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Ocular Phys > Block 12 > Flashcards

Block 12 Flashcards

1
Q

When the flow of AH in does not equal the flow of AH out

A

Glaucoma

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2
Q

2 pathways that AH leaves the eye

A

Unconventional path

Conventional path

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3
Q

AH path: through ciliary muscle and other downstream tissues

A

Unconventional path

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4
Q

AH path: through the TM and SC

A

Conventional path

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5
Q

AH path: the major pathway of AH out of eye

A

Conventional path

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6
Q

AH path: not affected by IOP (IOP independent)

A

Unconventional path

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7
Q

AH path: IOP dependent

A

Conventional path

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8
Q

The conventional pathways of AH flow is also called

A

Corneoscleral path

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9
Q

The unconventional path of AH outflow is also called

A

Uveoscleral outflow

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10
Q

2 models of conventional AH outflow path

A
  • bulk flow model

- pumping model

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11
Q

Conventional pathway model: simplest hydraulic model

A

Bulk flow model

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12
Q

Conventional pathway model: a rise in EVP results in a 1:1 ration of increase IOP

A

Bulk flow model

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13
Q

Conventional pathway model: receives power form transient IOP increase

A

Pumping model

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14
Q

With constant very high IOP, what can happen to SC

A

It can collapse on itself and obstruct entry into the venous sys

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15
Q

What 2 structures are the TM between

A

Anterior chamber and SC

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16
Q

The pssr of anterior chamber and SC are different, so what does the TM do

A

Sense the differential and strives to maintain parameters within a homeostatic range

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17
Q

What 2 things can cause outflow obstruction of AH

A

Occlusive angle

Injury to TM

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18
Q

Possible conditions to cause an occlusive angle, obstructing outflow

A 
Diabetes (severe - retinopathy)
Uveitis
Hyphens
Pseudoexfoliative glaucoma
Pigment dispersion glaucoma
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19
Q

75% of the resistance to AH outflow is localized to what structure

A

TM

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20
Q

2 conditions that may injure the TM, obstructing outflow

A

Fuch’s heterochromic irits

Glaucomatocyclitic crisis

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21
Q

3 long term influences of IOP

A

Genetic
gender
refractive error

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22
Q

The older we get, which gender has higher IOP

A

Women

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23
Q

Which will typically have a higher IOP, myopic or hyperopic patients

A

Myopic

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24
Q

The peak IOP is when during the day

A

Morning hours

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25
Q

Higher IOP with pt is sitting or laying

A

Laying

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26
Q

What gaze is there an increase in IOP

A

Up gaze

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27
Q

Thicker corneas cause readings of IOP to be

A

Artificially high

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28
Q

Pts with HIV or pts pregnant will have higher or lower IOP

A

Lower

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29
Q

Corticosteroids may cause your IOP to

A

Increase

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30
Q

largest organ of the eye

A

Vitreous

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31
Q

How much of light does the vitreous transmit

A

90%

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32
Q

How is the vitreous attached to the ILM

A

By anchoring fibrils and the membrane limitans itnerna (MLI)

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33
Q

The the MLI is composed of

A
  • fusing point of the anchoring fibrils
  • lamina dense
  • lamina Lucinda
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34
Q

Where is the vitreous base

A

Ora serrata

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35
Q

What is the strongest vitreal attachment

A

Vitreous base

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36
Q

Located between the posterior lens and anterior vitreous

A

Wieger’s ligament

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37
Q

The only vitreal attachment to not decline with age

A

Base

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38
Q

Which attachment is of medium strength

A

Peripapillary adhesion

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39
Q

Vitreal adhesion around the edge of the optic disc

A

Peripapillary adhesion

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40
Q

What is the weakest vitreal attachment

A

Macular/peripheral retinal attachment

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41
Q

What composes the majority of the vitreous

A

Water

42
Q

Main collagen type in vitreous

A

Type 2

43
Q

What are the 4 major composers of the vitreous

A

Water
Type 2 collagen
Vitreal cells
Vitamin C

44
Q

The gel structure of the vitreous results from

A

Arrangement of collagen fibrils suspended in HA

45
Q

3 main vitreal cells

A

Hyalocytes
Fibroblasts
Macrophage

46
Q

Majority of vitreal cells are which type

A

Hyalocytes

47
Q

4 main functions of vitreous

A

Support retina
Diffusion barrier
Metabolic buffer
Transparency

48
Q

Pathology associated with the support function of the vitreous

A

PVD

Macular edema

49
Q

Major cause of macular edema

A

Retinal ischemia

50
Q

The metabolic buffer function of the vitreous serves as a reservoir of what

A

Glucose/glycogen
Potassium
VITAMIN C

51
Q

Pathology associated with the diffusion barrier and metabolic buffer functions of the vitreous

A

nuclear sclerotic catract (NSC)
Reduced neovascularization of retina
Neovascular glaucoma

