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Oc Anatomy 2 > exam 1 > Flashcards

exam 1 Flashcards

1
Q

what is the average horizontal visible iris diameter

A

11.8 mm

cornea is 11 high and 12 mm across

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2
Q

contacts sizes

soft
large scleral
RGP

A

soft - 13 -14
large scleral 17 mm
RGP 9 mm

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3
Q

what does prolate mean

what does hyperprolate mean

what causes it

A

steeper in the center and flatter in the periphery

hyperprolate= ketaconus

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4
Q

what does oblate mean

what causes it

A

flatter in the center and steeper in the periphery

caused by lasik prk coldera shape

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5
Q

what is coldera shape

A

caused by lasik

steeper on the peripher and flatter in the center

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6
Q

average thickness of cornea

center
near limbus

A

center - 530 microns or 0.530 mm
near limbus - 710 microns

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7
Q

cornea is steeper in the ________ and thicker in the _________

it is more curved anterior or posterior?

A

steeper in the center and thicker in the periphery

more curved posterior

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8
Q

what are the curvatures of the anterior and posterior

A

postiero 6.5 mm More curved

anterior 7.8 mm less curved

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9
Q

refracting power of eye

  • cornea
  • lens
    -eye as a whole
A
  • cornea - 45 D
  • lens - 20
    -eye as a whole - 65
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10
Q

chondroitin sulfate and dermatan sulfate are examples of what

where are they located

A

ground substance of stroma layer

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11
Q

what is fleischer ring

A

iron deposit at base of cone for keratoconus

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12
Q

name the layers of cornea
and thicknes

A

epithelium
-50 microns (10%)
bowmens layer
-10 microns
stroma
-500 microns (90%)

endothelial
-5 microns thick
-single cell layer (cell are 5 microns thick and 20 microns long)

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13
Q

what is macular dystrophy

A

results of too many GAGs (keratan sulfate- the most abundant gag usually)

autosomal recessive

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14
Q

name the three layers of cells of K epithelium

what is the percent of the cornea doe the epithelium make and thickness

A

1.superficial
2. wing
3. basal

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15
Q

what does basal cells secrete

A

Basement membrane

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16
Q

where are the fibroblasts of the cornea found and what is it called

where are they found

decrease in number as you move where

A

kerotinocytes
make collagen proteoglycan

inbetween lamallae of stroma

decrease in number as you move more posterior to the stroma

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17
Q

surface cells replaced by what cell

A

basal cells, wing cells, and peripheral and limbal cells

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18
Q

vitamin A deficiency causes what

A

keratinized epithelium of cornea

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19
Q

what has more microvilli the cornea or conjunctivi

A

cornea

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20
Q

where are microvili and microplicae located

A

epithelium Superficial

microvili is fingerlike microplicae is ridgelike

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21
Q

glycococalyx

what secretes it

what does it confer

what does it join

A

what secretes it
-superficial cells plasma membrain

what does it confer
-hydrophilic prop on anterior surface of euperficial epithelial cells

what does it join
-mucous layer of tears

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22
Q

nothing can go inbetween what cells
it instead goes where

which cell has responsibility of proper fluid exchange

A

superficial cells for both answers

it goes between them

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23
Q

tear film works with what to make a smooth optical surface

A

superficial surface layer

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24
Q

what cells of the epithelium are joined together with desmosomes gap junctions and adherens

what about tight junction

A

what cells are joined together with desmosomes gap junctions and adherens
-basal

what about tight junction
-superficial

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25
Q

describe the size and layers of the different cells of the k epithelium

A
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26
Q

Basement membrane

  • layer of what cells
A

single layer basal cells

flat posteriorly

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27
Q

ground substance

where is it found?

what is it?

