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Eye And Eye Movements Flashcards

1
Q

What are the bones of the orbit?

A

Roof:
Frontal bone
lesser wing of sphenoid

Lateral wall:
Zygomatic process of frontal
Frontal process of zygomatic
Greater wing of sphenoid

Medial wall:
Orbital plate of ethmoid bone
Lacrimal bones
Frontal process of maxilla

Floor:
Perpendicular plate of palatine bone
Orbital surface of maxilla
Zygomatic bone

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2
Q

What foramina can you find in the orbit?

A

Superior orbital fissure

Inferior orbital fissure

Optic canal of sphenoid bone

Lacrimal foramina

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3
Q

What passes thru the SOF?

A

CN 3,4, V1, 6

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4
Q

what passes thru the inferior orbital fissure?

A

Maxillary N. (V2) as it goes to infraorbital and zygomatic n.

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5
Q

What passes thru the optic canal of the sphenoid bone?

A

CN 2

Ophthalmic a.

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6
Q

What is the strongest wall of the orbit?

A

Lateral wall

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7
Q

What is the weakest wall of the orbit?

A

Medial and inferior wall

Thin orbital floor with maxilla and thin medial wall with ethmoid bone

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8
Q

How are the medial walls of the orbit positioned to each other?

A

Parallel to each other

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9
Q

How are the lateral walls of the orbit positioned to each other?

A

At right angle to each other

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10
Q

What does the orientation of the orbits allow for?

A

Axes of orbit to diverge at 45 degrees

Optical axes to be parallel and straight ahead

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11
Q

Where is the frontal sinus compared to the orbit?

A

Superior and medial

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12
Q

Where is the ethmoid sinus compared to the orbit?

A

Between orbits

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13
Q

What can a chronic infection in the ethmoid sinus cause?

A

Can erode into orbits and cause OPTIC NEURITIS

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14
Q

Where is the maxillary sinus compared to the orbit?

A

Below orbit

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15
Q

What closes the eye? Muscle and nerve

A

Orbicularis oculi m.

Facial n.

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16
Q

What opens the eye? Muscle and nerve?

A

Levator palpebrae superioris m.

Oculomotor n.

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17
Q

What gently closes the eye?

What tightly closes the ey?

A

Gently: palpebral part

Tightly: orbital part

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18
Q

What innervates the ciliary Ms.?

A

Parasympathetically innervated by CN 3

(Edinger westphal nucleus —> CN 3 —> CN V1 (short ciliary n.))

To sphincter pupillae

(Dilator = sympathetics bc fight or flight)

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19
Q

What innervates the Tarsal Ms.

A

Sympathetically innervated

From superior cervical to jump on internal carotid plexus to Long Ciliary N. To Tarsal Ms.

To Dilator pupillae Ms.

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20
Q

What muscle helps levator palpebrae superioris raise the upper eyelid?

A

Superior tarsal M.

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21
Q

What comprises the lacrimal apparatus?

A

Lacrimal gland
Lacrimal canaliculi
Lacrimal sac
Nasolacrimal duct

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22
Q

Where is the lacrimal gland located?

A

Above and lateral to the eye, behind Tensor Levator palpebrae superioris M.

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23
Q

What do lacrimal canaliculi do?

A

Wick the tears in

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24
Q

What does the lacrimal sac drain to?

