Eye, Nose & Ear Flashcards
What are the 7 orbit bones?
Frontal Sphenoid Ethmoid Palatine Lacrimal Maxilla Zygomatic
*medial wall faces forward but lateral wall face laterally
Openings of Orbit: name bone and nerve
- Supraorbital foramen/notch:
Frontal bone; Supraorbital nerve: V1 terminal branch
Openings of Orbit: name bone and nerve
2. Optic Canal:
Sphenoid bone; Optic nerve and ophthalmic artery
Openings of Orbit: name bone and nerve
3. Superior orbital fissure:
Sphenoid bone; CN V1, ophthalmic division
-CN III, IV, and VI: blood vessels
Openings of Orbit: name bone and nerve
- Ethomodial foramina:
-Ethmoid bone; ethmoidal nerves and arteries (nasociliary, V1 branches)
Openings of Orbit: name bone and nerve
- Nasolacrimal canal: lacrimal bone and maxilla
Lacrimal bone and maxilla
-nasolacrimal duct: drainage of tear
Openings of Orbit: name bone and nerve
Inferior orbital fissure
sphenoid and maxilla
-venous plexus
What is the function of the lacrymal apparatus?
Tear production:
- moisture in the eye
- emotional expression
Drainage of tear:
- tear flows inferomedial across the eye to lacrimal canaliculi
- lacrimal canacliculi into the nasolacrimal duct (opening in the inferior meatus of nose)
What is the shuttle nerve for visceral motor innervation of the lachrymal apparatus:
CN V: Trigeminal N. as the shuttle
What is the sympathetic and parasympathetic visceral motor innervation of the lachrymal apparatus:
Sympathetic: postganglionic axons from the superior cervical ganglion to form deep petrosal nerve
-postganglionic fibers hike zygomatic nerve (V2) to lacrimal (V1)
Parasympathetic: preganglionic axons from CN VII: facial n. to from greater petrosal nerve
- *cross pterygoid canal: nerve of pterygoid canal**
- preganglionic axons form synapse in the pterygopalatine ganglion
What are the three layers of the orbit wall?
Out layer
- sclera: white dense (most of the eyeball) - cornea: clear dense for light passing through
Choroid: blood vessel plexus
Retina: sensory circulation
These are contents of what structure? anterior and posterior chamber -Iris: pupil -pupillary light reflex -Ciliary body: lens -Vitreous body: humor
Contents in the eyeball
What is the somatosensory innervation for the orbit?
Ophthalmic N. (V1) from CN V
What is the neurovascular orbit supply (medial to lateral for the main branches V1)?
Nasociliary nerve
Frontal nerve: ciliary nerve, supratrochlear and supraorbital nerves
Lacrimal nerve: smallest branch
*NFL
What is the blood supply of the orbit?
Ophthalmic artery from the internal carotid artery
What are the branches of the ophthalmic artery?
Central retinal artery Ciliary artery Supraorbital artery Ethmoidal artery Lacrimal artery
What does the supraorbital artery give blood supply to?
scalp and eye
What is the sympathetic and parasympathetic: visceral motor innervation of the eyeball?
Sympatehtic: postganglionic fibers from superior cervical ganglion. hike long/shhort ciliary nerve
Parasymapthetic: preganglionic fibers from CN III (Oculomotor N.) to for, ciliary ganglion
In the eyeball what does the ciliary body do?
modulate size of lens
What is the innervation of the ciliary body?
Only innervated by the postganglionic fibers from ciliary ganglion (parasympathetic)
What is the sympathtic function of te Iris?
dilate the pupil
What is the parasympatetic funtion of the Iris?
Constrict the pupil-pupillary light relfex
What CN is the afferent (toward) for the Iris?
Afferent; CN II
What CN is efferent (away) for the Iris?
Efferent; CN III
What syndrome is this referring to:
- must be balanced
- Constructed pupil
- eyelid ptosis
- no sweating on affected side
Horner’s Syndrome
What are the structures of the eyelid?
Msucle tendons
Orbital septum
Palperbral ligamnet: Lateral/medial
Tarus plate: superior/inferior
What is the nerve innervation for the eyelid?
V1: opthalamic (superior) and V2: maxillary (inferior) terminal nerve branches
What is the blood supply for the eyelid?
anstomosis of external and internal cartis arery terminal branches
What are the functions of the eyelid?
- Protecting
- Facial expression
What is the function of the orbicularis oculi:
orbital part:
palpebral part:
Close eyelid
wink
blink
What is bell’s palsy?
cant close eye
What is the nerve innervation of Orbicularis oculi:
CN VII (Facial N.)
What is the function of the Levator Palpebrae Superioris?
Open eyelid
What is the muscle attachment of the levator palpebrae superioris? (proximal/distal)
prox: common tendinous ring attcahing posterior orbital wall
distal: upper eyelid
What nerve innervates the levator palpebrae superioris?
What deficit is can be related to this muscle/nerve?
CN III: Oculomotor
Fully ptosis: dangerous triagnle/cavernosus sinus
Superior tarsal muscle function:
Open eyelid (open eyelid further when excited)
What is the muscle attachment of the superior tarsal muscle? (prox/distal)
Prox: musculotendinous junction of levator palpebrae superioris
Distal: superior tarsal plate
What is the nerve innervation of the Superior Tarsal muscle?
What deficit can be related to these muscles?
Sympathetic innervation from superior cervical ganglion
Horners syndrome (sympathetic non-functional), partial ptosis (drooping eyes)
All extraocular msucles EXCECPT the inferior oblique proximal attachment is the common tendimous ring attaching the psoteror orbit wall. T or F?
