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Ophthalmology > Anatomy & Exam > Flashcards

Anatomy & Exam Flashcards

1
Q

What bone make up the canine orbit

A

1) Lacrimal
2) Zygomatic
3) Frontal
4) Sphenoid
5) Palatine
6) Maxillary

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2
Q

What additional bone makes ip the porcine and primate orbit

A

ethmoid

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3
Q

What additional bone makes up the equine orbit

A

temportal bone

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4
Q

T/F: Dogs have bone all the way around their eyes

A

False- they have an open orbit. nothing holding it in place if the soft tissue structure breaks

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5
Q

What passes through the optic canal

A

1) Optic Nerve (CN II)
2) Internal ophthalmic artery

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6
Q

What passes through the orbital fissure

A

1) Oculomotor Nerve (CN III)
2) Trochlear (CN IV)
3) Ophthalmic branch of CN V
4) Abducens (CN VI)

if affected- cavernous sinus syndrome

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7
Q

Refers to deficits in more than one of the cranial nerves III, IV, V, and VI, as they are in close association in this region (floor of of calvarium where they leave the orbital fissure

A

Cavernous sinus syndrome

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8
Q

With Cavernous Sinus Syndrome, what cranial nerves can be damaged

A

1) Oculomotor Nerve (CN III)
2) Trochlear (CN IV)
3) Ophthalmic branch of CN V
4) Abducens (CN VI)

all leave the orbital fissure

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9
Q

What opening in the skull is assoiated with cavernous sinus syndrome

A

orbital fissure

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10
Q

What passes through the rostral alar foramen

A

Maxillary artery
Maxillary branch of CN V

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11
Q

What muscles open the eyelids

A

1) Levator palpebrae superioris m. (skeletal)

2) Mullers muscle (smooth muscle under sympathetic control)

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12
Q

A structural muscle that elevates the upper eyelid. It’s innervated by the sympathetic nervous system

A

Mullers muscle

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13
Q

What muscle closes the eyelids

A

Orbicularis oculi muscle (skeletal muscle)

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14
Q

A test that used to detect obstruction of the nasolacrimal ducts

A

Jones Test

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15
Q

What drains tears into the nose

A

Nasolacrimal duct

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16
Q

What is the function of meibomian glands

A

produce oily components of the lipid layer of the tear film, with these components being secreted along the margins of the eyelids. The lipid layer of the tear film facilitates smooth blinking and attenuates the evaporation of lacrimal fluid

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17
Q

mucous membrane that lines the eyelids and the globe
produces mucoid portion of tear film
has lymphoid tissue

A

conjunctiva

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18
Q

What produces the mucoid portion of the tear film

A

conjunctiva

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19
Q

What produces 65-70% of liquid tears

A

Lacrimal gland

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20
Q

where is the lacrimal gland located

A

above the eye

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21
Q

a t-shaped piece of cartilage that produces 30-35% of liquid tears

A

third eyelids

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22
Q

What is a common site for foreign bodies in the eye?

A

conjunctival fornix

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23
Q

What extra-ocular muscle rotates the top of eye ventronasally

A

dorsal oblique

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24
Q

What extra-ocular muscle rotates the bottom of the eye dorso-nasally

A

ventral oblique

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25
Q

What muscle pulls the eye backwards, not present in humans

A

Retractor bulbi

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26
Q

What are the three layers that make up the globe

A

1) Fibrous tunic (cornea and sclera)
2) Vascular tunic (iris, ciliary body, choroid)
3) Nervous tunic (retina and optic nerve)

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27
Q

What 2 structures are a part of the nervous tunic of the globe

A

1) Retina
2) Optic nerve

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28
Q

What 3 structures are a part of the vascular tunic of the globe

A

1) Iris
2) Ciliary body
3) Choroid

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29
Q

What 2 structures are a part of the fibrous tunic of the globe

A

1) Cornea
2) Sclera

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30
Q

Anterior uveitis means inflammation of the

A

iris and ciliary body

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31
Q

posterior uveitis means inflammation of the

A

choroid

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32
Q

T/F: Cornea and sclera are made of different materials

A

False - same collagen, differ on their arrangements

Sclera- opaque collagen
Cornea- fibers perfectly arranged allows light to pass through

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33
Q

What species have cartilaginous plates in their sclera

A

reptiles and fish

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34
Q

What species have bone in their sclera

A

birds

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35
Q

the point in the fibrous tunic where the cornea meets the sclera

A

limbus

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36
Q

Is fluorescein stain hydrophobic or hydrophilic

A

hydrophilic

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37
Q

What layer of the eye does Herpes attack

A

the epithelium of the cornea- replicates fast

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38
Q

Is the epithelium of the cornea hydrophilic or hydrophobic

A

hydrophobic

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39
Q

What kind of epithelium does the cornea have

A

columnar and becomes keratinized squamous cells

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40
Q

What part of the cornea absorbs the stain in corneal ulcers

A

Stroma (it is hydrophilic) and the fluorescein stain is hydrophilic

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41
Q

T/F: fluorescein stain stains the epithelium of the cornea

A

False

Fluorescein is a water-soluble dye; owing to its lipid insolubility, it does not penetrate intact corneal epithelium. Epithelial erosions or ulcers, which expose the hydrophilic stroma, allow penetration and retention of the dye.

