Anatomy of the Orbit Flashcards
How many bones make up the orbit of the eye?
7
Which bones make up the orbit of the eye?
- Frontal
- Zygomatic
- Maxilla
- Nasal
- Sphenoid
- Ethmoid
- Lacrimal
Which aspect of the frontal bone allows passage of the supraorbital nerve?
Supraorbital notch
Which bone contains the optic canal?
Sphenoid bone
The optic canal is the _____ of the bony orbit
The optic canal is the apex of the bony orbit
What is the main function of the optic rim?
Protects the eye from direct trauma
Which bones mainly comprise the following regions of the bony orbit?
a) Roof
b) Medial wall
c) Lateral wall
d) Floor
a) Roof - Frontal bone
b) Medial wall - Ethmoid bone
c) Lateral wall - Sphenoid bone
d) Floor - Maxilla
Which aspects of the bony orbit are particuarly weak and thin?
- Medial wall (ethmoid)
- Orbital floor (maxilla)
Which type of fractures are the medial wall and floor of the orbit particuarly susceptible to?
Blowout fractures

Which main problems arise with an orbital blowout fracture?
- Trapped orbital contents
- Infraorbital NVB damage
- Sensory deficit of facial skin
Which areas does the infraorbital nerve innervate?
- Ala of nose
- Skin around maxilla (lower eyelid to upper lip)

