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Ophthalmology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What are the features of the bony orbit?

A

Apex=optic canal, roof, medial wall, lateral wall, floor

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2
Q

What is the base?

A

Clinically known as orbital rim. Combined orbital margins

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3
Q

What protects the eyes from a direct blow?

A

Orbital margins

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4
Q

What is an orbital blowout fracture?

A

A traumatic deformity of the orbital floor or medial wall, typically resulting from impact of a blunt object larger than the orbital aperture, or eye socket

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5
Q

What aspect of the medial wall and orbital floor put them at risk of an orbital blowout fracture?

A

They are extremely thin

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6
Q

In an orbital blowout fracture what can happen to the orbital contents?

A

It can become trapped

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7
Q

In an orbital blowout fracture what can happen to the infraorbital NVB?

A

It can be damaged

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8
Q

What is the external layer of the eyelid?

A

Orbicularis oculi- orbital and palpebral part (superior and inferior)

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9
Q

What is the orbital septum made up of?

A

Sheet of fascia

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10
Q

Where are the tarsal glands found?

A

Embedded in the tarsi

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11
Q

What do the tarsal glands secrete?

A

Lipids

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12
Q

What is the iris covered by?

A

Cornea

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13
Q

What is the punctum?

A

Opening for tears

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14
Q

What does the conjunctiva do in terms of foreign bodies?

A

Forms a defensive barrier to FBs penetrating deep into the orbit

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15
Q

What does the lacrimal gland produce?

A

Lacrimal fluid

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16
Q

Where is the lacrimal gland located?

A

In the lacrimal fossa of the orbit-superolateral to the eye

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17
Q

What is the innervation of the lacrimal gland?

A

CNVII parasympathetic

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18
Q

Where are tears collected?

A

Lacrimal sac

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19
Q

What happens to lacrimal fluid when it’s produced?

A

Washes over eye, pushed towards medial angle, draims through lacrimal puncta, eventually reaches inferior meatus

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20
Q

Through what duct do tears drain through?

A

Nasolacrimal duct

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21
Q

What are the 3 layers of the eye?

A

Fibrous, uvea, retina

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22
Q

What is the outer layer of the eye?

A

Fibrous

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23
Q

What are the 2 parts of the fibrous layer?

A

Sclera-muscle attachment, cornea-2/3 refractive power

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24
Q

What is the middle layer of the eye?

A

Uvea (vascular layer)

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25
Q

What are the 3 parts of the uvea?

A

Iris-pupil diameter, ciliary body-controls iris, shape of lens and secretion of aqueous humour, choroid-nutrition and gas exchange

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26
Q

What is the inner layer of the eye?

A

Retina (photosensitive)

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27
Q

What are the segments of the eye?

A

Anterior and posterior

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28
Q

What makes up the anterior segment?

A

Anterior chamber and posterior chamber

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29
Q

What is the anterior chamber?

A

Chamber of eye beween cornea and iris, contains aqueous humour

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30
Q

What is the posterior chamber?

A

Chamber of eye between iris and suspensory ligaments, contains aqueous humour

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31
Q

What is the posterior segment?

A

Segment of eye behind lens. Contains vitreous body

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32
Q

What is contained with the vitreous body?

A

Vitreous humour (holds choroid and retina against sclera)- common location for ‘floaters’

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33
Q

What is a cataract?

A

Clouding of the lens

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34
Q

What is the circulation pathway of aqueous humour?

A

Ciliary body> aqueous circulates within posterior chamber> aqueous then passes through pupil into anterior chamber> aqueous reabsorbed into scleral venous sinus at iridocorneal angle

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35
Q

What does the ciliary body do?

A

The ciliary processes secrete aqueous

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36
Q

What can raised Intra-ocular pressure cause?

A

Ischaemia of the retina

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37
Q

What is the fundus?

A

Posterior area where light is focused

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38
Q

What is within the fundus?

A

Optic disc, macula, fovea

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39
Q

What is significant about the optic disc?

A

Point of CNII formation, only point of entry/exit for blood vessels and CNII axons, blind spot to light

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40
Q

What is significant about the macula?

A

It has the greatest density of cones in the eye

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41
Q

Where is the fovea located?

A

Centre of the macula

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42
Q

What is the fovea?

