OcAnat_Test 2 Flashcards
1
Q
What are the names of the bones in the orbital cavity?
A
Palantine, Lacrimal,Zygomatic, Maxillary, Ethmoid, Sphenoid and Frontal
2
Q
How many bones are there altogether in the Orbital Cavity?
A
11
3
Q
Which bones are shared between the orbits?
A
Ethmoid, Sphenoid, and Frontal, That is why there is only 1 of them.
4
Q
What is the numerical number of the bones that make up the orbital cavity?
A
7
5
Q
Which two bones compose the roof of the orbital cavity?
A
The anterior portion of Frontal bone
The posterior portion of Lesser wing of the Sphenoid bone
6
Q
What are the three landmark structures for the roof?
A
Lacrimal Fossa
Supra-Orbital notch
Trochlear fossa
7
Q
Where is the lacrimal fossa found?
A
Anterior-lateral angle.
8
Q
What passes through the supra-orbital notch?
A
Supraorbital nerve
Supraorbital artery
9
Q
What interrupts the superior orbital margin?
A
Supra-orbital notch
10
Q
What is situated close to the anterior-medial angle?
A
The trochlear fossa.
11
Q
What makes up the lateral wall of the orbita
A
Anteriorly: Zygomatic bones
Posteriorly: Greater wing of Sphenoid
12
Q
When he says to know what is inside of circle and what is outside???
A
Double check
13
Q
What are located inside the circle of the Lateral wall?
A
CN 3, CN 6
Ophthalmic artery
14
Q
What are located outside the circle of the Lateral wall?
A
Nerves
Veins (superior ophthalmicvein)
CN 4
15
Q
What makes up the floor of the orbital cavity?
A
Zygomatic(anterior-lateral)
Palantine(just posterior to the maxilla)
Maxillary(large central area)
16
Q
What is the purpose of the inferior orbital fissure?
A
Separation of the posterior section of lateral wall and floor
17
Q
What bones are involved in the inferior orbital fissure?
A
Sphenoid
Palantine
Maxillae
18
Q
What is significant about the medial wall of the orbit?
A
Thinnest of the walls
Translucent in nature
19
Q
What are the four bones that compose the Medial wall?
A
Maxillae(forms the frontal process)
Lacrimal(Anteriorly and slight inferiorly)
Ethmoid(central)
Sphenoid(small part of opsterior portion wall)
20
Q
The roof has 4 foramina…
A
Lacrimal fossa
Trochlear fossa
Supr-orbital margin
Optic canal
21
Q
The lateral wall has 3 foramina
A
Zygomatic canal
Meningeal foramen
Superior Orbital fissure(seps the sphenoids)
22
Q
The floor has 2 foramina
A
IOF
Infra-orbital groove
23
Q
The medial wall has 3 foramina
A
Naso-lacrimal canal
anterior ethmoid foramen
Posterior eethmoid foramen
24
Q
Who dumps into the middle meatus?
A
Frontal sinus
Ethmoid sinus
Maxillary sinus
25
Who dumps into the superior meatus?
The Sphenoid sinus
26
How does the eye position itself naturally?
Just over the superior limbus
| 1mm within inferior limbus
27
Where is the gray line found?
Just between the tarsal gland orifice and the eyelashes
28
Does the gray line contain blood vessels?
Nope
29
What does the gray line divide?
The lids: anteriorly and posteriorly
30
What is anterior to the gray line?
Skin
subcutaneous areolar tissue
orbicularis oculi
31
What is posterior to the gray line?
Tarsal plate
Smooth muscle
Conjunctiva
32
What are the 7 different layers of the eyelid?
```
Skin
Subcutaneous areolar tissue
Striated muscle layer
Submuscular areolar tissue
Fibrous layer
Smooth Muscle layer
Conjunctiva or mucous membrane
```
33
What composes the fibrous layer of the eyelid?
Orbital septum
| Tarsal plate
34
What composes the smooth muscle layer of the eyelid?
Superior tarsal muscle
| Inferior tarsal muscle
35
Which layer contains no fat of the eyelid?
