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J Ophthalmology > ANATOMY > Flashcards

ANATOMY Flashcards

1
Q

which bone forms the roof (superior orbital margin) of the bony orbit

A

frontal bone

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2
Q

what is at the apex of the bony orbit

A

optic canal (hole)

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3
Q

what 2 bones form the lateral wall (lateral orbital margin) of the bony orbit (one external one internal)

A

zygomatic - external

sphenoid - internal

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4
Q

what bone forms the floor (inferior orbital margin) of the bony orbit

A

maxilla

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5
Q

what 3 bones form the medial wall (medial orbital margin) of the bony orbit

A

maxilla
ethmoid
lacrimal

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6
Q

what is the hole in the frontal bone at the top of the bony orbit

A

supraorbital notch

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7
Q

what passes through the supraorbital notch (inn the frontal bone in the bony orbit)

A

supraorbital neurovascular bundle

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8
Q

what is the hole in the front of the maxilla called

A

infraorbital foramen

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9
Q

what structure does the infraorbital neurovascular bundle go into

where does it pass through

A

infraorbital foramen

infraorbital canal

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10
Q

what is the name of the sling that holds the eye just above the floor of the orbit

A

suspensory ligament

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11
Q

if you cut the pituitary gland coronally you can see a structure beside it that curves back on itself, what is this structure

A

internal carotid artery

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12
Q

which arteries branch off the ophthalmic artery to supply the optic nerve head and external retina

A

ciliary arteries

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13
Q

which artery branches off the ophthalmic artery to supply the inner 2/3 of the retina

A

central retinal artery

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14
Q

what is the clinical significance of the central retinal artery (what type of artery is it)

what is the potential clinical presentation

A

it is an end artery = susceptible to ischaemia = blindness in entire eye

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15
Q

in the middle of which structure does the central retinal artery travel

A

optic nerve

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16
Q

what 2 things travel in the middle of the optic nerve

A

central retinal artery

central retinal vein

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17
Q

where does the central retinal vein drain into

A

superior ophthalmic vein

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18
Q

apart from the central retinal vein there are other accessory veins that drain the eye, where do they drain (2)

A

superior ophthalmic vein

inferior ophthalmic vein

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19
Q

what are the 2 options for drainage of the superior and inferior ophthalmic arteries

A 
facial vein (anteriorly) 
cavernous sinus (posteriorly) - MAIN ONE
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20
Q

what is the danger of blood from the anterior face (eye) draining into the cavernous sinus

A

if infection (eg spot in the danger triangle of the face) spreads there = near the brain = meningitis, brain abscess, cavernous sinus thrombosis

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21
Q

another name for corneoscleral junction

A

limbus

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22
Q

what colour is the sclera

A

white

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23
Q

what happens in the sclera layer of the eye

A

muscle attachments

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24
Q

which part of the outer eye is covered in conjunctiva

A

sclera (also inner eyelids)

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25
Q

what colour is the cornea

A

clear/transparent

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26
Q

what is the angle that is ‘open’ or ‘closed’ in glaucoma called

A

iridocorneal angle (between the iris (flat) and the cornea (curved))

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27
Q

where is the cornea thickest

A

peripheries

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28
Q

which part of the eye supplies 2/3 of optical power

A

cornea

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29
Q

which part of the eye supplies 1/3 optical power

A

lens

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30
Q

what is the middle vascular layer of the eye called

A

uvea

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31
Q

which layer of the eye provides nutrition to the rest of he eye

A

uvea

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32
Q

where is aqueous humour produced

A

ciliary body

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33
Q

what shape is the ciliary body

A

sphincter/ring like structure

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34
Q

what is in front of the iris

A

cornea

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35
Q

contraction of what muscle dilates pupils

how are they arranged

A

dilator pupillae fibres

like sun rays around the sphincter pupillae fibres

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36
Q

contraction of what muscle constricts pupils

how are they arranged

A

sphincter pupillae fibres

like a sphincter inside the dilator pupillae fibres

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37
Q

what controls the sphincter pupillae muscles

A

parasympathetics

sphincter pupillae muscles cause pupil constriction

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38
Q

what controls the dilator pupillae fibres

A

sympathetics

dilator pupillae muscles cause pupil dilation

(think that your eyes open as wide as possible to see all danger = flight or fight response)

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39
Q

which edge (internal or external) of the dilator pupillae fibres is fixed

A

external

the internal is attached to the sphincter pupillae to move it (pupil vasodilation)

