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

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2
Q

How many bones are there altogether in the Orbital Cavity?

A

11

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3
Q

Which bones are shared between the orbits?

A

Ethmoid, Sphenoid, and Frontal, That is why there is only 1 of them.

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4
Q

What is the numerical number of the bones that make up the orbital cavity?

A

7

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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

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6
Q

What are the three landmark structures for the roof?

A

Lacrimal Fossa
Supra-Orbital notch
Trochlear fossa

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7
Q

Where is the lacrimal fossa found?

A

Anterior-lateral angle.

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8
Q

What passes through the supra-orbital notch?

A

Supraorbital nerve

Supraorbital artery

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9
Q

What interrupts the superior orbital margin?

A

Supra-orbital notch

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10
Q

What is situated close to the anterior-medial angle?

A

The trochlear fossa.

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11
Q

What makes up the lateral wall of the orbita

A

Anteriorly: Zygomatic bones
Posteriorly: Greater wing of Sphenoid

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12
Q

When he says to know what is inside of circle and what is outside???

A

Double check

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13
Q

What are located inside the circle of the Lateral wall?

A

CN 3, CN 6

Ophthalmic artery

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14
Q

What are located outside the circle of the Lateral wall?

A

Nerves
Veins (superior ophthalmicvein)
CN 4

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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)

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16
Q

What is the purpose of the inferior orbital fissure?

A

Separation of the posterior section of lateral wall and floor

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17
Q

What bones are involved in the inferior orbital fissure?

A

Sphenoid
Palantine
Maxillae

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18
Q

What is significant about the medial wall of the orbit?

A

Thinnest of the walls

Translucent in nature

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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)

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20
Q

The roof has 4 foramina…

A

Lacrimal fossa
Trochlear fossa
Supr-orbital margin
Optic canal

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21
Q

The lateral wall has 3 foramina

A

Zygomatic canal
Meningeal foramen
Superior Orbital fissure(seps the sphenoids)

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22
Q

The floor has 2 foramina

A

IOF

Infra-orbital groove

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23
Q

The medial wall has 3 foramina

A

Naso-lacrimal canal
anterior ethmoid foramen
Posterior eethmoid foramen

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24
Q

Who dumps into the middle meatus?

A

Frontal sinus
Ethmoid sinus
Maxillary sinus

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25
Q

Who dumps into the superior meatus?

A

The Sphenoid sinus

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26
Q

How does the eye position itself naturally?

A

Just over the superior limbus

1mm within inferior limbus

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27
Q

Where is the gray line found?

A

Just between the tarsal gland orifice and the eyelashes

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28
Q

Does the gray line contain blood vessels?

A

Nope

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29
Q

What does the gray line divide?

A

The lids: anteriorly and posteriorly

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30
Q

What is anterior to the gray line?

A

Skin
subcutaneous areolar tissue
orbicularis oculi

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31
Q

What is posterior to the gray line?

A

Tarsal plate
Smooth muscle
Conjunctiva

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32
Q

What are the 7 different layers of the eyelid?

A
Skin
Subcutaneous areolar tissue
Striated muscle layer
Submuscular areolar tissue
Fibrous layer
Smooth Muscle layer
Conjunctiva or mucous membrane
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33
Q

What composes the fibrous layer of the eyelid?

A

Orbital septum

Tarsal plate

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34
Q

What composes the smooth muscle layer of the eyelid?

A

Superior tarsal muscle

Inferior tarsal muscle

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35
Q

Which layer contains no fat of the eyelid?

A

Subcutaneous areolar tissue.

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36
Q

What are the portions of the orbicularis oculi?

A

Orbital portion
Palpebral portion
Ciliary
Muscle of Horner

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37
Q

What is the function of the orbital portion?

A

Closes lids forcefully

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38
Q

What is the function of the palpebral portion?

A

closes lids gently as in blinking

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39
Q

What is the function of the muscle of Riolan?

A

Holds lids to the globe.

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40
Q

What is the function of Horner muscle?

A

Dilates lacrimal sac to assist the entrance of tears into it and also out of the lacrimal sac.

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41
Q

What are the insertions of the Levator Palpebrae Superioris?

A

Cutaneous - skin below upper palpebral furrow, passes through orbicularis muscle
Osseous attachments.