A

Nasolacrimal duct

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25
What does the nasolacrimal duct drain to?
Inferior nasal meatus
26
What is the lacrimal gland innervated by?
CN 7–greater petrosal n. Greater petrosal + deep = N. To pterygoid canal (vidian n.) —> pterygopalatine ganglion —> with V2 zygomatic branch and V1 lacrimal n. —> lacrimal gland, nasal glands, palatine glands
27
Wher does the tendon of orbicularis oculi insert?
Onto lateral part of lacrimal sac
28
What nerves are part of the corneal reflex?
V1 and CN 7
29
What muscle is part of the corneal reflex?
Orbicularis Oculi
30
What happens when you flex orbicularis oculi by blinking?
Blink —> flex muscle —> open lacrimal sac —> draws tears down and into nasolacrimal duct —> inferior nasal meatus (Why you get sniffly when you cry)
31
What is the ciliary body? What is it composed of? What innervates it?
Circumferential tissue inside the ey Composed of ciliary m. And ciliary processes CN 3
32
Function of Ciliary processes?
Secrete aqueous humor which fills the anterior and posterior chambers
33
Where is the anterior chamber? | What is it filled with?
Space between cornea and iris/pupil Filled with aqueous humor
34
Where is the posterior chamber of the eye? What is it filled with?
Space between iris/pupil and lens/ciliary body Filled with vitreous humor
35
How does aqueous humor flow?
Secreted by ciliary process—> posterior chamber —> anterior chamber —> Scleral venous sinus (schlemm’s canal)
36
What happen if Schlemm’s canal is blocked?
Leads to increased pressure and a glaucoma | Eventually lead to blindness
37
What is Hyphema? Presents with?
pooling or collection of blood inside anterior chamber of eye Can block vision partially or completely Painful, could cause permanent damage
38
What goes thru the tendinous ring made by Rectus Ms.?
CN 3, CN V1- nasociliary, CN 6
39
What goes thru the superior orbital fissure but not ring?
CN 4, CN V1-lacrimal and frontal n.
40
Adduction and abduction of the eye moves it about what axis?
Vertical
41
Elevation and depression of the eye moves it about what axis?
Horizontal
42
Intorsion and extorsion of the eye moves it about what axis?
AP axis (visual axis)
43
Where do your extraocular Ms. come from embryologically?
Prechordal plate mesoderm
44
What are the extraocular Ms.?
``` Levator palpebrae superioris Superior oblique Inferior oblique Superior rectus Medial rectus Lateral rectus Inferior rectus ```
45
What is the eye movement done by Superior oblique?
Down and out
46
What is the eye movement done by Inferior oblique?
Up and out
47
What is the eye movement done by Superior rectus?
Up and in
48
What is the eye movement done by Inferior rectus?
Down and in
49
What is the eye movement done by Lateral rectus?
Out
50
What is the eye movement done by Medial rectus?
In
51
What is the eye movement done by Levator palpebrae superioris?
Elevates superior eyelid
52
understand the H test
Have patient draw an H with their eye, Muscles are opposite of their normal movements (I.e. Superior oblique does down and out but you put eye in first to test down)
53
When are msucles trapped from performing their function?
When the visual gaze axis s perpendicular to the muscle fiber direction
54
What is trochlear palsy?
Paralysis of SO Head tilts AWAY from affected side Diplopia w/ downward gaze
55
What is abducens Palsy?
Paralysis of Lateral rectus Unable to look laterally with affected eye
56
What is oculomotor palsy?
Eye will be down and out Have complete ptosis And dilated pupil
57
Why will a lesion to CN 3 cause dilation of pupil?
Bc constriction is done via CN 3 and short ciliary n. So without CN 3, sympathetics take over and just dilate eye
58
What is Horner syndrome? Presents with?
Lack of sympathetic innervation to one side of face Ptosis Miosis Anhydrosis Vasodilation
59
How does the Direct pupillary light reflex work?
Light SENSED by CN 2 Synapse in pretectal nucleus Synapse in edinger westphal nucleus (CN3) Pre-ganglion paras. Neuron travel w/ CN 3 Synapse in ciliary ganglion Post-ganglion paras. Neuron synapse in Pupillary constrictor m. *big take away: CN 2 = sensory; CN 3 = motor; 4 neuron arch
60
Why do we get a consensual pupillary light reflex?
Due to crossing golf fibers at the optic chiasm
61
What is the corneal reflex?
``` Receptors in corneal detect touch Travel in CN V1 Synapse in trigeminal nucleus To facial nucleus CN 7 causes eye to blink ``` **big take away: Sensory: CN V1; Motor: CN 7
62
What is accommodation? | How does it occur?
Change in optical power to focus on near objects Ciliary M. Changes shape of lens
63
What are the three things that should occur during accomodation?
1. Convergence of both eyes (eyes move medially) 2. Accomodation (change in lens shape in order to maintain focal point on retina) 3. Miosis (pupil constricts to bock divergent light rays from near object)
