exam 2 Flashcards
ciliary process functiion
secrete aqueous humor
pars plicata (corona ciliaris)
pars plana (orbicularis ciliaris)
which one is folded, flat, has ciliary process, ora seratta, transition to choroid
pars plicata (corona ciliaris)
- folded
-ciliary process
Pars Plana (orbicularis ciliaris)
-transition to choroid
-flat
-ora serata
valleys of kuhnt are where
between ciliary processes
what are dentate processes
what part of the eye has serrated patterns that contain dentate
elongation of retinal tissue into pars plana
ora serrata
what allows for ciliary body to slide against sclera
what does this part contain
supraciliaris
pigment
melanocytes
fibroblasts
collagen bands
Longitudinal muscle fibers
adjacent to
paralelle to
base at
what are stellate shaped terminations or muscle stars
tendon of origin atatches
fibers to _______ and to _________
Longitudinal muscle fibers
adjacent to - supraciliaris
paralelle to - sclera
base at - scleral spur
apex is - choid
what are stellate shaped terminations or muscle stars :
insertion of longitudinal ciliary muscles in the anterior one third of the choid
tendon of origin atatches
fibers to ___scleral spur____ and to ____trabecular meshwork_____
which part of the muscle
pulls choroid forward
brings ciliary body closer to lens
which part of the muscle
pulls choroid forward
-longitudinal
brings ciliary body closer to lens
-circular
what causes presbyopia
increase in CT in ciliary body
decrease in elaticity of tendon on ciliary muscle
Ciliary muscle contraction not affected
what layer of the ciliary body is highly vascularized and has loose ct
where is it between
what does it form
stroma
between muscle and epithelial layer
forms ciliary process
the ciliary stroma is continuous with what
the iris and choroid stroma
what BV supplies the ciliary body
what is it made of
is it anterior or posterior to the circular muscle
Major arterial circle
Long posterior ciliary artery and anterior ciliary art
anterior to the circular muscle
venous drainage
done by what bv
where is this located
vortex veins
in choroid
thinnest layer of ciliary body
what does it line
epithelium
lines posterior chamber and part of the vitrous chamber and ciliary body
what junction is important for the formation of aqueous and where
gap junction in the ciliary epithelium
basement membrane
joins what to what
posteriorly it is continuous with:
anteriorly it is continuous with:
basement membrane
joins what to what: pigment epi to stroma
posteriorly it is continuous with: bruchs membrane of choroid
anteriorly it is continuous with:iris epithelium
Non pigment ciliary body cell types and location
columnar - pars planar
cuboidal - pars plicata
where is the blood aqeuous barrier located
non pigment ciliary epi
what lines posterior chamber
internal limiting membrane of ciliary body
it is the basement membrane covering the non pigmented epithelium
located in pars plana region
what is the attatchment site for zonular fibers
internal limiting membrane
which has high amounts of mitochondria and why
non or pigmented epithelium
non pigmented
because it secretes more aqueous humor
pigment ciliary epithelium is continuosus with what
non pigment ciliary epi contines posteriorly at ______ and anteriorly with
pigment - RPE
& anterior iris epi
non pigment ciliary epi continues posteriorly at __ora serrat_ to become neural retina
anterior it is continuois with posterior irsi epith
pigmented ciliary epi transitions to __________
and transitions from nonpig to ___________
internal limiting membrane of ciliary body is continuous with
pigmented ciliary epi transitions to – -retinal pigment epi (RPE)
and transitions from nonpig to
—neural retina
internal limiting membrane of ciliary body is continuous with
-internal limiting membrane of retina
aqueous humor function
oxygen and glucose , removes waste and maintains shape
aqeuous humor is secreted by and where
ciliary epithelium covering the ciliary process , pars plicata
secretion of aqueous humor
