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Opthalmology > Anatomy- Reflexes > Flashcards

Anatomy- Reflexes Flashcards

1
Q

what supplies the sensory innervation of the face

A

trigeminal nerve CN V (ophthalmic, maxillary, mandibular)

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2
Q

what does the ophthalamic nerve supply

A

forehead, upper eyelid, cornea, conjunctiva, skin of the root/bridge/ tip of the nose

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3
Q

what does the maxillary nerve supply

A

skin of the lower eyelid and maxilla, skin of the ala of the nose, skin/mucosa of the upper lip

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4
Q

what does the mandibular nerve supply

A

skin over the mandible, and TMJ

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5
Q

what supplies the sensory innervation of the angle of the mandible

A

C2,3 spinal nerves

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6
Q

what is the sensory (afferent) limb of the blink/corneal reflex

A

action potentials conducted from cornea via CN V1 (ophthamlic) branches to trigeminal ganglion then along CN V to pons

connections there to CN VII (facial nerve)

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7
Q

what is the motor (efferent limb) of the blink/corneal reflex

A

action potentials conducted via CN VII to eyelid part of orbicularis oculi

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8
Q

where do sympathetic axons leave the spinal chord

A

between T1 and L2 - thoracocolumbar outflow

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9
Q

how do sympathetic axons reach organs

A

via splanchnic nerves

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10
Q

how do sympathetic axons reach the sympathetic chains

A

spinal nerves

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11
Q

how do sympathetic axons reach the eyes

A

pre synaptic:

exit at T1 spinal nerve

ascend sympathetic trunk

synapse in superior cervical sympathetic ganglion

post synaptic:

enter internal and external carotid nerves

pass onto surface of the internal and external carotid arteries (form a plexus)

carried to organs and into the orbit

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12
Q

where do all parasympathetic axons leave the spinal chord

A

via cranial nerves III, VII, IX, and X
and
via sacral spinal nerves

craniosacral outflow

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13
Q

what supplies the parasympathetics to the organs of the neck, chest and abdomen as far as the mid-gut

A

vagus

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14
Q

where to parasympathetics in the sacral spinal nerves go

A

to the hindgut, pelvis and perineum

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15
Q

what ganglion do parasympathetic axons go through to get to the eye and ciliary muscles

A

ciliary ganglion

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16
Q

what ganglion do parasympathetic axons go through to get to the lacrimal gland, nasal, palatine and pharyngeal gland

A

pterygopalatine ganglion

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17
Q

where does the CNIII (oculomotor) nerve join with the CNS

A

at junction between midline and pons

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18
Q

what sinus does the oculomotor nerve go through

A

cavernous sinus

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19
Q

where does the oculomotor nerve exit the cranial cavity

A

via superior orbital fissue (where it enters the orbit)

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20
Q

what does the oculomotor supply somatic motor innervation to

A

superior, medial and inferior rectus
inferior oblique
levator palpebrae superioris
ciliary glanglion (sphincter papillae and cilliary muscles)

