Motor Control Flashcards

1
Q

What is motor control?

A

Motor control involves a dynamically changing mix of conscious and unconscious regulation of muscle force, informed by continuous and complex sensory feedback, operating in a framework sculpted by evolutionary pressures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the types of motor control?

A

Voluntary: running, walking, talking playing guitar etc.,…….
Involuntary: eye movements, facial expressions, jaw, tongue, postural muscles throughout trunk, hand and fingers, diaphragm, cardiac, intercostals (around lungs), digestive tract……

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the key concepts of motor control?

A

Motor control governed by lower and upper motor neurons.

•The lower motor neuron begins (has its cell body) in brainstem or spinal cord and projects to the muscle

•The upper motor neurons originate in higher centres and project down to meet the lower motor neurons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do basal ganglia and cerebellum differ?

A

In the sensorimotor system

Basal ganglia - what to do
Cerebellum - how to do it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the overview of the sensorimotor system?

A

A descending controls system but with lots of ascending feedback

Association cortex -> motor cortex -> brainstem circuits -> spinal circuits -> motor unit -> effect on world -> sensory systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do muscle fibres act?

A

Individual muscle fibres act in an ‘all-or-none’ manner, and so control of muscle force depends on the way in which lower motor neurons activate different types of muscle fibre.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are muscles like?

A

Make up about 40% of body weight
•Three types: cardiac, smooth, skeletal

•Smallest is the stapedius, found in the inner ear
•Largest is the gluteus maximus, found in the hip/buttock
•Strongest (based on weight) is the masseter, found in the jaw
•Hardest working?
•Heart (3 billion beats over average lifetime [no rest!])
•Eye muscles (10,000 precisely controlled movements in 1 hour of reading)
•Neck (keeps your 5Kg head in position)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How do muscles act?

A

Muscles can only contract or relax (i.e. stop contracting)
•The activation of muscle fibres is all or none
•So how do we achieve such a range of movements and forces ??
•Antagonistic arrangement – combined co-ordinated action
•Recruitment of muscle fibres – fast/slow twitch, small and large motor units (see later)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are muscle fibres like across individuals?

A

The number of muscle fibres varies across individuals, but changes little with either time or training – appears to be genetically determined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do muscles contract?

A

A skeletal muscle is attached to the bone by the tendon
•A skeletal muscle comprises several muscle fasciculi (group of muscle fibres)
•A muscle fasciculus comprises several muscle fibres (= muscle cells)
•A muscle fibre is constituted of several myofibrils
•Myofibrils contain protein filaments: Actin and Myosin myofilaments
•When the muscle fibre is depolarised actin and myosin slide against each other which produce muscle contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the myosin cross-bridge cycle?

A

Release of the neurotransmitter acetylcholine (ACh) triggers a biochemical cascade in muscle cells.

calcium ions, magnesium ions and ATP (energy)

Actin involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the rigor mortis?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does the myosin cross-bridge cycle occur?

A

The release of acetylcholine causes a cascade of events resulting in the release of packets of calcium from inside the muscle cell (fibre)

This causes the myosin head to change shape, enabling it to bind with the actin filament

ATP (provides energy for cells) is required to break the bond between the myosin head and the actin filament

ATP is produced by oxidative metabolism, which stops upon death

So the muscle become contracted and remain that way until enzymes begin to disrupt the actin/myosin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a motor unit?

A

Motor unit = single alpha () motor neuron + all the muscle fibres it innervates – Different motor neurones innervate different numbers of muscle fibres – fewer fibres means greater movement resolution - those innervating finger tips and tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are motor units like?

A

The motor unit is the final common pathway for motor control
• Activation of an alpha motor neuron depolarises and causes contraction of all muscle fibres in that unit (all or none)
• Muscle fibres innervated by each unit are the same type of fibre and often distributed through the muscle to provide evenly distributed force (and may help reduce effect of damage)
•More motor units fire – more fibres contract – more power

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the control of muscle force like?

A

Average number of muscle fibres innervated by single motor neuron (a motor unit) varies according to two functional requirements for that muscle:
1. Level of control
2. Strength
Typically a range of motor units in a muscle, some with few, some with many fibres.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the size principle for control of muscle force?