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42
Q

What are the osseous attachments of Levator palpebral superioris

A

Lateral horn of aponeruosis is attached to whitwalls tubercle
Medial horn of aponeurosis is attached to medial palpebral ligament.

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43
Q

Up and Low tarsal plates purpose of

Anterior and posterior surfaces?

A
Anterior = convex: Insertion of levator tendons
Posterior = concave: for eye via conjunctiva
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44
Q

Does the upper and lower tarsal plates contain Meibomian glands?

A

Yes

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45
Q

What is anterior to tarsal plates?

A
aponeurosis of levator
Fat
Orbicularis oculi
Hair follicle
.............
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46
Q

What are lateral and medial palpebral ligaments sometimes considered?

A

Extineions of the tarsal plates

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47
Q

Where does the MPL attach?

A

frontal process of the maxilla bone

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48
Q

What does the MPL contain?

A

canaliculi of the lacrimal drainage apparatus

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49
Q

Where does the LPL attach?

A

Orbital tubercle of zygomatic bone (Whitnall’s tubercle

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50
Q

Where does the LPL lie?

A

Behind the lateral palpebral raphe

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51
Q

What is the nerve innervation for smooth muscle layer

A

Sympathetic innervation: droopy lid???

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52
Q

Where is the land of moll located

A

Eyelid margin with ducts opening up in eyelid margin

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53
Q

What does the gland of moll secrete?

A

Sweat

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54
Q

What is the function of glands of moll?

A

Unknown

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55
Q

Where is the glands of zeis located?

A

On eyelash follicles. There are 2 for each.

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56
Q

What does the Gland of zeiss secrete?

A

sebum

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57
Q

What is the function of the gland of zeiss?

A

keeps eyelashes flexible

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58
Q

T/F?

Is the gland of zeiss more anterior to gland of moll?

A

True

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59
Q

Where can you find the accessory palpebral lacrimal gland of wolfring?

A

Peripheral aspect of the tarsal plate

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60
Q

What is the function of the accessory palpebral lacrimal gland of Wolfring?

A

Similar to the lacrimal glands as its serous secretion(accessory lacrimal glands)

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61
Q

Where can you find the accessory conjunctiva lacrimal gland of Krause?

A

Conjunctival fornix

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62
Q

What is the function of accessory conjunctiva lacrimal gland of krause?

A

Similar to the lacrimal gland (accessory lacrimal glands)

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63
Q

What are the two pathways for venous drainage?

A

Superficial (pre-tarsal) system

Deep (post-tarsal) system

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64
Q

What does the anterior facial vein drain into?

Which system?

A

Internal Jugular Vein

Superficial System

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65
Q

What does the superficial temporal vein drain into?

Which system

A

External jugular vein

Pre-tarsal system

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66
Q

What does the Ophthalmic vein drain into?

Which system?

A

Cavernous sinus

Post-tarsal system

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67
Q

What does the Deep facial vein drain into first?

A

Pterygoid plexus, later into cavernous sinus like the ophthalmic veins
Deep system

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68
Q

Where does the lateral portion of upper and lower lids drain?

A

Pre-auricular and parotid lymph nodes

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69
Q

Where does the medial portion of upper & lower lids portion drain?

A

Submental and submandibular nodes

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70
Q

What is the sensory innervation of:

  1. Upper lid
  2. Lower lid
  3. Medial
  4. Lateral
A
  1. Supraorbital nerve
  2. infraorbital nerve
  3. Supratrochlear nerve and Infratrochlear
  4. Lacrimal branches of the Ophthalmic Nerve
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71
Q

What is the motor innervation of:

  1. Orbicularis Oculi
  2. Levator
  3. Muller
A
  1. CN 7
  2. CN 3
  3. Sympathetic nerves
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72
Q

What are the two different portions of the palpebral conj?

A

Tarsal Conj

Orbital Conj

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73
Q

Between the two palpebral conj structures, who is more anterior?

A

The tarsal conj is more anterior than the orbital palpebral conj

74
Q

Name the four divisions of the Palpebral fornix?

A

Superior Fornix
Inferior Fornix
Medial Fornix
Lateral Fornix

75
Q

Which fornix has the most depth?

A

Superior FOrnix
14-15mm in depth
It is connected by fascial expansion

76
Q

Which fornix has the lest depth?