what kind of transport
what kinds of gradients
active ionic transport
hydrostatic osmotic gradients
where are dense network of dense network of fenestrated capillaries found
in the stroma of the cilary body
non pigment faces
pigment faces
non pigment faces aquous humor
pigment faces ciliary stroma
what is the complex syncytium
tight junctions are present where
formed by pig and non pigment epithelium apical membranes through gap junctions
inbetween nonpigment to as a paracellular barrier
what two mechanisms are responsible for the formation of reservoir of plasma ultrafilrate in the stroma
what is the difference between them
diffusion and ultrafiltration
via active secretion
ultrafiltration is bulk flow through finestrated cilary epithelia (semipermeable membrane)
diffusion is movement across from higher to lower concentration
what type of mechanism is pressure sensitive and how does it affect it
ultrafiltration
increase in IOP causes decrease in ultrafiltration
aquaporins are located where and during what mechanisms
active secretion… located in NPE
Define the the different medications used to decrease pressure and how do they do it
alpha 2 adrenergic agonist
-dual mechanisms
-they decrease production
-decrease uveoscleral outflow
-inidine
-purple
B antagonist
-decrease aqueous transmission into posterior chamber
-olol
-yellow cap
carbonc anydrase inhibitor
-oral diamox
-olamide
Rho Kinase Inhibitor
-rhopressa Netarsudil ophtlamic solution
-reverse damage of TM
-increases outflow
-vasodilator reduces episcleral venous pressure
prostaglandins analog
-lumigan, latanoprost, travatan ( most effective)
-remodels ECM in CT causing more space
-increase out flow
Name meds that decrease aqueous production
adrenergic agonist
-brimonIDINE
betablockers- adrenergic ANTAGONIST
-olol
name meds that increase outflow
prostaglandins analog
-lumigan latan, trav
remodels ECM in CT
Rhokinase INHIBITOR
-reverse damage of TM
-vasodilator reduces episcleral venous pressure
What is composed of flattened perforated sheets (lattice work branches that interlace)
Trabecular meshwork
Where is schwabes line
The apex of the trabecular meshwork
It is the termination of decemts membrane
What encircles the anterior chamber
Trabecular meshwork
What is has the location of posterior edge of internal sulcus
Scleral spur
What has circular oriented collagen bundles
Scleral spur
Scleral spur
attatchment sites …..
Posterior
Anterior
It is continuous with ….
At posterior edge, it blends with
Posterior - longitudinal cilary muscle fibers
Anterior - trabecular meshwork sheet
Continuous with trabeculae
At posterior edge its fibers blend with oblique sclearl fibers
The outside of the trabecular meshwork lies against
Stroma
Sclera schlems canal
Sclera
Diffference between uveal mech work and corneoscleral meshwork
Uveal
-inner ( nearest to posterior chamber)
-attch to
1. Ciliary stroma
2. Longitudinal muscles fibers
3. Some at iris root
Corneoscleral
- flatter sheets
- outer
- attatch to scleral spur
what is convention current
flow of aqueous will go up the iris and down the cornea
what is the blood aqueous barrier
ciliary process and choid are finestrated allow large molecules to exit the blood
but
nonpigment epithelial cells have tight junction occludins that prevents things entering posterior chamber
what structure has evagination that extend into juxtacanalicular tissue towards the TM
what are these evaginations called
schlemms canal
evaginations are internal collector channels of sondermann
does uveitis decrease or increase IOP
increases IOP by blocking outflow
decrease IOP by destruction of blood aqueous barrier
what are two important aqueous humor components
ascorbate
- it free radical scavenger
- 20 X more than in blood
-actively transported to cornea and lens
Proteins
-200 X less than in blood
anterior chamber is where what two things meet
corneoscleral coat
uveal coat
average angle of anterior chamber is
36 degreees
scleral spur or trabecular meshwork ?