A

Size Principle
Control of Muscle Force
Units are recruited in order of size (smallest first)
Fine control typically required at lower forces
Try playing the violin with weights attached to your arms!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the speed of muscle fibres?

A

Slow
Fast fatigue resistant
Fast fatigable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the difference between between fast and slow muscle fibres?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are lower (alpha) motor neurons?

A

Originating in the grey matter of the spinal cord, or in the brainstem, an alpha motor neuron and the muscle fibres it connects to represent the ‘unit of control’ of muscle force.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the motor pool?

A

All the lower motor neurons that innervate single muscle

•The motor pool contains both the alpha and gamma motor neurons (see later)

•Motor pools are often arranged in a rod like shape within the ventral horn of the spinal column

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where do alpha motor neurones originate from?

A

Alpha Motor Neurons originate in the Spinal Cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the arrangements for alpha motor neurons?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are alpha motor neurone origination like?

A

Cell bodies in the ventral horn: activated by:
•Sensory information from muscle
•Descending information from brain

Note the closeness and prominence of sensory input to the dorsal horn indicated in this diagram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is sensing in muscles?

A

Muscles can be contracted or relaxed to provide movement, but a good control system (the CNS) needs to know two things:
(1)how much tension is on the muscle;
(2)what is the length (stretch) of the muscle

Key part in proprioception

Golgi tendon organs sense tension

Muscle spindles sense stretch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are Golgi tendon organs like in muscle tension (force)?

A

The GTO is within the tendon (where the muscle joins to bone)
•Mostly, it sends ascending sensory information to the brain via the spinal cord about how much force there is in the muscle
•Critical for proprioception

Under conditions of extreme tension, it is possible that GTOs act to inhibit muscle fibres (via a circuit in the spinal cord) to prevent damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are muscle spindles like In muscle length (stretch)?

A

Muscle spindles sense the length of muscles, i.e. the amount of stretch

•This information forms a key part of reflex circuits…….

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the reflex circuits?

A

C5 – Biceps

C6 – Biceps, Brachioradialis

C7 – Triceps

L4 – Patellar (knee jerk)

S1 – Achilles (ankle jerk)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are reflexes like?

A

Reflexes can be quite simple or quite complex. They can operate without engaging with the brain, and are critical for the avoidance of injury and effective motor control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the reflex circuit?

A

Most simple reflex – MONOSYNAPTIC – e.g. the patellar tendon reflex

Extradural and intramural muscle fibres etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the reflex circuit?

A

Most simple reflex – MONOSYNAPTIC – e.g. the patellar tendon reflex

Extradural and intramural muscle fibres etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What system detects stretch?

A

We need a system to detect stretch regardless the current muscle length
If intrafusal muscle fibre is controlled by same motor neurons as extrafusals, when muscle is slack (or taught), the system won’t be sensitive to slight changes
So, intrafusal fibres are innervated separately, by gamma () motor neurons
They keep the intrafusal fibres set at a length that optimises muscle stretch detection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the imp of muscle spindle feedback?

A

An efficient motor control system needs to know how much each muscle is stretching – information provided by muscle spindles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What occurs in muscle spindle feedback?

A

Embedded within most muscles
Composed of intrafusal fibers
Detect stretch regardless of the current muscle length
Sensory fibres are coiled around the intrafusal fibers
Intrafusal fibers are innervated separately, by gamma () motor neurons
They keep the intrafusal fibers set at a length that optimizes muscle stretch detection

Muscle sensory receptors = muscle spindles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the simplest reflex?

A

Stretch reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What occurs in the quadruped reflexes?

A

In quadrupeds, sequence and precise control of limb movements appears complex and is substantially altered by speed changes (e.g. walk, trot, gallop)
Under control of higher brain centre…?
NO!

Quadrupeds will walk on treadmill if weight supported if spinal cord damaged at thoracic level
Will change to appropriate patterns of limb movement as treadmill speed is altered
Complex reflex system responding to nothing more than stretch of muscle spindles!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What occurs in the withdrawal reflex?

A

Reciprocal Innervation

Principle described by Sherrington (also called Sherrington’s Law of reciprocal innervation)

Reciprocal innervation of antagonistic muscles explains why the contraction of one muscle induces the relaxation of the other

Permits the execution of smooth movements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the buttered cat paradox?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Why do cats always land on their feet?