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42
Q

Is Descemets membrane hydrophilic or hydrophobic?

A

Descemet’s membrane is hydrophobic. It’s a thick, dense, relatively transparent, and cell-free matrix that separates the corneal stroma from the endothelium.

Does not take up fluorescein stain

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43
Q

What is the function of the corneal endothelium

A

transports water from the stroma into the anterior chamber

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44
Q

What makes the cornea clear

A

1) Regularity of the collagen fibers (compared to the sclera)
2) Very low cellularity
3) Lack of blood and lymph vessels
4) Relative dehydration
-stroma is hydrophilic (sponge)
-epithelium is hydrophobic barrier
-endothelium actively pumps fluid out of cornea

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45
Q

Why is it challenging to deliver drugs to the cornea

A

relative dehydration

-stroma is hydrophilic (sponge)
-epithelium is hydrophobic barrier
-endothelium actively pumps fluid out of cornea

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46
Q

What 3 structures make it so the cornea is relatively dehydrated

A

-stroma is hydrophilic (sponge)
-epithelium is hydrophobic barrier
-endothelium actively pumps fluid out of cornea

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47
Q

How many corneal layers do fish have

A

2
Scleral cornea
Dermal cornea

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48
Q

a scale that covers the eye of the snake
normally shed when the skin is shed
part of cornea

A

spectacle

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49
Q

What species is corneal vascularization normal in

A

big horn sheep and manatees

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50
Q

T/F: Descemetocele stains fluorescein

A

False- it is hydrophobic

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51
Q

How does superficial corneal pathology differ from deeper corneal pathology

A

Superficial: see branching vascularization

Deep: see dense vessels (hedge bush appearance) tells that you are concerned with a deeper issue like uveitis

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52
Q

What two features of the cornea bends light into the eye

A

1) Angle of incidence (curvature of cornea)
2) Density of the medium (tear film) bends the light

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53
Q

What does LASIK surgery do

A

uses a laser to change the curvature of the cornea
helps for near sighted patients because it is easier to decrease the curvature than it is to increase the curvature

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54
Q

a fluid filled space between the cornea and lens

A

Anterior chamber

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55
Q

what maintains the shape of the globe

A

aqueous humor in the anterior chamber

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56
Q

ultra filtrate that carries nutrients for the lens and cornea
maintains shape of globe

A

anterior chamber

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57
Q

the colorful part of the eye

A

the iris

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58
Q

what regulates the amount of light that enters the eye
controlled by iris sphicter and dilator muscles

A

size of the pupil

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59
Q

a ___________ pupil allows a more precise image to be focused on the retina

A

smaller

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60
Q

what creates aqeuous humor

A

ciliary body

61
Q

dark, pigmented structures in a horse’s eye that help reduce glare from bright light

A

corpora nigra

62
Q

What are the different structures of the lens

A

1) Lens capsule (basement membrane)
2) Lens epithelium- makes cortex
3) Cortex
4) Nucleus

each layer is clear but as it gets more compact - it gets cloudy

63
Q

a condition where there are multiple layers of lens packed together and the eye os cloudy
occurs in older animals
affects dim light vision

A

Lenticular sclerosis

64
Q

what methods of accommodation do dogs and humans have

A

muscles in the ciliary body contract which pulls on the lens, causing the lens to stretch, which decreases the curvature of the lens

65
Q

what methods of accommodation do birds have

A

ciliary muscles contract and push on lens, causing it to round up

66
Q

What methods of accommodation do fish have

A

Retractor lentis moves the lens forward or backward to change focis

also have very round lens to make up for the loss of corneal refraction in aquatic environment

67
Q

gel like structure between the lens and retina
made of glycoaminoglycans and some collagen, very few cells
can degenerate and become cloudy

A

Vitreous

68
Q

how is the vitreous attached to the lens and retina

A

tiny ligaments, therefore vitreous can place traction on the retina and cause tears of detachments

69
Q

what breeds are prone to vitreous degeneration

A

greyhounds and whippets

70
Q

“Floaters”

A

when the vitreous degnerates and becomes cloudy

can lead to a retinal tear

71
Q

Vitrous degeneration can lead to

A

retinal tear / detachments

72
Q

neural tissue that is stimulated by photons
generates instaneous impulses that are modulated and sent to brain
brain then interprets this signal to determine color, contrast, brightness, movement, depth, and texture