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40
Q

where is the anterior eye segment in front of

A

the lens

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41
Q

where is the posterior eye segment behind

A

the lens

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42
Q

where are the photoreceptors in the eye in comparison to veins, arteries, ganglion etc

A

posterior

not a typo, the light has to go through all the other layers before it reaches them

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43
Q

what are the 2 cell types that after the light signal before its passed on to ganglion cells

A

horizontal cells

amacrine cells

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44
Q

what are the 2 types of photoreceptor

A

rods

cones

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45
Q

where are there rods

A

peripheries of eye

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46
Q

where are there cones in high density

A

fovea

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47
Q

which photoreceptor has low visual acuity but supplies your peripheral vision

A

rods

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48
Q

which photoreceptor has detailed, colour vision

A

cones

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49
Q

what happens to light signals after they’ve been passed from the photoreceptors to ganglion cells

A

axons of optic nerve

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50
Q

where are the ganglion cells in respect to the photoreceptors

A

anterior

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51
Q

why do we have a ‘blind spot’

A

there are no photoreceptors in the optic disc (need space for blood vessels nerve fibres etc)

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52
Q

what is the fovea

A

middle 1.5mm of macula

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53
Q

what does the macula look like on fundoscopy

A

darker red circle horizontally in line with the optic disc

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54
Q

on fundoscopy where do the central retinal artery and vein enter

A

optic disc

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55
Q

what are the red lines you can sometimes see on the white bit of your eye

A

dilated conjunctival vessels

sclera is covered in conjunctiva that is vascular

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56
Q

what is the name of the conjunctiva on the inner eyelids

A

palpebral conjunctiva

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57
Q

what is the name of the conjunctiva on the sclera

A

bulbar conjunctiva

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58
Q

what is the angle between bulbar conjunctiva (on sclera) and palpebral conjunctiva (on inner eyelid) called

A

conjunctival fornix

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59
Q

how is the lens connected to the ciliary body

A

suspensory ligaments of the lens

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60
Q

what shape is the ciliary body

A

sphincter/ring like shape

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61
Q

for far vision what happens to the lens

how does the ciliary body achieve this

A

flattens

ciliary body relaxes

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62
Q

for close vision what happens to the lens

how does the ciliary body achieve this

A

becomes more spherical

ciliary body contracts

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63
Q

if there is parasympathetic supply to the ciliary body what happens to it

what happens to the lens

what type of vision is this used for

A

contraction of ciliary body

more spherical lens

close vision

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64
Q

what are the 2 chambers of the anterior eye segment (in front of lens)

A

anterior chamber

posterior chamber

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65
Q

where is the anterior eye chamber

A

between iris and cornea

in anterior segment

66
Q

where is the posterior eye chamber

A

between iris and suspensory ligaments

in anterior segment

67
Q

2 main components of aqueous humour

A

ascorbate (antioxidant)

bicarb (made from carbonic anhydrase)

68
Q

if you want to decrease aqueous humour production (to decrease intraocular pressure) what do you give

A

carbonic anhydrase inhibitor

69
Q

normal intraocular pressure

A

17mmHg

70
Q

where is aqueous humour produced

A

ciliary body

71
Q

from production of aqueous humour in ciliary body, where does it go next

A

posterior chamber of anterior segment

72
Q

what does aqueous humour do in the posterior chamber of the anterior segment of the eye

A

nourish lens

73
Q

what does aqueous humour do in the anterior chamber of the anterior segment of the eye

A

nourish cornea

74
Q

where does aqueous humour drain after its nourished the cornea in the anterior chamber (specifically)

where is in relation to the iris and cornea

A

scleral venous sinus and trabecular meshwork

between the iris and cornea (iridocorneal angle)

75
Q

where do ‘floaters’ arise

A

posterior segment of eye, vitreous body

76
Q

which segment of the eye is associated with aqueous humour

A

anterior

77
Q

which segment of the eye is associated with vitreous humour

A

posterior

78
Q

what is the orbicularis oculi supplied by

why

A

CN VII facial nerve

muscle of facial expression (closing eyes)

79
Q

what is the orbicularis oculi used for

A

closing eye

80
Q

what are the 2 parts of the orbicularis oculi

A

palpebral part

orbital part

81
Q

what is the palpebral part of the orbicularis oculi used for

A

blinking

82
Q

what is the orbital part of the orbicularis oculi used for

A

screwing up your eyes

83
Q

which part of the orbicularis oculi is the outside bit

A

orbital part

Orbital = Outside of Orbicularis Oculi

84
Q

what 2 things lift the superior tarsus muscle

A

mullers muscle

tendon of levator palpebral superioris

85
Q

nerve supply of tendon of levator palpebrae superioris (the one that lifts the superior tarsus)