A

More complex reflexes (4)!

The righting reflex, or vestibular righting reflex

Vestibular system detects that the body is not upright (orientation), as well as any acceleration due to gravity (i.e. falling)

Information from the vestibular system is combined with visual, somatosensory and proprioceptive sensory input in order to specify a pattern of motor activity that will restore ‘uprightness’ and a safe landing

The cerebellum, which compares the intended motor plan with the actual situation is critical for computing the desired motor activity (see next in lecture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is variable muscle force provided by?

A

Variable muscle force is provided by gradual recruitment of motor units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

why is it so hard to build robots that can walk, run, track moving objects with robotic eye etc….?

A

Control of gross movement patterns (which can be quite complex) can be devolved to simple spinal circuitry, but constant modulation based on sensory feedback is required to account for the unexpected.
•Higher CNS centres constantly adjust ongoing activity to resolve conflicting demands on the motor system and direct it towards goals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the brainstem structures like?

A

Pathways and nuclei within the brainstem (and midbrain) connect sensory input to motor output in quite direct ways, providing an evolutionarily ancient but still very important control system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the ancient brainstem motor control?

A

without cortical involvement

e.g. balance and postural control

…also orienting, gross limb movement/positioning

Vestibular organ - effects on oculomotor control - head movement - vertical positioning of eyes

e.g. branches of vagus nerve project to larynx to control speech – this circuit richly interconnected with cerebellum and other brainstem sensorimotor systems

Also control of respiration!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is a combination of ancient and modern cooperation?

A

Speech : primitive sounds sculpted by cortex

In many motor activities, ancient and modern (cortical) control systems work co-operatively…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the primary motor cortex like?

A

Primary motor cortex exerts quite direct, top down control over muscular activity, with as few as one synapse (in the spine) between a cortical neuron and innervation of muscle cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are descending projections from cortical motor areas?

A

Motor command originates in motor cortex pyramidal cells (in layer 5-6, grey matter).
•These are the upper motor neurons.
•Pyramidal cell axons project directly or indirectly (e.g. via brainstem) to spinal cord, where they synapse with lower motor neurons.
•The axons of these upper motor (pyramidal) neurons form the pyramidal tract
•Most cortical projections innervate contralateral motor units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the hommunculus?

A

Homunculus is a reasonable representation, but an oversimplification: damage to a single finger area doesn’t mean loss of voluntary control of that finger.
•Representations are more complex and overlapping
•After all, few motor commands require isolated activation of a single motor unit

Involved In motor control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is an overview of motor control?

A

But the Basal Ganglia and Cerebellum are doing quite different things, not just opposing one another (simplified schematics have their limits!)

49
Q

What are the Descending Projections from Motor Cortex?

A
50
Q

How are the dorsolateral and ventromedial tracts similar?

A

Both contain a direct corticospinal route
Both contain an indirect route via brainstem nuclei

51
Q

What occurs in the dorsolateral tract?

A

Via red nucleus
Innervate contralateral side of one segment of spinal cord
Sometimes project directly to alpha motor neuron

Project to distal muscles, e.g. fingers

52
Q

What occurs in the ventromedial tract?

A

Via tectum, vestibular nuclei, reticular formation & cranial nerve nuclei
Diffuse innervation projecting to both sides and multiple segments of spinal cord

Project to proximal muscles of trunk and limbs

53
Q

How movement modulated by basal ganglia and cerebellum?

A
54
Q

What is the basal ganglia?

A

A group of structures beneath the cortex that act as a ‘gate-keeper’ for control of the motor system (muscles)

55
Q

What is the basal ganglia like?

A

The basal ganglia are a group of nuclei lying deep within cerebral hemispheres
•Widely studied (including here at Sheffield)
•Role in motor control not fully understood
•Basal ganglia dysfunction implicated in many disorders

56
Q

What is the basal ganglia involved in?

A

Receives excitatory input from many areas of cortex (Glutamate)
•Output goes back to cortex via the thalamus
•Output is mainly inhibitory (GABA)
•Complex internal connectivity involving 5 principle nuclei:
Substantia Nigra (pars compacta & pars reticulata)
Caudate & Putamen (together=striatum)
Globus Pallidus (internal and external segments)
Subthalamic Nucleus

57
Q

What is the selection problem?