Subcutaneous areolar tissue.
36
What are the portions of the orbicularis oculi?
Orbital portion
Palpebral portion
Ciliary
Muscle of Horner
37
What is the function of the orbital portion?
Closes lids forcefully
38
What is the function of the palpebral portion?
closes lids gently as in blinking
39
What is the function of the muscle of Riolan?
Holds lids to the globe.
40
What is the function of Horner muscle?
Dilates lacrimal sac to assist the entrance of tears into it and also out of the lacrimal sac.
41
What are the insertions of the Levator Palpebrae Superioris?
Cutaneous - skin below upper palpebral furrow, passes through orbicularis muscle
Osseous attachments.
42
What are the osseous attachments of Levator palpebral superioris
Lateral horn of aponeruosis is attached to whitwalls tubercle
Medial horn of aponeurosis is attached to medial palpebral ligament.
43
Up and Low tarsal plates purpose of
| Anterior and posterior surfaces?
```
Anterior = convex: Insertion of levator tendons
Posterior = concave: for eye via conjunctiva
```
44
Does the upper and lower tarsal plates contain Meibomian glands?
Yes
45
What is anterior to tarsal plates?
```
aponeurosis of levator
Fat
Orbicularis oculi
Hair follicle
.............
```
46
What are lateral and medial palpebral ligaments sometimes considered?
Extineions of the tarsal plates
47
Where does the MPL attach?
frontal process of the maxilla bone
48
What does the MPL contain?
canaliculi of the lacrimal drainage apparatus
49
Where does the LPL attach?
Orbital tubercle of zygomatic bone (Whitnall's tubercle
50
Where does the LPL lie?
Behind the lateral palpebral raphe
51
What is the nerve innervation for smooth muscle layer
Sympathetic innervation: droopy lid???
52
Where is the land of moll located
Eyelid margin with ducts opening up in eyelid margin
53
What does the gland of moll secrete?
Sweat
54
What is the function of glands of moll?
Unknown
55
Where is the glands of zeis located?
On eyelash follicles. There are 2 for each.
56
What does the Gland of zeiss secrete?
sebum
57
What is the function of the gland of zeiss?
keeps eyelashes flexible
58
T/F?
| Is the gland of zeiss more anterior to gland of moll?
True
59
Where can you find the accessory palpebral lacrimal gland of wolfring?
Peripheral aspect of the tarsal plate
60
What is the function of the accessory palpebral lacrimal gland of Wolfring?
Similar to the lacrimal glands as its serous secretion(accessory lacrimal glands)
61
Where can you find the accessory conjunctiva lacrimal gland of Krause?
Conjunctival fornix
62
What is the function of accessory conjunctiva lacrimal gland of krause?
Similar to the lacrimal gland (accessory lacrimal glands)
63
What are the two pathways for venous drainage?
Superficial (pre-tarsal) system
| Deep (post-tarsal) system
64
What does the anterior facial vein drain into?
| Which system?
Internal Jugular Vein
| Superficial System
65
What does the superficial temporal vein drain into?
| Which system
External jugular vein
| Pre-tarsal system
66
What does the Ophthalmic vein drain into?
| Which system?
Cavernous sinus
| Post-tarsal system
67
What does the Deep facial vein drain into first?
Pterygoid plexus, later into cavernous sinus like the ophthalmic veins
Deep system
68
Where does the lateral portion of upper and lower lids drain?
Pre-auricular and parotid lymph nodes
69
Where does the medial portion of upper & lower lids portion drain?
Submental and submandibular nodes
70
What is the sensory innervation of:
1. Upper lid
2. Lower lid
3. Medial
4. Lateral
1. Supraorbital nerve
2. infraorbital nerve
3. Supratrochlear nerve and Infratrochlear
4. Lacrimal branches of the Ophthalmic Nerve
71
What is the motor innervation of:
1. Orbicularis Oculi
2. Levator
3. Muller
1. CN 7
2. CN 3
3. Sympathetic nerves
72
What are the two different portions of the palpebral conj?
Tarsal Conj
| Orbital Conj
73
Between the two palpebral conj structures, who is more anterior?