A

Medial Fornix; none

Filled by plica and caruncle

77
Q

What are the two layers associated with the Conj? WHich is more anterior

A

Stromal
Epithelial
Stroma is more anterior(closer to tarsal plate)

78
Q

What kind of cells make up the epithelium layer of conj?

A

Stratified squamous
2-6 layers. THickets at eyelid margin and limbus
Goblet cells are missing in these aras.

79
Q

What kind of cells make up the stromal layer of the conj

A

Connective tissue.

Has an adenoid and deep fibrous layer(more anterior)

80
Q

What kind of epithelial tissue makes up the skin of the lids?

A

Stratified, squamous keratinized

serves as protection-skin

81
Q

What kind of epithelial tissue makes up the palpebral conj from the mucocutaneous junction?

A

Stratified, squamous non-keratinized
4-5 layers
(still serves as a protection, but mucous membrane)

82
Q

What kind of epithelial tissue makes up the conjunctival-fornix?

A

Stratified, columnar non-keratinized.
2 cells thick, goblet cells
(serves as protection, rarely seen)

83
Q

What kind of epithelial tissue makes up the limbus?

A

Stratified squamous, nonkeratinized
10 cells thick
(serves as protection, mucous)

84
Q

What kind of epithelial tissue makes up the cornea

A

Stratified, squamous, non-keratinized
2-5 cells thick
(serves as protection, mucous; has nuclei up top)

85
Q

What are the two layers of the lympathic system?

A
Superficial plexus(drains adenoid layer;stroma)
Deep plexus (drains the deep fibrous layer; stroma)
86
Q

Who supplies the layers of the conj nervewise?

A

Sennsory orginated

CNV: Ophthalmic and Maxillary

87
Q

How is the distribution of the vasculature to the layers of the conju?

A

dually automatic.

Meaning both para and symp components

88
Q

Where does the sympathetic comp of vasculature for layers of conj come from?

A

Superior cervical ganglion

89
Q

Where does the parasym comp of vasculature for layers of conj come from?

A

Pterygopalantine ganglion

90
Q

Which conjunctiva has complex sensory nerve endings(corpuscles)

A

Bulbar Conj

91
Q

In the bulb conj, where is the location of the most corpuscles?

A

limbal conj

92
Q

Mechanoreceptor role belongs to who?

A

Bulbar conj

Touch sensitivity

93
Q

What is so special about the conjunctiva?

A

It is the most immunologically active tissue of the external eye.

94
Q

How do you distinguish papillae formation from follicle formation?

A

Presence of blood vessels at the centers for papillae

95
Q

What is papillae

A

Substantia propria abnormally bulges into overlying epithelial layer, elevating the latter tissue.

96
Q

Which of the two formations is a specific clinical sign?

A

Follicle. Prsent in conditions of cell immune reaction(viral infections, hypersensitivity)

97
Q

What re follicles

A

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
Q

Where is the lacrimal gland located?

A

In the fossa for the lacrimal gland in the frontal bone

99
Q

WHat are the two portions for the lacrimal gland?

A

Orbital and palpebral portion

100
Q

What divides the two portions of the lacrimal system?

A

THe aponeurosis of the levator muscle

101
Q

Which portion of the lacrimal gland is more superior

A

THe orbital portion

102
Q

How much of the lacrimal gland does the orbital portion represents?

A

65-75% of the gland

103
Q

How much of the lacrimal gland does the palpebral portion represent?

A

25-35%

104
Q

How many secretory ducts are there in the lacrimal system?

A

12 ducts

105
Q

How many ducts originate in the orbital portion?

A

2-5

106
Q

How many ducts originate from the palpebral portion?

A

6-8

107
Q

If you cut out the palpebral portion, what do u run the risk of doing?

A

interrupting the drainage from the orbital portion of the lacrimal gland.

108
Q

Where do the ducts exit from posteriorly?

A

Superotemporal portion of the conjunctival fornix. Orbital ducts have to go through palpebral ducts to exit.

109
Q

When is the lacrimal gland mature?

A

Until after birth, 2 weeks-babies can produce tears.

110
Q

What kind of gland is the lacrimal gland?

A

A serous tubuloacinar gland

111
Q

What are the three types of ducts of the Lacrimal gland

A
  1. Intralobular ducts
  2. Interlobular ducts
  3. Main excretory ducts
112
Q

What is the final destination of the three ducts of the lacrimal gland?

