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Neuro Endocrine > Eye and Eye movements > Flashcards

Eye and Eye movements Flashcards

1
Q

what bones make up the orbit and what foramina are found in the orbit

A 
frontal
ethmoid
sphenoid
zygomatic
lacrimal
maxillary

optic canal
superior orbital fissure
Inferior orbital fissure

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2
Q

What locations on the orbit are easy to fracture?

A

The lateral aspect of the orbit and the floor of the orbit due to how thin the bone is there

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3
Q

what is considered a blow out fracture of the eye and what are its symptoms?

A

indirect trauma to the orbit

usually happens medially and inferiorly into the maxillary bone

orbital contents can get entrapped in maxillary sinus

leads to Diplopia,
globe ptosis (eye sinks down)
exophthalmos (protrusion of the eyeball)

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4
Q

what angle does the orbital socket face from midline?
what angle does the lateral walls deviate from the medial walls?
What angle does the optical axis face

A

45 degrees

90 degrees

o degrees (looks directly straightforward

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5
Q

What are all the movements of the eye

A

Abduction and Adduction (vertical axis)

Elevation and depression (Horizontal axis

Intorsion (medial rotation)
Extorsion (lateral rotation)
(Anterior posterior axis)

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6
Q

Innervation and action of levator palpebrae superioris

A

INN: superior branch of Oculomotor (CN III)

Action: Elevates the superior eyelid

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7
Q

Innervation and action of superior oblique

A

INN: trochlear

action: Abducts
depresses
Medially rotates the eyeball

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8
Q

Innervation and action of inferior oblique Muscle

A

INN: Oculomotor

action: ABducts
Elevates
laterally rotates the eye

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9
Q

Innervation and action of Superior rectus Muscle

A

INN: Oculomotor

Elevates, adducts and rotates eyeball medially

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10
Q

Innervation and action of inferior rectus muscle

A

INN: Oculomotor

Depresses adducts and laterally rotates the eyeball

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11
Q

Innervation and action of medial rectus

A

INN: Oculomotor

Adducts the eyeball

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12
Q

Innervation and action lateral rectus

A

INN: Abducent

Abducts the eyeball

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13
Q

What muscles do Extorsion

A

Lateral rotation

Inferior Oblique
Inferior rectus

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14
Q

What muscles do Introsion

A

Medial rotation

Superior oblique muscle
Superior rectus

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15
Q

What muscles do elevation

A

Inferior oblique

Superior rectus

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16
Q

WHat muscles do depression

A

Superior oblique

Inferior rectus

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17
Q

WHat muscles do ABduction

A

INferior oblique
lateral rectus
superior oblique

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18
Q

WHat muscles do ADduction

A

Inferior rectus
Medial rectus
Superior rectus

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19
Q

How do clinicians test each muscle of the eye individually

A

They must trap the paired muscle to test the muscle they want by trapping the visual gaze so that the paired muscle they arent testing muscle fibers are perpendicular to the muscle fibers they are testing

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20
Q

To test the superior rectus how must the eye be looking

A

THe eye must be ABducted by the Lateral rectus

then you elevate the eye

(this would make the inferior oblique perpendicular)

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21
Q

To test the inferior rectus how must the eye be looking

A

THe eye must be ABducted by the lateral rectus

then you depress the eye

(THis would make the superior oblique perpendicular)

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22
Q

To test the superior oblique how must the eye be looking

A

THe eye must be ADducted by the medial rectus

then you depress the eye

(This makes the inferior rectus perpendicular)

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23
Q

To test the inferior oblique how must the eye be looking

A

the eye must be ADducted by the medial rectus

then you elevate the eye

(this makes the superior rectus perpendicular)