encircles most of the inner aspects of scleral sulcus
continuous with trabeculae
apex at termination of descemts membrane
at posterior edge it blends with oblique scleral fibers
composed of flattened perforated sheets
located at the posterior edge of the internal sulcus
most of the inner aspects of scleral sulcus
fibers blend with oblique scleral fibers
encircles most of the inner aspects of scleral sulcus -scleral spur
continuous with trabeculae - spur
apex at termination of descemts membrane - trab
at posterior edge it blends with oblique scleral fibers -scleral spur
composed of flattened perforated sheets -trab
located at the posterior edge of the internal sulcus - spur
most of the inner aspects of scleral sulcus - trab
fibers blend with oblique scleral fibers - spur
what is the termination of decemets membrane
schwalbes line
anterior to posterior what can you see on gonio
schwables line
TM - non pigmen
TM - pig
scleral spur
Ciliary body
iris root
what is imbert fick principle
used for applanation
it is the pressure = force to flatten / area of flattening
when is pressure higher laying down or sitting
laying down
name two ways that the aqeuous drains
which one is most common and by what percent
50-75%via trabecular outflow
episcleral venous system is formed by what
aqueous veins
anterior limit of schlemms canal is where
in between TM pigmented and TM nonpigmented
SC is closer to pigment
what layer has the highest resistance for aqueous flow
juxtacanalicular tissue has narrowest spaces
cilliary muscle contraction does what to outflow
it decreases the outflow resistance by widening spaces between the sheets
what is visible on gonio if examiner applys pressure
why does this occur
schlems canal
looks like a red line
episcleral venous pressure exceeds IOP
Schlemms canal location in terms of TM
how does aqueous humor difuse into schlemms canal
SC is behind TM
difuses passively
what are internal collector channels of sondermann
they are evagninations that extend from schlemms canal to TM
they increase the surface area of the canal
what are two structions of schlemms canal and what are their purposes
internal collector channel
-increase surface area extrends from schlemms to TM
giant vacuoles
-helps transport large molecules across epithelium
external collector channel branches and empty into what
where do these drain into
external collector channel drains and branches to deep scleral and intrascleral PLEXUS which drains into episcleral conjunctival veins
what two ways does aqeuous veins branch from
what part of the eye does it feed into the episcleral vein
directly from schlemms or from external aqueous collecting channel
a the limbus
what kind of drug is pilo and how does it affect pressure
it is a cholenergic agonist
it contracts ciliary muscles and therefore allows more space between layers and decreased outflow resistance
explain how IOP affects episcleral veins
high pressures cause white veins
low pressures causes filling with blood
which method of outflow is not affected by IOP
explainthe routes for this method
uveoscleral
through uveal meshwork> CT around ciliary muscles > suprachoidal space> absorbed by sclera> anterior ciliary and vortex veins
increased resistance is usually do what tissue
juxtacanalicular tissue
how does age affect tissues and mechanism that increase risk of GLC
-uveosclero unconventional out flow DECREASES
-proliferation of juxtacanalicular tissue INCREASES
-CROSS SECTIONAL DIAMERTER OF SCHLEMMS CANAL REDUCED
where is the cilio spinal center of budge
c8-T2
whats more strong sphincter or dilator
what happens to pupil if edinger westphal nucleus is not inhibited
what happens if midbrain supranaculear is inhibited
sphincter
westphal…
if not inhbited = miosis small pupil
if inhibited = dilation
midbrain
if inhbited = dilation awake
what inner vation activation is not required for pupil dilation
sympathetic
Pt has anisicoria worse at night and has different colored eyes this shows that
defect was present in early life
explain the dilating and miotic gtts
pupil location
inferior nasal
pupil reduces retinal illumination by ____ log in _____ seconds
larger or smaller pupils reduce aberation
1.5 log in 0.5
smaller pupils reduce aberations
describe what is happening if pt has dilated pupil and third nerve palsy
non pupil involved CN3 palsy?
the subarachnoid space is being compressed
dure to intracranial aneurysm internal coratid art pituitary tumor
pupil not involved = ischemia
describe the locations of pupil fibers and fibers for eoms
pupils fiber are outside CN 3 and EOM is inside it