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21
Q

what does the superior division of oculomotor nerve supply

A

superior rectus and LPS

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22
Q

what does the inferior division of oculomotor nerve supply

A

MR, IR, IO, and cilairy ganglion

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23
Q

what do the ciliary nerves supply

A

automonic axons to control diameter of iris and refractive shape of the lens

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24
Q

what types of fibres are in the long ciliary nerves

A

sympathetic and somatic sensory

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25
what types of fibres are in the short ciliary nerves
sympathetic, parasympathetic, somatic sensory fibres
26
what nerves form the first part of the blink reflex
the long ciliary nerves
27
what are the autonomic reflexes of the eye
maximal eyelid elevation in fight or flight pupillary dilation/ constriction to adjust to light focussing lens far and near vision: accommodation reflex lacrimation reflex tear production vestibulo-ocular reflex oculocardiac reflex
28
what is the vestibulo ocular reflex
turns the eyes in the opposite direction to the head to stabilise gaze CNS connections between CN VIII and CN III,IV and VI
29
what is the oculocardiac reflex
reflex bradycardia in response to tension on extraocular muscles or pressure on eye CNS connection between CN V1 (ophthalamic) and CN X
30
what are the sympathetic functions of the eye
opens eyes wider gets more light into eyes focus on far objects emotional lacrimation
31
what are the parasympathetic functions of the eye
gets less light into eyes focus on near objects reflex lacrimation (allow obricularis oculi to work - more somator motor)
32
what types of muscle in levator palpebrae superioris
skeletal and smooth (F or F) muscle
33
how do postsynaptic sympathetic fibres reach levator palpebrae superioris
superior cervical sympathetic ganglion internal carotid nerve internal carotid plexus axons carried on the ophthalmic artery… and on its branches to the orbital structures
34
how does sympathetics affect the pupil
dilate it- in dim light and in fight or flight/ the sick patient
35
what is a mydriatic pupil
non physiologically enlarged pupil
36
what do mydriatic drugs do
induce dilation of the pupil
37
what dilates the pupil
dilator pupillae muscle fibres
38
describe the arrangement of dilator pupillae fibres
radially arranged originate around the external circumference of iris (fixed) insert around the internal circumference of iris (mobile)
39
how does parasympathetics affect the pupil
constrict the pupil in bright light and rest an digest
40
what is a miotic pupil
non physiologically constricted pupil (seen in horners syndrome)
41
what is a fixed pin point pupil a sign of
serious- e.g. opiate drugs
42
what is a fixed dilated pupil a sign of
serious- e.g. CN III pathology
43
what constricts the pupil
sphuncter pupillae fibres encircle pupil
44
where are sphincter pupillae fibres
around the internal circumference of the eye
45
what is the sensory afferent limb of the pupillary light reflex
ipsilateral CN II - optic nerve CNS connection occurs in midbrain
46
what is the motor efferent limb of the pupillary light reflex
bilateral CN III- oculomotor nerves
47
why in the pupillary light reflex is the afferent on one side and efferent on both sides
so a torch shone in one eye will cause a consensual light reflex in the non stimulated eye
48
what are the 4 neurones chains in the pupillary light reflex
1st- retinal ganglion- optic nerve- optic chiasm- synapse in pretectal nucleus in midbrain 2nd- (bilateral) midbrain- pretetcal nucleus- synapse again in Edinger westphal nucleus 3rd- (bilateral) EW nucleus- CN III- CN III inferior division- synapse in ciliary ganglion 4th- (bilateral) short ciliary nerves- sphincter pupillae muscles
49
what is significant about the Edinger Westphal nucleus
location of the cell bodies of the parasympathetic axons of CN III
50
what does the suspensory ligament of the lens do
connects the circumference of the lens and the ciliary body
51
describe the ciliary body
muscular and vascular, sphincter around a circumference
52
in what vision does the ciliary muscle relax
far - makes ligament tighten to focus on an object in the distance
53
when does the ciliary body contract
in near vision- relaxes the ligament which makes the lens become spherical to focus on near objects
54
what innervation controls the constriction of the ciliary muscle
parasympathetic
55
what innervation controls the relaxation of the ciliary muscle
happens when there is no parasympathetic actions
56
what are the 3 aspects of the accommodation reflex
bilateral pupillary constriction (CN III) bilateral convergence (medial rotation of both eyes CN III) bilateral relaxation of the lens (CN III)
57
in the accommodation reflex what is the purpose of bilateral pupillary constriction
to prevent diverging light rays from hitting the periphery of the retina and resulting in a blurred image. Reduces amount of light that get into eye, only focused ray of light get in
58
in the accommodation reflex what is the purpose of bilateral convergence
simultaneous movement of both eyes in opposite directions to obtain or maintain single binocular vision (Cross eyes)
59
in the accommodation reflex what happens in bilateral relaxation of the lens
lens become spherical due to the contraction of the ciliary muscles
60
what is the role of basal tears
important in cornea (avascular) health- clean, nourish and hydrate contain lysozyme (hydrolyses bacterial cell walls)
61
what is the role of reflex tears
extra tears in response to mechanical or chemical stimulation
62
what are the afferent and efferent limbs of the reflex tears reflex
afferent limb is CN V1 from cornea/conjunctiva | efferent limb is parasympathetic axons originating from CN VII
63
what nerves carries parasympathetic axons for the lacrimal gland
CN VII | then branches of V2 then V1
64
what nerves does facial expression
CN VII somatic
65
what are the symptoms of horners syndrome (ipsilateral)
miosis ptosis reduced sweating (annhydrosis) increased warmth and redness
66
what causes horners syndrome
Impaired sympathetic innervation to head and neck- compression of the cervical parts of the sympathetic trunk: - root of neck trauma - carotid dissection - internal jugular vein engorgement - deep cervical node metastases - pancoast tumour (lung apex)

Opthalmology (16 decks)

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