A

Superior lateral aspect of the conjunctival fornix.

113
Q

What forms the acini?

A

single layer of pie-shaped secretory cells enclosed by a BM

114
Q

What types of cells make up the acinI?

A
Mucous cell( light granules)
Serous cell(dark granules, they are seriously dark)
115
Q

What surrounds the ascinar cell?

A

loose collagen fiber
capillary network
lymphatic
Rich nerve supply

116
Q

What are myoepithelial cells?

A

Sourrounds the outside of the acinar secretory cell.

More active when you are crying

117
Q

What lines the ductile lumen of the lacrimal gland?

A

microvilli

118
Q

Names of the accessory lacrimal glands?

A

Accessory palpebral lacrimal gland of Wolfring

Accessory conjunctival lacrimal gland of Krause

119
Q

What is the functions of the accessory lacrimal glands?

A

Secretes Tear fluid

Functions provide everyday or basic secretion for water-tear film layer of pre-corneal film

120
Q

Which is accessory lacrimal gland is more numerous?

A

Accessory conjunctiva lacrimal gland of krause.

But more smaller than Wolfring

121
Q

What kind of nerve fibers does the lacrimal nerve carry?

A

Sensory

From ophthalmic branch of CNV

122
Q

Innervation sympathetics for Lacrimal gland?

A

Derived from the superior cervical ganglion

123
Q

What happens when u stimulate the symp nervous system for the lacrimal gland?

A

No change in tear secretion

If destroy superior cervical ganglion, secretion is not affected.

124
Q

Innervation parasymp for Lacrimal gland

A

Derived from nervus intermedius CNVII.

Responsible for secretion and is main contributor to tera film

125
Q

Which nerve fiber is the only one inside of the lacrimal gland?

A

Parasym fibers are the only fibers inside the acinus

126
Q

What is the reflex secretions of main lacrimal glands?

A

CNV - sensory (afferent) pathway

CNVII - parasymp (efferent) pathway

127
Q

Myoepithelial cell innervation?

A

No nerve terminals next to the myoepithelial cells in the acinus
Directly innervated myoepithelial cells in the intermediate and main ducts.

128
Q

What is the drainage apparatus for the lacrimal system?

A
  1. Lacrimal papillae
  2. Lacrimal puncta
  3. Lacrimal canaliculi
  4. lacrimal sac
  5. Nasolacrimal duct and boney nasolacrimal canal
  6. Nasal sinus
129
Q

How much tears get drained through the lacrimal system?

A

75-80%

The rest is evaporated

130
Q

Where is the location of lacrimal papillae?

A

Directed backwards out of view. Functions to keep the punctum open.

131
Q

WHere is the location of the lacrimal puncta?

A

In line with the tarsal gland openings

132
Q

What are the components of the Lacrimal canaliculi?

A

Vertical part 2mm
Horizontal part 8mm
Ampulla
Horner’s muscle

133
Q

Horner’s muscle significance in the lacrimal canaliculi?

A

Surrounds vertical and horizontal parts.

When Orbic oc contracts, puncta pulled medially, ampullae narrows, canaliculi shortens.

134
Q

What happens to the ampulla when you blink?

A

Ampulla contracts

Drives tears into lacrimal sac

135
Q

How long is the lacrimal sac?

A

12 mm long

Sits in the lacrimal fossa(Lacrimal bone and Frontal process of maxilla).

136
Q

T/F

Most of the lacrimal sac lie underneath the Anterior limb of the MPL

A

True

137
Q

T/F

The posterior branch of MPL connects to the fascia of lacrimal sac.

A

tRUE

138
Q

Which limb of MPL is anterior to the lacrimal sac?

A

The anterior limb of MPL.

139
Q

HOrner’s muscle role with lacrimal sac?

A

Dilate the sac.

Orbic oris does this too.

140
Q

Location of horner’s muscle in lac sac

A

just posterior to the lacrimal sac and limbs of MPL.

141
Q

What are the two parts of the nasolacrimal duct?

A

Intra-osseous part

Intra-meatal part

142
Q

What is the intra-osseous part

A

surrounded by bones of bony nasolacrimal, maxillary, and inferior conchae bones

143
Q

What is the intra-meatal part

A

Not completely surrounded by bone.

