Cavernous Sinuses

Question 1

Muscles of the orbit:

• what closes
• what innervates them
• what antagonizes the closing muscle. what innervates it

Answer 1

Question 2

• Superior tarsus innervation, attachment
• lps attachment

Answer 2

Question 3

Tear Drainage:

• formed where?
• pathway of drainage leads to what

Answer 3

Question 4

Innervation of lacrimal gland

Answer 4

Question 5

blow out fracture:

• force?
• signs
• gaze direction

Answer 5

Question 6

Le Forte Fractures:

• Types
• clinical signs

Answer 6

Question 7

Cavernous sinuses:

• between what layers of dura
• location of sphenoid sinuses compared to cavernous sinuses

Answer 7

Question 8

Cavernous Contents

-OTOM CAt

Answer 8

Question 9

CST:

• Etiology
• clinical signs

**impingement of what nerve

Answer 9

Question 10

Cardinal signs of gaze:

how are nerves best tested

Answer 10

Question 11

Fasciae of the orbit
-Periorbita fascia

Answer 11

Question 12

Fasciae of the orbit:

• endosteal
• meningeal

Answer 12

Question 13

Extraocular muscles:

• innervation
• paralysis

Answer 13

Question 14

know this

Answer 14

Question 15

Answer 15

Question 16

Answer 16

Question 17

Answer 17

Question 18

Answer 18

Question 19

Direct and Consensual corneal reflex:

stimulus:

Receptor of stimulus goes to which afferent fibers, then to which sensory mucleus, motor nucleus, efferent fibers, Effector muscle, overall response

Answer 19

Question 20

Accomodation parasympathetic responses

Answer 20

Question 21

opthalmic artery divisions:

Answer 21

know supraorbital, posterior ethmoidal, anterior ethmoidal, lacrimal, short ciliary arteries

Question 22

Arterial supply to retina:

• opthalamic artery gives rise to what two structures that innervate eye
• what is arterial circle of zinn haller

Answer 22

The ophthalmic artery gives rise to the posterior ciliary and central retinal arteries, both of which supply the optic nerve. Central Retinal Artery courses infero-medial to the optic nerve and constitutes the main supply to the retina. Occasionally, branches from the choroid layer (short posterior ciliary) may also supply the retina. The central retinal artery courses anteriorly in the orbit outside, but adherent to the underside, of the optic (dural) sheath. It pierces the sheath and enters the nerve 10-15 mm posterior to the globe. At the junction of the optic nerve and globe the anastomosis of the central retinal and posterior ciliary arteries forms an incomplete arterial circle of Zinn-Haller.

Question 23

what is hyphema

Answer 23

Question 24

-main vein that drains orbit into cavernous sinus

Answer 24

Question 25

Direct Light Reflex:

• should result in constriction of what
• afferent component
• efferent component
• ANS

Answer 25

Shining a pen light on the retina of one eye normally results in reflex pupillary constriction of the stimulated eye and consensual pupillary constriction in the opposite eye. The afferent component is mediated by the optic (II) nerve and the efferent by the parasympathetic component of the oculomotor (III) nerve. The direct light reflex is elicited by shining a bright light in an eye. As a result, there is ipsilateral pupillary constriction, which is mediated at the level of the brainstem via the parasympathetics.

Question 26

Consensual light reflex

-same as direct except what is added?

Answer 26

posterior commissure

Question 27

Pupillary Dilation Response:

• how it works
• horners

Answer 27

A decrease in the amount of the light reaching the retina results in bilateral reflex dilation of the pupils. This sympathetic response is mediated through the brainstem and upper spinal cord.
Horner’s Syndrome. Interruption of the following pathway results in Horner’s syndrome. This transient condition is characterized by ipsilateral pupillary constriction, slight ptosis, and anhydrosis and vasodilation (blushing) of the face. It is commonly seen in cervical injuries to the spinal cord.

Question 28

Triad of accomodation

Answer 28

Accommodating gaze and vision to view objects in the near field of vision is initiated in the cerebral cortex and mediated by the oculomotor nerve. Accommodation is a cortically-mediated visual response which originates in the frontal eye field (8) of the frontal lobe, and projects to the midbrain. The Triad of Accommodation includes three responses: convergence of vision, pupillary constriction and thickening of the lens.

Question 29

Know these

Question 30

Lesion of pretectum leads to what pupil disorder

-Do they accomodate and react to light?

Answer 30

Question 31

Holmes-Adie Pupil

• Slow what?
• Parasympathomimetic drugs do what to tonic pupil?

Answer 31

Parasympathomimetic drugs constrict tonic pupil but have no effect on normal pupil

Holmes-Adie Pupil or tonic (Adie) pupil is a benign condition which may be due to a
lesion of the ciliary ganglion. Although it may be initially confused with an Argyll-
Robertson pupil because of their similar light reflexes, they are distinguished by their
different reactions to accommodation. Initially, the tonic pupil does not appear to react to
convergence. However, if convergence is maintained for several seconds, the pupil will
slowly constrict; eventually, the affected pupil may be smaller than the normal pupil.
Tonic pupil is more common in young adult females.

Question 32

Papilledema:

sign of what

Answer 32