Eye and Eye Movements Flashcards
An orbital blow out fracture is usually caused by indirect trauma that can result in orbital contents spilling out and becoming entrapped within which of the following sinuses?
A. Ethmoid sinus
B. Sphenoid Sinus
C. Frontal Sinus
D. Maxillary Sinus
Maxillary Sinus
Which of the following sinuses is superior medial to the orbit?
A. Frontal
B. Maxillary
C. Ethmoid
Frontal
The Ethmoid sinus is ______ to the orbit.
A. Lateral
B. Medial
C. Superior
D. Inferior
Medial
Chronic infection of the ethmoid sinus can cause its erosion into the orbits and cause which of the following?
A. Orbital Blow Out Fracture
B. Orbital Neuritis
C. Optic Neuritis
D. Trigeminal Palsy
Optic Neuritis
Our axis of orbit is _____ degrees while the optical axis is/axis of gaze are ______
A. 45, parallel
B. 90, parallel
C. 45, perpendicular
D. 90, perpendicular
45, parallel
Which side of the eye will you find the superior oblique muscle?
Medial
The Superior Oblique M. and Inferior Oblique muscles both ______ the eye
Abduct
The Superior Muscles of the eye, (rectus and oblique) both rotate the eye ______
Medially Rotation
What are the 3 muscle actions of the Superior Oblique M?
Abduct
Depress
Medially Rotate (intorsion)
What are the 3 muscle actions of the Inferior Rectus M?
Adduct
Depress
Laterally Rotate (extorsion)
If we want to test the elevation and depression of the Superior and Inferior Rectus muscles, we must go into adduction using the medial rectus. Explain why this is.
The Medial Rectus ADDucts, which cancels out the ABduction of the oblique muscles. This allows us to test the elevation of the inferior oblique, and the depression of the superior oblique
T/F: In order to test a specific eye muscle, we must get the muscle perpendicular to the gaze axis, in order to cancel out the horizontal axis actions
True
In order to test the Superior Rectus M. and Inferior Rectus M. we must change the gaze axis from 0 to which of the following?
A. 20 degrees
B. 23 degrees
C. 50 degrees
D. 51 degrees
23 degrees
The ______ (long/short) ciliary n. come directly off the nasociliary n. while the ________ (long/short) ciliary n. comes off the ciliary ganglion
The long ciliary n. comes directly off the nasociliary n. while the short ciliary n. comes off the ciliary ganglion
The Nasociliary N. is a branch off the opthalmic n. (V1), and gives off what 4 Ns.?
Infratrochlear N
Anterior Ethmoidal N
Posterior Ethmoidal N
Long Ciliary N.
Which of the following nerves goes to the back of the orbit and provides general sensory for the cornea?
A. Infratrochlear N
B. Anterior Ethmoidal
C. Frontal N
D. Long Ciliary N
Long Ciliary N
Which of the following nerves pierces the dura near the Tentorum cerebelli and is very susceptibel to damage from falls?
A. Abducens
B. Opthalmic
C. Trochlear
D. Facial
Trochlear N
Which of the following nerves pierces the dura near the clivus?
Abducens N.
Which of the following nerves supplies the Levator Palpebrae Superioris and Superior Rectus?
A. Superior Branch of Oculomotor N.
B. Inferior Branch of Oculomotor N.
C. Trochlear N.
D. Supraorbital N.
Superior Branch of Oculomotor N.
Which of the following nerves supplies the the Inferior Oblique, Inferior Rectus, and Medial Rectus?
A. Superior Branch of Oculomotor N.
B. Inferior Branch of Oculomotor N.
C. Trochlear N.
D. Supraorbital N.
Inferior Branch of Oculomotor N.
T/F: In the ciliary ganglion we have the synapse of the pre- and postganglionic fibers for the parasympathetics
True
Seven of the following nerves travel through the superior orbital fissure, but only 4/7 also travel through the Tendinous Ring formed by the rectus muscles. Select these nerves
Lacrimal N.
Frontal N.
Trochlear N.
Abducens N.
