LACRIMAL GLAND PART 2 Flashcards
what does the schirmer’s tear test test for? when do you do this test? (quantitative test)
quantity of tears produced. you do this test when patient has dry eye or excessive watery eye.
describe the schirmer’s test.
give anesthesia, wait a minute, put tear film on temporal side of eye, record result after 5 minutes. Measure wet part of strip: 15mm or more is normal. for patients 60 yrs or older 10mm may be normal.
What does a qualitative tear film test for? name the two types of tests.
tear film stability.
TBUT (tear break up time)= invasive (10 seconds or less)
Results:
normal (clear, clear, clear)
not normal (clear, blurry after blink, clear)
Keretometer mire= noninvasive (10 sec or less)
what affects the outcome of schirmer’s test? how can you get a false negative?
if you place strip on nasal side instead of temporal side can get false negative result.
Also, reflex tearing, effects of anesthesia, age variation, and subjective measurement.
How much tears define normal, mild, moderate or severe dry eye in schirmer’s test?
After 5 min: normal tears= 15mm or more mild dry eye= 14mm-9mm moderate dry eye= 8-5mm severe dry eye= 4mm or less
what does an ocular surface assessment do?
test surface of integrity by using tissue sampling cytology and staining techniques in eye.
What is the function of acinar cells do in lacrimal gland?
secrete fluid composed with electrolytes, similar to the plasma
what does the Na+ K+ ATPase pump do?
sends Na+ and water out and lets K+ in.
what is the difference between hypertonic and isotonic?
hypertonic= low pressure isotonic= high pressure
what do ductal cells do in lacrimal glands?
ductal cells modify acinar cell fluid by secreting fluid rich in KCl.
what is the difference between lacrimal fluid and plasma?
higher K+ and Cl- concentration.
The secretory cells of the lacrimal gland are innervated by what?
nerves innervated by secretory cells and steroids and peptides found in the blood that stimulate secretion
the lacrimal gland is innervated by what?
parasympathetic, sympathetic, and sensory nerves.
which one is the main contributor of tear production in lacrimal gland….Sympathetic or Parasympathetic nerves?
Parasympathetic fibers of CN VII is the main contributor of tear film and secretion.
Stimulation of sympathetic nerves produces no change in tear film.
stimulation of the lacrimal secretory cells can be caused by?
norepinephrine, bright light hitting optic nerve, sensory nerve at optic surface, acetylcholine and VIP (Vasoactive Intestinal Protein)
what is the function of the conjunctiva?
Provides passage for the secretion produced by the lacrimal gland and accessory lacrimal glands
Sero-mucous secreting tissue
conjunctiva reactions can be provoked by what?
allergy, infection or inflammation
reactions to conjunctiva are characterized by what two structural changes?
papillae formation and follicle formation
papillae has macrophages and lymphoctyes…..true or false.
false….follicles are made of macrophages and lymphoctyes.
follicles have blood vessels above and below but never inside. true or false
true. follicles are viral.
where is papillae commonly found on upper or lower lid? what are they composed of?
upper eyelid. they are composed of neutrophils an eosinophils.
papillae have blood vessels in the center. True or False.
true. usually found in contact lens wearers.
Are eosinophils and basophils present in normal conjunctiva epithelium? If not, what conditions are they present in?
No. they are present in two conditions. Vernal conjunctivitis
Giant papillary conjunctivitis
If a contact lens has dislocated and cannot be seen in the eye, where should you check first?
superior fornix. has the greatest depth. not possible for contact to go to back of eye.
