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Opthalmology > Anatomy and physiology > Flashcards

Anatomy and physiology Flashcards

1
Q

What are the components of the adnexa?

A
  • Eyelids
  • Conjunctiva
  • Nasolacrimal system
  • Orbit
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2
Q

What are the 3 tunics of the globe and what are the components?

A
  • Fibrous: cornea and sclera
  • Vascular uvea: Iris, ciliary body, choroid
  • Nervous: retina
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3
Q

What are the 2 component of the ocular media?

A
  • Aqueous humor

- Vitreous humor

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4
Q

What makes up the eyelid?

A
  • Outermost haired skin
  • Inner surface conjunctiva
  • Stroma containing muscle
  • Medial and lateral canthus
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5
Q

What makes up the eye margin?

A
  • Cilia: eyelashes

- Tarsal gland: Meibomian

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6
Q

What muscles are important for eyelid movement?

A
  • Orbicularis oculi (circumferential striations): innervated by CN VII = CLOSE
  • Levator palpebrae superioris (vertical striations): innervated by CN III = OPEN
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7
Q

What is the function of the eyelids?

A
  • Protect
  • Lubricate: distribute tears
  • Tarsal glands produce oil lipid layer of the tear film
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8
Q

What are the pathophysiology related to eyelid diseases?

A
  • Corneal irritation

- Tear-film quality disorders

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9
Q

What are the components of the third eyelid?

A
  • T-shaped cartilage
  • Lined by conjunctiva
  • Lymphoid follicles on bulbar surface
  • Tear-producing gland at the base of cartilage
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10
Q

What is the function of the third eyelid?

A
  • Protection

- Gland of third eyelid produces aqueous tears

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11
Q

What are the pathophysiology related to third eyelid issues?

A
  • Corneal irritation

- Tear film quantity disorders

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12
Q

What are the 2 types of conjunctiva and what do the connect to?

A
  • Bulbar conjunctiva: lines the globe and extends from the limbus to the fornix
  • Palpebral conjunctiva: lines the inner eyelid and extends from the fornix to the lid margin
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13
Q

What is the function of the conjunctiva?

A
  • Goblet cells produce mucin layer of tears

- Lymphoid follicles act as immune surveillance

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14
Q

What is the pathophysiology of conjunctival disease?

A
  • Reaction to antigens: lymphoid hyperplasia
  • Inflammation
  • Tear film quality disorders
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15
Q

What are the 3 tear film layers? What produces them? What is there function?

A
  • Innermost mucin: produced by the goblet cells of the conjunctiva
    o Act as stability of tear film; hydrophilic surface for tears to spread evenly
  • Middle aqueous: produced by the aqueous humor
    o Acts to supply oxygen and nutrients to the cornea
  • Outer oily: produced by tarsal glands of the eyelids
    o Act to reduce and prevent evaporation
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16
Q

What are the functions of tears?

A
  • Provide optically uniform corneal surface
  • Remove foreign material and debris
  • Permit passage of oxygen and nutrients to the cornea
  • Antimicrobial function
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17
Q

What is the result of alteration of quantity and quality of tears?

A
  • Chronic dry eye
  • Corneal edema
  • Vascularization
  • Keratinization
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18
Q

What are the component of the nasolacrimal system?

A
  • Upper and lower puncta
  • Canaliculi
  • Lacrimal sac
  • Nasolacrimal duct
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19
Q

What is the function of the nasolacrimal system?

A
  • Tear drainage
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20
Q

What happens if the NL system is not working?

A
  • Epiphora
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21
Q

What are the components of the orbit?

A
  • Orbital bones
  • Periorbital: connective tissue around the orbit and orbital floor (soft tissue)
  • Fat
  • Extraocular muscles
  • Lacrimal gland
  • Vessels and nerves: orbital foramina
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22
Q

What is the purpose of the open verses closed orbit?

A
  • Carnivores = open: extension of the jaw

- Herbivores = closed: protection

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23
Q

What are the extraocular muscles and function?

