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Ophthalmology 2020 > Anatomy > Flashcards

Anatomy Flashcards

1
Q

what is the iris?

A

thin diaphragm

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2
Q

what does the iris control?

A

size of the pupil which is an opening in the iris

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3
Q

what is sclera covered by?

A

conjunctiva

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4
Q

what is the iris covered by?

A

cornea

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5
Q

what are the three layers of the eye?

A
  1. fibrous (outer layer)
  2. uvea (vascular/middle layer)
  3. retina (photosensitive/ inner layer)
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6
Q

what does the fibrous layer consist of?

A

sclera

cornea

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7
Q

what does the uvea consist of?

A

iris
ciliary body
choroid

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8
Q

what are the two segments of the eye?

A
  1. anterior segment

2. posterior segment

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9
Q

where is the anterior segment?

A

in front of the lens

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10
Q

what is the anterior segment split into?

A

anterior chamber

posterior chamber

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11
Q

where is in the anterior chamber?

A

between cornea and iris

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12
Q

where is the posterior chamber?

A

between iris and suspensory ligaments

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13
Q

where is the posterior segment?

A

behind the lens

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14
Q

what does the posterior segment contain?

A

vitreous body to secrete vitreous humour

collagen can clump together to form floaters

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15
Q

what secretes aqueous?

A

ciliary body has ciliary processes that secrete aqueous

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16
Q

where is aqueous reabsorbed?

A

Canal of Schlemm at the iridocorneal angle

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17
Q

role of aqueous

A

nourishes avascular structures

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18
Q

describe the arterial supply to the eye

A

ICA gives off the ophthalmic artery which branches into ciliary arteries and central artery of the retina

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19
Q

how does the ICA get into the cranial cavity?

A

carotid canal

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20
Q

what does the ophthalmic artery pass through?

A

optic canal

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21
Q

what is the fundus?

A

area on the retina where light is focused

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22
Q

what does the fundus contain?

A

optic disc
macula
fovea

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23
Q

what is the optic disc?

A

CNII formation

point of entry/exit for blood vessels and axons

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24
Q

where is the fovea found?

A

centre of the macula

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25
Q

where are objects in the right visual field processed in the brain?

A

left visual cortex

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26
Q

what are the 6 extraocular muscles?

A 
lateral rectus
superior rectus
inferior rectus
medial rectus
inferior oblique
superior oblique
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27
Q

role of LR

A

abduct the eye

brings into plane of SR and IR

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28
Q

role of SR

A

when in abduction, it elevates

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29
Q

role of IR

A

when in abduction, it depresses

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30
Q

role of MR

A

adducts

brings into plane of SO and IO

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31
Q

role of IO

A

when in adduction, it elevates

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32
Q

role of SO

A

when in adduction, it depresses

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33
Q

innervation of the extraocular muscles

A

LR6, SO4, AO3

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34
Q

role of levator papillae superioris

A

elevates the eyelid

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35
Q

innervation of levator papillae superioris

A

CNIII

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36
Q

what does the SO run through before inserting onto sclera?

A

trochlea

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37
Q

where do all the rectus muscles originate from?

A

common tendinous ring (annulus ring)

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38
Q

where does SO originate from?

A

sphenoid

39
Q

where does IO originate from?

A

maxilla

40
Q

where do all the extraocular muscles insert?

A

sclera

41
Q

what supplies somatosensory innervation to the face?

A

CNV

42
Q

what does CNV1 (ophthalmic division) provide sensation to?

A

upper eyelid
cornea
conjunctiva

43
Q

what branch of CNV1 supplies the face and how does it get there?

A

supraorbital branch passes through the supraorbital foramen

+ nasal skin branches

44
Q

what does CNV2 (maxillary branch) provide sensation to?

A

skin of lower eyelid

skin over maxilla

45
Q

what branch of CNV2 supplies the face and how does it get there?

A

infraorbital nerve via the infraorbital foramen

46
Q

what does CNV3 (mandibular branch) provide sensation to?

A

skin over mandible

TMJ, except angle of the mandible

47
Q

what is the corneal reflex?

A

blinking

48
Q

describe the pathway of the corneal reflex?

A

AP conducted from cornea via CNV1 to trigeminal ganglia along CNV to pons to CNVII to orbicularis oculi

49
Q

sympathetic effect on the eye

A

opens eyes wider
gets more light into the eyes
focuses on far objects

50
Q

parasympathetic effect on the eye

A

less light (protection/ when asleep)
focus on near objects
reflex lacrimation

51
Q

what is the vestibulo-ocular reflex?

A

eyes turn in opposite direction to head movement

stabilises gaze

52
Q

cranial nerve connections in vestibulo-ocular reflex

A

CNVII and CNIII, IV and VI

53
Q

what is the oculocardiac reflex?

