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Ophthalmology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

Position of optic canal in orbit

A

Medial

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2
Q

The eye is protected by the _____________ from a direct blow

A

Orbital margins

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3
Q

Which wall most often affeted in blowout fracture?

A

Medial wall

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4
Q

Fractured zygoma rotates:

A

Medially

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5
Q

What prevents spread of infection from periorbital to orbital cellulitis?

A

Orbital septum

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6
Q

Below eyelids

A

Tarsal plates (attachment for LPS)

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7
Q

Ligaments medial and lateral to eye

A

Medial and lateral palpebral ligaments

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8
Q

Limbus

A

Corneoscleral junction (external)

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9
Q

Conjunctival fornix

A

Where conjunctiva is reflected off sclera onto internal eyelid

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10
Q

Para supply to lacrimal gland

A

CN VII

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11
Q

Where do tears drain?

A

Superior and inferior puncta
Superior and inferior canaliculi
Lacrimal sac
Nasolacrimal duct

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12
Q

Outer fibrous layer

A

Sclera

Cornea

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13
Q

Vascular layer (uvea)

A

Iris
Ciliary body
Choroid

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14
Q

Where is aqueous produced?

A

Ciliary body

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15
Q

Anterior segment

A 
Cornea
Anterior chamber
Iris
Lens
Ciliary body
Posterior chamber
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16
Q

Anterior chamber

A

between cornea and iris

contains aqueous

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17
Q

Posterior chamber

A

Between iris and vitreous

Contains lens and aqueous

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18
Q

Posterior segment

A

Vitreous body

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19
Q

What are floaters?

A

Gel and clumping of collagen

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20
Q

Iridocorneal angle

A

In anterior chamber
Between cornea and iris (internal)
Angle in glaucoma

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21
Q

Raised IOP can cause:

A

Ischaemia of retina

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22
Q

Where is aqueous reabsorbed?

A

Canal of Schlemm at iridocorneal angle and trabecular meshwork

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23
Q

Area of greatest density of cones

A

Fovea (in centre of macula)

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24
Q

Cones are responsible for:

A

Day vision, colour vision, central vision

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25
Q

Rods are responsible for:

A

Night vision, peripheral vision

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26
Q

Blood to eye

A

Ophthalmic artery off ICA (through cavernous sinus)

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27
Q

Contents of cavernous sinus

A 
III
IV
V1
V2
ICA
VI
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28
Q

Carotid canal is in

A

temporal bone

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29
Q

Branches of ophthalmic artery

A

Central artery of retina
Nasal branches
Forehead branches
Ciliary arteries (choroid) = red eye

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30
Q

Venous drainage of eye

A

Superior ophthalmic vein to cavernous sinus (SOF)
Inferior ophthalmic vein to superior oph vein
Facial vein (valveless)

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31
Q

Layers of the retina

A

Photoreceptors
Bipolar cells
Ganglion cells
Axons of ganglion cells

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32
Q

Common tendinous ring of muscles attach round:

A

Optic canal

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33
Q

How to test superior and inferior rectus

A

Abduct eye

Then elevate or depress

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34
Q

How to test superior and inferior oblique

A

Adduct eye

Then elevate or depress

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35
Q

Pure elevation

A

SR and IO

Antagonists as rotators

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36
Q

Pure depression

A

IR and SO

Antagonists as add/abductors

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37
Q

Suspensory ligament of the eye

A

Fascial sling that holds the eye

Diplopia if drops down

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38
Q

CNV1 supplies

A

Upper eyelid
Cornea
Conjunctiva
Tip of nose

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39
Q

CNV2 supplies

A

Lower eyelid
Maxilla
Alae
Upper lip

40
Q

CNV3 supplies

A

Mandible
TMJ
NOT the angle of the mandible (C2,3)

41
Q

Blink (corneal) reflex

A

V1 of cornea to trigeminal ganglion to V in the pons to VII to palpebral part of orbicularis oculi

42
Q

How do symp axons get to organs of head?

A 
Descend SC
Exit T1
Ascend symp trunk
Synapse in sup cervical ganglion
ICA plexus to opthalmic artery
43
Q

Inferior cervical and 1st thoracic ganglia fuse to form

A

Stellate ganglion

44
Q

How do para axons get to organs of head?

A

III (ciliary ganglion)

VII, IX (otic ganglion), X, sacral spinal nerves

45
Q

Where does CN III join brainstem?

A

Between midbrain and pons

46
Q

What nerves supply autonomic axons to iris and lens?

A

Ciliary nerves

47
Q

Which nerve forms 1st part of blink reflex?

A

Long ciliary nerve

48
Q

Which type of nerve synapses in ciliary ganglion?