A

Multiple command systems

•Spatially distributed

•Processing in parallel

•All act through final common motor path

•[Cannot do more then one thing (well) at a time]

•How do you resolve the competition???

58
Q

How does disinhibitory gating of motor cortex output occur in the basal ganglia?

A

Excitatory Input from Cortex

Dopaminergic Input from Substantia Nigra

59
Q

What are the loops?

A

Motor
Oculomotor
Prefrontal
Limbic

60
Q

What is the cerebellum?

A

The cerebellum is a large brain structure that acts as a ‘parallel processor’, enabling smooth, co-ordinated movements. It may also be very important in a range of cognitive tasks.

61
Q

What is the cerebellum like?

A

Like basal ganglia, no direct projection to the lower motor neurons – instead modulate activity of upper motor neurons

Contains approx half total number of CNS neurons
•Just 10% of total brain weight
•Projects to almost all upper motor neurons

62
Q

What are the inputs and outputs of the cerebellum?

A

Spinal cord, cerebral cortex and vestibular system -> pons -> cerebellum -> thalamus -> motor cortex

Cortical
- Mostly from motor cortex (copies of motor commands)
- Also somatosensory and visual areas of parietal cortex

Spinal
- Proprioceptive information about limb position and movement (muscle spindles, other mechanoreceptors)

Vestibular
- Rotational and acceleratory head movement (semicircular canals / otoliths in inner ear)

63
Q

What is the cerebellar function?

A

A) It knows what the current motor command is
A)It knows about actual body position and movement
B)It projects back to motor cortex

Computes motor error and adjusts cortical motor commands accordingly

  1. Not just motor control, but motor learning too, in collaboration with basal ganglia and cortical circuits.
    2.Functional brain imaging studies have demonstrated that the cerebellum is involved in a wide variety of non-motor tasks
64
Q

Could recordings of cortical electrical activity be used to directly control lower motor neurons, thus bypassing (possibly damaged) spinal pathways?

A

DISCUSS. The direct projection from primary motor cortex to lower motor neurons is very direct.

More resent answer yes

65
Q

Where do motor commands originate?

A

Motor commands originate in upper motor neurons of primary motor cortex and descend along corticospinal tracts to lower motor neurons originating in spinal cord

66
Q

Where does a great deal of motor control and muscle activity, happen?

A

outside of conscious awareness

67
Q

What is the final common pathway of motor control?

A

•The motor unit innervated by a single alpha motor neuron, is the final common pathway of motor control

68
Q

What is precise motor control governed by?

A

Precise motor control is governed by the size principle, different types of muscle fibre, and the antagonistic arrangement of muscles

69
Q

What are motor commands like?

A

•Motor commands are ‘gated’ by the basal ganglia nuclei, by a system of ‘disinhibition’

70
Q

What does the cerebellum provide?

A

The cerebellum provides precise control, fine adjustment and co-ordination of motor activity based on continual sensory feedback

71
Q

What is the organisation of the motor pathway - peripheral?

A
72
Q

How do we move?

A

We need constantly to process a vast amount of
afferent information from muscle spindles

73
Q

What do basal ganglia do?

A

processing all that afferent information

74
Q

What are peripheral nerves like?

A

Peripheral nerves are motor and sensory
• Some carry autonomic fibers
• Pathology could be axonal, demyelination or
both (Read)
• When impaired features are
– Numbness, tingling, burning, freezing pain
– Weakness and muscle wasting
– Poor balance as a result
– Deformities secondary to weakness

75
Q

What are some causes of peripheral nerve damage?

A

Diabetes
Idiopathic
(Leprosy)
(HIV)
Deficiency states e.g. B12 Folate
Alcohol/Toxins/Drugs
Hereditary Neuropathies
Paraneoplastic Syndromes
Metabolic abnormalities Porphyria

76
Q

What are the major event in neuromuscular transmission?

A

Motor neuron depolarization causes action potential to
travel down the nerve fiber to the neuromuscular junction
(1).
• Depolarization of the axon terminal causes an influx of
Ca2+ (2) which triggers fusion of the synaptic vesicles (3)
and release of neurotransmitter (Acetylcholine; ACh) (4).
• ACh diffuses across the synaptic cleft and binds to post-
synaptic ACh receptor (AChR) located on the muscle fiber
at the motor end-plate (5).