The tarsal conj is more anterior than the orbital palpebral conj
74
Name the four divisions of the Palpebral fornix?
Superior Fornix
Inferior Fornix
Medial Fornix
Lateral Fornix
75
Which fornix has the most depth?
Superior FOrnix
14-15mm in depth
It is connected by fascial expansion
76
Which fornix has the lest depth?
Medial Fornix; none
| Filled by plica and caruncle
77
What are the two layers associated with the Conj? WHich is more anterior
Stromal
Epithelial
Stroma is more anterior(closer to tarsal plate)
78
What kind of cells make up the epithelium layer of conj?
Stratified squamous
2-6 layers. THickets at eyelid margin and limbus
Goblet cells are missing in these aras.
79
What kind of cells make up the stromal layer of the conj
Connective tissue.
| Has an adenoid and deep fibrous layer(more anterior)
80
What kind of epithelial tissue makes up the skin of the lids?
Stratified, squamous keratinized
| serves as protection-skin
81
What kind of epithelial tissue makes up the palpebral conj from the mucocutaneous junction?
Stratified, squamous non-keratinized
4-5 layers
(still serves as a protection, but mucous membrane)
82
What kind of epithelial tissue makes up the conjunctival-fornix?
Stratified, columnar non-keratinized.
2 cells thick, goblet cells
(serves as protection, rarely seen)
83
What kind of epithelial tissue makes up the limbus?
Stratified squamous, nonkeratinized
10 cells thick
(serves as protection, mucous)
84
What kind of epithelial tissue makes up the cornea
Stratified, squamous, non-keratinized
2-5 cells thick
(serves as protection, mucous; has nuclei up top)
85
What are the two layers of the lympathic system?
```
Superficial plexus(drains adenoid layer;stroma)
Deep plexus (drains the deep fibrous layer; stroma)
```
86
Who supplies the layers of the conj nervewise?
Sennsory orginated
| CNV: Ophthalmic and Maxillary
87
How is the distribution of the vasculature to the layers of the conju?
dually automatic.
| Meaning both para and symp components
88
Where does the sympathetic comp of vasculature for layers of conj come from?
Superior cervical ganglion
89
Where does the parasym comp of vasculature for layers of conj come from?
Pterygopalantine ganglion
90
Which conjunctiva has complex sensory nerve endings(corpuscles)
Bulbar Conj
91
In the bulb conj, where is the location of the most corpuscles?
limbal conj
92
Mechanoreceptor role belongs to who?
Bulbar conj
| Touch sensitivity
93
What is so special about the conjunctiva?
It is the most immunologically active tissue of the external eye.
94
How do you distinguish papillae formation from follicle formation?
Presence of blood vessels at the centers for papillae
95
What is papillae
Substantia propria abnormally bulges into overlying epithelial layer, elevating the latter tissue.
96
Which of the two formations is a specific clinical sign?
Follicle. Prsent in conditions of cell immune reaction(viral infections, hypersensitivity)
97
What re follicles
Aggregates of lymphocytes and macrophages in the adenoid layer.
FOllicles are clear, fluid-filled pockets and have blood vessels passing either above or below, never within the adenoid layer.
98
Where is the lacrimal gland located?
In the fossa for the lacrimal gland in the frontal bone
99
WHat are the two portions for the lacrimal gland?
Orbital and palpebral portion
100
What divides the two portions of the lacrimal system?
THe aponeurosis of the levator muscle
101
Which portion of the lacrimal gland is more superior
THe orbital portion
102
How much of the lacrimal gland does the orbital portion represents?
65-75% of the gland
103
How much of the lacrimal gland does the palpebral portion represent?
25-35%
104
How many secretory ducts are there in the lacrimal system?
12 ducts
105
How many ducts originate in the orbital portion?
2-5
106
How many ducts originate from the palpebral portion?
6-8
107
If you cut out the palpebral portion, what do u run the risk of doing?
interrupting the drainage from the orbital portion of the lacrimal gland.
108
Where do the ducts exit from posteriorly?