A
  • Dorsal, ventral, medial and lateral rectus: movement of the eye
  • Dorsal and ventral oblique: twist/rotate the eye
  • Retractor bulbi: sucks the eye into the orbit
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24
Q

What are the nerves that innervate the EO muscles?

A
  • DVM rectus + V oblique: CNIII
  • D oblique: CN IV
  • L rectus, retractor bulbi: CN V
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25
Q

What are some periorbital structures?

A
  • Oral and nasal cavity
  • Tooth roots
  • Paranasal sinuses
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26
Q

What are the functions of the orbit?

A
  • Protect and cushion the globe
  • Conduit for vessels and nerves
  • Attachment for muscles to move the eye
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27
Q

What would happen if a tumor or an abscess grew in the orbit?

A
  • Exophthalmos: push the globe out of the eye
  • Decreased movement: muscle impingement
  • Dry cornea
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28
Q

What are the pathophysiology of orbital disease?

A 
- Change in volume
     o Exophthalmos: increase 
     o Enophthalmos: decrease
- Impaired function of orbit structures
     o Motility, strabismus, anisocoria, blindness, episcleral congestion, tear production
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29
Q

What makes up the fibrous tunic of the globe

A
  • Cornea: clear
  • Sclera: not clear
  • Limbus: line of pigment at the junction between cornea and sclera
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30
Q

What is the cornea made up of?

A
  • Outer epithelium
  • Stroma: collagen
  • Descemet’s membrane: basement membrane
  • Endothelium: 1 cell layer thick
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31
Q

What is the function of the cornea?

A
  • Refracts light: corneal curvature

- Protection

32
Q

how is the cornea clear for vision?

A
  • No pigment and non-keratinized
  • Organized collagen lamellae
  • Low water content
  • Avascular
33
Q

How is the low water content maintained in the cornea?

A
  • Active pumping in endothelium via a NA/K ATPase

- Physical barrier: tight junctions in the endothelium and epithelium

34
Q

Where does the cornea get nutrition and oxygen from?

A
  • Aqueous humor and tears
35
Q

What changes do you expect in the cornea related to disease?

A
  • Corneal edema
36
Q

How does the cornea loss clarity?

A
  • Edema
  • Cellular, lipid or mineral infiltration
  • Scarring
  • Pigmentation
  • Keratinization
37
Q

What is corneal ulceration? How do you diagnose this?

A
  • Loss of the superficial layer of the epithelium

- Dx: fluorescein stain

38
Q

What are the different layers to the sclera?

A
  • Episclera: loose connective tissue below the conjunctiva

- Sclera proper: dense connective tissue

39
Q

What are the functions of the sclera?

A
  • Protection of intraocular structures

- Attachment for extraocular muscle

40
Q

What is the pathophysiology of scleral disease?

A
  • Inflammation
  • Motility disorders
  • Strabismus
41
Q

What are the components of the vascular tunic?

A
  • Anterior uvea: iris and ciliary body

- Posterior uvea: choroid and tapetum

42
Q

What are the muscles associated with the iris?

A
  • Sphincter muscle (near the pupil): innervated by CN III

- Dilator muscle (posterior stroma): sympathetic innervation

43
Q

What is the function of the iris?

A
  • Pupil: opening for light entering the eye
44
Q

What are the components of the ciliary body?

A
  • Bilayer epithelium: pigmented and non-pigmented
  • Stroma: vascular and smooth muscle
  • Pars plicata: ciliary processes which suspends the lens via the zonules
  • Pars plana: smooth transition to the retina
45
Q

What is the function of the bilayer epithelium of the ciliary body?

A
  • Production of aqueous humor
46
Q

What is the function of the zonules?

A
  • Suspend the lens
47
Q

What is the function of the smooth muscle of the ciliary body?

A
  • Accommodation of light: focus
48
Q

What is the filtration angle?