A

where is it found?
stroma

what is it?
amorphous gel
composed of GAGS, proteins, collagen

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28
Q

what cells of epithelium have the ability to divide

A

basal cells on the basement membrane

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29
Q

how does basal cells attatch to basement membrane or basal lamina

A
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30
Q

what cells secretes

basement membrane

glycocalyx

A

BM - basal cells

glycocalyx - plasma membrane of superficial cells

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31
Q

where are cornela stem cells

A

1 m around limbus

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32
Q

what is the corneal epithelium turn over

keratocytes turn over

A

cornea epithlium - 7 days

keratocytes turn over - 2 - 3 years

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33
Q

bowmans layer

  • how thick

-describe what it consists of

-does it regenerate

A

10 microns thick

  • how thick
    10 microns

-describe what it consists of
random collagen fibrils and proteoglycans

-does it regenerate
no

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34
Q

what is kerotacan

where is it found

A

protein in stroma associated with kerton sulfate

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35
Q

what layer is not needed in the cornea

A

bowmans

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36
Q

the alger brush makes sure you do not penetrate what layer

A

bowmans

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37
Q

what does the stoma contain

what part of the sclera does it attach to

A

collagen keratocyes
and ground substance

attaches to anterior sclera

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38
Q

which layer has fibrils and which has bundles

A

bowmans and stroma

stoma has the bundles = lamellae

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39
Q

what is corneal plana

A

flat cornea caused by mutated keratocan protein (stroma)

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40
Q

stromal collagen

what percent constitutes DRY weight of cornea

size and arangement of fibrils

total lamellae

A

what percent constitutes DRY weight of cornea
- 70%

size and arangement of fibrils
-25-30 nanometeres
-parallel to corneal surface

amount of lamellae
-lamellae are bundles of fibrils
-200-300

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41
Q

keratocyte

what are they

% of the cell layer it resides in

turn over?

where are they found?

where are they found in highest frequency?

A

what are they
-fibroblasts that make collagen and proteoglycan in stroma

% of the cell layer it resides in
-2-3% of stoma

turn over?
-2 - 3 years

where are they found?
-inbetween lamellae

where are they found in highest frequency?
anterior stroma

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42
Q

what is the difference between Stromal Lamellae for ….

anterior

posterior

A

anterior (1/3)
-lamellae are thin
-branch interweave (crosslink - more rigid)

posterior (2/3)
-lamellae are thicker moving more posteriorly
-form thin layer that binds to decements

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43
Q

what is sclerocornea

A

scleralization of cornea caused by mutated keretocan protein in stroma

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44
Q

what is the basement membrane of the corneal endothelium

how often does it get produced

does it regenerate

A

descemet membrane

it is always being produced and increases in thickness as you get older

it regenerates

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45
Q

what is the main purpose of proteins in the stroma

A

bind with water to space fibrils exactly

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46
Q

what is Lumican and where is it found

what happens if your deficient

A

protein in stroma

important for collagen spacing, and collagen sizing

no lumican = cloudy, 3 X increase in light scatter maximal increase to posterior stroma , thick fibrils in posterior stroma

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47
Q

does it regenerate?……..

descemet membrane

bowmans

endothelial

A

DEScemet membrane
-DOES regenerate

bowmans
-no regeneration

endothelial
-no regenation

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48
Q

what is bullous keratopathy

A

decrease in cell density of endothelial

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49
Q

whose job is to pump

A

endothelium

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50
Q

what happens as endothelial cells die

A

neighboring cells change shape and increase in size

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51
Q

what are guttae and what are the different classifications for it

A

protusions of the descemets membrane

  1. fuchs
    - surrounding epithelial cells are abn
    -central
    causes swelling
  2. hassall henle bodies
    -surrounding epithelial cells are norm
    -periphery
    -normal to have
    -identical to fuchs histopathologically
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52
Q

cornea strives to be what % water

if it changes by ____ % edema will occur or light scatter

A

78

5% or more will cause edema or light scatter

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53
Q

what is deturgescence

A

process the stroma does to dehydrate to kept it transparent

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54
Q

turgid vs turbid

A

turgid = swollen
turbid = opaque

turgid leads to turbid

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55
Q

what two layers function as diffusion barriers to tears and aqueous

how do they do this

A

endo and epithelium

sites of active ion transport inducing osmotic water movement out of stroma

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56
Q

what produces swelling pressure that pulls water in stroma

A

proteoglycan

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57
Q

what layers have role in hydration?

what do they do and how does it do it

which has the primary role of maintaining transparency?