A

CN III

bc its closer to the eye than orbicularis oculi (its supplied by CN VII)

86
Q

nerve supply of lacrimal gland

A

CN VII

87
Q

what does the lacrimal gland produce

A

lacrimal fluid (tears)

88
Q

what 3 things are in basal tears (to nourish the avascular cornea)

A

lysozyme
IgA
IgG

89
Q

where is the lacrimal gland

A

above the eye laterally

90
Q

what is the swelling in your lower eyelid called

A

lacrimal papilla

91
Q

what is the hole in the swelling in your lower eyelid called

A

lacrimal puncta

92
Q

how do tears get from the lacrimal gland to the lacrimal canaliculi (medial aspect of eye)

A

washed over with a blink

93
Q

where does lacrimal fluid drain after it enters the lacrimal puncta (small hole in bottom eyelid)

then the …

A

lacrimal sac

nasolacrimal duct

94
Q

where does the nasolacrimal duct drain into

A

inferior meatus of nasal cavity (below the inferior concha)

95
Q

what component of tears has an antibiotic property

A

lysozyme

96
Q

for the superior and inferior obliques to work, which other extraocular muscles needs to be in use

(just think about it from a superior view)

A

medial rectus

when the eye is medially rotated you will use your superior and inferior obliques to look up/down

97
Q

what does your medial rectus do

A

adduct (medially rotate)

98
Q

what does your lateral rectus do

A

abduct (laterally rotate)

99
Q

what does your superior rectus do

A

lift eye superiorly when in an abducted (lateral) position

100
Q

what does your inferior rectus do

A

make eye look down when in an abducted (lateral) position

101
Q

what does you inferior oblique do

A

lifts eye superiorly when in an adducted (medial) position

102
Q

what does your superior oblique do

A

makes eye look down when in an adducted (medial) position

103
Q

for the superior and inferior rectus muscles to work which other extraocular muscle must be in use

(just think about it from a superior view)

A

lateral rectus

when the eye is laterally rotated it lines up with the superior and inferior rectus muscles (bc they travel medially back towards the tendon sheath which is beside the optic canal

104
Q

what 2 extraocular muscles work together when you want to look STRAIGHT UP

A

superior rectus and inferior oblique

105
Q

what 2 extraocular muscles work together when you want to look STRAIGHT DOWN

A

inferior rectus and superior oblique

106
Q

what is the optic nerve surrounded by (2)

what clinical condition is this important in

A

meninges (dura mater, pia mater, arachnoid)
cerebrospinal fluid

papilloedema (compression of optic nerve from increased intracranial pressure)

107
Q

where should your blind spot be (in the test you start in the middle and work temporally)

A

15 degrees temporal

108
Q

what are the 2 branches of CN III

A

superior and inferior

109
Q

what 2 extraocular muscles does the superior branch of CN III supply

A

superior rectus, levator palpebrae superioris (LPS)

the 2 superior muscles

110
Q

what does the inferior branch of CN III supply (3)

A

medial rectus
inferior rectus
inferior oblique

(the 3 non superior ones)

111
Q

what does the superior branch of CN III supply parasympathetics to

A

ciliary body
sphincter pupillae

(the 2 sphincters)

112
Q

where does CN II enter the skull

A

optic canal

113
Q

where does CN III enter the skull

A

superior orbital fissure (same as CN IV, V1, VI)

114
Q

what does CN IV supply

A

superior oblique

bc its the trochlear nerve = supplies the extraocular muscle that goes through the trochlea

115
Q

what does CN VI supply

A

lateral rectus

bc its the abducent nerve = supplies the extraocular muscle that causes eye abduction

116
Q

what is the pneumonic thing for remembering the CN supply of extraocular muscles

A

LR6 SO4 AO3

117
Q

which CN that supplies something in the eye has a weird course;

arises from the back (dorsum) of the brainstem (rest are anterior) and crosses over (so the one that started off at the left ends up at the right eye)