77
Q

What does the binding of ACh to AChRs do?

A

Binding of ACh to AChRs opens the intrinsic ion
channel, resulting in a cation entry locally. This results
in a local depolarisation of the sarcolema.
• Local sarcolemmal depolarisation results in opening
of the sodium channels (VGSC) causing an influx of
Na (5), depolarization of the sarcolemma that travels
down the t-tubules (6) and ultimately causes the
release of Ca2+ from the sarcoplasmic reticulum -
CONTRACTION.
• Unbound ACh in synaptic cleft defuses away or is
hydrolyzed (inactivated) by acetylcholinesterase
(AChE) (7).

78
Q

What is skeletal muscle like?

A

Muscle cell = muscle fiber (a single cell with one
nucleus)
– Muscle fibers are made of myofibrils (striated)
– Myofibrils are made of units called sarcomeres
– Sarcomeres are made of thick and thin filaments
– Z line is the end of the sarcomere
– Thick and thin filaments slide over one another to
shorten the muscle during contraction

79
Q

What is the sliding filament theory?

A

Links the structure of a sarcomere to its function
• During contraction thin filaments slide over thick
filaments
• Thick filaments= myosin and have “heads”
• Thin filaments = actin, these slide
• Ca and ATP required for sliding and attachment

80
Q

Describe the sliding filament theory

A
  1. ATP binds to myosin head, which is released from an actin filament
  2. Hydrolysis of ATP cocks the myosin head
  3. The myosin head attaches to an actin binding site with the help of calcium
  4. The power stroke slides the actin (thin) filament
81
Q

What is the structure of muscle like?

A

100-1000‘s muscle fibres
make up a muscle
Muscle fibres long
structure
multinucleated
bound by sarcolemma

82
Q

What is the structure of myofibril like?

A

Myofibril
The contractile element
within the myofibre

Myofibril
Thin filaments (I) - Actin
Thick filaments (A) -
Myosin

83
Q

What is needed to coordinate the movement?

A

Coordinate the movement- extrapyramidal
system is needed

Coordination is also mediated by cerebellum
(read features of cerebellar dysfunction, ataxia)
• Sensory input about place of joints in relation to
the 3D space (read about joint position sense,
dorsal column structure and purpose, sensory
ataxia)

84
Q

Why do we have 2 eyes?

A

Useful to have a spare
•Allows us to see in 3D (stereopsis)
•Widens our visual field

85
Q

What are the layers of the eye?

A

Outer layer
Sclera and cornea

•Middle layer
Uvea

•Inner layer
Retina

86
Q

What is the outer layer for the eye like?

A

Sclera – tough fibrous outer coat, made up of collagen

•Cornea – also made up of collagen!

Light transmission – must be transparent
Barrier to trauma and infection – must be tough

Responsible for ~2/3 refractive power of the eye (43D)

87
Q

What is the outer layer for the eye like?

A

Sclera – tough fibrous outer coat, made up of collagen

•Cornea – also made up of collagen!

Light transmission – must be transparent
Barrier to trauma and infection – must be tough

Responsible for ~2/3 refractive power of the eye (43D)

88
Q

What are the layers of the outer layer of the eye?

A

5 layered structure

  1. Epithelia
  2. Bowman’s layer
  3. Stroma
  4. Descemet’s layer
  5. Endothelium
89
Q

What are the layers of the outer layer of the eye?

A

5 layered structure

  1. Epithelia
  2. Bowman’s layer
  3. Stroma
  4. Descemet’s layer
  5. Endothelium
90
Q

What is the middle layer of the eye like?

A

Made up of iris, ciliary body and choroid

91
Q

What is the middle layer of the eye like?

A

Made up of iris, ciliary body and choroid

92
Q

What is the iris like?

A

Iris –
coloured part at front of the eye
contains dilator and sphincter pupillae muscles
pupillary reflexes

93
Q

What is the ciliary body like?

A

Ciliary body –
glandular epithelium produces aqueous humour
ciliary (smooth) muscle controls accommodation

Choroid –
blood supply to outer third of retina
heat sink

94
Q

What is the choroid like?

