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OPTO 3002 > examinable > Flashcards

examinable Flashcards

1
Q

Structures in blood aqueous barrier:

A

Ciliary NPE facing posterior chamber with tight junctions
2 layers of ciliary epithelium
Iris vessel endothelium have tight junctions

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2
Q

Purpose of blood aqueous barrier

A

Prevents passive transport of blood material to aqueous.

Barrier between BV in iris and blood in ciliary stroma

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3
Q

Aqueous humor flow

A

Formed in posterior chamber by ciliary body, flows through iris, exits at anterior chamber drainage angle (iris-cornea junction)
Higher pressure in pos. chamber, also warmer near iris

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4
Q

Aqueous humor formation

A

Active transport via ciliary stromal BVs and pigment epith.

Water passes with gradient of ions.

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5
Q

Blood aqueous barrier during infection

A

Uvitis causes vessels in iris to allow inflammatory cells into vitreous

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6
Q

Aqueous humor outflow

A

Trabeculo-canalicular: trabecular meshwork -> schlemms canal -> collector channel -> episcleral veins
Uveoscleral: ciliary BV’s -> suprachoroid space -> vortex veins

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7
Q

Trabicular meshwork cells

A

Trabicular cells: phagocytoses debris

Cribriform cells: forms compounds to help flow

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8
Q

Anterior chamber drainage angle structures

A 
Iris
Ciliary body band
Scleral spur
Trabecular meshwork
Schwalbe's line
cornea
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9
Q

Eyelid layers

A 
Skin
Subcutaneous areolar layer
Striated muscle
Submuscular areolar layer
Orbital septum / tarsal plate
Smooth mullers muscle
Conjunctiva
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10
Q

Eyelid innervation

A

Sensory: CN V
Muscle:
Orbicularis oculi: temporal / zygomatic branches of CN VII
Muller: Superior cervical sympathetic ganglion
LPS: sup. Division of CN III

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11
Q

Levator palpebrae superioris issues

A

Full ptosis in CN III lesions.

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12
Q

Muller issues

A

Partial ptosis (horners syndrome)

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13
Q

Binocular motions of the eyes

A 
Dextroversion: Right
Laevoversion: left
Supraversion: up
Infraversion: down
Cycloversion: around Y axis
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14
Q

Ophthalmic Artery branches to EOMS

A

Lateral branch: LR, SR, SO
Medial branch: IR, MR, IO
Lacrimal artery: LR
Infraorbital artery: IO

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15
Q

Muscle designation

A

Agonist: primary driver
Synergist: agonist assistor
Antagonist: agonist opposer
Yoke muscles: agonist of both eyes for binocular focus

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16
Q

Medial rectus innervation and use

A

innervated by Inf. Div. VN III (oculomotor)

Only used for adduction

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17
Q

Lateral rectus innervation and use

A

Only muscle innervated by CN VI (abducens)

Only used for abduction

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18
Q

Superior rectus innervation and use

A

Innervated by Sup. Div. CN III (oculomotor)

Primary elevation, secondary intorsion, tertiary adduction (as it attaches at an angle to optic axis)

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19
Q

Inferior oblique innervation and use

A

Innervated by Inf. Div. CN III (oculomotor)

Primary extorsion, secondary elevation, tertiary abduction.

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20
Q

Cornea layers

A

Epithelium, bowmans membrane, stroma, descements membrane, endothelium

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21
Q

Cornea epithelium

A

Superficial layer: squamous
Middle: wing cells, replace superficial
Basal: columnar, stem cells form new cells

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22
Q

Cornea stroma

A

Passes non mylenated nerves
Regular diameter / spacing for collagen fibrils
Contains glycoaminoglycans GAGs

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23
Q

Ciliary stroma

A

Superciliaris layer connects to sclera
Highly vascularised, myelated nerves
Contains the ciliary muscle.