A

Para only

Symp and somatic sensory pass through but don’t synapse

49
Q

Vestibulo-ocular reflex

A

Turns eyes in opposite direction of head movement

III, IV, VI, VIII

50
Q

Oculocardiac reflex

A

Reflex bradycardia in response to tension on extraocular muscles or pressure on eye
V1 and X

51
Q

Type of muscle in LPS

A

Skeletal and smooth

52
Q

Mydriatic pupil

A

Non-physiologically enlarged pupil

53
Q

Origin and insertion of Dilator pupillae

A

Fixed origin
Mobile insertion
Radial fibres

54
Q

Miotic pupil

A

Non-physiologically contracted pupil, e.g. opiates

55
Q

Blown pupil

A

Fixed dilated pupil

CN III pathology inhibiting para ciliary nerves

56
Q

Sphincter pupillae

A

Circumferential, encricling

57
Q

Pupillary light reflex

A

Retinal ganglion cells to optic nerve to chiasm to tract to pretectal nucleus in midbrain to EWN (now bilateral) to ciliary ganglion to sphincter pupillae of both eyes

58
Q

Symp to lens

A

Ciliary muscle relaxes = suspensory ligament tightens = lens flattens for far vision

59
Q

Para to lens

A

Ciliary muscle contracts = suspensory ligament relaxes = lens round for near vision

60
Q

3 components of accommodation reflex

A

Bilateral pupillary constriction III
Bilateral convergence III
Bilateral relaxation of lens III

61
Q

Types of lacrimation

A

Basal tears
Reflex tears (V1 and VII)
Emotional tears

62
Q

How does VII get to lacrimal gland?

A

Greater petrosal nerve
presynaptic to pterygopalatine ganglion
postsynaptic to V2 to V1 to lacrimal gland

63
Q

Monroe-Kellie hypothesis

A

To increase pressure in one place you have to decrease in another

64
Q

Hydrocephalus

A

CSF overproduction

Enlarged ventricles, sunset sign

65
Q

Symptoms of raised ICP in the eye

A 
Diplopia
LOV
Blurred vision
Papilloedema
Dilated pupil
66
Q

Sensory supply to dura

A

CN V

67
Q

Layers of dura`

A

Endosteal and meningeal

68
Q

Where is CSF produced and reabsorbed?

A

Produced in choroid plexus

Reabsorbed by arachnoid granulations

69
Q

How do ventricles communicate?

A

IV foramen of monro (lateral to 3rd)
cerebral aqueduct (3rd to 4th)
2 medial and 1 lateral apertures (4th to central canal or subarachnoid space)

70
Q

CN III palsy

A 
Susceptible to compression in raised ICP (aneurysm, just posterior to post comm artery)
Down and out
Ptosis
Loss of pupillary reflex
Dilated pupil
71
Q

Coning

A

Brain herniates through septa (folds of dura)

72
Q

CN IV palsy

A 
Long intracranial course = susceptible to damage, comes out posteriorly
Contralateral palsy
Eye can't move inferomedially
Gaze to right = moves up
Diplopia when looking down
73
Q

CN VI palsy

A

Long intracranial course = raised ICP damages. Arises from pons
Medial deviation of eye

74
Q

Types of conjunctiva

A

Palpebral

Bulbar

75
Q

pH of tear film

A

7.6

76
Q

What nerve needs to be intact for reflex tear production?

A

V

77
Q

Layers of tear film

A

Lipid phase
Aqueous phase
Mucus phase

78
Q

Layers of cornea

A 
Epithelium
Bowman's membrane
Stroma
Descements membrane
Endothelium
79
Q

Lens is attached to ciliary body by

A

Zonules

80
Q

Pancoast tumour

A

Compresses symp chain = symp III LPS compromised = ptosis

81
Q

Stimulus for accommodation reflex

A

Blurred image

82
Q

Hutchison’s sign

A

Shingles vesicles on nose tip = V1 involvement = corneal involvement = acyclovir

83
Q

Where does VI arise?

A

Pons

84
Q

Through tendinous ring

A 
Optic nerve and Ophthalmic artery (optic canal)
Sup and Inf divisions III
Nasociliary nerve
VI
(SOF)
85
Q

Outside tendinous ring SOF

A

Lacrimal nerve
Frontal nerve
Superior ophthalmic vein
IV

86
Q

Outside tendinous ring IOF

A

Inferior ophthalmic vein

87
Q

Outside tendinous ring

A

LPS

SO

88
Q

In tendinous ring

A

All 4 rectus muscles

89
Q

Symptom of optic neuritis

A

Pain on eye movements (muscles attach to tendinos ring)
Progressive unilateral visual loss
Usually MS (young)

90
Q

Shortest and thickest of rectus muscles

A

MR

91
Q

Blowout fracture traps what muscle?

A

IR

92
Q

Type of epithelial in retinal pigmented cells

A

Simple cuboidal

93
Q

Where is blind spot?

A

15 degrees temporal

94
Q

How many fibres decussate?

A

53%

95
Q

Symptom of blowout fracture

A

Pain on upgaze

Ophthalmology (11 decks)

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