A

Choroid –
blood supply to outer third of retina
heat sink

95
Q

What is the inner layer of the eye?

A

Retina
•Specialised organ of
phototransduction
•Many layers

96
Q

What is the retina made up of?

A

Macula lutea
•Fovea centralis
•Cones
•Rods

97
Q

What are the layers of the retina?

A

8 layers?

98
Q

What does the retina contain?

A

Retinal photorecptors
•Bipolar cells
•Amacrine & horizontal cells
•Mullers glial cells
•Retinal ganglion cells

99
Q

What is Phototransduction?

A
100
Q

What is the anterior segment?

A

Aqueous humour
•Nutrition to lens and
cornea
•Maintains intraocular
pressure

101
Q

What is the lens like?

A

Biconvex
•Responsible ~1/3 refractive
power of the eye (~20D)
•Accommodation

102
Q

What is the lens like?

A

Biconvex
•Responsible ~1/3 refractive
power of the eye (~20D)
•Accommodation

103
Q

What is Emmetropia?

A
104
Q

What is Hypermetropia?

A

Underpowered to focus near objects on retina
•May be due to:
- corneal curvature too shallow
- lens not flexible enough
- axial length of eyeball too short

105
Q

What is myopia?

A

Overpowered so can’t focus far objects on retina
•May be due to:
- corneal curvature too steep
- axial length of eyeball too long

106
Q

What is in the posterior segment?

A

Vitreous humour
•Avascular viscoestalic gel
•Hyaluronic acid (GAG)
•Collagen

107
Q

What is adnexae?

A

Lids
•Conjunctiva
•Tear film

108
Q

What is the structure of the adnexae?

A

Levator palpebrae superior is muscle
Superior suspensory ligament of the globe
Aponeurosis
Superior tarsal (mullers muscle)
Superior suspensory ligament of the fornix

109
Q

What does teh adnexae include?

A

Lids – protect the globe
•Anterior skin
•Eye lashes
•Meibomian glands
•Orbicularis oculi
•Tarsal plate
•Tarsal conjunctiva
•Levator palpebrae superioris & sympathetic muscle

110
Q

What are …. Of the adnexae?

A

Conjunctiva
palpebral (tarsal) vs. bulbar (ocular)
•Conjunctival fornix
•Limbal stem cells
•Mucous membrane (Goblet cells)
•Lymphoid cells (protective)

111
Q

What is the tear film like in the adnexae?

A

Tear film
•3 layers
anterior lipid
middle aqueous
posterior mucous
•Protective
•Nutrition for cornea

112
Q

What is the tear film like in the adnexae?

A

Tear film
•3 layers
anterior lipid
middle aqueous
posterior mucous
•Protective
•Nutrition for cornea

113
Q

What is the arterial supply of the eye?

A

Internal carotid a. → ophthalmic a.
•Branches of ophthalmic a. (ocular group)
central retinal a.
posterior ciliary a. → long and short posterior ciliary a.
muscular a. → anterior ciliary a.
•Branches of ophthalmic artery (orbital group)
lacrimal a.

114
Q

What is the blood supply of the inner retina?

A

Inner 2/3 retina supplied
by central retinal a.
•Branches into
superior/inferior/temporal/nasal
branches
•Drained by branch retinal veins
→ central retinal v. →
ophthalmic v. → cavernous sinus
→ internal jugular v.

115
Q

What is the blood supply of the outer retina?

A

Outer 1/3 supplied by choroid
•Posterior ciliary a. → choroidal a. → choriocapillaris
•Blood-retinal barrier at RPE
regulates movement of nutrition and solutes from choroid into subretinal space

116
Q

What is the venous drainage for the eye?

A

Vortex veins drain the choroid
•Usually one for each quadrant
•Superior drain to SOV, inferior drain to IOV

117
Q

Where do the veins drain into for the eye?

A

Superior ophthalmic veins drain directly into the cavernous sinus
•Inferior ophthalmic veins drain into pterygoid venous plexus
•Valveless system – orbital cellulitis/facial infection can precipitate cavernous sinus thrombosis

118
Q

What is the lymphatics for the eye?

A

No lymphatic drainage from the globe
•Conjunctiva and lids do have lymphatic drainage to submandibular and pre-auricular nodes

119
Q

How does light travel through the eye?

A