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Ocular Physiology > Eyelids > Flashcards

Eyelids Flashcards

1
Q

What is Blepharochalasis?

A

Orbital fat herniation into the eyelid that causes droopiness and puffiness of the eye.

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2
Q

What structure of the eyelid is very thin, elastic and fat free?

A

Skin.

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3
Q

True or False: Benign growths are evenly distributed between upper and lower lids.

A

True.

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4
Q

Malignant tumors are four times more common in which lid? Why?

A

Lower lid. Upper eyelid has eyebrows to protect the eyelid from sun.

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5
Q

What is the action of the levator palpebrae superioris muscle?

A

To elevate the upper lid.

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6
Q

What is the action of the orbicularis oculi muscle?

A

Closes the lids, helps hold the lid tightly against the eye, which assists in spreading tears and flushing away waste products.

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7
Q

What is the action of Mueller muscle fibers?

A

To modulate position of lids of the open eye and to keep it open.

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8
Q

A fold of skin separating the palpebral from the orbital potion of the lid marks insertion of what muscle?

A

Levator.

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9
Q

Absence of the fold is seen during what condition?

A

Ptosis.

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10
Q

Orbicularis oculi is what type of muscle?

A

Striated and voluntary.

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11
Q

Which cranial nerve is orbicularis oculi innervated by?

A

CN VII (facial).

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12
Q

Paralysis of CN VII for the orbicularis oculi results in what?

A

Dry eye condition, lagophthalmus, due to an inability to close the eyelids.

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13
Q

Levator palpebrae superioris is what type of muscle? Which lid is it found in?

A

Striated; Only upper eyelid.

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14
Q

Once the levator palpebrae superioris becomes tendinous as it enters the lid, it is now known as what?

A

Aponeurosis of the levator.

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15
Q

Which cranial nerve is the levator palpebrae superioris innervated by?

A

Superior division of oculomotor CN III.

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16
Q

The tarsal muscle (both superior and inferior position aka Mueller) is innervated by the parasympathetics or sympathetics?

A

Sympathetics.

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17
Q

Damage to the sympathetics causes what?

A

Droopy eyes.

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18
Q

What is submuscular areolar tissue and where is it found?

A

Loose connective tissue between muscle and tarsal plate. It’s fat free.

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19
Q

Dense fibrous tissue that gives firmness and shape to eyelids is known as what?

A

Tarsal plate.

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20
Q

What allows the upper eyelid to be everted?

A

Collagen being more developed in the upper lid.

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21
Q

What is Floppy Eyelid Syndrome?

A

Upper eyelids flaccid and easily everted. Tarsal plate loses its elasticity.

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22
Q

What are symptoms of Floppy Eyelid Syndrome?

A

Burning and irritation of eyes, contact between eye and pillow during sleep, inadequate spreading of tear film, meibomian gland dysfunction.

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23
Q

Floppy Eyelid Syndrome is often associated with what?

A

Sleep apnea.

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24
Q

How many eyelashes are in the upper and lower eyelid?

A

100-150 upper cilia and 50-75 lower cilia.

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25
Q

How long do eyelashes last?

A

2-5 months.

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26
Q

How long does it take for forcibly removed eyelashes to grow back?

A

2 months.

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27
Q

Chief secretion of the eyelid is what? What part of the eyelid secretes this?

A

Sebum, oily material secreted by meibomian glands.

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28
Q

What is the purpose of the oily layer in the tear film?

A

Slows evaporation of the aqueous component and allows for hydrophobic barrier to prevent tear spillage.

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29
Q

What is in the tear film from deep to superficial?

A

Mucous, Aqueous, Oil.

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30
Q

What are meibomian glands?

A

Tarsal glands, modified sebaceous glands located within the lid margin that secrete sebum, or oily layer of the tear film.

31
Q

Blood supply of the eyelid is through what two systems?

A 
Facial system (from external carotid artery) and orbital system (from internal carotid artery). 
Arteries in the lid anastomose (form two transverse arcades per eyelid).
32
Q

Venous drainage of the eyelid is through what two systems?

A

Superficial (pre-tarsal) system and deep (post-tarsal) system.

33
Q

Lymphatics of eyelids and conjunctiva is divided into what two systems?

A

Superficial or pre-tarsal plexus and deep or post-tarsal plexus.

34
Q

Paralysis of CN VII causes what?

A

Causes eyebrow to be lower on affected side.