Superotemporal portion of the conjunctival fornix. Orbital ducts have to go through palpebral ducts to exit.
109
When is the lacrimal gland mature?
Until after birth, 2 weeks-babies can produce tears.
110
What kind of gland is the lacrimal gland?
A serous tubuloacinar gland
111
What are the three types of ducts of the Lacrimal gland
1. Intralobular ducts
2. Interlobular ducts
3. Main excretory ducts
112
What is the final destination of the three ducts of the lacrimal gland?
Superior lateral aspect of the conjunctival fornix.
113
What forms the acini?
single layer of pie-shaped secretory cells enclosed by a BM
114
What types of cells make up the acinI?
```
Mucous cell( light granules)
Serous cell(dark granules, they are seriously dark)
```
115
What surrounds the ascinar cell?
loose collagen fiber
capillary network
lymphatic
Rich nerve supply
116
What are myoepithelial cells?
Sourrounds the outside of the acinar secretory cell.
| More active when you are crying
117
What lines the ductile lumen of the lacrimal gland?
microvilli
118
Names of the accessory lacrimal glands?
Accessory palpebral lacrimal gland of Wolfring
| Accessory conjunctival lacrimal gland of Krause
119
What is the functions of the accessory lacrimal glands?
Secretes Tear fluid
| Functions provide everyday or basic secretion for water-tear film layer of pre-corneal film
120
Which is accessory lacrimal gland is more numerous?
Accessory conjunctiva lacrimal gland of krause.
| But more smaller than Wolfring
121
What kind of nerve fibers does the lacrimal nerve carry?
Sensory
| From ophthalmic branch of CNV
122
Innervation sympathetics for Lacrimal gland?
Derived from the superior cervical ganglion
123
What happens when u stimulate the symp nervous system for the lacrimal gland?
No change in tear secretion
| If destroy superior cervical ganglion, secretion is not affected.
124
Innervation parasymp for Lacrimal gland
Derived from nervus intermedius CNVII.
| Responsible for secretion and is main contributor to tera film
125
Which nerve fiber is the only one inside of the lacrimal gland?
Parasym fibers are the only fibers inside the acinus
126
What is the reflex secretions of main lacrimal glands?
CNV - sensory (afferent) pathway
| CNVII - parasymp (efferent) pathway
127
Myoepithelial cell innervation?
No nerve terminals next to the myoepithelial cells in the acinus
Directly innervated myoepithelial cells in the intermediate and main ducts.
128
What is the drainage apparatus for the lacrimal system?
1. Lacrimal papillae
2. Lacrimal puncta
3. Lacrimal canaliculi
4. lacrimal sac
5. Nasolacrimal duct and boney nasolacrimal canal
6. Nasal sinus
129
How much tears get drained through the lacrimal system?
75-80%
| The rest is evaporated
130
Where is the location of lacrimal papillae?
Directed backwards out of view. Functions to keep the punctum open.
131
WHere is the location of the lacrimal puncta?
In line with the tarsal gland openings
132
What are the components of the Lacrimal canaliculi?
Vertical part 2mm
Horizontal part 8mm
Ampulla
Horner's muscle
133
Horner's muscle significance in the lacrimal canaliculi?
Surrounds vertical and horizontal parts.
| When Orbic oc contracts, puncta pulled medially, ampullae narrows, canaliculi shortens.
134
What happens to the ampulla when you blink?
Ampulla contracts
| Drives tears into lacrimal sac
135
How long is the lacrimal sac?
12 mm long
| Sits in the lacrimal fossa(Lacrimal bone and Frontal process of maxilla).
136
T/F
| Most of the lacrimal sac lie underneath the Anterior limb of the MPL
True
137
T/F
| The posterior branch of MPL connects to the fascia of lacrimal sac.
tRUE
138
Which limb of MPL is anterior to the lacrimal sac?
The anterior limb of MPL.
139
HOrner's muscle role with lacrimal sac?
Dilate the sac.
| Orbic oris does this too.
140
Location of horner's muscle in lac sac
just posterior to the lacrimal sac and limbs of MPL.
141
What are the two parts of the nasolacrimal duct?
