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PCO 3 > LACRIMAL SYSTEM EVAL > Flashcards

LACRIMAL SYSTEM EVAL Flashcards

1
Q

what comprises the afferent lacrimal system

A

secretory lacrimal system

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2
Q

basal tears are a part of which lacrimal system?

A

afferent / secretory

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3
Q

the secretory lacrimal system is responsible for what

A

tear production

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4
Q

the afferent lacrimal system has what two types of tears

A

basal tears and reflex trears

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5
Q

what are reflex tears

A

produced in response to ocular surface irriation or emotions

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6
Q

T/F there is 100x more basal tears than reflex tears

A

false

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7
Q

what system is responsible for tear drainage

A

excretory efferent lacrimal system

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8
Q

what is the efferent lacrimal system responsible for

A

tear drainage

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9
Q

T/F 90% of tears are drained by the nasepharynx and 10% evaporate

A

true

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10
Q

what percentage of tears evaporate?

A

10%

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11
Q

what percent of tears are drained by the naseopharynx

A

90%

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12
Q

what nerve innervates the lacrimal system?

A

lacrimal nerve, a branch of the opthalmic division of the trigeminal nerve (CN V)

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13
Q

the lacrimal nerve is a branch of what nerve

A

ophthalmic division of the trigemnial nerve (CN V)

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14
Q

T/F reflex tearing occurs with stimulation of branches of the opthalmic nerve or in response to external stimuli such as intense light

A

true

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15
Q

what are functions of the tear film

A

surface moist
lubricant
trap debris
remove epithelial cells
oxygen source
smooth refractive surface
antimicrobial
corneal hydration
ocular surface wound healing

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16
Q

what are the three layers of the tear film

A

lipid layer
aqueous layer
mucin layer

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17
Q

what produces the lipid layer of the tear film

A

meibomian glands, zeiss and moll glands

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18
Q

what is the function of the lipid layer

A

thicken, stabilize and decrease evaporation of the aqueous layer

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19
Q

what is the outermost layer of the tear film

A

lipid layer

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20
Q

in healthy eyes how thick should the lipid layer be

A

~0.10 um

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21
Q

t/f blinking releases the lipid layer

A

true

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22
Q

T/F forceful blinking releases more lipids

A

true

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23
Q

what is the middle layer of the tear film

A

aqueous layer

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24
Q

what produces the aqueous layer of the tear film

A

accessory exocrine glands of krause and wolfring

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25
Q

what is the function of the aqeuous layer of the tear film

A

provides oxygen to the cornea, cushions the globe from the eyelids and contains antimicrobial proteins

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26
Q

what are the antimicrobial proteins contained in the aqueous layer of the tear film

A

lactoferin and lysozymes

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27
Q

T/F Aqeuous layer tear film production rate decreases with age

A

True

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28
Q

What is the inner most layer of the tear film

A

Mucin layer

29
Q

what procudes the mucin layer of the tear film

A

goblet cells and tarsal crypts of Henle

30
Q

what is the function of the mucin layer of the tear film

A

lubrucate the lids and serves as the absorbing site for the aqueous layer, also performs waste management

31
Q

What layer of the tear film lubcircates the lids and performs waste management

A

Mucin Layer

32
Q

What will happen if the mucin layer of the tear film is disrupted or contaminated?

A

elicit tear break up

33
Q

What layer has these?
Cholesteryl esters
cholesterol
triglyceride
phospholipids

A

Oily layer (0.1um)

34
Q

What layer of the tear film has these
98-99% water
approx 1% inorganic salts
approx 0.2-0.6% proteins, globulins, and albumins
approx 0.02-0.06% lysozyme
rest: glucose, urea, neutral mucopolysaccharidse, and acidic mucopolysaccharides

A

Water Layer (8um)

35
Q

What Layer of the tear film has these?
Conjunctival and goblet cells

A

Mucin Layer 0.8um

36
Q

what percentage of tears pass through the nasolcarimal drainage system?

A

75%

37
Q

What system is composed of the Puncta, canaliculi, lacrimal sac, nasolacrimal duct

A

nasolacrimal system

38
Q

What can we use to evaluate the quality of the tear film?

A

Fluorescin staining, tear break up time, rose bengal/lissamine green

39
Q

What can we use to evaluate the quantity of the tear film?

A

Schirmer test 1 and 2, red phenol thread

40
Q

What ophthalmic dye penetrates areas of corneal epithelium and conjunctival epithelium where intracellular junctions are disrupted?

A

Fluroescein

41
Q

What dye will be observed under direct diffuse cobalt blue at low mag

A

Fluroescein

42
Q

T/F the wratten filter can be used with diffuse cobalt blue and fluorescein to observe the cornea

A

True

43
Q

What dye is used to evaluate cornea and conjunctival epithelium disruptions

A

fluroescein

44
Q

what dye is used in tear break up time

A

flourescein

45
Q

What test quantifies the stability of the precorneal tear film

A

tear break up time

46
Q

what test must be performed prior to anesthesia and tonometry

A

tear break up time

47
Q

T/F TBUT must be performed before any other procedure that may mechanically or pharmacologically alter the ocular surface

A

True

48
Q

These are the steps to what procedure?
1. apply fluroescein using a wet NaFl strip
2. under low mag w cobalt blue illumination scan the cornea. ask the patient to blink several times and stare ahead without blinking
3. count the seconds it takes for the first tear film breaks to appear

A

tear break up time

49
Q

what is the name of this mechanism? who was it described by? in what year?

A

Holly and Lamps mechanism for tear film break up
Desribed by Holly in 1973

50
Q

Values of less than 10s for TBUT

A

abnormal

51
Q

Values of 5-9s for TBUT?

A

borderline dry eye

52
Q

values of less than 5s for TBUT

A

indicates dry eye

53
Q

T/F perfroming TBUT after installing anesthesia may provide false positives

A

true

54
Q

What test is pictured?

A

TBUT w fluroscein dye

55
Q

toposcope is used for

A

non invasive tear break up time

56
Q

What dye is used in the picture?

A

Rose Bengal

57
Q

what dye is used in dectection of keratoconjunctivitis sicca and early detection of ocular surface disease

A

rose bengal

58
Q

T/F rose bengal is very painful and could be toxic

A

true

59
Q

T/F lissamine green is an alternative for rose bengal

A

true

60
Q

what dye is used in the picture

A

Lissamine green

61
Q

Lissamine green has an affinity for staining what?

A

dead and degenerated cells

62
Q

when evaluating with lissamine green, if illumination is too intense or bright what will happen to the contrast?

A

contrast will be diminished causing an underestimation of staining

63
Q

what is the following picture used to grade

A

staining

64
Q

What test measures primarily aqueous production due to the aqueous layer composing the largest part of the tear film and performed using Whatman no 41 filter paper?

A

Schimer Test I

65
Q

what filter paper does the Schimer test I use?

A

Whatman no 41 filter paper

66
Q

how much is the head of the whatman filter paper folded for the Schirmer test I?

A

5 mm

67
Q

What test has the procedure below
- apply strip w folded end onto lower lid margin at lateral canthus after dryer the excess tears, ask patient to look nasal and insert temporal, instruct pt to keep eyes open and blink normally

A

Schimer test I

68
Q

T/F in the Schimer test I you want to make sure the Whatman no 41 filter paper is touching the cornea at all times

A

FALSE

69
Q

What test is depicted in the picture

A

Schirmer Test I

PCO 3 (2 decks)

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