A

_____Epithelium________
- ion pumps
pumps ions through cells
- aquaporins
2 way osmotic water transport
nothing goes inbetween them only through

_____endothelium _______
-ion transport systems
counteract imbibition of water
**primary role of maintaining transparency ** loss will = increased imbibition

58
Q

what happens when there is loss or damage of endothelial cells

A

increased imbibition of water

59
Q

what forms vascular arcade of limbus

what does it branch from

A

anterior cilliary artery

ophthalmic artery

60
Q

neovascular stages

A
61
Q

what are ghost vessels

A

emptying of blood vessels when you remove CL that has caused neovascularization

62
Q

how is oxygen supplied to cornea

A

diffusion from tear fluid which gets it from the air

also from
-aqueous
-limbal capillaries

63
Q

what happens when cornea is hypoxic

A

lactate produced
increase in H ions so decrease in pH (acid)

loss of K

cells shrink

it causes corneal edema

64
Q

compare swelling when using CL at night…..
conventional hydrogel CL
silicone hydrogel CL

A

conventional hydrogel CL
-8% -15%

silicone hydrogel CL
- 4 % (same as non CL wears)

65
Q

NERVES of cornea

what nerve provides perilimbal nerve ring

compare the amount of nerve endings to skin

what are the sensory nerve derived from

where do nerves terminate

what layers do not have nerves

where do they enter

A

NERVES of cornea

  1. what nerve provides perilimbal nerve ring
    - long ciliary nerves
  2. compare the amount of nerve endings to skin
    -400 - 500 X more in K
  3. what are the sensory nerve derived from
    -ciliary nerve which branches from V1 (ophthalmic branch)
  4. where do nerves terminate
    - wing cells - epithelium
  5. what layers do not have nerves
    -basement membrand and endothelium
  6. where do they enter
    -stroma where they are demylinated and then begin to branch
66
Q

Nerves of cornea….

influence what of the cornea

Loss of corneal anesthesia & nerve endings lead to

A

influence what of the cornea
-metabolism
-tissue maintence

Loss of corneal anesthesia & nerve endings lead to
-loss of integrity
-cell adhesion
-decreased mitosis
-epitheliam permeability
-decreased wound healing

67
Q

neurotrophic keratitis

causes what

caused by what

A

causes what
- stromal melting
-perforation

caused by what
-HSV HZV

68
Q

proparacaine

how long does it take to work

how long does it last

A

how long does it take to work
-30 seconds

how long does it last
-15 min

69
Q

what is A and B disease

A
70
Q

scattering of an incident ray of light by each _____________ collagen fibril irs canceled by interference from other scattered ray

A

collagen fibril

71
Q

compare mono dispersed media vs polydisperse media

A

monodispersed media (cornea like) has increased light transmission and less spatial dispersion compared to poly disperse (sclera like)

72
Q

what is destructive interference

A

a good thing

spacing of fibers + index of refraction

73
Q

Lumican deficient stromas displayed ___________ X backscatter light with maximal increase confined to ____________

A

Lumican deficient stromas displayed _____3______ X backscatter light with maximal increase confined to _____posterior stroma_______

74
Q

dry eye is when tear film is hypo or hyper osmolarity

A

hyper

75
Q

refracting power of cornea in air vs water

how can we improve vision under water

A

air is about 47

water is about 6.3

loses its refractive power

improve it by accomodation or make pupil smaller by increasing depth field

76
Q

what is the refractive index of cornea

A

1.376

77
Q

visible wavelenths are betweenwhat

A

ultra violet and infrared

78
Q

lesser/greater amounts of UV are absorbed by cornea as wavelength decreases

A

greater

79
Q

uvc is how many nm

A

200-290

80
Q

describe how the eye transmits/absorbs ate different wave lengths

A

200-300 nm
- cornea absorbs (cellular elements)

300-400 nm
-cornea transmits and lens absorbs

81
Q

corneal action spectrum peaks at what wavelength

what wavelength is the cornea most sensitive

what is produced when the cornea absorbs this wavelength

A

270 nm

260 - 270nm (UVR - ultraviolet radiation)

when absorbed it creates ROS = dangerous

82
Q

UVR radiation number

what part of cornea absorbs

what can be a line of defense

A

260-270 ultraviolet

epithelium and bowmans layer

ascorbate (vitamin C)

83
Q

what is photokeratitis

A

UVR injury snow blindness welders keratitis sunlamps

usually delayed for about 8 to 12 hrs from exposure

84
Q

welders have _____ times the maximum permissible exposure of UV even with helmets

A

4-5

85
Q

what prevents leaking of tears to cornea

what prevents leaking of aqueous humor to cornea

A

what prevents leaking of tears to cornea
- tight junctions (zonula occludens) in the epithelium

what prevents leaking of aqueous humor to cornea
-tight junctions (macula occuldens) of endothelium