True
What nerve innervates the 4 rectus muscles?
Inferior, Medial and Superior rectus muscles are innervated by CN III (oculomotor)
Lateral Rectus inervated by CN VI (abdunces)
-which means it abducts
What is the proximal attachment of the inferior oblique?
medial orbital of maxilla
What is the nerve innervation of the 2 oblique muscles?
CN III (oculomotor)- inferior oblique CN IV (trochlear) - superior oblique
What is the function of the superior oblique?
eyeball rolls down and outward
What is the function of the inferior oblique?
eyeball rolls up and outward
What is Esotropia:
adducted eyeballs; CN VI (abducens) palsy
What is Exotropia:
Abducted eyeball; medial rectus not working
What is hypertrophia:
Elevated eyeball(s): CN IV palsy
What is Hypotropia:
depressed eyeball(s): inferior oblique not working (CN III)
What are the three parts of the ear?
External ear
Middle ear
Inner ear
Location of the External ear:
from auricle tympanic membrane
Location of the middle ear:
tympanic cavity, between tympanic membrane and bony cages for vestibulocochlear
What connects the middle ear to the nasopharynx?
-pharyngotympanic tube/eustachian tube: connecting middle ear to the nasopharynx
Location of the inner ear:
-from vestibulocochlear organs to the internal acoustic meatus
What is elastic cartilage and the scaffold
Aurcile
Auditory ossicles: from lateral to medial
Malleus
Incus
Stapes
External Ear: sensory innervation
Tip of Ear Posteroinferior Center Posterior auditory canal External acoustic meatus:
CN V (trigeminal)
C2 spinal nerves
CN X (vagus)
CN VII/IX and X (facial, glossopharyngeal, vagus)
V3, CN VII, IX, & X (mandibular, facial, glossopharyngeal, vagus)
Middle ear: sensory innervation
CN IX: glossophyrngeal n.
-viseral motor for mucosla glands, somatic snesory for general sensation
Internal ear: sensory innervation
special sensation organs- hearing nd proprioception/balance
What are the boundaries of the middle ear/tympanic cavity?
Anterior: internal carotid Lateral wall: tympanic membrane Medial: labyrinthine Roof: tegmental part of the temporal bone (middle cranial fossa) Posterior: mastoid sinus (aditus) Floor: internal jugular
What nerve innervates the anterior border of the tympanic cavity
lesser petrosal nerve
What nerve innervates the lateral wall of the tympanic cavity
CN V
-muscles malleus and tensor tympani
What nerve innervates the medial border of the tympanic cavity
lesser petrosal nerve- otic ganglion for parotid gland
CN VII: Facial N.
What nerve innervates the posterior border of the tympanic cavity
CN VII: Facial N.
What is hyperacusis?
a disorder in loudness perception
What is the nerve innervation for tensor tympani
CN V3 (trigeminal/mandibular)
What is the function of the tensor tympani?
tensing tympanic membrane, decreasing vibration thus dampening chewing noise
coordinated with mastication muscles innervated by CN V3
What is the nerve innervation for the Stapedius muscles?
CN VII: Facial N.
What is the function of the Stapedius muscles? (smallest muscle in the body)
dampening vibrations passed to the cochlea via the oval window
What are the two compartments of the internal ear?
Cochlear and Vestibular compartment
What is the function of the cochlea compartment of the inner ear?
hearing through cochlear CN VIII (Vestibulocochlear N.)
What is the function of the vestibular compartment of the inner ear?
proprioception and balance CN VIII: (Vestibulocochlear N.)
What is the function of the Vestibulo-ocular reflex (VOR)
stabilize the vision
-when driving head is wobbly all the time but stabilize gaze
What is the vestibulospinal reflex?
maintain upright posture
VCR is one subtype but specialized VSR
What is vestibulocollic reflex?
No bobblehead
neck muscles contract/relax according to to head position detected by the vestibular system
Wrong/insufficient motor response can result to fall and injury is called what
Imbalance: Colles/Smith facture
Boundaries of the nasal cavity:
Lateral wall: irregualr
Medial wall: nasal septum
Roof: narrow-frontal ethmoidal sphenoidal
Floor: broad- maxilla (palatine processes) and palatine bone
Functions of the nasal cavity:
Repiraton
Olfactions
Drainage spaces if crinal sinuses and lacrimal gland
Functions of the drainage sinuses into the nasal cavity
Produce mucus to moisturize nasal cavity
Lighten the skull
Improve voice
Innervation of the nasal cavity:
Olfactory nerve CN V2 (somatic sensory)
Nasopalatine nerve V1 or V2?
V2
What is the parasympathetic innervation of the nasal cavity (except vestibule)
Facial nerve
Hiking V1/V2
What is the blood supply of the nasal cavity?
Internal and external carotid a.
food stimulates the soft palate, elevates and prevents food get into the nasal cavity, and pharynx/larynx muscle contract to move food down the esophagus
- Afferent:
- Efferent
Swallowing reflex
Afferent: CN IX
Efferent CN X
CN X: innervates most of the ear?
True:
- center
- post. auditory canal
- prominence ant. canal
- external acoustic meatus
Where is the tympanic cavity located, external ear, middle ear or internal ear?
middle ear
Tensor tympani and mastication muscles are innervated by
CN V3
What ear muscles dapens chewing noises?
Tensor Tymani
What ear msicles dapens vibration passed to chochlea?
Where does mastoid sinus drain?
Middle ear through aditus, pharyngotympanic tube to nasopahrynx