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Oc Physio > OcPhysio T1 > Flashcards

OcPhysio T1 Flashcards

1
Q

What is the main role of conj?

A

To connect the globe to the eyelid

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2
Q

Which part of the eyeball does the conj cover?

A

The posterior surface.

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3
Q

What kind junction does the conj make with eyeball?

A

Indirect

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4
Q

Is there a true conj on the medial side of the eye?

A

Nope.

It is an extendable plica.

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5
Q

Are the eyelids and globe independent of each other?

A

Yes

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6
Q

What is another role of conj?

A

To stabilize the tear film.

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7
Q

How is the tear film organized?

A

Complicated arrangement of microvilli and microplicae

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8
Q

What is the importance of the outfoldings of the surface cell membranes?

A

Supporting, stabilizing, and anchoring the tear film.

Prevents irregular streams and flow patterns.

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9
Q

Deeper circulation of conj furnishes blood supply to….

A

peripheral corneal arcades, the iris, and ciliary body.

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10
Q

Where do superficial vessels dilate in the eye?

A

Moving away from the limbus.

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11
Q

Where do the deeper vessels dilate in the eye?

A

Moving towards the limbus.

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12
Q

How is the patterns of the bulbar conj characterized?

A

Randomly.

No real differentiation into specific functional units.

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13
Q

What is the the significance of localized venous dilation?

A

Nothing. They can appear in normal ppl and ppl with a disease.

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14
Q

What does topically applied 1:5000 epinephrine do to capillary bed?
What about heat, cold, wind?

A

Constricts the precapillary sphincter; thus closing and emptying the capillary bed.
Wind, heat, and cold constricts the vessels.

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15
Q

Where layer are mast cells found in?

A

Adenoid layer.

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16
Q

Are mast cells found in the conj stroma or conj epithelium?

A

Found in the conj stroma. NOne will be present in the epithelium unless you got a nasty bug. This includes basophils and eosinophils.

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17
Q

How is the mast cell released?

A

When activated by neurogenic or antigenic stimulation.

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18
Q

Mast cells degranulate in what sort of manner?

A

Controlled manner.

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19
Q

What kind of shape are the IgE antibodies?

A

Y-shaped. THey are attached on the cell membrane

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20
Q

What happens when the antigen binds to two IgE molecules?

A

THe membrane becomes more permeable to calcium

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21
Q

What becomes active when calcium is allowed in?

A

Phosphlipase A2

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22
Q

What is a componenet of the immediate reaction?

A

Histamine.

Gets released to the outside environment

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23
Q

What are components of the inflammatory phase?

A

Prostaglandins and leukotrienes.

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24
Q

When does clinical papillae occur?

A

When the substantia propria abnormally bulges into the overlying epithelial layer, levating the latter tissue.

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25
Q

Where does the leakage of fluid come from in papillae?

A

Vascular core.

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26
Q

How is papillae distinguished from follicles?

A

Presence of blood vessels in their centers.

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27
Q

Is a papillae specific or nonspecific clinical sign?

A

nonspecific.

Can result from any type of inflammation or chronic irritation.

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28
Q

What do the areas of hypertrophy in a papillae contain?

A

Neutrophils and eosinophils

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29
Q

What layer is the follicle contained in?

A

Adenoid layer.

Contains lymphocytes and macrophages

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30
Q

Describe how a follicle look like?

A

Clear, fluid filled pickets.

Never has blood vessels passing through the middle.

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31
Q

What does a follicle sign indicate?

A

A specific clinical sign.

Present in conditions of cell immune reaction: viral infections and hypersensitivity.

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32
Q

WHo are the primary regulators of conjunctival goblet cell secretion?

A

Nerves

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33
Q

What are the three types of nerves that conj is innervated by?

A

Efferent Symp
Efferent Parasymp
Afferent sensory

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34
Q

Who does goblet cells have receptors for NTs for?

A

Symp nerves

Parasymp nerves

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35
Q

What NTs parasymp stimulate the goblets cells

A

Ach

VIP - vasoactive intestinal peptide.

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36
Q

Who is the driving force for conj fluid secretion?

A

Basolateral Na+/K+ ATPase

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37
Q

The Levator Palpebrae Superioris is supplied by which nerve?

A

CN III

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38
Q

Which nerve is supplies the Mueller’s muscle

A

Sympathetic nerves

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39
Q

Which nerve supplies the Frontalis

A

Facial nerve

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40
Q

What is the function of the orbital portion of Orbicularis oculi

A

closes lid forcefully

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41
Q

What are the three eyelid elevators?