64
What are the major branches of the ophthalmic a. ?
``` Supratrochlear a. Supraorbital a. Ethmoidal As. Lacrimal A. Central Retinal A. ```
65
What are the anastomotic connections of the ophthalmic a.?
Supraorbital —Superifical temporal Supratrochlear — angular a. Ethmoidal a. — sphenopalatine a. Lacrimal a. — middle meningeal a.
66
What is the chief blood supply to the retina?
Central Retinal A.
67
What is Central Retinal A. Occlusion? From what? Presents with?
Blocked central retinal a. From atherosclerosis, embolism Presents as pale and red spot, retina will be white, macula cherry red spot
68
What is in the optic nerve?
Central retinal a. And v.
69
What surrounds the optic n.?
Pial sheath Subarachnoid space Arachnoid sheath Dural sheath
70
What veins can go back to the cavernous sinus?
Superior Ophthalmic V. Inferior Ophthalmic V. Angular V.
71
What veins go to the pterygoid venous plexus?
Infraorbital v. Angular v. Facial v.
72
What causes Central retinal v. Occlusion? Presents with?
Causes: Hardening of the CRA compressing CRV, hemorrhages, dilated veins Presents as “ketchup splatter”
73
What is medial to the cavernous sinus?
Sphenoid sinus
74
What does the cavernous sinus drain into?
Superior and inferior petrosal sinus
75
What does the ciliary body connect the iris to?
To the choroid
76
What does the ciliary muscle do?
Alters the curvature of the lens
77
What are the radial ciliary processes?
Lens are suspended by ligaments from here
78
What is the ciliary ring?
Adjoins the choroid
79
What is the iris? Function? What 2 muscle groups make it up?
Contractile structure mainly made of smooth muscle Controls the size of the pupil Sphincter pupillae Dilator pupillae
80
What does contraction of the dilator pupillae cause? How is this done?
Increased pupil size Via sympathetics
81
What does contraction of sphincter pupillae cause? | How is this done?
Decreases pupil size Via parasympathetics
82
What is partial ptosis caused by?
Paralysis of superior tarsal muscle Lack of sympathetic stimulation (Seen in Horner’s syndrome)
83
What is complete ptosis?
Paralysis of levator palpebrae superioris Lesion of CN 3
84
How does a Blow out fracture of the orbit occur? What structures are involved? How does this manifest clinically?
Caused by indirect trauma (punch or baseball to eye) Medial and inferior parts of orbit - maxillary bone and maxillary sinus Diplopia, globe ptosis, exophthalmos Orbital contents could prolapse and become entrapped in maxillary sinus
85
How is a Le Forte 1 fracture described?
Floating palate
86
How is a Le Forte 2 fracture described?
Floating maxilla (pyramidal)
87
How is a Le Forte III fracture described?
Floating face (transverse)
88
What is cause and appearance of Papilledema?
Increased intracranial pressure in subarachnoid space ^Makes this an EMERGENT thing to find cause of increased ICP Bulging optic disc
89
What could cause increased intracranial pressure in subarachnoid space?
Hydrocephalus, tumor, leaky CSF
90
What is the macula?
Center of vision
91
What is the fovea?
Area of the macula most concentrated by cones
92
What kind of receptors does the optic disc have?
Has NO receptors
93
What are the three layers of the eye?
Fibrous Vascular Inner
94
What is in the fibrous layer of the eye?
Sclera | Cornea
95
What is the in vascular layer of the eye?
Choroid Ciliary body Iris
96
What is the function of the choroid?
Primarily concerned w/ providing nourishment to cones and rods of retina
97
What is function of ciliary body?
Producer of aqueous humor and adjuster of lens
98
What happens when the ciliary body is parasympathetically innervated?
Reduces tension on lens | Thickens for near vision
99
What happens when there is a lack of stimulation to the ciliary body?
Relaxes ciliary body Stretches lens Thinner for far vision
100
What is the function of the iris?
Protector of the retina
101
What is in the inner layer of the eye?
Retina
102
What is the two parts of the conjunctiva of the eye?
Palpebral Bulbar Conjunctiva - clear thin membrane covering anterior portion of sclera and inner eyelids
103
What is palpebral conjunctiva?
Lines inside of eyelid
104
What is the bulbar conjunctiva?
Lines outermost part of the eyeball, covers anterior part of the sclera
105
Where does the conjunctiva come together at?
Superior and inferior conjunctival fornix
106
What is conjunctivitis? | Bacterial vs. viral?
Infection of conjunctiva of eye Bacterial - oozy and pus forming Viral - red and hurting
107
What is a subconjunctival hemorrhage? What can cause this?
Bleed and rupture of a blood vessel that is between sclera and bulbar conjunctiva Increase abdominal pressure Really hard cough or sneeze Throwing up Pooping

Neuro (18 decks)

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