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OPTM 5032 - Ocular Physiology > Eyelids > Flashcards

Eyelids Flashcards

1
Q

What are the 6 structures of the eyelids?

A

Skin

Subcutaneous layer

Muscles

Submuscular areolar layer

Fibrous layer

Palbebral conjunctiva

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2
Q

Three characteristics of skin

A
  1. Thin
  2. Elastic
  3. Fat Free
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3
Q

How often should people where sunglasses?

A

After 20 minutes or more in the sun

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4
Q

Blepharochalasis

A

Orbital fat herniation

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5
Q

Basal cell carcinoma is related to ____ _____ exposure

A

Ultraviolet radiation (UVR)

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6
Q

Are benign growths of the eyelid evenly or unevenly distributed between upper and lower lids?

A

evenly

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7
Q

Where are malignant tumors more common (upper or lower lid) ?How much more common?

A

4 times more common in the lower lid

(Eyebrow protects upper eyelid from sun)

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8
Q

Which muscle elevates the upper lid?

A

Levator Palpebrae Superioris

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9
Q

Which muscle closes the eyelids?

A

Orbicularis Oculi

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10
Q

What do the Müeller muscle fibers do?

A

Modulate position of lids of the open eye

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11
Q

What marks the insertion of the levator on the eyelids?

A

A fold of skin separating the palpebral from the orbital portion of the lid

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12
Q

The orbicular is is striated/unstriated and voluntary/unvoluntary

A

Striated Voluntary

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13
Q

What is the function of the orbicular is oculi?

A

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

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14
Q

Which nerve innervates the orbicularis oculi?

A

CN VII (Facial)

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15
Q

What happens with damage to the CN VII in the orbicularis oculi?

A

leads to dry eye condition, lagophthalmus, dut to inability to close eyelids

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16
Q

Levator palpebrae superioris is striated or unstraited

A

striated

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17
Q

Where does the levator become tendinous?

A

At the “aponeurosis of the legator” - where it enters the lid

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18
Q

Which nerve innervates the Levator?

A

CN III (Oculomotor nerve)

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19
Q

Where is the tarsal muscle, superior and inferior (Muller) found?

A

Found in the upper and lower lids, lines the levator internally

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20
Q

What happens when sympathetic innervation is damaged?

A

Droopy lid

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21
Q

Where is the submuscular areolar tissue and what is it?

A

Loose connective tissue between muscle and tarsal plate - fat free

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22
Q

What is the fibrous layer of the eyelid?

A

dense fibrous tissue that gives firmness and shape to the eyelids - known as the tarsal plate

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23
Q

Where is the collagen more developed (upper or lower) lid?

A

upper lid - allows lid to be everted

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24
Q

Upper eyelids are _____ and easily ____

A

flaccid everted

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25
Q

Floppy Eyelid Syndrome symptoms

A
  • patients present with burning and irritation of eyes
  • Contact between eye and pillow during sleep poor apposition of eyelid to globe
  • Meibomian gland dysfunction
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26
Q

How many Cilia in upper and lower lids?

A

100-150 upper

50-75 lower

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27
Q

What is the life span of the cilia?

A

3-5 months

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28
Q

How long does it take for forcibly removed cilia to regrow?

A

~2 month

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29
Q

What is the chief secretion of the eyelid?

A

Sebum - oily material secreted by the meibomian glands

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30
Q

The sebum forms which layer in the eye?

A

The superficial layer over the pre corneal tear film - slows evaporation of aqueous component

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31
Q

_____ on the glands will cause sebum to be excreted from the openings of the glands at the lid margins

A

Pressure

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32
Q

What secretes sebum and how many of them?

A

Meibomian glands ~30 glands

33
Q

Which other glands are found in the lids?

A

Accessory lacrimal gland tissue

Glands of Krause

Glands of Wolfring

34
Q

Arterial supply to the eyelids

A

Facial system (from external carotid artery Orbital system (from internal carotid artery)

35
Q

Venous drainage of the eyelids

A

Superficial (pre-tarsal) system

Deep (post-tarsal) system

36
Q

Lymphatics of the eyelids are dived into which two systems?

A

Superficial or pre-tarsal plexus

Deep or post-tarsal plexus

37
Q

Paralysis of CN 7 can cause the brow to be?