86
Q

what is more leaky epi or endothelium

why is this beneficial

how does it happen

A

endothelium

because aquous humor supplies nutrients

10 nm wide intercellular space created by macular occludens

87
Q

where is the site of epithelial stem cells

A

palisades vogt

(transition of cornea to sclera - highly vascularized papillae)

88
Q

what doe ion transporters do

where are they located

what ions are major driving forces

A

transport water osmotic gradients down its concentrationfrom stroma to
-tear film
-anterior chamber

in epi and endothelium

Cl- and Na +

89
Q

how do ions move across epithelium vs endo

A
90
Q

where does cornea get its glucose

A

aqueous humor thorugh leaky endothelial cells

91
Q

what happens to pH with lactate

A

increase in H + ions so decrease in pH(acid)

loss of K
cells decrease in size

92
Q

what stimulates production of matrix and enhances adhesion when the epithelium is is healing

A

growth factors
(EGF epithelium growth factor)
(TGFB transforming growth factor)

93
Q

what is one of the most important metabolic pumps

how many are there and where are they

what inhibits it

what increases it

A

Na/K ATPase

basolateral side of epithelial

3 million on single cell

inhibited by Ouabain (cardiac glycoside) = corneal swelling & cytokines

increased by steriod

94
Q

compensatory pumps

when do they start being made

where are they

when does the mechanism fail

A

compensatory pumps

when do they start being made
-2000 - 270 cells/mm2

where are they
-endothelial cells

when does the mechanism fail
-500 cells/mm2 or less
-cells to flat to add sprinkles
-stromal edema (such as with fuchs)

95
Q

name factors that can alter endothelial pumps

A

-Na/K inhibitorys
-carbonic anhydrase inhibitors
-low cell density
-low temp

96
Q

what regulates differentiation and prolifferation of epithelium cells

A

growth factors

97
Q

what are bullae

how to tread

A

bullae is formed when epithelial cells have edema and lift from basement membrane it causes this.
looks like cyst

treat with muro128 or 5% sodium chloride

98
Q

describe epithelaial edema & stromal edema

A
99
Q

describe corneal sx

A

dsaek and dmek only replaces endothelium, can also just remove descemets membrane and be fine just takes long

100
Q

what are khodadoust lines

A

white blood cells on endothelium rejection line fro cornea graft rejection

101
Q

What cell has a turn over of 2-3 years

A

Keratinocytes

102
Q

what cells have centripetal movement

what layer does this involve

A

limbal and peripheral cells

103
Q

what is plalisades of vogt

A

vascularized papillae at transition of cornea and conjunctiva

site of epithelial stem cells

104
Q

how long does differention of basal cells to surface cells take

A

7-14 days

105
Q

what is desquamation

A

slough of epithelial cells

106
Q

what are the effects of wound in epithelium and what is the purpose of it

A
  1. edema
    (increase flow of fluid due to disrupted junction and pumps)
  2. loss of protective barrier

both caused by epithelium junction damage

107
Q

describe basic wound healing steps in epithelium

A
  1. injury
  2. cells slide
  3. mitosis
  4. cells attach to basement membrane
108
Q

describe what happens right after injury to epithelium

A
  1. mitosis stops
  2. Growth factors from stroma and epi come
  3. desmosome dissociate
  4. wound edges develope filopodia (migration of cells)
109
Q

importance of adhesion molecules in wound healing

A

no hemidesmosomes present so this is used for leadign edge of epi sheets to adhere to BM

110
Q

what provides provisional matrix when epi wound healing

when does it occur

A

fibronectin

right after injury (first stage)

111
Q

where doe epithelial cells attatch to when healing

A

fibronectin matrix

112
Q

when does proliferation start again

when does it stop

what regulates it

A

after migration of cells

stops after normal density is established

regulated by growth factors

113
Q

epithelium is healed quickly ( 60 -80 microns/ hr) unlesssss what

A

the basment membrane is involved which can take months to heal

114
Q

corneal erosion is caused by what

treatment?