52
Q

Pathology associated with the transparency function of the vitreous

A

Synchisis scintillations

Asteroid hyalosis

53
Q

Protects against oxidative stress

Protect the retina from metabolic and light induced free radicals

A

Vitamin C

54
Q

T/F: the vitreous provides a transparent medium

A

True

55
Q

T/F: the vitreous cushions the globe

A

True

56
Q

T/F: the vitreous stores ions and nutrients for the retina and lens

A

True

57
Q

A common disorder of the tear film caused by tear deficiency or excessive tear evaporation

A

Dry eye syndrome

58
Q

3 main functions of the tear film

A
  • Smooth refractive surface
  • maintain corneal and conj health
  • act as first line of defense against microbial infection
59
Q

Layers of the tear film starting at the corneal epithelium

A

Mucous layer
Aqueous layer
Lipid layer

60
Q

Main component of the mucous layer of the TF

A

Mucin

61
Q

High molecular weigh glycoproteins that are heavily glycosylated

A

Mucin

62
Q

2 types of mucins

A

Membrane associated mucins

Secretory mucins

63
Q

Which type of mucin acts as a dense barrier to pathogen penetrance

A

Membrane associated mucins

64
Q

Which type of mucin act as a cleaning crew

A

Secretory mucin

65
Q

4 functions of the mucus layer of the TF

A
  • maintain water on the surface of eye
  • Lower surface tension, stabilizing the TF
  • lubrication for eyelid movement
  • traps exploited surface cell, foreign particles and bacteria
66
Q

Sources of the mucus layer

A

Goblet cells and squamous cells of cornea and conj

67
Q

Major components of the aqueous layer of the TF

A 
Water
Electrolytes
Protein
Peptide growth factors
Vitamins
68
Q

4 main electrolytes in the aqueous layer of the TF

A

Sodium
Chloride
Potassium
Calcium

69
Q

2 electrolytes that are the main contributors to osmolarity of tear film

A

Sodium and chloride

70
Q

Does osmolarity inc or dec with dry eye

A

Increase

71
Q

What 2 electrolytes are important for maintaining corneal epithelium health

A

Potassium and calcium

72
Q

What do the electrolytes in the aqueous layer of the TF do

A

Act as buffer to maintain a constant pH and contribute to maintain epithelial integrity of the ocular surface

73
Q

What pH range can the eye handle, due to the buffering system

A

3.5 to 10.5

74
Q

During sleep, what happens to the pH

A

Decrease

75
Q

What happens to the pH in dry eye

A

Increases due to osmolarity increases

76
Q

2 glands that help make the aqueous layer of TF

A

Main lacrimal glands

Accessory lacrimal glands

77
Q

Which glands are responsible for reflex and emotional tearing

A

Main lacrimal glands

78
Q

Which glands are responsible for maintenance tearing

A

Accessory lacrimal glands

79
Q

The lipid layer of the TF is composed of

A

Meibomian oil

80
Q

2 phases that compose the lipid layer

A 
Polar surfactant phase
Nonpolar phase (overlaid polar phase)
81
Q

4 main functions of the lipid layer of TF

A
  • Barrier to evaporation
  • stability to TF through interaction with aqueous-mucin phase
  • smooth surface for cornea
  • barrier against foreign particles
82
Q

Main resource for lipid layer of TF

A

Meibomian glands

+ zeis and moll sebaceous glands

83
Q

Largest category of dry eye

A

Tear deficient dry eye

84
Q

Occurs because of a disorder in lacrimal gland function

A

Tear deficient dry eye

85
Q

Lacrimal gland function is normal, but another tear abnormality exits that leads to increased tear evaporation

A

Evaporative dry eye

86
Q

Major barrier to evaporation form ocular surface

A

Lipid layer of TF

87
Q

Test for tear secretion

A

Schirmer (1 and 2)
Phenol red thread test
Meinscometry

88
Q

Test for tear film stability

A

TBUT
Ocular protection index
Videokertography
Tear turnover

89
Q

Test for tear film osmolarity

A

TF osmolarity
Tear forming
Tear evaporation

90
Q

Test for lipid layer evaluation

A

Interferometry

Meibometry

91
Q

Test for ocular surface evaluation

A

Fluorescein
Rosa Bengal
Lissamine Green

92
Q

How does B-lysine function in terms of destroying a pathogen

A

Acts as a detergent

- pokes holes in cell and causes rupture, reducing membrane integrity

93
Q

3 ways that a defensin functions

A
  • bind to microbial membrane
  • embed into membrane
  • act as a detergent (for a pore in membrane and lose ions)
94
Q

Are defensins easily synthesized; what are synthetic defensins called

A

Yes; mimetics (drugs that act like defensins)

95
Q

What do lysozymes do

A

Cleaves linkages between sugars

96
Q

What type of bacteria do lysozymes target

A

Gram + bacteria

- causes them to rupture

97
Q

What areas are affected by lysozymes

A

Areas where there is a lot of air (surface)

98
Q

Which will affect peptidoglycan

A

Lysozyme

99
Q

Lactoferrin binds to what

A

Iron

100
Q

What is enzyme is associated with breast cancer

A

Lactoferrin

101
Q

Levels of what enzyme are lower in dry eye diseases and diseases like Sjögren’s syndrome

A

Lactoferrin

Ocular Phys (5 decks)

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