Superior and Inferior Branch of Occulomotor N.
Nasociliary N.
Abducens
Superior Branch of Occulomotor N
Inferior Branch of Occulomotor N
Nasociliary N. (V1)
Within the ciliary ganglion we have what 3 types of roots?
Sympathetic Roots
Sensory Roots from Nasociliary
Parasympathetic Roots of Ocululomotor N.
Sympathetics come from lateral horn of T1-T4 via white rami and synapse in the Superior Cervical Ganglion. At the ganglion the fibers will come off and hitch a ride on the As. to innervate certain structures.
Internal Carotid Plexes
External Carotid Plexes
A Sympathetic root jumps on the nasociliary to get to the _____________
A. Dilator Pupillae
B. Mucous Secreting salivary glands
C. Eyelid and Tarsal Muscle
D. None of the above
Dilator Pupillae
A Sympathetic root jumps on the superior division of CN III (oculomotor n) to get to the _____________
A. Dilator Pupillae
B. Mucous Secreting salivary glands
C. Eyelid and Tarsal Muscle
D. None of the above
Eyelid and Tarsal Muscle
Trochlear Palsy presents with which of the following?
A. Medially rotated eye
B. Paralysis of legs
C. Head tilts towards the affected side
D. Head tilts away from the affected side
Head tilts AWAY from the affected side
Which of the following makes it very hard to go downstairs?
A. Abducens Palsy
B. Trochlear Palsy
C. Occulomotor Palsy
D. Horner’s Syndrome
Trochlear Palsy
Which of the following causes people to not look laterally with the affected eye?
A. Abducens Palsy
B. Trochlear Palsy
C. Occulomotor Palsy
D. Horner’s Syndrome
Abducens Palsy
Horner’s Syndrome presents with constricted pupil (miosis), eyelid drop (ptosis), vasodilation of vessels causing increased skin temperature and redness, and anhydrosis (no sweating). What causes this disease?
A. Destruction of Oculomotor Parasympathetics
B. Lesion of Abducens
C. Damage to Sympathetics of Inferior Cervical ganglia
D. Damage to sympathetics of Superior Cervical Ganglia
Damage to sympathetics of Superior Cervical Ganglia
leads to Horner’s Syndrome
Occulomotor palsy is a disorder that is caused by lesion to the oculomotor N. The following include what occurs during the disease. Explain why each of the following occurs
- Eye points down and out
- Complete ptosis
- Pupil Dilation
- Eye points down and out: because all the muscles are lost except SO and LR
- Complete ptosis: because we lost Levator PAlpebrae Superioris
- Pupil Dilation: Because we lost the parasympathetic innervation to the pupil
The Pupillary light reflex is a 4 neuron pathwat where light is sensed and the pupil is triggered to constrict. What is the sensoty portion and what is the motor portion of this reflex?
Sensory: Optic N. (CN II)
Motor: Oculomotor N. and Parasympathetics
- Summary*
- Light is sensed by CN II and sends an afferent fiber to synapse in the pretectal nucleus*
- Cells from the prectal nucleus synapse in the Edinger Westphal nucleus*
- the preganglionic parasympathetic neurons will travel with the CN III and synapse in the ciliary ganglion*
- post-ganglionic parasympathetic neurons synapse in pupillary constrictor muscle*
What is the sensory and motor component of the Corneal Reflex?
Corneal Reflex occurs when the cornea is touched, in which it is then triggered to blink
Sensory: Trigeminal
Motor: Facial N.
There are 3 general layers of the eye. Fibrous, Vascular and inner layer. What does the fibrous layer include?
Sclera and Cornea
There are 3 general layers of the eye. Fibrous, Vascular and inner layer. What does the vascular layer include?
Choroid, ciliary layer, and iris
There are 3 general layers of the eye. Fibrous, Vascular and inner layer. What is the only structure included in the inner layer
Retina
The orbit contains two conjunctiva . The Palpebral conjunctiva lines the _________ part of the eyelids, while the Bulbar conjunctiva lines the _________ part of the eyeball
The orbit contains two conjunctiva . The Palpebral conjunctiva lines the inner part of the eyelids, while the Bulbar conjunctiva lines the outer part of the eyelids
The Superior Tarsal M. works with the Levator Palpebrae Superioris M to keep the eye lid up. It is innervated by which of the following?