A
  1. EBMD epithelial basement membrane dystrophy
  2. preve trauma or abrasion

weakly adhered epi cells

treatment is debriding or removing epithelium

115
Q

what happens when bowman membrane is injured

A

it is replaced not regenerated

replaced by
1. epithelim
2. stroma like fibrous tissue (fibroblast and connective tissue form scar)

116
Q

what are the wound healing steps in stroma

include important cells

A
  1. destruction
    - remove bad tissue with polymorphonuclear leukocytes (PMN) but also macrophages proteoglycanases collagenases
  2. synthetic
    - fibroblast make new collagen and proteoglycans, closure of wound
  3. remodel
    -initial scar turns more clear change in organization of collagen
117
Q

what cell maintains balance of destruction and synthesis of ECM

A

keratocytes

118
Q

what happens to keratocytes when there is an injury

A

1.they increase in number
2. they change into myofibroblasts (can change back after heal
-these produce EXCM degrade
collagen and have cytokines
-bed contraction
- cause scar

119
Q

whats stronger scar in stroma or normal uninjured stroma

A

normal stroma

120
Q

polymorphonuclear leukocytes (PMN) improtant for

A

destruction phase of stroma repair

121
Q

what steps occur when descemets membrane is injured

A

regenerated via stromal keratocyes or endothelium

122
Q

how does the endothelium repair

do the endothelium cells divide

A

it usually compensated with hypertrophy or limited migration

it doesnt usually divide but can with injury

123
Q

what is the purpose of fuchs crypts

A

it allows deeper access to deeper stroma (IRIS)

124
Q

pupillary margin rests where

A

anterior to lens

and anterior to iris termination

125
Q

what is the thinnest part of the iris and how thin is it

where is it in regards to the ciliary body

A

iris root

0.5 mm thick

it sits anterior to ciliary body

126
Q

what is iridodialysis

what is rubeosis iridis

A

_______Iridodialysis __________
iris root breaks and iris dissociates
caused by trauma

causes bv damage and nerve damage

______rubeosisi iridis _________
(neovascularization of iris)

127
Q

what layer of iris

is absent at crypts

is continuous with ciliary body

has Blood vessels

forms iris processes near ciliary body

has sphincter muscles

has fibroblasts and lymphocytes mas and macrophages

A

is absent at crypts
-anterior border

is continuous with ciliary body stroma

has Blood vessels
stroma

forms iris processes near ciliary body
anterior border

has sphincter muscles
stroma

has fibroblasts and lymphocytes mas and macrophages
-stroma

128
Q

what encircles iris bloodvessels

where is the minor circle of iris

are iris capillaries finestrated

what is part of the blood aquous barrier

where is the major circle of iris found

A

what encircles iris blood vessels
-collagen to help it stay put and to prtect against kink

where is the minor circle of iris
-in stroma

are iris capillaries finestrated
-no

what is part of the blood aquous barrier
-iris capillaries

where is the major circle of iris found
-cilliary body near iris root

129
Q

where is the sphincter muscle

how many motor segments and how is it innvervated

A

stroma in pupillary zone

20 motor seg each individually innervated innervated by parasympathetic

130
Q

name the three grooves found on the back side of iris

A
  1. radial contraction furrow
  2. structure fold of schwabe
  3. ciliary contraction folds
131
Q

the arcades originate from what

what does it go through

A

originates from minor arterial circle

goes towards pupil through sphincter

132
Q

name the layers of iris

A

anterior border layer
stroma
iris sphincter, vasculature
stroma
iris dilator
anterior epithelium
posterior epithelium

133
Q

sensory innervation of iris

sympathetic

para sympathatic

A

_____Sensory_______
nasociliary - uvea

_____sympathic _____
fibers from superior cervical ganglion to iris dilator

_____parasympathetic____
fibers from ciliary gangion to sphincter

134
Q

what is iris bombe

A

synechia posterior causes increase in pressure and pushes iris forward

135
Q

what has the most pigment anterior or posterior epi

which has columnar cells

which has cuboidal cells

which has basment membrane coverage. what else does it cover

whch has myoepithelil cells

A

what has the most pigment anterior or posterior epi
-posterior

which has columnar cells
-posterior

which has cuboidal cells
-anterior on apical side

which has basement membrane coverage. what else does it cover
-posterior, also covers posterior chamber

whch has myoepithelil cells
-anterior

136
Q

equation for finding the degree of variation in size

A

standard deviation/ mean

137
Q

normal numbers for

polymegathism

pleomorphism

density

A

polymegathism
- coefficient variaion (CV)
<40 and 25%

pleomorphism
-hex
>50% 70-80%

density
25000

138
Q

epithelium innervated by

endo innvervated by

A

epi short and long ciliary nerve

endo not inervated

139
Q
A
140
Q

Most abundant GaG

A

Keratan SULFATE too

Oc Anatomy 2 (3 decks)

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