Intra-osseous part
| Intra-meatal part
142
What is the intra-osseous part
surrounded by bones of bony nasolacrimal, maxillary, and inferior conchae bones
143
What is the intra-meatal part
Not completely surrounded by bone.
| Sourrounded by soft tissue of lateral part of nasal cavity.
144
Purpose of valve of Hasner
Prevents air entrance on sneezing and coughing
145
Which part of drainage system does orbital septum belong to?
Nasolacrimal sac.
| Septum is attached to area just behind posterior lacrimal crest.
146
Outer layer(thin) of tear film is produced by
Oily layer
Tarsal glands (meibomian)
Zeiss: sebum
Moll: sweat
147
The middle layer(thick) of tear film is produced by
Aqueous layer
| Lacrimal glands: Krause & Wolfring
148
The inner layer(thin) of tear film is produced by
Mucin layer
Goblet cells of the conjunctiva
Lacrimal gland cells
149
WHat is the purpose of the outermost layer?
Prevent evaporation of the underlying watery layer.
150
What is the purpose of the middle layer?
Lysozyme, immunoglobulins, beta lysine
| Defense against invaders
151
What is the purpose of the inner layer
Wets the microvilli of the corneal epithelium.
152
Which fiber type is predominant in the orbital layer of rectus and oblique muscles?
%?
Orbital Singly-innervated Fiber
| 80%
153
What kind of neuromuscular sites does the Orbital SIF have?
Neuromuscular contacts are at a single site.
154
Which orbital layers has oil droplets?
```
Orbital SIF(1st)
Global Red SIF (2nd)
Intermediate Red SIF (3rd)
Global White SIF
Associated with the mitochondria and glycogen granules
```
155
How does the twitching vary for the Orbital MIF?
Fast twitch near center
| Slow twitch at proximal and distal end.
156
Where do the red SIFs predominate?
Transition zone b/w
Orbital and global layers
They decrease in number w/ progression into global layer
157
Which fiber layer is distributed equally throughout transition zone and global layer?
Global Intermediate SIF
158
What type of response is exhibited
Slow graded
| Nonpropagated response following neural or pharmacological activation
159
What are oculomotor regulatory centers?
Coordinate and regulate muscle actions
160
Who keeps the Oculomotor reg centers updated?
```
Muscle Spindles
Golgi tendon organs
Myotendinous cylinders(palisade endings)
```
161
What are myotendinous cylinders
AKA Palisade endings
| Specialized sensory receptors for global multiply innervated fibers.
162
What do the global MIFs display that no-one else can?
Sensory receptors called
| Myotendinous cylinders aka palisade endings
163
Which special muscle does not arise from the annulus of zinn?
Inferior Oblique
164
Where does the IO take origin?
Front of the orbit
165
What angle does the SR and IR make with the visual line?
23 degrees
166
What angle does SO make with the visual axis?
54 degrees
167
What angle does IO make with Visual axis?
51 degrees
168
Which muscle has the smallest distance from the limbus?
Medial Rectus
Closest to the Cornea
Covered by Caruncle
169
Which muscle is farthest from the limbus?
Superior rectus
| Farthest from the cornea
170
Inferior Branch = Medial Branch
| Supplies....
IO, IR, MR
171
Superior Branch = Lateral Branch
SO, SR, LR, levator
172
Which is the largest extraocular muscle?
Medial rectus
| Stronger than the lateral rectus
173
Which is the shortest recti muscle?
IR
174
Which is the longest and thinnest recti muscle?
SO
175
Which extraoc muscle has the shortest tendon of insertion
IO
176
Which muscles have innervation from the inferior branch of CNIII
MR (innervates on lateral surface)
IR
IO
177
Who innervates the SO muscle
Trochlear nerve on the upper-surface near its lateral border.
178
Who does the LR receive its only blood supply from?
Lacrimal artery
179
Who uses a stiff pulley made out of cartilage
SO
| All the other muscles use soft pulleys.
180
What additional things are posterior to Gray Line?
Meibomian gland orifices
| Mucocutaneous Junction