A
  • Located where the cornea and iris meet
  • Pectinate ligaments span the opening
  • Made up of a trabecular meshwork
49
Q

What is the function of the filtration angle?

A
  • Drainage of aqueous humor
50
Q

What are the components of the choroid?

A
  • Stroma: highly vascular and contains the tapetum dorsally

- Choriocapillaries: on the surface of the choroid that act as feeders into the tapetum

51
Q

What is the function of the choroid?

A
  • Nutrition to outer retina

- Tapetum: increases light capture

52
Q

What are the components of the blood aqueous barrier?

A
  • Tight junctions between the nonpigmentary ciliary epithelial cells and between iris capillary endothelial cells
53
Q

What is the function of the BAB?

A
  • Prevents low molecular weight substances from entering aqueous humor: protein and cells
54
Q

What is some pathophysiology of the BAB?

A
  • Uveitis (inflammation of the uvea) causes a breakdown in the BAB and leads to corneal edema
55
Q

What are the main components of the retina?

A
  • Retinal pigment epithelium: one cell thick

- Neurosensory retina: multiple layers

56
Q

What are the functions of the retinal pigment epithelium?

A
  • Transport of ions and metabolites

- Photoreceptor renewal

57
Q

What is the pathophysiology of retinal disease?

A
  • Retinal degeneration
58
Q

What are the function of the photoreceptors?

A
  • Rods = night vision

- Cones = day vision, colour, high resolution

59
Q

How does phototransduction occur?

A
  • Light is changed into an electrical signal

- Transmitted through retinal layers to optic nerve

60
Q

What is the relationship between neurosensory retina and the RPE?

A
  • Layers are apposed but there is no firm attachment

- Thus the RPE and neurosensory retina detach easily

61
Q

What are the pathophysiology of retinal and optic nerve disease?

A
  • Detachment
  • Tears/holes
  • Inflammation
  • Degeneration
62
Q

What are the 2 components of ocular media?

A
  • Aqueous humor

- Vitreous humor

63
Q

Describe the aqueous humor?

A
  • Clear, watery and found in the anterior chamber
64
Q

Describe the vitreous humor?

A
  • Clear, gel-like and found in the posterior chamber
65
Q

What is the composition of the vitreous humor?

A
  • 98% water, 2% collagen and hyaluronic acid

- Collagen fibrils provide a frame work

66
Q

What is the function of the vitreous humor?

A
  • Transmits light
  • Maintains shape of eye
  • Maintains normal position of retina
67
Q

What is the pathophysiology of vitreous humor?

A
  • Degeneration: condensation of collagen fibrils leads to loss of framework and liquefaction
  • Opacities
68
Q

What is the consequence of retina with disease of the vitreous humor?

A
  • Retinal detachment
69
Q

What is the function of aqueous humor?

A
  • Maintains the intraocular pressure

- Nutrition and waste removal

70
Q

What is involved in aqueous circulation?

A
  • Posterior chamber, pupil, anterior chamber, filtration angle and collecting veins
71
Q

What happens to the aqueous humor when the BAB is broken?

A
  • Protein and cellular leakage into the aqueous humor
    o Leads to cloudy aqueous = aqueous flare and Hypopyon
  • Disruption of normal nutrition and waste removal
    o Cornea – edema
    o Lens - cataract
72
Q

What happens to eye if aqueous humor outflow is reduced?

A
  • Increase intra-ocular pressure
73
Q

What are the components to the lens?

A
  • Suspended by zonules from ciliary processes

- Capsule surrounds lens cells: fibers

74
Q

What are the function of the lens?

A 
- Clarity
     o Avascular
     o Dehydrated state
     o Solubility of lens proteins
- Refraction of light: focus onto the retina
75
Q

What is the pathophysiology of lenticular disease?

A
  • Cataracts
    o Due to proteins and or hydration changes: opacity
  • Lens luxation
    o Due to zonular breakdown

Opthalmology (3 decks)

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