Module 1: Intro/Anatomy Flashcards
How large is the average eyeball
24mm
How many layers of the eye
3 layers
-Tough outer layer
-consists sclera and cornea
the 1st layer of the eye
-Rich vascular tissue
-consists of iris, ciliary body, and choroid
2nd layer of the eye
-Inner layer consisting of the retina
-light is changed to electric impluses sent to the brain
the 3rd layer of the eye
What do eyelids do
procect the globe and help spread tear film
space/distance between lower and upper eyelids
palpebral aperture
hold eyelids open by contracting, closing by relaxing
Levator palpebrae superioris
-produce lipid layer and tear film
-located posterios surface of lids
Meibomian glands
tiny opening located inner aspect of the lids
Punctum
-allow tear drainage
-connect to small canals
Puncta
-3 layers giving lubrication
-keeping eyes clear and comfortable
Tear film
-1st tear film layer
-produced by meibomian glands
-prevents tear evaporation
Lipid layer
-2nd tear film layer
-secreted by lacrimal gland
Aqueous layer
-3rd tear film layer
-secreted by goblet cells
-covers the surface of cornea/conjuctiva
Mucin Layer
located superior temporal of eye
Lacrimal gland
conjunctival epithelial cells
Goblet cells
-window of the eye
- 5 layers
-avascular/fibrous/transparent
Cornea
outer most layer/ 1st layer
Epithelium
Bowman’s membrane
2nd layer
Stroma
3rd layer, thickest
Descemet’s membrane
4th layer
Endothelium
5th layer, deepest
-tough white fibrous outer coating
-supportive tissue from optic nerve
-located at the posterior of the eye to the anterior surface.
Sclera
Extraocular muscles
attach to the sclera
-Loose structure
-fibrous/elastic tissue
-located at outer part of sclera
-contains blood vessels
Episclera
-junction of cornea and sclera
-location of surgical incisions
Limbus
-mucous membrane
-covers the globe adjacent to cornea
-covers visible sclera
-lines the inside eyelids
Conjunctiva
visible sclera
Bulbar conjunctiva
inside lining of the eyelids
Palpebral conjunctiva
pocket located at bulbar and palpebral conjunctiva meet
Fornix
space directly behind cornea/infront of iris
Anterior chamber
-clear fluid that fills anterior chamber
-creates pressure within the eye
Aqueous humour
normal range is between 13-20 mmHg
Intraocular pressure (IOP)
-coloured
-circular muscle
-located behind cornea
-directly infront of lens
-regulates amount of light enters eye, by changing size.
Iris
dim illumination causes pupil to enlarge called mydriasis
Dilator muscle
bright light causes pupil to contract called miosis
Sphincter muscle
-dark center surrounded by iris
-pathway to retina
Pupil
-located between retina and sclera
-rich in blood vessels
-provides oxygen and nutrients to retina and ciliary body
Choroid
-donut shaped muscle
-holds cystalline lens
-resting = pulls tightly= focused for distance
-contracting = relaxed = focused for near
-produces aqueous humor
Ciliary Body
the ability to focus between distance and near by contracting and relaxing the ligament
Accommodation
-produced by ciliary body
-located in the posterior chamber
-flows from posterior chamber to anterior chamber
-drains out to canal of schlemm
Aqueous humor
space between back of iris and front of lens
Posterior chamber
-circular channel located deep inside the limbus
-collects aqueous from anterior chamber to episcleral veins
Canal of schlemm
-transparent (colourless)
-suspended body in front of eyeball
-located between iris and vitreous
-brings rays of light to focus on retina
Crystalline lens
attach the crystalline lens to ciliary body
Zonular fibers
-delicate nerve layer
-10 layers thick
-contains sensitive photoreceptor cells (rods and cones)
Retina
-clear daytime vision
-colour enhancement
Cones
-dim lighting
-night vision
Rods
-small indentation/ pit
-inside retina
-highest amount of cones
-sharpest vision
Fovea centralis
-contains fovea centralis
-name means slightly yellow
- yellow spot on retina
Macula lutea
- soft jelly material
- fills up vitreous chamber
- transparent
- made of collagen fibers and water
- liquefies with age
- collagen fibers break off making floaters
Vitreous humour
- millions of fibers
