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Conjunctiva Flashcards

1
Q

Glycocalyx

A

Interface b/w tear film and the ocular surface

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2
Q

Conjunctival folds decrease contact b/w

A

Bulbar and palpebral conjunctiva.

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3
Q

Dimension of conjunctiva sac medially with open eyes (from lid margins)

A

0mm

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4
Q

Palpebral conjunctiva lines___.

And subdivided into

A

Posterior surface of the eyelid

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5
Q

Accumulation of goblet cells but not glands

A

Crypts of Henle

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5
Q

Potential space the conjunctiva creates

A

Conjunctival sac

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6
Q

What is the conjunctiva

A

Thin and transparent mucous membrane that lines the eyelids and that’s is reflected at the inf. And sup cornices onto the anterior surface of the eyeball

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7
Q

Bulbar conjunctiva is located on top of

A

Tenons capsule and on top of sclera

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8
Q

Functions of the conjunctiva

A

Allows independent movement of the eyeball and eyelids, protection of the cornea from external environment

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9
Q

How does the conjunctiva protect the cornea

A

Tear film formation
Contains glycocalyx
CALT

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10
Q

Conjunctival folds

A

Increase surface
Decrease area of contact b/w bulbar and palpebral conjunctiva
Reduce friction during movement

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11
Q

Parts of bulbar conjunctiva

A

Scleral and limbal

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12
Q

Parts of palpebral conjunctiva

A

Marginal
Tarsal
Orbital

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13
Q

Conjunctival fornices allow

A

Eyeball and lids to move independently

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14
Q

Conjunctival fornices include

A

Superior, inferior, lateral and plica semilunaris w/caruncle medially

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15
Q

Bulbar conjunctiva covers

A

The anterior part of eyeball from fornices to the limbus

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16
Q

Subtarsal sulcus are located

Landmark:

A

2mm off from the eyeball margin.

Branches from marginal arcade that supply the conjunctiva pierce the tarsal plate here

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17
Q

Subtarsal sulcus (groove) is

A

A shallow groove on the internal side of the eyelids that runs parallel to the lid margin

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18
Q

Clinical revelance of subtarsal sulcus

A

Traps small foreign bodies that may get into the conjunctival sac and moves them medially to the caruncle protecting the cornea and bulbar conjunctiva

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19
Q

Palpebral conjunctiva is continuous with

A

The skin of the eyelid

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20
Q

Mucotaneous junction transition b/w

A

Keratinized epithelium and the nonkeratinized epithelium of the marginal conjunctiva

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21
Q

Mucocutaneous junction is covered w/

A

Lipids secreted by meibomian glands

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22
Q

The lipid coat on the mucocatenous junction allows

A

Separation b/w dry keratinized epithelium of the skin and wet non keratinized conjunctival epithelium at the lid margin