35
Q

Weakness of CN III in the levator palpebrae superioris causes what?

A

Ptosis of the upper lid.

36
Q

Paralysis of CN III in the levator palpebrae superioris causes what?

A

Complete closer of the upper lid.

37
Q

Sympathetic paralysis of Mueller’s muscle causes what? This is one of the components of what syndrome?

A

Minor ptosis, droopy eyes. Horner’s syndrome.

38
Q

What is one way of treating sympathetic paralysis of Mueller’s muscle to stop eye droopiness?

A

Weak solutions of epinephrine causes reversal of the ptosis secondary to sympathetic paralysis.

39
Q

What is Horner’s syndrome?

A

Ptosis, miosis (constriction of pupil), anhydrosis (sweating decreased).

40
Q

What is the action of the frontalis muscle?

A

Raises eyebrow.

41
Q

How many portions does the orbicularis oculi have?

A
  1. Orbital, palpebral, ciliary, lacrimal.
42
Q

What is the action of the corrugator supercilii muscle?

A

Pulls eyebrows together (frown).

43
Q

What is Bell’s phenomenon?

A

The globe turns upward as the eyelids are forced closed.

44
Q

What is reflex blinking?

A

Involuntary blinking of the eyelids elicited by stimulation of the cornea and tactics, optics, and auditory sensations like: touch, strong light, approaching objects, loud noise.

45
Q

What quantifies as the corneal reflex?

A

Aesthesiometer.

46
Q

When does the tactile corneal reflex become diminished slightly?

A

In contact lens users.

47
Q

A natural, high-speed response to tactile and proprioceptive stimuli is what?

A

Reflex Blink.

48
Q

A slow, sustained closure to nociceptive (pain) stimuli is what? (twitch, involuntary closure of eyelid).

A

Blepharospasm.

49
Q

When does spontaneous blinking occur?

A

On a regular basis without external stimulus.

50
Q

Computer users, or any activity that involves increased attention causes blink rate to what?

A

Decrease.

51
Q

Is the blinking rate or infants high or low?

A

Low.

52
Q

During blinking, most of the movement is caused by which eyelid?

A

Upper. Lower remains relatively stationary.

53
Q

During each blink, how does the palpebral fissure narrow?

A

A zipper-like motion laterally to medially.

54
Q

Where does the tears move into?

A

Puncta.

55
Q

What is the spontaneous blink rate?

A

15 blinks per minute.

56
Q

What is the duration of each blink?

A

300-400 msec.

57
Q

What is the average time between blinks?

A

2.8 seconds.

58
Q

What is voluntary winking?

A

Consciously initiated closure of one eye.

59
Q

Most people can freely wink in which eye?

A

Left, due to the predominance of right-handedness.

60
Q

What is blepharospasm?

A

An idiopathic disorder of neuromuscular control of orbicularis oculi that results in simultaneous bilateral, symmetrical, progressive, involuntary closure of both eyes.

61
Q

Does blepharospasm raise or lower IOP? How is this relieved?

A

Rasies; botulinum-A toxin (botox).

62
Q

What is myokymia? Is it related to the severe dystonias? How is it caused?

A

Fibrillary twitching of the eyelids; no; caused due to fatigue, thyrotoxicosis, and stress.

63
Q

Incomplete closure of the eyes during sleep resulting in desiccation and excessive exposure of the lower portions of the cornea is called what?

A

Lagophthalmos.

64
Q

A falling away of the lower eyelid away from the globe is called what?

A

Ectopion.

65
Q

What causes ectopion and what does this result in?

A

Weakness of orbicularis muscle; results in epiphoria (overflow of tears down face) and poor blink closure.

66
Q

A turning in of the eyelid is known as what?

A

Entropion.

67
Q

What is a result of entropion?

A

Trichiasis.

68
Q

How wide is the palpebral fissure vertically and horizontally?

A

8-11 mm vertically 27-30 horizontally.

69
Q

Forward displacement of the eye causes the palpebral to what?

A

Widen.

70
Q

Exophthalmos is seen in what type of disease?

A

Thyroid Disease.

71
Q

True or False: Retraction of the upper eyelids causes a widening of the palpebral fissure.

A

True.

72
Q

Collier’s sign is?

A

Retraction of the upper lid(s).

73
Q

Delay of movement of the upper lid when shifting gaze from up to down and causes a staring expression is known as what?

A

Von Grafe’s Sign.

Ocular Physiology (6 decks)

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