A

Retina

73
Q

millions of axons (of ganglion cells) extending from the retina to the brian

A

Retina

74
Q

What are the two types of photoreceptors

A

1) Rods: assist with dim light vision, movement and contrast

2) Cones: color and detailed vision (Dogs have 2cones- Blue and Yellow-Green)

75
Q

photoreceptors that assist with dim light vision, movement, and contrast

A

rods

76
Q

photoreceptors that provide color and detailed vision

A

cones

77
Q

How many types of cones do dogs have

A

2
1) Blue
2) Yellow-Green

this is similar to being red-green color blindness (Deuteranopia)

78
Q

Deuteranopia

A

Red-green colorblind (canine color vision)

79
Q

The reflective layer of the choroid (beneath the retina)

A

tapetum

80
Q

What species have a cellular vs fibrous tapetum

A

Cellular: dogs and cats

Fibrous: horses and ruminants

81
Q

is the tapetum a part of the retina or choroid

A

Choroid (beneath the sensory retina)

82
Q

normal variation in the coloration of the eyes of dogs and cats that results in a lack of pigment in the non-tapetal fundus. This allows the choroidal vessels to be visible against the white sclera

A

subalbinotic

83
Q

a dense network of blood vessels that covers the majority of the retina’s light-sensitive region
entire retina has blood supply
present in dog, cat, human, ruminants

A

Holangiotic

84
Q

a small, round, yellowish spot in the center of the retina at the back of the eye that’s responsible for central vision, color vision, and fine details
present in human

A

macula

85
Q

a type of retina where the entire retina has a blood supply

A

holangiotic

86
Q

what species have a holangiotic retina

A

dog
cat
humman
ruminant

87
Q

a retina where there are blood vessels over the miridian of the retina

A

merangiotic (rabbits)

88
Q

what species have a merangiotic retina

A

rabbits

89
Q

a retina type where the vessels are small and extend only a short distance from the disc.
present in horse, elephant, and guinea pigs

A

paurangiotic

90
Q

What species hae paurangiotic

A

horses
elephants
guinea pigs

91
Q

end-on vessels that feed retina can be visualized in an equine fundus exam

A

Stars of Winslow

92
Q

Why are the Stars of Winslow relevant clinically

A

if a horse has a retinal detachment, blood supply is lost and the retina dies within minutes

however, dogs and cats keep their blood supply so if you can reattach the retina then everything will be ok

93
Q

a term used to describe the absence of blood vessels in the retina of certain animals, such as birds and reptiles

A

Anangiotic

94
Q

What species have an anangiotic retina

A

birds
reptiles

95
Q

What cranial nerves are you testing with an ocular exam

A

II: Optic
III: Oculomotor
IV:Trochlear
V: Trigeminal
VI: Abducens
VII: Facial Nerve
VIII: Vestibulocochlear

2-8 are being tested

96
Q

afferent nerve for menance and pupillar light reflex is

A

Optic Nerve (CN II)

97
Q

what is the efferent pupillary light reflex nerve

A

Oculomotor (CN III)

98
Q

What does oculomotor nerve innervate

A

Dorsal, vental, medial rectus
Ventral Oblique
Levator palpebrae superioris

99
Q

What nerve innervates dorsal oblique

A

trochlear nerve

100
Q

the only muscle that is controlled by the same side of the brain

A

Dorsal oblique (innervated by trochlear nerve CN IV)

101
Q

afferent for palpebral reflex

A

trigeminal nerve (V)

102
Q

what happens when the pterygoid muscle becomes inflammed

A

it is on the floor of the orbit, eye becomes exophthalmic

103
Q

what happens when the pterygoid muscle becomes atrophied (from denervation of CN V- masticatory muscle)

A

enophthalmos
it is on the floor of the orbit s

104
Q

What muscles does abducens nerve innervate

A

lateral rectus
retractor bulbi

105
Q

efferent nerve for the palpebral

A

facial nerve

106
Q

what carries parasympathetic fibers to the lacrimal gland, travel with the ophthalmic branch of CN V

A

facial nerve (CN VII)

107
Q

Sympathetic stimulation the eye causes

A

1) Pupil dilation
2) Mullers muscle holds the upper eyelid up
3) Maintains some ridigity to the extra ocular muscles

108
Q

What is the path of the nerve conducting sympathetic enervation to the eye

A

down the spinal cord from the brainstem where it exits at T1, T2, T3 in the brachial plexus then up the vagus nerve, synapsing in the cranial cervical ganglion, past the inner ear to the eye

109
Q

what is ptosis

A

a dropping of the upper eyelid

seen with loss of sympathetic innervation to Mullers muscle (ex: Horners)

110
Q

What should you use for sedation in equine eye examination

A

a2 agonist- detomidine, xylazine
opioid- butorphanol

111
Q

What should you do for nerve blocks in equine eye examination

A

Auriculopalpebral- motor of upper lid (most important)