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24
Q

Sclera layers

A

Episclera: seperates from tenon’s capsule
Stroma
lamina fusca

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25
Q

Paranasal sinuses and their innervation

A 
Frontal: supraorbital nerve of CN V
Ethmoidal: Ethmoidal nerves of CN V
Sphenoidal Ethmoidal nerves of CN V
Maxillary: Maxillary branch of CN V
All join nasal cavity
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26
Q

Frontal sinuses

A

Enlarge until adulthood

Drain into nasal cavity via frontonasal duct

27
Q

Ethmoidal sinus issues

A

Seperated from orbit via small bone

Infection can pass bone causing orbital cellulitis

28
Q

Sinisitis

A

Preseptal cellulitis: inflammation Ant. Orbital septum
Orbital cellulitis: infection behind orbital septum
Meningitis: infection to brain and spine

29
Q

Blood retina barrier components

A

RPE tight junctions (outer)
Muller cells provide passage for retinal vessels
Retinal capilaries have tight junctions (inner)
Bruchs membrane somewhat protects some material

30
Q

Blood retinal barrier purpose

A

Maintains retinal homeostasis required for vision. Diseases can occur otherwise.

31
Q

^9 layers of retina + RPE. Outermost to innermost^

A 
*retinal pigmented epithelium
Photoreceptor layer
Outer limiting membrane
Outer nuclear layer
Outer plexiform layer
Inner nuclear layer
Inner plexiform layer
Ganglion cell layer 
Nerve fiber layer
Inner limiting membrane 
(Then viterous)
32
Q

Retinal pigmented epithelium structure

A

Single layer of tight junction cuboidal hexagonal cells from ON to ora serrata, where it continues as pigmented epithelium layer of CB.
Basal RPE anchors to Bruch’s membrane (separates from choroid)
Apical surface has microvilli (more contact with photoreceptor)

33
Q

Retinal pigmented epithelium function

A

Absorbtion of light via melanin
Turnover of vitamin A material and visual pigment
Phagocytosis of outer segments of photoreceptors
Active transport of nutrients from choroid to photoreceptor (no passive due to tight junctions)
Acts as blood retina barrier

34
Q

Outer/external limiting membrane

A

OLM/ELM is formed by cytoplasmic condensation between photoreceptors and glial cells

35
Q

Outer nuclear layer

A

ONL formed by cells bodies and nuclei of photoreceptors.
Rods for night/colorless vision
Cones (RGB) for color and detail
Cones:rods = 1:20

36
Q

Photoreceptor cell layer

A

Outer segment: contact RPE. Light sensitive, have discs of pigment
Inner segment: houses mitochondria / organelles. Adjacent segments are insulated by muller cells for conductivity.
Cell body/nucleus: located in outer nuclear layer of retina.
Terminal synapses in outer plexiform layer

37
Q

Outer plexiform layer

A

OPL transitions from 1st order neurons (photoreceptors) to 2nd order neurons (bipolar cells and horizontal cells) with filled space of muller cell processes.
Outer zone: axons of photoreceptors and axons of muller cells
Inner zone: synapses (rod spherules and cone pedicles)
Thickest at fovea due to pedicle density

38
Q

Inner nuclear layer cell bodies

A 
INL contains cell bodies of:
Bipolar cells (BC)
Horizontal cells (HC)
Amacrine cells (AC)
Interplexiform cells (IC)
Muller cells (glial cells)
39
Q

Inner plexiform layer

A

Synapse layer, relays visual data between 2nd order neurons (BC), and 3rd order neurons (ganglion).
Synapses called Dyads between BC and ganglion or AC
Absent in fovea

40
Q

Nerve fiber layer

A

Axons of ganglion cells form NFL as they run towards ON.
Non-myelinated until lamina cribrosa
Axons arranged in arcades
Superior and inferior ON NFL bindles are thickest
Papillomacular bundle between ON and macular are thinnest.

41
Q

Inner limiting membrane

A

ILM has muller cells on the retinal side, and viterous fibrils and GAGs on the outside (hyaloid membrane).
Seperates retina from viterous

42
Q

Transparent biconvex. Has capsule, epithelium and fibers.

A

Posterior surface fits onto anterior viterous face in the hyaloid fossa.
Constant growth through life.

43
Q

Function of lens

A

Accommodation, UV filtration / absorption, separates vitreous chambers. Nutrition via diffusion from humors

44
Q

Lens capsule

A

elastic collagen membrane. Thick equator, thin poles. Zonule attachment point. Barrier for large molecules.