A

Depression of 1.5mm diameter- the area of most acute vision

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43
Q

What does complete interruption of flow in a retinal artery branch/retinal vein cause?

A

Loss of an area of visual field corresponding to the area of ischaemia

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44
Q

What does complete interruption of the central (end) artery or vein cause?

A

Monocular blindness

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45
Q

What are the 3 layers of the retina and their position?

A

The photoreceptors, ganglion cells lie anterior to the photoreceptor cells , axons of ganglion cells lie anterior to the ganglion cells and photoreceptor cells

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46
Q

Where do the retinal veins and arteries lie in relation to the retina?

A

Anteriorly

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47
Q

What part of your brain will light from the right visual field be processed?

A

Left primary visual cortex

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48
Q

Where is light from objects in the lower visual field processed by?

A

Upper part of the primary visual cortex

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49
Q

What is the visual pathway?

A

R/L visual field>lens>retina> optic nerve> optic chiasm> lateral geniculate nucleus (LGN), primary visual cortex

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50
Q

Light from objects passing through which retina will cross over at the optic chiasm?

A

Nasal retina

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51
Q

Where is the central (end) artery of the retina?

A

Within the optic nerve

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52
Q

What is the significance of the central vein of the retina?

A

It is the only vein draining the retina (and is located within optic nerve)

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53
Q

What is the danger triangle?

A

Danger area for bacterial infection/squeezing spots etc. From upper lip/external nose to between eyebrows

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54
Q

Where does the inferior ophthalmic vein drain into?

A

Mainly into superior ophthalmic vein

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55
Q

Where does the orbit also drain into?

A

Anteriorly into the facial vein

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56
Q

How many extraocular muscles do we have?

A

7

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57
Q

What are the 4 rectus muscles?

A

Superior rectus, inferior rectus, medial rectus, lateral rectus

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58
Q

Where do all the rectus muscles originate and insert?

A

All originate from common tendinous ring, all insert onto sclera

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59
Q

What are the 2 oblique muscles?

A

Superior oblique and inferior oblique

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60
Q

Where do the oblique muscles insert?

A

Sclera

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61
Q

What does the leator palpebrae superioris do?

A

Lifts the upper eyelid

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62
Q

How can you remember the somatic motor innervation of EO muscles?

A

LR6 SO4 AO3 - Lateral rectus: CNVI, Superior Oblique: CNIV, All Others: CNIII

63
Q

What movements can the eyeball make on the vertical axis?

A

Abduction/adduction-direction of gaze

64
Q

What movements can the eyeball make on the transverse axis?

A

Elevation/depression-direction of gaze

65
Q

What movements can the eyeball make on the anteroposterior axis?

A

Intorsion (medially)/extorsion (laterally)-superior pole of eyeball

66
Q

What is the direction of your optical axis?

A

Straight forward (different to orbital axis)

67
Q

Why do muscles of the eye usually have multiple movements?

A

Due to angle of attachment based on orbital canal position

68
Q

True or false: The orbital septum lies just anterior to the orbicularis oculi muscle.

A

False

69
Q

The tear film has antibacterial properties due to…?

A

Action of lysozyme

70
Q

At what rate is the tear film produced by the lacrimal gland?

A

A constant rate

71
Q

What is the pH of tears?

A

7.6

72
Q

What is the conjunctiva composed of?

A

Palpebral and bulbar parts

73
Q

What part of the conjunctiva is more vascular?

A

Bulbar

74
Q

Where is the cornea thinnest?

A

In the middle(check)

75
Q

How thick is the cornea?

A

540 microns thick

76
Q

What does the stroma of the cornea contain?

A

Regularly spaced collagen fibres

77
Q

How does the endothelium maintain transparency of the cornea?

A

By pumping fluid into the stroma

78
Q

What is the lens attached to the ciliary body by?

A

Zonules

79
Q

What does a decrease in tension of zonular fibres allow for?

A

Near focussing

80
Q

Do the lens fibres have good or bad lens regeneration properties?

A

Bad

81
Q

What is the outermost part of the lens known as?

A

The cortex

82
Q

What is the uvea composed of?

A

Iris, ciilary body and choroid

83
Q

What is the uvea’s role in absorbing reflected light in the eye?

A

It has none

84
Q

What is the suspensory ligament?