Frontal Nerve- sensation of the upper lid and cornea

fast acting, short duration (lidocaine, carbocaine)

112
Q

blocks sensation to cornea and upper lid in the horse

A

frontal nerve block

113
Q

What are different tools used in an ophthalmology exam

A

-Transilluminator
-Loupes
-Slit Lamp Biomicroscope

Fundoscopy
-Direct Ophthalmoscopy
-Pan-optic
-Indirect ophthalmoscopy

114
Q

How can you test cranial nerve II

A

Pupillary light response
dazzle
menace
tracking
maze test

115
Q

How can you test cranial nerve III

A

Movements of dorsal, ventral, medial rectus, ventral oblique, lebator palpebrae superiorsus, efferent PLR

116
Q

How do you test CN V

A

Sensory to skin
globe cornea
mostly afferent
muscle of mastication

117
Q

How do you test CN VIII

A

nystagmus, head tilt

118
Q

How can you tell the eye is painful

A

Rubbing, squinting, tearing, red eyes

119
Q

characterized by a difference in pupil sizes.

A

anisocoria

120
Q

where will corneal vessels start

A

limbus

121
Q

How should you examine the third eyelid

A

Retropulse the globe to evaluate
Prolapsed gland of third eyelid (cherry eye)
Scrolled cartilage (giant breeds)
Elevated in exophthalmos, Enophthalmos, Horner’s, pain

122
Q

What might cause protrusion of the third eyelid

A

exophthalmos
enophthalmos
horner’s
pain

123
Q

What should you evaluate on the irus

A

Texture, shape, color
-Atrophy
-Persistent Pupillary Membranes
-Neovascularization (Rubeosis irides)
-Synechia (anterior or posterior)

124
Q

what is an alternative for Schirmer tear test

A

phenol red thread test

125
Q

How do you differentiate cataracts from nuclear sclerosis

A

often need to dilate with tropicamide 1%
assess tapetal reflection with transilluminator

Nuclear sclerosis: hazy appearance to the center of the lens (can still see tapetal reflection)

Cataract: will completely block light

126
Q

What are the different types of cataracts

A

1) Incipient (localized)
2) Immature (15-90%)
3) Mature (>90%)
4) Hypermature

127
Q

allows fundus and lens to be evaluated

A

tropicamide 1%

128
Q

When should you not dilate the eye with tropicamide 1%

A

-Increased intraocular pressure (glaucoma)
-questionable lens positon (luxation)

129
Q

tapetum is part of the

A

choroid

130
Q

where do you place the schirmer tear test strip

A

lateral 2/3rds of inferior eyelid

131
Q

what is a normal schirmer tear test result

A

15mm wetting in 60 seconds

132
Q

How do you perform a fluorescein stain?

A

do not touch dry strip to eye -moisten with saline first or mix with <1ml saline
1) Pattern of staining tells you ulcer location and depth
2) Can be used to check patency of nasolacrimal duct (Jones test)
3) Evaluate leaking aqueous (Seidels test)

133
Q

Seidels test

A

fluorescein stain to evaluate the leaking aqueous

134
Q

What are the different ways to test intraocular pressure

A

Schiotz: Indentation - Requires a patient patient

Tonopen: Applanation - Require Proparocaine

Tonovet: Rebound (NO proparocaine)

135
Q

What happens after chronic chorioretinitis

A

retinal atrophy- results in hyper reflective

136
Q

What is normal intraocular pressure

A

8-25mmHg
No more than 3-5mmHg discrepancy between eyes
not a diagnosis

technique is everything- any pressure on the neck or eyelids may alter the results

137
Q

There should be no more than _______ intraocular presure discrepancy between eyes

A

3-5mmHg

138
Q

IOP is elevated in ______ but decreased in ____________

A

elevated in glaucoma
decreased in uveitis and old age

139
Q

evaluates the iridocorneal angle

A

gonioscopy

140
Q

should be does for corneal ulceration

A

cytology +/- culture

141
Q

can evaluate the globe and retrobulbar space

A

ultrasound

142
Q

tests the electrical function of the retina

A

electroretinogram

143
Q

What cranial nerve does touching the cornea do?

A

Trigeminal (afferent)
Abducens (efferent)

144
Q

What cranial nerve does touching the palpebral do?

A

Trigeminal (afferent)
Palpebral (efferent)

144
Q

Dogs with cranial nerve III damage, what way can the eye move

A

laterally (that is controlled by abducens VI)

145
Q

Dogs with CN III damage, will the pupil be dilated or constricted

A

dilated (lack of parasympathetic input to the eye)

146
Q

direct PLR

A

ipsilateral illumination

147
Q

indirect PLR

A

contralateral illumination

148
Q
A

Ophthalmology (7 decks)

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