Aqueous Humor Flashcards
What are the primary purposes of aqueous humor?
1) Maintain globe shape2) Nourishment & waste removal for the avascular cornea & lens.3) Source of antioxidants for corneal epithelium & lens4) Shock Absorber
Refractive index of aqueous humor is…?
1.333
Name the 3 vascular circles in the ciliary body.
Episcleral circle
intramuscular circle
major arterial circle (near iris root)
Ciliary process is supplied by which 2 branches of the Major Arteriole Circle?
Anterior ciliary process arteriole
Posterior ciliary process arteriole
Aqueous humor is secreted by which part of the eye?
ciliary epithelium of ciliary process
Which two enzymes are involved in aqueous humor formation?
Na+ K+ ATPase
Carbonic Anhydrase
Aqueous humor formation follows a _____ rhythm.It is greatest in which part of the day?
circadian.8am-noon, then afternoon, then least after midnight.
What does carbonic anhydrase do?What do inhibitors of carbonic anhydrase do?
Turns carbonic acid into CO2 & H2O.Inhibitors can decrease aqueous humor production.
Where is Na K ATPase found?
Bound to plasma membrane of non-pigmented epithelium of ciliary process.
The Retinal Pigmented Epithelium and the Non-PIgmented Epithelium are joined by _____ which created a ______ between the blood vessels and aqueous humor.
tight junctions
blood aqueous barrier
Which of these have fenestrated capillaries? Which have nonfenestrasted? ciliary process iris choroid retina
Fenestrated: ciliary process choroid Nonfenestrated: iris retina
What are the primary and secondary pathways for aqueous humor outflow?
Primary: Trabecular meshwork routeSecondary: Uveoscleral/posterior route
Inflow rate + outflow rate of aqueous humor = ?
Intraocular Pressure (IOP)
A breakdown in the blood aqueous barrier increases _____.
IOP
When aqueous humor inflow by ultrafiltration is suppressed it is called _____?Does this increase or decrease IOP?This inflammatory process also reduces or increases secretion of aqueous humor?
Pseudofacility.
Decrease IOP.
Reduces secretion.
How does increased plasma components in anterior chamber and increased net inflow of fluid from blood to aqueous humor affect IOP?
Increases IOP
Which factors increase IOP?Which factors decrease IOP?Increased ageWomen over 40WinterSupine PostureExerciseBlinking hardAlcohol, marijuana, heroinCaffeine, Tobacco
Increase:Increased age Women over 40 Winter Supine Posture Blinking hard Decrease:Exercise Alcohol, marijuana, heroin
Mean IOP magic # is _____?
21
What is this equation called?
W + S = P x A + B
What is it used for?
Modified Imbert-Fick Law.Used to ascertain IOP. W (external force) A (area) P (pressure inside sphere) S (surface tension) B (force req'd to bend cornea)
What factors affect IOP measurements?
central corneal thickness
corneal curvatureage-related
corneal changes
biomechanics (rigidity, hydration, elasticity)
The test performed to measure IOP is called ____?
tonometry
The cornea’s physical properties can be described as _____?
visco-elastic
The Pulsatile Ocular Blood Flow is a calculated value that represents ______ circulation?
Choroidal
What are some reasons 24-hour IOP measurement would be helpful?
evaluate efficacy of drug testing,check for Normal Tension Glaucoma progression,identify IOP spikes over short & long term
What are some methods of noninvasive and temporary 24-hour IOP measurement?
contact lensescontinuous applanation or indentation devices
What are some methods of invasive and permanent 24-hour IOP measurement?
subconjunctivalante chamber implants in AC as IOL hap tics scleral buckle scleral fixated sensorpost chamber implants - choroidal
80-90% of aqueous humor formation is done by which process?Which two processes form the rest of aqueous humor?
Secretion.Diffusion & Ultrafiltration.
What are the 4 layers of the ciliary process?
CapillariesStromePigmented EpitheliaNonpigmented Epithelia
What kind of outflow represents 70-95% of aqueous humor outflow?
Trabecular meshwork
What kind of outflow represents 5-30% of aqueous humor outflow?
Uveoscleral
What does Na K ATPase do in aqueous humor formation?What does this cause water to do?
Pushes Na+ ions into posterior chamber from ciliary process.Water follows it from the ciliary process cells, contributing to aqueous humor.
Aqueous humor formation works against or with the concentration gradient?
Against.
What are the 3 muscles in the ciliary body?
longitudinalcircularradial
The Major Arterial Circle is made of paralimbal branches of which arteries?
Long Posterior Ciliary Arteries
The longitudinal fibers attach the ciliary body to the _____?
limbus
The radial muscles connect which two other muscles in the ciliary body?
longitudinal and circular muscles
The circular muscles are found in which portions of the ciliary body?
anterior and inner portions
Which time of the day is aqueous humor produced at about 2.97 µl/min.?
8am - noon
Which time of the day is aqueous humor produced at about 1.28 µl/min.?
midnight - 6am
Which time of the day is aqueous humor produced at about 2.68 µl/min.?
afternoon
What is a pneumotonometer?
An instrument that blows a puff of air at the cornea to cause flattening and hence measure intraocular pressure. It is commonly used in tests for glaucoma.
What is a Perkins tonometer?
A type of portable applanation tonometer
What is applanation tonometry?
A method which measure IOP based on the force required to flatten (applanate) a constant area of the cornea.
What are the conditions to Imbert-Fick law?
Must be perfect sphere, dry, infinitely thin
W= P1 x A
Aqueous humor secreted by ciliary epithelium of ciliary process enters posterior chamber by what three ways? and describe them
Diffusion- lipid soluble substances
Ultrafiltration- water and water soluble substances
secretion - larger size substances of greater charge
What is hypotony?
low intraocular pressure oftern related to chronic intracolular inflammation (uveitis) , wound leaks after eye surgery or retinal detachment
pneumotonometer also gives____ amplitude and calculates _____ volume
pulse, pulse
pneumotonometer measures ___ pulses and selects ___ best to calculate IOP and POBF
7 , 5
T/F the IOP measurement you take inside , could be different then the one you take outside
T
T/F the pneumotonometer has a large range of normality and the values are derived making numerous assumptions which makes accurate
F. it makes it INACCURATE