A

A thick fascial sling that holds the eye just above the floor or the orbit

85
Q

Where does the suspensory ligament attach to?

A

Zygoma laterally

86
Q

What may result in the eye lowered towards the orbital floor?

A

Fractured zygoma. Diplopia may occur

87
Q

What can damage to the infraorbital NVB?

A

Fractured zygoma

88
Q

What can damage to the infraorbital NVB result in?

A

A general sensory deficit of facial skin

89
Q

Where will a fractured zygoma tend to rotate?

A

Rotate medially towards floor of the orbit

90
Q

What does CNV1 supply (general sensory)?

A

Upper eyelid, cornea, conjuctiva, forehead, skin of root/bridge/tip of nose

91
Q

What does CNV2 supply (general sensory)?

A

Skin of lower eyelid, skin over maxilla, skin of ala of nose, skin mucosa of upper lip

92
Q

What is the general sensory supply of the angle of the mandible?

A

Greater auricular nerve-branch of C2/3 spinal nerves

93
Q

When a blink (corneal) reflex occurs how are APs conducted centrally?

A

Centrally via CNV1 to trigeminal ganglion then in CNV5 to pons

94
Q

When a blink reflex occurs how are APs conducted peripherally?

A

Peripherally in CNVII to the eyelid part of orbicularis oculi

95
Q

How can a blink be elicited?

A

Sterile point of cotton wool, gently touch the cornea

96
Q

What is the space inbetween the pre-tracheal and prevertebral fascia?

A

Retropharyngeal space

97
Q

What ganglion of the sympathetic cervical chain is associated with supply to the orbit?

A

Superior

98
Q

What often fuses to form the stellate ganglion?

A

Inferior cervical and 1st thoracic ganglia

99
Q

What cranial nerves contain parasympathetic axons?

A

CNIII,VII,IX,X

100
Q

What ganglion does the CNIII parasympathetic axons synapse with and then supply ?

A

Ciliary ganglion in the orbit, and then to the eye

101
Q

Where does CNIII connect with the CNS?

A

Near the midline at the junction between the midbrain and pons

102
Q

Where does CNIII leave the cranial cavity?

A

Superior orbital fissure

103
Q

What branches of CNIII come through the superior orbital fissure?

A

Superior and inferior

104
Q

What does the superior branch of CNIII supply?

A

SR and LPS

105
Q

What does the inferior branch of CNIII supply?

A

MR, IR, IO and ciliary ganglion (parasympathetic supply)

106
Q

What plexus supplies the orbit?

A

Internal carotid plexus

107
Q

What nerve do sympathetic axons travel in post optic canal and ciliary ganglion(do not synapse here)?

A

Long and short ciliary nerve

108
Q

What nerve do parasympathetic axons travel post ciliary ganglion?

A

Short ciliary nerve

109
Q

What do autonomic axons from the ciliary nerves do?

A

Control the diameter of the iris (and pupil) & the refractive shape of the lens

110
Q

What do the long ciliary nerves form the first part of?

A

The afferent limb of the blink reflex

111
Q

What are the autonomic reflexes of the eye?

A

Wide eye opening of fight or flight, light reflex, accomodation reflex, reflex tear production, vestibulo-ocular reflex, oculocardiac reflex

112
Q

What CNS connections occur in the vestibulo-ocular reflex?

A

CNVIII & CNs III,IV, VI

113
Q

What is the oculocardiac reflex?

A

Reflex bradycardia in response to tension on the extraocular muscles or pressure on the eye

114
Q

What CNS connections occur in the oculocardiac reflex?

A

CNV1 and CNX

115
Q

What are the sympathetic eye functions?

A

Open wider, get more light into eye, focus on far objects, emotional lacrimation

116
Q

What are the parasympathetic eye functions?

A

Allow orbicularis oculi to work, get less light into eyes, focus on near objects, reflex lacrimation

117
Q

What kind of muscle is levator palpebrae superioris?

A

Skeletal and smooth

118
Q

What muscle dilates the pupil?

A

Dilatory pupillae fibres

119
Q

What is the insertion of the dilator pupillae fibres?

A

All around the internal circumference of iris (mobile)

120
Q

What is the origin of the dilator pupillae fibres?

A

All around the external circumference of iris (fixed_

121
Q

What is the reflex in the stimulated eye?