A. Facial N.
B. V1
C. Occulomotor
D. Sympathetics
Sympathetics
What is the difference between complete and partial ptosis? Think in terms of nerves or strutures affected
Complete ptsosis is caused by a lesion of the Occulomotor N. that innervates the LPS
Partial Ptosis is caused by injury to the Tarsal M. or by the sympathetics that innervate it
Site of a bulging Optic disc is caused by increased intracranial pressure in the subarachnoid space. This is caused?
Papilledema
Where does a Subconjunctival Hemmorage occur?
A. Between the Palpebral conjunctiva and sclera
B. Between the Bulbar conjunctiva and the sclera
Between the Bulbar conjunctiva and the sclera
Go to purpose games to see the arterial supply to the eye
Got it
What arteries anastomos in the Kisselbach area?
Posterior and Anterior Ethmoidal As. anastomose with the Sphenopalatine As.
What artery anastomoeses with the Lacrimal A?
Middle Meningeal A.
What causes the following presentation:
Hardening of the central retinal A. that compresses the central retinal v.
Central Retinal V. Occlusion “ketchup”
What causes the following presentation:
Atherosclerosis or embolism of the Central Retinal A.
- causes the retina to appear white and a cherry red spot (maccula)
Lacrimal Sac drains into the Nasolacrimal duct that drains into _________
Inferior Nasal Meatus
Describe the neuronal pathway that leads to tear production in the eye
Include: nerves and ganglion
- The Greater Petrosal N. (parasympathetics) and Deep Petrosal N.(sympathetic fibers) combine to form the Vidian N.
- Parasympathetic fibers synapse in the Pterygopalatine ganglion
- THe parasympathetic fibers will travel with V2’s Zygomatic N
- V2’s Zygomatic N. will give off a communicating branch to the LAcrimal N. of V1
- Tears
Which of the following is the space between the cornea and iris/pupil?
A. Anterior Chamber
B. Posterior Chamber
C. Ciliary Body
D. Ciliary Process
Anterior Chamber
Which of the following secrete aqueous humor that fills in chambers in the anterior cavity
A. Anterior Chamber
B. Posterior Chamber
C. Ciliary Body
D. Ciliary Process
Ciliary Process
Which of the following is tissue that goes around the inside of the eye and is composed of muscle?
A. Anterior Chamber
B. Posterior Chamber
C. Ciliary Body
D. Ciliary Process
Ciliary Body
Which of the following is the space between the iris/pupil and the lens and ciliary body
A. Anterior Chamber
B. Posterior Chamber
C. Ciliary Body
D. Ciliary Process
Posterior Chamber
Galucoma is caused by the blockage of Schlemm’s canal that is also known as what?
SClera venous sinus
T/F: The Ciliary process secretes aqueous humor that goes from the anterior chamber through the pupil, to the posterior chamber and into the sclera venous sinus aka Shlemm’s Canal
False: The ciliary process secretes aqueous humor that goes from the posterior chamber through the pupil, to theanterior chamber and into the sclera venous sinus aka Schlemm’s canal
When you get hit in the eye, Hyphema can occur where the blood vessels that supply the ________, will actually fill the area with blood
A. Posterior Chamber
B. Schlemm’s Canal
C. Anterior Chamber
D. All of the above
Anterior Chamber
The Ciliary Body is involved in accomodation which involves 3 things
- Contraction of ciliary muscles to ________ (increase/decrease) the size of the ciliary body
- _________ (increase/decrease) tension on the Suspensory ligaments
- Lens becomes ________ (flattened/rounded) to see near
- Contraction of ciliary muscles to DECREASE the size of the ciliary body
- DECREASE tension of the Suspensory Ligaments
- Lens becomes ROUNDED to see nearby
