Lens epithelium?

A

Simple cuboidal

143
Q

What is volume of vitreous?

A

4ml

(80% of eye volume)

144
Q

What bone is Optic Canal located in?

A

Lesser wing of sphenoid bone

145
Q

What connects Lateral ventricles to 3rd ventricle?

A

Foramen of Munro

146
Q

What connects 3rd and 4th ventricles?

A

Aqueduct of Sylvius

147
Q

How wide is Ciliary body?

A

5-6mm

148
Q

What does Ciliary body extend to anteriorly + posteriorly?

A

Anterior: Scleral spur
Posterior: Ora serrata

149
Q

What is Anterior part of Ciliary body called?

A

Pars Plicata

150
Q

What is Posterior part of Ciliary body called?

A

Pars plana

151
Q

What is Bowmans membrane?

A

Layer just underneath corneal epithelium

152
Q

How thick is Bowmans membrane?

A

8-12 um

153
Q

If Bowmans membrane is injured what happens?

A

Replaced by scar tissue from stromal keratocytes

(cannot regenerate)

154
Q

What is Lamina Vitrea?

A

aka Bruchs membrane

Layer between Retina + Choroid

155
Q

Where is Retina in relation to choroid?

A

Retina is more inside

156
Q

What is Lamina Fusca?

A

Inner portion of sclera

157
Q

What is Lamina cribrosa?

A

Part of Sclera that allows optic nerve to pass

158
Q

What is Lamina Densa?

A

Part of BM of Corneal epithelium

159
Q

Which EO muscle has shortest muscle belly?

A

Superior oblique (32mm)

others are 37-40mm

160
Q

Which part of ciliary processes actively secretes Aqueous humour?

A

NON-pigmented epithelium

161
Q

What bone does the Foramen Ovale pierce?

A

Greater wing of sphenoid

162
Q

What nerve innervates lacrimal gland?

A

Trigeminal nerve (CN V)

the secretion from the lacrimal gland contains IgA
parasympathetic innervation originates in the lacrimatory nucleus
a layer of myoepithelial cells surrounds each acinus

163
Q

What Ig does lacrimal gland secretion contain?

A

IgA

164
Q

Where does PS innervation originate for the lacrimal gland?

A

Lacrimatory nucleus

165
Q

What epithelial cells surround each acinus of lacrimal gland?

A

Myoepithelial cells

166
Q

Where does CN 7 exit brainstem?

A

Cerebellopontine angle

167
Q

What are the phagocytic cells of the CNS?

A

Microglia

168
Q

What drains into the Superior Meatus?

A

Posterior ethmoidal sinus

169
Q

What drains into the Middle Meatus? (3 things)

A
  1. Anterior ethmoidal sinus
  2. Frontal Sinus
  3. Maxillary Sinus
170
Q

What drains into the Inferior Meatus?

A

Nasolacrimal duct

171
Q

Where does the Olfactory nerve terminate?

A

Primary olfactory cortex

FRCOphth Part 1 (12 decks)

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