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24
Q

What modalities are carried in Long ciliary nerve

A

Comes off of nasociliary N

carries sensory and sympathetics

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25
WHat modalities are carried in short ciliary nerve
comes off of naso ciliary N travels through ciliary ganglion carries sensory, parasympathetics and sympathetics
26
What muscle is innervated by the inferior branch oculomotor
Inferior oblique Inferior rectus Medial Rectus
27
What muscle is innervated by the superior branch of oculomotor
Levator palpebrae superioris | Superior rectus
28
What nerves travel through the Common tendinous ring
Optic Nerve (and optical canal) ``` Frontal Nerve Lacraimal Nerve (V1) Trochlear Nerve (CN IV) ``` Oculomotor Nerve superior and inferior branches Nasociliary nerve Abducent Nerve (these 4 also travel through superior orbital fisure)
29
WHat is horners syndrome
When the cervical ganglion is cut so that you lose all sympathetics to the face ``` patients present with constriction of the pupil: miosis Drop eye lid: Ptosis Anhydrosis= no sweat Dilation of the blood vessels so redness and increased temperature in the face ```
30
What do Parasympathetic innervation do in the eye
Sphinctor muscle | ciliary muscle
31
What do sympathetic innervation do in the eye
DIlator pupillae | superior and inferior tarsal muscles
32
What does seensory innervation do in the eye
Choroid iris Cornea
33
Lesions to the trochlear nerve
Trochlear palsy headtilts away from the affected side to compensate for the laterally rotated eye Diplopia on downward gaze
34
Lesions to the Abducens nerve
Abducens palsy Cannot look laterally with the affected eye cannot ABduct the eye
35
Lesion to the oculomotor nerve
Oculomotor palsy Down and out eye: due to ocular muscle innervation only leaving Superior oblique and Lateral rectus intact Complete ptosis: loss of innervation to levator palpebrae superioris Pupil dilation: Loss of parasympathetic innervation to the pupil
36
What are the 4 neurons in the pathway for the pupilary light reflex
1) Light sensed by CN II and will synapse on the pretectal nucleus 2) Cells from pretectal nucleus will synapse in edinger-westphal nucleus (bi-laterally) 3) Preganglionic parasympathetic neurons will travel with CN III and will synapse in the cilary ganglion 4) Postganglionic parasympathetic neurons will synapse in the pupillary constrictor muscle Optic Nerve = sensory oculomotor = motor
37
What is the 3 neuron pathway of the coneal reflex
1) receptors in corneal will detect touch or irritation, travel in CN V1 and synapse in trigeminal sensory nucleus or spinal trigeminal nucleus 2) Cells from the trigeminal nuclei project to facial nucleus 3) neuron in facial nerve will cause eye to blink ``` Sensory= V1 Motor= CN VII ```
38
What are the 3 layers of the eye
Fibrous layer Vascular Layer Inner layer
39
What makes up the Fibrous layer
Sclera and the cornea
40
What makes up the vascular layer
Choroid ciliary body Iris
41
What makes up the inner layer
Retina
42
What is found in the middle of CN II
Central Retinal vein and Artery this supplies the Retina and is surrounded by meninges
43
What are the two conjunctiva and what do they do
Palpebral conjunctiva: lines the innermost part of the eyelids Bulbar (ocular) cojunctiva: lines the outermost part of the eyeball
44
What innervates the superior tarsal muscle
Sympathetics to help open the eye
45
WHat are the two types of conjunctivitis
can be bacterial and viral bacterial conjunctivits produces yellow discharge called pheum viral conjunctivitis produces a watery secretion
46
Subconjunctival hemorrhage
this is a bleed between the sclera and the bulba conjunctival this can be caused from a blood vessel popping due to too much pressure
47
Complete PTOSIS
Loss of the Levator Palpebrae superioris caused by destruction of Oculomotor CN III pr one of its branches to the Levator Palpebrae superioris muscle
48
Partial PTOSIS
Loss of the Tarsal muscle (of Muller) innervated by Postganglionic sympathetic fibers that originate at the level of T1 Horners syndrome usually involves loss of this muscle
49
Papilledema
Cause: is increased intracranial pressure (ICP) Emergent: need to find the cause of the increased ICP can detect by seeing the optic disk in the back of the eye when looking into the eye
50
What is the macula and the fovea
Macula: center of vision Fovea: an area of the macula most concentrated by cones optic disk: is your blind spot
51
what are the arteries of the eye
``` Ophthalmic artery coming off of internal carotid artery gives rise to: short posterior ciliary artery long posterior ciliary artery Supratrochlear Artery Supraorbital A Ethmodial Arteries Lacrimal A ``` Lacrimal artery will give rise: anterior ciliary artery also in Optic Nerve is the central retinal A
52
Anastamoses with nerves in the eye | and the significance of them
Supratrochlear A = Angular A Supraorbital A = superfical temporal A Lacrimal A = Middle meningeal A since it is important to get the eue blood and to central retinal A therefore if their is a slow occulusion blood can find a way to central retinal A if there is a fast occlusion you will go blind because cant enough blood to the eye
53
What is the venous drainage of the eye
Will go back through superior ophthalmic V to cavernous sinus Inferior Ophthalmic to pterygoid venous plexus Angular Verin to facial V
54
Central Retinal Vein Occulusion
looks like ketchup on the back of the eye cause: hardening of the central retinal artery and hypertension in the CRA can compress the CRV Hemorrhages dilated veins
55
Central Retinal Artery Occlusion
Pale and red spot caused by atherosclerosis, embolisms Retina appears white cherry red spot since the choroid is still getting blood supply Veins and arteries attenuated
56
WHat is the pathway of the tear through the eye
goes from the lacrimal gland which is lateral of the eye then it will cross the eye medially then the Lacrimal canaliculi will wick the eyes into the lacrimal duct the tears will then travel down the nasolacrimal duct into the inferior Nasal meatus
57
Why does blinking help clear tears
The lacrimal part of the orbicularis oculi muscle kis attached to the lacrimal sac so blinking will help widen the opening of the lacrimal sac
58
What is the route of parasympathetics from the brain to the lacrimal gland
Leave the superior salivatory nucleus as Facial Nerve travel through the internal auditory foramen through the hiatus for the greater pertrosal nerve as the greater petrosal Nerve Meets up with deep petrosal Nerve and becomes the Nerve of the pterygoid canal and will enter the pterygoid canal then will reach the pterygopalatine ganglion and synaspse their Then the postganglionic parasympathetic fibers will travel on V2 the zygomatic branch then will jump on a communicating branch then will join on to the lacrimal Nerve of V1 and will reach the lacrimal Gland
59
What are the two chambers of the eye
Anterior chamber: space between the cornea and the ris/pupil Posterior chamber: Space between the iris/pupil and the lens and ciliary body
60
What is the ciliary body
the circumferential tissue inside the eye composed of the ciliary muscle and ciliary processes
61
What is the ciliary process
secretes the aqueous humor which fills the anterior and posterior chambers
62
What is the flow of the Aqueous humor
1) ciliary process from the ciliary body 2) goes from the posterior chamber to the anterior chamber 3) into the scleral venous sinus (Schlemms Canal)
63
What happens if the schlemms canal is blocked
this can lead to increased pressure and glaucoma
64
What is hyphema
Rupture of an artery in the anterior chamber that causes it to fill up with blood
65
Ciliary body and the impact on the lense
Contraction of ciliary muscles decreases the size of the ciliary body this reduces tension on suspensory ligament of lens the lens then becomes more rounded to aid in near vision aids in accomadation

Neuro Endocrine (20 decks)

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