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Opthalmology > Anatomy > Flashcards

Anatomy Flashcards

1
Q

What nerve supplies sensory innervation of the facial skin and the anterior surface of the eyes?

A

CN V (the trigeminal nerve)

  • all 3 divisions
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2
Q

Which parts of the facial skin/anterior surface of the eye does CN V1 (the opthalmic nerve) supply?

A
  • upper eyelid
  • cornea
  • conjunctiva
  • skin of the root/bridge/tip of the nose
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3
Q

Which parts of the facial skin/anterior surface of the eye are supplied by CN V2 (the maxillary nerve)?

A
  • skin of the lower eyelid
  • skin of the maxilla
  • skin of the ala of the nose
  • skin/mucosa of the upper lip
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4
Q

Which parts of the facial skin/anterior surface of the eye are supplied by CN V3 (the mandibular nerve) ?

A
  • skin over the mandible and temperormandibular joint
  • apart from the angle of the mandible- supplied by C2, 3 spinal nerve
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5
Q

Describe the steps of the ‘blink (corneal) reflex’

A
  • Sensory (afferent) Limb
    1. Action potentials conducted from cornea via CN V1 (the opthalmic) branches
    2. Reaches trigeminal ganglion
    3. Goes along CN V
    4. Reaches pons

Central CNS connections between CN V and CN VII

  • Motor (efferent) Limb
    1. Action potentials conducted via CN VII
    2. To eyelid part of orbicularis oculi
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6
Q

Why is the blink reflex important for corneal health?

A

Blinking is part of the immune system protection

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7
Q

Describe the anatomy of the oculomotor nerve (CN III) and be able to identify the nerve in illustrations/prosections/models

A
  1. connects with CNS at junction between midline and pons
  2. passes through cavernous sinus
  3. exits via orbital fissure
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8
Q

Which parts of the orbit/its surrounding structures recieve somatic motor innervation from CN III?

A
  • Somatic motor to…
    • superior rectus
    • medial rectus
    • inferior rectus
    • inferior oblique
    • levator palpebrae superioris (LPS)
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9
Q

What’s the connection between CN III (Oculomotor nerve) and ciliary ganglions?

A

CN III (Oculomotor) has presynaptic parasympathetic axons to the ciliary ganglion

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10
Q

What do the superior division and inferior division of the oculomotor nerve (CN III) supply?

A
  • Superior Division
    • Superior rectus
    • Levator palpebrae
  • Inferior Division
    • Medial rectus
    • Inferior rectus
    • Inferior oblique
    • Ciliary ganglion
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11
Q

Describe the anatomy of the ciliary ganglion.

A

Ciliary nerves supply autonomic axons to control diameter of iris** & **refractive shape of lens

  • Long ciliary nerves:
    • sympathetic
    • somatic sensory
    • form first part of the blink reflex
  • Short ciliary nerves:
    • sympathetic
    • parasympathetic
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12
Q

List the autonomic reflexes of the eye

A
  1. Maximal eyelid elevation/wide eye opening of fight/flight
  2. Pupillary dilation/constriction adjusting light entry: (pupillary light reflex)
  3. Focussing lens far & near vision: accomodation reflex
  4. Lacrimation relfex tear production
  5. Vestibulo-ocular reflex:
    • turns the eyes in the opposite direction to a head movement
    • stablises gaze on an object during head movement
    • CNS connections between CN VIII & CNs III, IV & VI
  6. Oculocardiac reflex
    • reflex bradycardia in response to tension on extraocular muscles or pressure on eye
    • CNS connections between CN V1 and CN X

Baby Elephants Play Lacrosse Too Much

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13
Q

What are the sympathetic functions of the eyelid?

A
  • open eyes wider :. gets more light into eyes
  • pupil dilates :. get more light into eyes
  • focus on far objects (lens lengthens)
  • emotional lacrimation
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14
Q

What are the parasympathetic (rest and digest) functions of the eye its surrounding structures?

A
  • get less light into eye
    • to protect retina from bright light or when asleep
  • focus on near objects
  • reflex lacrimation
    • to wash away the stimulant foreign body and clean the cornea
  • allow orbicularis oculi to work
    • BUT this is more about somatic motor but closing the eye when resting and digesting could be explained by parasympathetic
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15
Q

How do we open our eyes wider?

A
  • levator palpebrae superioris contains skeletal AND smooth muscle
  • postsynaptic sympathetic fibres reach levator palpebrae superioris via:
    • superior cervical sympathetic ganglion
    • internal carotid nerve
    • internal carotid plexus
    • axons carried on the opthalmic artery…
      • and on its branches to the orbital structures
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16
Q

Describe pupillary dilation

A

sympathetics dilate the pupil!

in dim light; fight/flight in the ‘sick’ patient

Dilator pupillae fibres are radially arranged

  • orginate around the external circumference of iris- fixed
  • insert around the internal circumference of iris-mobile
17
Q

What is a non-physiologically enlarged pupil called?

A

a non-physiologically enlarged pupil is a MYDRIATIC PUPIL

mydriatic drugs induce dilation of the pupil

18
Q

Describe pupillary constriction

A

parasympathetics constrict the pupil

in bright light and ‘rest & digest’

Sphincter pupillae fibres encircle pupil around internal circumference of iris

19
Q

What is a non-physiologically constricted pupil known as?

A

a non-physiologically constricted pupil is known as a miotic pupil

e.g. a component of Horner’s syndrome

20
Q

Briefly discuss fixed “pin-point” pupil and a “fixed-dilated” (“blown”) pupil

A
  • Fixed “pin-point” pupil* is often a serious pathological sign
  • opiate drugs

A “fixed-dilated” (“blown”) pupil is often a serious pathological sign

  • CN III pathology
21
Q

Describe the anatomical relation of the lens and the ciliary body

A

suspensory ligament of lens connects the circumferences of the lens and the ciliary body

  • the ciliary body is:
    • muscular and vascular
    • smooth muscle like a sphincter around circumference
22
Q

Describe what happens in “far vision”

A
  • the ciliary muscle relaxes in “far vision”
    • no parasympathetics
    • ligament tightens & lens flattens to focus on an object in the distance
23
Q

Describe what happens in “near vision”

A
  • the ciliary muscle contracts in “near vision”
    • parasympathetic
    • ligament relaxes & lens becomes spherical to focus on near objects
24
Q

What are the three different types of tears?

A

Basal tears

Reflex tears

Emotional tears

25
Q

Describe basal tears

A
  • important in corneal health
  • clean/nourish & hydrate the avascular cornea
  • contain lysozyme
    • enzyme that hydrolyses bacterial cell walls
26
Q

Describe reflex tears

A
  • extra tears in response to mechanical or chemical stimulation
  • afferent limb is CN V1 from cornea/conjunctiva
  • efferent limb is parasympathetic axons orignating from CN VII
27
Q

Describe the efferent nerves involved in lacrimation

A

At internal acoustic meatus

there’s a branch of of CN VII containing parasympathetic axons

branches of V2 and V1 carry axons to lacrimal gland

(sorry wtf p.s. don’t understand this help)

28
Q
A

Opthalmology (1 decks)

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