A

lower on the affected side

38
Q

Paralysis of CN 3 can cause what versus weakness

A

Paralysis - complete closure of the upper lid Weakness - ptosis of the upper lid

39
Q

Sympathetic paralysis can cause

A

minor ptosis

One of the components of Horner’s syndrome

40
Q

Strong or weak solutions of epinephrine applied topically will cause reversal of ptosis in sympathetic ptosis

A

Weak

41
Q

Function of the corrugator supercilli

A

pulls eyebrows together (frown)

42
Q

What happens in Bell’s phenomenon?

A

globe turns upward as the eyelids are forced closed

43
Q

What is reflex blinking?

A

rapid closure movement of short duration

44
Q

What causes reflex blinking?

A

External stimuli:

  1. Strong lights
  2. Approaching objects
  3. Loud noises
  4. Cornel, conjunctival, or ciliary touch
45
Q

What quantifies the corneal reflex?

A

an aesthesiometer

46
Q

In CL wearers the tactile corneal reflex is _______ slightly

A

dimished

47
Q

Two examples of blink reflexes

A

Dazzle reflex

Menance reflex

48
Q

The reflex blink is a _____-speed response to _____ and ______ stimuli

A

High Tactile Proprioceptive - detects motion

49
Q

What is blepharospasm

A

slow, sustained closure to nociceptive (pain) stimuli

50
Q

What can changed the regular basis of spontaneous blinking?

A

Level of visual activity

Emotional states

Environmental conditions (computer users)

51
Q

Spontaneous blinking is (high or low) in infants

A

low or absent

52
Q

Is spontaneous blinking present in blindness?

A

Yes; does not depend on optic stimulation

53
Q

What does the lower lid do during spontaneous blinking?

A

Remain almost stationary (most movement is done by upper lid)

54
Q

Spontaneous blink rates is?

A

~15 times per min

55
Q

What is the duration of the blink?

A

300-400 msec

56
Q

average time between blinks is?

A

2.8 sec

57
Q

obscuring visual input up to ____ msec is barely detectable but obscuring it greater than ____ msec is easily detectable

A

3 msec

30 msec

58
Q

What can give you temporary relief for blepharospasm? How long does it last?

A

Botulinum-A (botox) ~3 months

59
Q

Blepharospasm (raises or lowers) IOP?

A

raises

60
Q

What is myokymia

A

Fibrillary twitched of the eyelids

61
Q

What causes myokymia

A

fatigue

thyrotoxucosis

physical stress

62
Q

What is lagophthalmos?

A

incomplete closure of the eyes during sleep

63
Q

What is the result of lagophthalmos?

A

desiccation and excessive exposure of the lower portion of the cornea

64
Q

Ectropion is what?

A

a falling away of the lower lid away from the globe

65
Q

What causes ectropion?

A

weakness of the orbicularis

66
Q

What is the result of ectropion?

A

Epiphora or poor blink closure

67
Q

What is senile ectropion?

A

Loss of tone and loss of orbital fat deep to the eye with age

68
Q

Entropian vs. Ectropian

A

Entropian - lid turns toward the eye (contact between lashes and corneal surface)

Ectropian - turns away from the eye

69
Q

In which diseases is entropian a symptom?

A

Trachoma and ocular pemphigus

70
Q

The palbebral fissure is usual how wide and how long?

A

8-11 mm wide

27-30 mm long

71
Q

A large eye within a shallow orbit will appear as a?

A

prominent globe with a wider fissure

72
Q

Proptosis

A

forward movement of the globe within the orbit

73
Q

What will proptosis cause?

A

a widening of the palpebral fissure on the side

74
Q

In which disease is exophthalmos found?

A

Thyroid disease

75
Q

What is exophthalmos?

A

retraction of the upper eyelids (causes a widening of the palpebral fissure)

76
Q

The principal component in the apparent exophthalmos os thyroid eye disease is?

A

The degree of lid retraction (measurement of vertical palpebral fissure may be more important measurement than exophthalmometry)

77
Q

Exophthalmometry measurements range from ____ to ____ mm in normal subjects (mean of ____ mm) and ____ to _____ mm (mean of ____ mm in thyroid eye disease subjects

A

12-21 mm

16 mm mean

12-24 mm

18 mm mean

78
Q

What is Collier’s Sign of Thyroxicosis?

A

retraction of the upper lid(s)

79
Q

What is Von Grafe’s Sign of Thyroxicosis?

A

Delay of movement of the upper lid when shifting gaze from up to down; causes staring expression

OPTM 5032 - Ocular Physiology (9 decks)

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