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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
Paranasal sinuses and their innervation
``` 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 ```
26
Frontal sinuses
Enlarge until adulthood | Drain into nasal cavity via frontonasal duct
27
Ethmoidal sinus issues
Seperated from orbit via small bone | Infection can pass bone causing orbital cellulitis
28
Sinisitis
Preseptal cellulitis: inflammation Ant. Orbital septum Orbital cellulitis: infection behind orbital septum Meningitis: infection to brain and spine
29
Blood retina barrier components
RPE tight junctions (outer) Muller cells provide passage for retinal vessels Retinal capilaries have tight junctions (inner) Bruchs membrane somewhat protects some material
30
Blood retinal barrier purpose
Maintains retinal homeostasis required for vision. Diseases can occur otherwise.
31
^9 layers of retina + RPE. Outermost to innermost^
``` *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
Retinal pigmented epithelium structure
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
Retinal pigmented epithelium function
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
Outer/external limiting membrane
OLM/ELM is formed by cytoplasmic condensation between photoreceptors and glial cells
35
Outer nuclear layer
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
Photoreceptor cell layer
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
Outer plexiform layer
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
Inner nuclear layer cell bodies
``` INL contains cell bodies of: Bipolar cells (BC) Horizontal cells (HC) Amacrine cells (AC) Interplexiform cells (IC) Muller cells (glial cells) ```
39
Inner plexiform layer
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
Nerve fiber layer
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
Inner limiting membrane
ILM has muller cells on the retinal side, and viterous fibrils and GAGs on the outside (hyaloid membrane). Seperates retina from viterous
42
Transparent biconvex. Has capsule, epithelium and fibers.
Posterior surface fits onto anterior viterous face in the hyaloid fossa. Constant growth through life.
43
Function of lens
Accommodation, UV filtration / absorption, separates vitreous chambers. Nutrition via diffusion from humors
44
Lens capsule
elastic collagen membrane. Thick equator, thin poles. Zonule attachment point. Barrier for large molecules.
45
Lens Epithelium:
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
Lens fiber generation
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
Lens fiber structure
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
Lens crystallins:
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
Lens zonules
Suspensory ligaments, from ciliary body to capsule. Allows accommodation. Fibrillin glycoproteins = strength / elasticity GAG + Hyaluronan = viscoelasticity 3 bands of connection: anterior, posterior, equatorial.
50
Lens transparency with age
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
Lacrimal apparatus function
Tear secretion / distribution / elimination
52
Tear film composition
``` 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
Tear film function
Smooth refraction, antimicrobial, cleaning / lubrication, corneal nourishment
54
Tear film distribution
Blink / gravity directs tear medially. Contractions expands lacrimal sac acting as tear pump. Tear overflow is epiphora.
55
Tear drainage system
Puncta (upper/lower) lead to canaliculi (upper/lower) leading to lacrimal sac which drains into the nasolacrimal duct to nasal cavity.
56
Ciliary body function
Secretes aqueous humor, lens nourishment, accommodation muscle, aquesous humor outflow assistance, viterous hyaluronic acid contribution
57
Pars plana:
Forms Ora Serrata to Pars Plicata Retina becomes ciliary epithelium, RPE becomes pigmented ciliary epithelium Looks scalloped, give rise to Ant. Zonules
58
Pars Plicata
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
Process of accommodation
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
Innervation of ciliary body
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
Bitemporal hemianopia
Lesion to the optic chiasm cross, resulting in loss of temporal FOV (nasal portion of retina)
62
Anopia
Lesion to the optic nerve of the L/R eye. | Loss of L/R eyes vision
63
Homonymous hemianopia with/without macula sparing
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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