Sourrounded by soft tissue of lateral part of nasal cavity.

144
Q

Purpose of valve of Hasner

A

Prevents air entrance on sneezing and coughing

145
Q

Which part of drainage system does orbital septum belong to?

A

Nasolacrimal sac.

Septum is attached to area just behind posterior lacrimal crest.

146
Q

Outer layer(thin) of tear film is produced by

A

Oily layer
Tarsal glands (meibomian)
Zeiss: sebum
Moll: sweat

147
Q

The middle layer(thick) of tear film is produced by

A

Aqueous layer

Lacrimal glands: Krause & Wolfring

148
Q

The inner layer(thin) of tear film is produced by

A

Mucin layer
Goblet cells of the conjunctiva
Lacrimal gland cells

149
Q

WHat is the purpose of the outermost layer?

A

Prevent evaporation of the underlying watery layer.

150
Q

What is the purpose of the middle layer?

A

Lysozyme, immunoglobulins, beta lysine

Defense against invaders

151
Q

What is the purpose of the inner layer

A

Wets the microvilli of the corneal epithelium.

152
Q

Which fiber type is predominant in the orbital layer of rectus and oblique muscles?
%?

A

Orbital Singly-innervated Fiber

80%

153
Q

What kind of neuromuscular sites does the Orbital SIF have?

A

Neuromuscular contacts are at a single site.

154
Q

Which orbital layers has oil droplets?

A
Orbital SIF(1st)
Global Red SIF (2nd)
Intermediate Red SIF (3rd)
Global White SIF
Associated with the mitochondria and glycogen granules
155
Q

How does the twitching vary for the Orbital MIF?

A

Fast twitch near center

Slow twitch at proximal and distal end.

156
Q

Where do the red SIFs predominate?

A

Transition zone b/w
Orbital and global layers
They decrease in number w/ progression into global layer

157
Q

Which fiber layer is distributed equally throughout transition zone and global layer?

A

Global Intermediate SIF

158
Q

What type of response is exhibited

A

Slow graded

Nonpropagated response following neural or pharmacological activation

159
Q

What are oculomotor regulatory centers?

A

Coordinate and regulate muscle actions

160
Q

Who keeps the Oculomotor reg centers updated?

A
Muscle Spindles
Golgi tendon organs
Myotendinous cylinders(palisade endings)
161
Q

What are myotendinous cylinders

A

AKA Palisade endings

Specialized sensory receptors for global multiply innervated fibers.

162
Q

What do the global MIFs display that no-one else can?

A

Sensory receptors called

Myotendinous cylinders aka palisade endings

163
Q

Which special muscle does not arise from the annulus of zinn?

A

Inferior Oblique

164
Q

Where does the IO take origin?

A

Front of the orbit

165
Q

What angle does the SR and IR make with the visual line?

A

23 degrees

166
Q

What angle does SO make with the visual axis?

A

54 degrees

167
Q

What angle does IO make with Visual axis?

A

51 degrees

168
Q

Which muscle has the smallest distance from the limbus?

A

Medial Rectus
Closest to the Cornea
Covered by Caruncle

169
Q

Which muscle is farthest from the limbus?

A

Superior rectus

Farthest from the cornea

170
Q

Inferior Branch = Medial Branch

Supplies….

A

IO, IR, MR

171
Q

Superior Branch = Lateral Branch

A

SO, SR, LR, levator

172
Q

Which is the largest extraocular muscle?

A

Medial rectus

Stronger than the lateral rectus

173
Q

Which is the shortest recti muscle?

A

IR

174
Q

Which is the longest and thinnest recti muscle?

A

SO

175
Q

Which extraoc muscle has the shortest tendon of insertion

A

IO

176
Q

Which muscles have innervation from the inferior branch of CNIII

A

MR (innervates on lateral surface)
IR
IO

177
Q

Who innervates the SO muscle

A

Trochlear nerve on the upper-surface near its lateral border.

178
Q

Who does the LR receive its only blood supply from?

A

Lacrimal artery

179
Q

Who uses a stiff pulley made out of cartilage

A

SO

All the other muscles use soft pulleys.

180
Q

What additional things are posterior to Gray Line?

A

Meibomian gland orifices

Mucocutaneous Junction