A

reflex bradycardia in response to tension in extraocular muscles/ pressure on eye

54
Q

what division of the nervous system is involved in pupillary constriction?

A

parasympathetic innervation along CNIII to sphincter pupillae

55
Q

what is pinpoint pupils an issue with?

A

pontine

56
Q

what division of the nervous system causes pupillary dilation?

A

sympathetic innervation to dilator pupillae

57
Q

what is the pupillary light reflex?

A

response to shining light into the eye causes pupillary constriction of both eyes

58
Q

what nerve connections are involved in the pupillary light reflex?

A

ipsilateral CNII
midbrain (PTN > EWN > ciliary ganglion > ciliary nerve)
bilateral CNIII (direct and consensual response)

59
Q

what is the lens accommodation reflex?

A

changes in the lens shape to look at close and distant objects

60
Q

lens accommodation reflex in far vision

A

ciliary muscle relaxes causing ligaments to tighten and lens to flatten

61
Q

lens accommodation reflex in near vision

A

ciliary muscle contracts
ligaments relax
lens adopts a spherical shape

62
Q

what cranial nerve is responsible for the lens accommodation reflex?

A

CNIII

63
Q

three types of lacrimation

A
  1. basal tears
  2. reflex tears
  3. emotion
64
Q

what bones make up the orbit?

A 
frontal 
zygomatic
maxillary
sphenoid
ethmoid
lacrimal
65
Q

which bones have orbital plates?

A

frontal
ethmoid
maxillary

66
Q

what are orbital plates?

A

areas of thinner bone that are more likely to fracture

67
Q

what is a blow-out fracture?

A

pressure is transferred to orbital plates causing fracture

68
Q

what is a trapdoor fracture?

A

contents such as fat, muscle, nerves can herniate through a blow-out fracture

69
Q

location of the optic canal in the orbit?

A

posteromedial

70
Q

which bone is the superior orbital fissure found?

A

sphenoid bone

71
Q

what does the superior orbital fissure allow passage of?

A

CNIII
CNIV
CNVI

72
Q

what is the external eyelid composed of?

A

orbicularis oculi

73
Q

what are the two parts of orbicularis oculi and their roles?

A

orbital (screwing shut)

palpebral (gentle closure)

74
Q

what is the internal eyelid composed of?

A

fibrous skeleton of superior and inferior tarsus with medial and lateral palpebral ligaments and orbital septum

75
Q

what are tarsal glands?

A

glands in the eyelid that secrete lipids to line the eyelid and stop lacrimal fluid overflowing

76
Q

where is the lacrimal gland located?

A

superolateral

77
Q

what innervates the lacrimal gland?

A

CNVII

78
Q

what does the lacrimal gland do?

A

produces fluid that passes into the cornea and washes over it collecting medially at the lacrimal lake

79
Q

where does the lacrimal gland fluid drain?

A

lacrimal puncta into canaliculi through the lacrimal sac into the nasolacrimal duct (inferior nasal meatus)

80
Q

pathway of sympathetic innervation to the head and neck

A

AP exit T1 and ascend within the sympathetic chain to superior cervical sympathetic ganglion
travels with ICA and ECA following opthalmic artery into the orbit

81
Q

what are the four parasympathetic ganglia in the head and neck?

A

ciliary
pterygopalatine
otic
submandibular

82
Q

what cranial nerve synapses in the ciliary ganglia?

A

CNIII to become the ciliary nerve

83
Q

what do the meninges cover?

A

brain and spinal cord

84
Q

layers of the meninges

A

dura mater (CNV)
arachnoid mater
sub-arachnoid space
pia mater

85
Q

what level does the spinal cord end?

A

L2

86
Q

what level does the subarachnoid space end?

A

S2

87
Q

describe circulation of CSF

A
  1. secreted by choroid plexus in lateral and third ventricles
  2. flow into 4th ventricle via the cerebral aqueduct
  3. drains into sub-arachnoid space and is reabsorbed by arachnoid granulations
  4. passes into dural venous sinuses
88
Q

why do people with raised ICP report visual symptoms?

A

optic nerves are also covered by the meninges

pressure is transmitted and can compress the nerve, central artery or vein of the retina

leads to papilloedema

89
Q

CNIII oculomotor nerve palsy cause

A

compressed due to herniate of the uncal (medial lobe)

90
Q

presentation of oculomotor nerve palsy CNIII

A 
slowed light reflex
dilated pupil
ptosis
eye down and out
loss of accommodation
91
Q

what can damage the CNVI?

A

stretching as it runs through the dura

92
Q

presentation of CNVI palsy

A

eye is unable to move lateral causing medial deviation

93
Q

presentation of CNIV palsy

A

on adduction there is upwards movement as IO is unopposed

Ophthalmology 2020 (25 decks)

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