- transfers visual info from retina to brain
Optic nerve
-the location where the optic nerve leaves the eye
-no sensory receptors
-the blindspot
Optic Disc
-anatomical pathway
-electrical signals made by retina
- sent to the brain
Visual pathway
-Step 1
- retinal fibers leave optic nerve
- half cross to the opposite side
-nasal fibers OD connect with temporal fibers OS
Optic Chiasm
-Step 2
-when nasal OD connects with temporal OS
-wraps around the midbrain
- connects to Lateral Geniculate Nucleus (LGN)
Optic Tract
-Step 3
- all axons must synapse (pass from one neuron to another)
-axons fan out through the deep white matter called optic radiations
Lateral Geniculate Nucleus (LGN
-Step 4
-deep white matter of the brain
-travel to posterior portion of brain to occiplital lobe
Optic Radiation
-Step 5
-inside the occipital lobe
-fibers join with brain cells
-produces images we see
Primary visual cortex
- 6 muscles
- responisble for moving the eyes
Extraocular muscles
Adduction (inwards)
Medial rectus
Abduction (outwards)
Lateral rectus
1) Elevation (upwards)
2nd) Intorsion, adduction
Superior rectus
1) Depression (downwards)
2nd) Extorsion, adduction
Inferior rectus
1) Intorsion (inward rotation)
2nd) Depression, abduction
Superior oblique
1) Extorsion (outward rotation)
2nd) Elevation, adbuction
Inferior oblique
-ability of both eyes to see 3D images
-eyes must function optimally
-relies on balanced motor and sensory
- eye not equal, images cannot fuse together
Binocular vision
double vision
Diplopia
-brain ignores fuzzy image
- caused by imbalance between OD and OS
Suppresion
movement of one eye from one position to another in one direction.
Duction
Movement of two eyes in the same direction
Version
OD and OS directed in opposite directions at same time
Vergence
-OD and OS rotate inwards towards each other
-near triad occurs
- pupil constriction
- accommodation
Convergence
OD and OS rotate outwards from each other
Divergence
-adjustment of the eye for seeing at different distances
-made by crystalline lens changing shape
Accommodation
-ciliary muscles contract
-zonular fibers of len relax
-lens shape becomes thicker
- age causes ciliary contraction declines
Near accommodation
-Age (40’s) causes ciliary muscles contraction to decline
-lens becomes harder
- loses ability to see near objects
- decline in accommodation
Presbyopia
Prepare call/email
- be familiar with phone and computer to prevent disconnecting or wrong line/ wrong person
-pad and pen next to phone
-answer phone promptly within 3 rings - voicemails and emails responded same day
- always smile when answering the phone
Train your voice
-use normal voice, never raised
-speak clearly, not too fast or will think your too busy
-dont use high pitch, seems busy or agitated
- low pitch is calm and confidence
-never eat or drink on the phone
Greetings
- all patients warm welcome (into your home)
- each visit like it’s their first time
-always indentify practice and Drs, yourself (with a smile) gag - emails need your name
-intro statement slow and clear
Watch your language
- language clear and conventional no slang
-dont use medical terminology they cause confusion, alarm and discourage px
-dont use short form or acronyms
-never use the word “ NO” * gag*
-“let me explain how we handle that” gag
Positive expressions
- call if you have any questions
-the doctor is booked up until…
-the doctors schedule has been interrupted
-im calling to reconfirm your appointment
-one of our patients re-scheduled
Negative expressions
-Call if you have any problems
-the drs are scheduled, they are available…
-the Dr is running behind
-im calling to remind of ur appointment
- one of our patients canceled
Take notes
- as soon as the px identifies write it down
-use px name during conversation
-repeat same words back to them
Be friendly
- nothing is more important than their call
-personalize the conversation
-let the caller hang up first
Listen carefully
-active listener “i see”, “uh-huh”, “yes”
-paraphrase
ask questions
- builds understanding
-purposeful and efficient
-open-ended
apologize
- alleviate tense situations
-never make excuses/pass blame
-be honest