Why may a fractured zygoma result in double vision?
- Fractured zygoma rotates medially
- Suspensory ligament attaches to zygoma laterally
- Eye lowered to orbital floor as tension reduced
- Diplopia occurs
What is the name given to the muscle surrounding the orbit of the eye?
Orbicularis oculi
The orbicularis oculi is split into which two parts?
- Orbital part
- Palpebral part
Which type of secretion do the tarsal (eyelid) glands secrete?
Lipid secretion
What is the orbital septum and what is its function?
Sheet of fascia
Aids in preventing spread of infection
What is the name of the muscle(s) which elevates the upper eyelid?
- Levator palpebrae superioris
- Superior tarsal (Müller’s*) muscle
*Do not confuse with orbitalis muscle (also known as Müller’s muscle)
Which muscle is primarily responsible for:
a) Gently closing eyes
b) Screwing up eyes
a) Orbicularis oculi (palpebral aspect) - Gently closing eyes
b) Orbicularis oculi (orbital aspect) - Screwing up eyes
Which cranial nerve innervates the orbicularis oculi?
Facial nerve
(CN VII)
Which structure covers the iris?
Cornea
What is the limbus?
Corneal/scleral junction
Which glands are responsbile for tear production?
Lacrimal
Where does lacrimal fluid drain within the eye?
Puncta (inferior and superior)
What is the conjunctival fornix?
Loose arching folds connecting the conjunctival membrane lining the inside of the eyelid with the conjunctival membrane covering the eyeball
The conjunctiva does not cover which part of the eye?
Cornea
What is the pathway of lacrimal fluid drainage?
- Lacrimal puncta
- Canaliculi
- Lacrimal sac
- Nasolacrimal duct
- Nasal cavity
What is the approximate diameter of the eye?
25mm
What are the 3 main layers of the eye?
- Fbrous layer
- Vascular layer (uvea)
- Inner layer (retina)
The fibrous layer of the eye is comprised of which two main components?
- Sclera
- Cornea
The vascular layer (uvea) of the eye is comprised of which 3 parts?
- Iris
- Ciliary body
- Choroid
The inner layer of the eye (retina) is comprised of which 3 main parts?
- Macula
- Optic disc
- Retina
What is the anterior segment of the eye?
The part of the eye anterior to the lens
The anterior segment of the eye is split into which two chambers?
- Anterior (between cornea and iris)
- Posterior (between iris and suspensory ligaments)
Both the anterior chamber and posterior chamber of the anterior segment of the eye contain which type of fluid?
Aqueous humour
What is the key function of the choroid of the eye?
Nutrition and gas exchange
What is the posterior segment of the eye?
2/3rd of the eye posterior to the lens
What does the posterior segment of the eye contain?
Vitreous body which contains vitreous humour
What is the iridocorneal angle?
Angle formed by the iris and cornea to allow drainage of aqueous humour from the eye
Why is the posterior segment of the eye a common location for “floaters”?
Vitreous humour is composed of a gel-like substance which may include areas of liquefaction and clumps of collagen fibres which are the “floaters”
N.b. This is pathological and not normal
A cataract is a _________ of the lens
A cataract is a clouding of the lens
Where is aqueous humour produced?
Ciliary processes of ciliary body
Which type of muscle is the ciliary body composed of?
Smooth
Describe the circulation of aqueous humour
- Secreted from ciliary body
- Nourishes lens in posterior chamber
- Passes through pupil to anterior chamber
- Nourishes cornea
- Reabsorbed into scleral venous sinus (Canal of Schlemm) at iridocorneal angle
What may be the outcomes of raised intra-ocular pressure?
- Ischaemia of retina
- Glaucoma
Which artery gives off artieries which supply the eye?
Internal carotid artery
Which artery supplies the contents of the orbit?
Opthalmic artery
Which branches does the opthalmic artery give off?
- Ciliary arteries
- Central artery of retina
- Nasal cavity branches
- Forehead/scalp branches
Which vesses travel within the optic nerve?
- Central artery of the retina
- Central vein of the retina
Why is it a major problem if the central artery of the retina became occluded?
It is an end artery so is the only blood supply to the retina
Describe the venous drainage of the orbit
Superior and inferior opthalmic veins drain anteriorly via the facial vein and posteriorly via the caverous sinus
What is the “Danger triangle”?
A triangular area on the face covering the nose and upper lip
Infection (e.g. from squeezing acne) can enter the facial vein and travel posteriorly via the inferior/superior opthalmic veins to the canverous sinus
Here, meningeal infection can manifest itself
What is the fundus?
The posterior area of the retina where light is focused
Which three parts comprise the fundus?
- Optic disc
- Macula
- Fovea
The optic disc is the point of formation for what?
Optic nerve
What is the blind spot?
Created due to the postition of the optic nerve and lack of photoreceptive cells in the area
What is the macula?
The area of the fundus with the greatest density of cones
What is the fovea?
Depression in the centre of the macula
(Area of most acute vision)
List the layers of the retina from posterior to anterior
- Photoreceptor cells
- Ganglion cells
- Axons of ganglion cells
(Retinal veins and arteries lie posterior to the retina)
Loss of a specific area of a visual field in one eye may be due to ischaemia in which vessel type?
Retinal artery/vein
(not central artery/vein)
Monocular blindness is due to what?
Complete interruption of flow of the central retinal artery or vein
Light from objects in the right visual field is processed where?
Left primary visual cortex
Light from objects in the lower visual field is processed where?
Upper part of primary visual cortex
What comprises the right visual field?
- Nasal retina of left eye
- Temporal retina of right eye
How many extraocular muscles are there?
7
What are the three types of extraocular muscles?
- 4 Rectus muscles
- 2 Oblique muscles
- 1 Levator palpebrae superiorus
What are the 4 rectus muscles?
- Superior rectus
- Inferior rectus
- Medial rectus
- Lateral rectus
Where do all the rectus muscles originate?
Common tendinous ring
Where do all the rectus muscles insert?
Sclera
What is the innervation of the lateral rectus muscle?
Abducens nerve (CN VI)
(Remember LR6 SO4 AO3)
What is the innervation of the superior oblique muscle?
Trochlear nerve (CN IV)
(Remember LR6 SO4 AO3)
Excluding the lateral rectus and superior oblique muscles, what is the innervation of the extraocular muscles?
Oculomotor nerve (CN III)
(Remember LR6 SO4 AO3)
What are the three axes which the eye can rotate upon?
- Vertical axis (adduct/abduct)
- Transverse axis (elevate/depress)
- AP axis (lateral/medial rotation)

Which extraocular muscles do not have secondary movements?
- Medial rectus
- Lateral rectus
Which eye movement is the lateral rectus responsible for?
Abduction
How can the functioning of the superior rectus be tested?
When the eye is in abduction, the superior rectus can only elevate
How can the functioning of the inferior rectus be tested?
When in abduction, the inferior rectus can only depress
Which movement is the medial rectus responsible for?
Adduction
How can the functioning of the inferior oblique be tested?
When in adduction, the inferior oblique can only elevate
How can the functioning of the superior oblique be tested?
When in adduction, the superior oblique can only depress
What is “pure elevation”?
Synergistic action of the superior rectus and inferior oblique resulting in elevation of eyes
(the muscles are antagonists as rotators)
What is “pure depression”?
Synergistic action of the superior oblique and inferior rectus to depress eyes
(antagonists as adductors/abductors)