45
Q

Lens Epithelium:

A

Singular cuboidal only under ant. Lens.
Secrets / transports nutrients.
Germinative zone(equator): columnar for division/differentiation into fibers and lens cortex
Central zone: stable

46
Q

Lens fiber generation

A

At equatorial germinative zone, epithelial cells elongate, nuclei migrate anteriorly forming lens bow shape. Organelles/nuclei dissapear. New generations push older ones inward, differentiating into secondary lens fibers.

47
Q

Lens fiber structure

A

Nucleus: earliest (embryonic, feoetal)
Cortex: later formed fibers (5/day)
Sutures: were fibers meet (ant. Y / pos. lander). Tight packing via interlocking interdigitations to allow motion and rigidity.

48
Q

Lens crystallins:

A

Lens fibers produce crystallins following nuclei loss.
High-packing density and RI proteins with variable density (most in nucleus)
Alpha (large)
Beta (common)
Gamma (uncommon)

49
Q

Lens zonules

A

Suspensory ligaments, from ciliary body to capsule. Allows accommodation.
Fibrillin glycoproteins = strength / elasticity
GAG + Hyaluronan = viscoelasticity
3 bands of connection: anterior, posterior, equatorial.

50
Q

Lens transparency with age

A

Maintained with regular arrangement, avascular and lack of tissue / organelles.
Age has accumulation of metabolic products, osmotic / oxidative stress, crystallin aggregation, disruption of arrangement = increased light scatter (CATARACT)

51
Q

Lacrimal apparatus function

A

Tear secretion / distribution / elimination

52
Q

Tear film composition

A 
Lipid layer (outermost): meibomian / zeis gland secretion, reduces evaporation
Aqueous layer (middle): basal (constant) and reflex (crying) via lacrimal gland
Mucin layer (innermost): conjunctiva, goblet, plica semilunaris secretion, attaches tear to cornea
53
Q

Tear film function

A

Smooth refraction, antimicrobial, cleaning / lubrication, corneal nourishment

54
Q

Tear film distribution

A

Blink / gravity directs tear medially. Contractions expands lacrimal sac acting as tear pump.
Tear overflow is epiphora.

55
Q

Tear drainage system

A

Puncta (upper/lower) lead to canaliculi (upper/lower) leading to lacrimal sac which drains into the nasolacrimal duct to nasal cavity.

56
Q

Ciliary body function

A

Secretes aqueous humor, lens nourishment, accommodation muscle, aquesous humor outflow assistance, viterous hyaluronic acid contribution

57
Q

Pars plana:

A

Forms Ora Serrata to Pars Plicata
Retina becomes ciliary epithelium, RPE becomes pigmented ciliary epithelium
Looks scalloped, give rise to Ant. Zonules

58
Q

Pars Plicata

A

From Pars Plana to iris
Has ciliary processes (seen on microscope) for aqueous humor secretion into Pos. chamber, and zonule attachment
Thickest part of ciliary with underlying muscle.

59
Q

Process of accommodation

A

Distance: ciliary muscle relaxes, zonules taught, lens is thin
Near: CN III parasympathetic innervation. ciliary muscle contracts, moves towards lens. Zonules relax, lens thickens, anterior chamber becomes shallower. (convergence and pupil constriction occur)

60
Q

Innervation of ciliary body

A

Parasympathetic: short ciliary nerves, inferior division of CN III.
Sympathetic: long ciliary nerves from superior cervical ganglion.
Sensory: long ciliary nerves, nasociliary branch of ON (CN V)

61
Q

Bitemporal hemianopia

A

Lesion to the optic chiasm cross, resulting in loss of temporal FOV (nasal portion of retina)

62
Q

Anopia

A

Lesion to the optic nerve of the L/R eye.

Loss of L/R eyes vision

63
Q

Homonymous hemianopia with/without macula sparing

A

Lesion to L/R optic tract, either before or after LGN.
Full loss of L/R FOV = homonoymous hemianopia before LGN
Macular sparing = lesion within occipital lobe on L/R side

OPTO 3002 (10 decks)

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