A

CN VI abducent

118
Q

where does CN VI enter the skull

A

superior orbital fissure

same as CN III, IV, V1

119
Q

what is the general function of CN V

A

facial sensation

120
Q

what are the 3 branches of CN V

A

ophthalmic V1
maxillary V2
mandibular V3

121
Q

what is the name of CN VII

A

facial nerve

122
Q

which CN V is the supraorbital nerve a branch of

A

CN V1

123
Q

which CN V is the infraorbital nerve a branch of

A

CN V2

124
Q

which CN V has a nasociliary branch

A

CN V1

125
Q

where does the nasociliary branch of CN V1 supply (2)

A

cornea

tip of nose

126
Q

which facial nerve branch can be affected in shingles

A

CN V1 nasociliary branch

127
Q

which nerve supplies sensory to upper eyelid (be specific)

A

CN V1

128
Q

which nerve supplies sensory to lower eyelid (be specific)

A

CN V2

129
Q

CN VI palsy, when is there diplopia

A

when looking laterally

130
Q

common aetiology of optic chiasm compression

A

pituitary tumours

131
Q

how does pituitary tumour compressing on optic chiasm present with patients eyesight

A

bitemporal hemianopia (loss of peripheral vision, bc nasal retina AP transmission is disrupted)

132
Q

where do the sympathetic nerves to the eyes go after they synapse (what do they follow)

A

hitch a ride on internal carotid then ophthalmic artery (part of periarterial plexus)

133
Q

pre synaptic sympathetic chemical

A

ACh

134
Q

post synaptic sympathetic chemical (stimulates eyes)

A

noradrenaline

135
Q

sympathetic affect on pupils

via

A

dilation via dilator pupillae fibre contraction

136
Q

example of sympathetic control of pupils in normal physiology (1)

A

dim lighting

pupil dilation

137
Q

example of sympathetic control of pupils iatrogenic (1)

A

mydriatic drugs (pupil dilators)

pupil dilation

138
Q

post synaptic parasympathetic chemical (stimulates eyes)

A

ACh

139
Q

pre synaptic parasympathetic chemical

A

ACh

140
Q

where are the parasympathetic ganglions for the eye

A

right next to the eye

141
Q

parasympathetic affect on pupils

via

A

constriction via pupillae sphincter contraction

142
Q

example of parasympathetic control of pupils in normal physiology (1)

A

bright lights

143
Q

example of parasympathetic control of pupils pathologically

A

horners syndrome

144
Q

fixed pin point pupil cause

A

opiate drugs

145
Q

what should happen if you shine a torch into 1 eye

A

both eyes constrict

146
Q

what is the afferent limb (from eye to brain) in the pupillary light reflex

A

CN II (optic nerve, bc photoreceptors recognise the light)

147
Q

what is the efferent limb (from brain to eye) in the pupillary light reflex

A

CN III (oculomotor bc it supplies the pupillae sphincter/dilator fibres)

148
Q

what are the 4 steps of the pupillary reflex (when you shine a torch in one eye)

A
  1. from eye to midbrain
  2. edinger westphal (EW) nucleus in midbrain
  3. ciliary ganglion
  4. short ciliary nerves to sphincter pupillae muscles
149
Q

in the pupillary light reflex, if there is no constriction contralateral side what nerve damage is there

A

CN III (efferent nerve for pupillary reflex)

150
Q

in the pupillary light reflex, if there is no constriction in either eye what nerve damage is there

A

CN II (afferent nerve for pupillary reflex)

151
Q

what happens to accommodation reflex as you get older

A

it decreases

152
Q

which nerve are you testing with the accommodation reflex

A

CN III

153
Q

how do you test accommodation reflex clinically

A

make someone go ‘cock eyed’ by following the pen torch as you bring it in towards their nose

154
Q

what are the 3 things that should happen bilaterally in accommodation reflex

A 
convergence ('cock eyed') 
pupil constriction 
spherical lens (ciliary body contraction)
155
Q

does the long ciliary nerve enter the ciliary ganglion

A

no

goes above it

156
Q

does the short ciliary nerve enter the ciliary ganglion

A

yes

157
Q

what is the ciliary ganglion

A

a place nerves go through/synapse at near the eye

158
Q

efferent limb of blink reflex (from brain to eyelid - palpebral orbicularis oculi)

A

CN VII (bc its a facial thing not an eye thing)

159
Q

afferent limb of blink reflex

A

CN V1 (bc this is the sensory supply to the upper face incl upper eyelid)

160
Q

which nerve supplies the lacrimal gland (motor)

A

CN VII

161
Q

afferent limb of tear reflex (from eyes to brain eg if its windy)

A

CN V1

162
Q

efferent limb of tear reflex (from brain to eye)

A

CN VII

J Ophthalmology (6 decks)

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