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23
Q

Entropion and extortion affect on the mucocatenous junction

A

Physiological position is moved forward/back

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24
Tarsal conjunctiva is firmly attached to
Tarsal plate | And is thinner than orbital conjunctiva and fornices
25
Eyelids that has more meibomian glands
Superior eyelid
26
Orbital conjunctiva is continuous w
Tarsal conjunctiva and fornices
27
Orbital conjunctiva contains
More goblet cells than tarsal region | Tarsal muscle and accessory lacrimal glands
28
Wolfring glands are located in which conjunctiva
Orbital
29
What makes the superior and inferior fornices
Palpebral conjunctiva makes a 90 degree turn to the tarsal plate
30
From the fornices, the conjunctiva continues as the
BULBAR PORTION
31
Histology of the conjunctiva
Non keratinized stratified squamous/ columnar containing goblet cells overflying a highly vascular loose CT layer (stroma) profusely innervated and abundant lymphoid tissue
32
Parts of the conjunctiva that has non keratinized stratified squamous/columnar
Squamous- closer to margin | Columnar- fornices + orbital conjunctiva
33
Conjunctival stroma contains
``` Nerve cells Melanocytes Tarsal muscle Accessory lacrimal glands MALT/CALT ```
34
Stroma is subdivided into
Superficial lymphoid layer | Deep fibrous layer
35
Where are melanocytes present
In the basal epithelial layers
36
Stroma aka
Laminate propia | Substantial propia
37
Melanocytes come from | And are responsible for
Neural crest | Pigmentation
38
Racial Melanosis
Individuals will have more pigmentation that others. | Concerning when there is an accumulation of melanocytes in conjunctiva : melanoma (cancer)
39
SR + levator aponeurosis and fornix of conjunctiva work as a team
As well as inferior fornix and IR
40
Conjunctiva stroma is beneath
The basement membrane
41
Conjunctival epithelium sits on
The basement membrane
42
Difference b/w racial melanosis and conjunctival melanoma
Racial melanosis- only located in conjunctiva so they move if you move conjunctiva and no change Melanoma- atypical features
43
Epithelium of the conjunctiva is continuous w
Epithelium of theEyelid skin and corneal epithelium at the limbal region
44
Palpebral conjunctiva contains numerous unfolding rich on goblet cells known as
Crypts of henle
45
Where are goblet cells more abundant
More abundant at the fornices than in tarsal and bulbar conjunctiva
46
Type of epithelium tarsal conjunctiva has
Squamous
47
Conjunctiva is thinner at tarsal conjunctiva Bc
Presence of tarsal plate
48
No goblet cells in which conjunctiva
Limbal
49
Density of goblet cells is affected by
Age Diseases (dry eye) Vitamin A deficiency Environment
50
where will you Krause and wolfring ?
Stroma of the conjunctiva
51
Local/systemic processes may cause hypertrophy of the lymphoid tissue underlying the conjunctiva forming-
Follicles/ papillae
52
Follicular conjunctivitis
Acute inflammation of conjunctiva Could be due to viral infection Small, pale elevated nodules
53
Papilla hypertrophy
Large cobblestone papillae on the tarsal/limbal conjunctiva due to allergic reaction in papillary conjunctivitis Central vascular core can occur Mucous produced
54
Hypertrophy of lymphoid tissue in conjunctiva in response to immune stimulus
Follicle and papilla
55
Function of fornices
Ease stretching of conjunctiva during eye movement
56
Part of conjunctiva loosely attached to fascial expansions of the EOMS
Fornices
57
Largest fornix
Superior fornix
58
Medial fornix is integrated by
Plica semilunaris and caruncle
59
Levator palpebral superior is and SR connect to
Superior fornix
60
MR connects to
Deep tissue in the plica semilunaris and caruncle
61
Fornices histology
Stratified non keratinized (mostly columnar/cuboidal) with numerous goblet cells
62
Fornices contain a deep fibrous layer containing
tarsal muscle and accessory glands of Krause to orbital portion of palpebral conjunctiva which contains wolfring glands and tarsal muscle
63
Bulbar conjunctiva is fused to the
Anterior tenons capsule and attach firmly to the sclera at the limbal region
64
Palisades of Vogt are found in
The limbal portion of bulbar conjunctiva
65
Difference in histology of bulbar and palpebral conjunctiva
Epithelium of bulbar is smoother than epithelium in the palpebral portion and contains broader and less consistent papilla reactions than the palpebral portion of the conjunctiva.
66
Does the limbal portion of bulbar conjunctiva contain goblet cells?
NO
67
What are palisades of Vogt
found on limbal conjunctiva Structures around the limbus that radiate outward from the cornea Form epithelial ridges that cover underlying condensation of conjunctival CT
68
Functions of palisades of Vogt
Trap small foreign objects and move them away Allow conjunctival blood vessels to nourish the periphery of the cornea Limbal stem cells
69
Conjunctival invasion of the cornea after limbal stem cells depletion causes
Corneal neovascularization and opacification Blindness
70
Blood supply to the conjunctiva consists of
Branches of ophthalmic artery and anastomosis with Muscular Medial palpebral Lacrimal arteries
71
Palpebral arcades are formed by the anastomosis of
Lateral and medal palpebral arteries that pierce the orbital septum to communicate w the anterior aspects of the orbit
72
Palpebral arcades consists of
Marginal and peripheral
73
Marginal arcades
supply marginal palpebral conjunctiva and portions of tarsal conjunctiva
74
Peripheral arcades
Supply the majority of tarsal conjunctiva, orbital conjunctiva, fornices and the majority of bulbar conjunctiva
75
Tarsal conjunctiva is supplied by
Posterior conjunctival arteries derived from palpebral arcades
76
Most of bulbar conjunctiva is supplied by
posterior conjunctival arteries derived from palpebral arcades
77
Branches from peripheral palpebral arcades anastomose with branches from anterior ciliary arteries which supply
Perilimbal conjunctiva
78
The epicscleral arterial plexus that supplies the parts of the bulbar conjunctiva is chiefly formed by
Branches from anterior ciliary arteries
79
Venous drainage of palpebral and most of bulbar conjunctiva
Venous plexus of eyelids- sup/inferior ophthalmic vein
80
Venous drainage of perilimbal region ring around limbus
Anterior ciliary veins - sup/inferior ophthalmic veins
81
Conjunctiva lymphatic drainage anastomoses with
Episcleral lymphatic plexus and/or into the lymphatic of the eyelids
82
Does the eyeball contain lymphatic vessels
NO
83
Lymphatic of conjunctiva and eyelid drain to what lymph nodes
PREAURICULAR PAROTID AND SUBMANDIBULAR LYMPH NODES
84
Lymphangiectasis
Dilated large collecting lymphatic vessels due to drainage impairment
85
sensory innervation to conjunctiva
Branches of ophthalmic nerve and minor contributions from infraorbital nerve ( CNV2)
86
Bulbar conjunctiva innervation
Long ciliary nerves from nasociliary nerve
87
Superior palpebral conjunctiva and fornix innervation
Frontal and lacrimal nerve branches
88
Lateral aspects of inferior palpebral conjunctiva and fornix innervation
Lacrimal nerve
89
Medial aspects of inferior palpebral conjunctiva and fornix innervation
Infraorbital nerve CNV2
90
Parasympathetic innervation to conjunctiva
CNVII pterygopalatine ganglion
91
Conjunctiva postganglionic autonomous fiberscome from
Ciliary ganglion
92
Conjunctivitis
Accumulation of fluids in conjunctival CT (chemosis) Dilatation of superficial blood vessels that will become more visible (conjunctival injection)
93
Pinguecula and pterygia are the results of
Alterations of the CT of conjunctiva
94
Pinguecula
Yellowish, slightly raised, lipid like deposit in the nasal and temporal limbal conjunctiva (asymptomatic)
95
Pterygium
Fibrovascular overgrowth of the bulbar conjunctiva onto the cornea
96
Lose connective tissue layer of conjunctiva
Substantia propia

Ocular Anatomy (7 decks)

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