A

The direct light reflex

122
Q

What is the reflex in the non-stimulated eye?

A

The consensual light reflex

123
Q

What is the special sensory limb of the light reflex?

A

The ipsilateral CNII

124
Q

What is the motor limb of the light reflex?

A

Bilateral via CNs III

125
Q

How many neurone chains in the light reflex?

A

4

126
Q

What is the 1st neurone chain in the light reflex ?

A

Retinal ganglion cells pass via ipsilateral optic nerve to decussate in optic chiasm, then synpase in the pretectal nucleus of midbrain

127
Q

What is the 2nd neurone chain (Bilateral) in the light reflex ?

A

Located entirely within midbrain and connect the pretectal nucleus to the next synapse in the Edinger Westphal nucleus (location of cell bodies of parasympathetic axons of CNIII)

128
Q

What is the 3rd neurone chain (Bilateral) in the light reflex ?

A

Pass from EW nucleus, via CNII then its inferior division, to synpase in the ciliary ganglion

129
Q

What is the 4th neurone chain (Bilateral) in the light reflex ?

A

Course in the short ciliary nerves to the sphincter pupillae muscles

130
Q

How is the refractive shape of the lens controlled in far vision?

A

Ciliary muscle relaxes in far vision, ligament tightens and lens flattens to focus on object in distance

131
Q

How is the refractive shape of the lens controlled in near vision?

A

Ciliary muscle contracts in near vision, ligament relaxes and lens becomes spherical to focus on object nearby

132
Q

What components of the accomodation reflex (response to near) are assessed?

A

Bilateral pupillary constriction (CNs III), bilateral convergence -medial rotation of both eyes (CNs III), bilateral relaxation of lens-lens becomes spherical due to contraction of ciliary muscles (CNsIII)

133
Q

What are the 3 types of tears?

A

Basal, reflex, emotional

134
Q

What do basal tears do and contain?

A

Clean/nourish and hydrate avascular cornea. Contains lysozyme (hydrolyse bacterial cell walls)

135
Q

What are reflex tears?

A

Extra tears in response to mechanical or chemical stimulatioon

136
Q

What do postsynaptic sympathetic fibres reach levator palpebrae superioris via?

A

Superior cervical sympathetic ganglion, internal carotid nerve and plexus, axons are carried on ophthalmic artery and on its branches to orbital structures

137
Q

Do sympathetics dilate or constrict the pupil?

A

Dilate

138
Q

What is a non-physiologically enlarged pupil?

A

Mydriatic pupil

139
Q

What do mydriatic drugs do?

A

Induce dilation of the pupil

140
Q

Do parasympathetics constrict or dilate the pupil?

A

Constrict

141
Q

What is a non-physiologically constricteed pupil?

A

Miotic pupil

142
Q

What is a fixed dilated (blown) pupil a sign of?

A

Pathological injury-CNIII pathology (inhibting the pupillary constriction action of parasympathetic axons in ciliary nerves)

143
Q

Where is the encircling arrangement of sphincter pupillae fibres?

A

All around the internal circumference of iris

144
Q

What are the afferent and efferent limbs of lacrimation of reflex tears?

A

Afferent is CNV1 from cornea/conjunctiva. Efferent is parasympathetic axons originating from CNVII

145
Q

The presynaptic parasympathetic axons for what are contained with the chorda tympani?

A

Submandibular and sublingual glands

146
Q

Is the intracranial volume constant or varied?

A

Constant

147
Q

What 3 membranes make up the meninges?

A

Dura, arachnoid, pia

148
Q

What is the space between arachnoid and pia?

A

Sub-arachnoid space

149
Q

What are the meninges?

A

Protective coverings of brain and spinal cord

150
Q

Describe the dura mater

A

‘Hard mother’, tough, sensory supply from CNV, encloses dural venous sinuses

151
Q

Describe the arachnoid mater

A

‘Spidery mother’, arachnoid granulations

152
Q

What is within the subarachnoid space?

A

Circulating CSF and blood vessels

153
Q

Describe the pia

A

‘Faithful mother’, adheres to brain (and vessels and nerves entering/leaving)

154
Q

Where is CSF reabsorbed into?

A

Into the dural venous sinuses, via arachnoid granulations

Ophthalmology (11 decks)

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