A

Frontalis
LPS
Mueller’s

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42
Q

What is the function of the palpebral portion of O.O

A

Closes lid gently.

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43
Q

What is the function of the muscle of Riolan

A

Holds the eyelid to the globe

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44
Q

What is the purpose of Horner’s muscle and rest of O.O.

A

dilates lacrimal sac to let tears in and out

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45
Q

What is bell’s phenomenon?

A

Upward and outward rotation of the eyes on bilateral closure (or attempted closure of eyelids)

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46
Q

Synergism of what two muscles take place in Bell’s phenomenon?

A

LPS and SR

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47
Q

What are the 5 Relex blinking types

A 
THink Mr. Toad
Menace
Tactile
Orbicularis
Auditory
Dazzle
MTO = Cortical central connection
48
Q

Who has a cortical Central connection?

A

MTO
Menace
Touch
Orbicularis

49
Q

What is the afferent CN for Orbicularis Oculi?

A

CN V

50
Q

Is the LPS inhibited or excited during a blink?

A

inhibited. In bell’s phenomenon it is not inhibited. It works together with the SR to make it happen.

51
Q

What is the rate for spontaneous blink?

A

15 times per minute.

52
Q

What is the purpose of spontaneous blink?

A

It redistributes the precorneal tear film

53
Q

What has the highest EMG amplitude?

A

Voluntary blink.

Least is spontaneous blink

54
Q

As for intervals and frequencies, which phase is faster?

A

Closing phase is faster than the opening phase.
Closing phase has a shorter duration.
Closing phase is actually closing your eyeball. 1:2 ratio

55
Q

Tell me about the blink rate for dry eye and dry eye with tears?

A

The blink rate is more for dry eye patients without tears.

56
Q

Tell me about gaze position and blink rate?

A

Blink rate increases significantly as you look up.

57
Q

Compare blink rates of reading, conversation and rest

A

Blink rate from low to high

  1. reading
  2. rest
  3. conversation
58
Q

What is Bell’s Palsy?

A

A idiopathic hemi-facial paralysis.

59
Q

What is blepharospasm?

A

Involuntary closure of both eyelids

It is eliminated with SLeep!!!

60
Q

Which part of the sclera has the highest internal radial stress?

A

Anterior sclera
Equatorial sclera.
Y? Thinnest in these areas

61
Q

Who has the highest circumferential wall stress?

A

The limbus
Y?
A two-fold higher amount of stress is req’d to sustain the curvature change from the cornea to the sclera.

62
Q

What is the dual function of the sclera?

A

Posterior: extensible. Acts as a mechanical buffer or cushion against acute increase in IOP
Anterior and equatorial: Rigid support and stability of the globe.

63
Q

What happens when IOP increases or stress is applied to a system?

A

The sclera’s elastic stress-strain curve increases exponentially.
This will also reveal a slower time-dependent viscous response decrease with time.

64
Q

What is the shape of the stress-strain curve for sclera?

A

J-shaped

65
Q

How does the J-shaped curve arise for sclera?

A

Its extensible elastin fibers and the wavy collagen fibrils that take up slack at first.
Get used to stress and resistance is built up

66
Q

Is the level of sceral distensibility fixed or not fixed?

A

Not fixed

67
Q

How is scleral distensibility determined?

A

Pressure changes
The amount of time acting on the sclera
Innate biomechanical properties and thickness of the sclera.

68
Q

What order kinetics is the sclera responsible for?

A

First-order kinetics.

69
Q

What are the two types of mucin?

A

Secreted

Membrane

70
Q

What are the three main important membrane associated proteins?

A

MUC 1, 4, and 16

71
Q

Which cells produce the membrane associated proteins?

A

Apical cells of stratified corneal and conjunctival epithelium.

72
Q

Which cells express the popular secreted mucin?

A

goblet cells of the conj epithelium

73
Q

What is the purpose of the MAMs?

A

A barrier to protect the ocular surface against pathogen invasion.
Provide a hydrating, lubricating surface.

74
Q

What is the purpose of MUC5AC

A

It is secreted into the tear film.

Lids move the soluble mucin over the surface of the eye to trap and remove foreign debris.

75
Q

Does conj epithelium have both secreted and membrane associated mucins?

A

Yep

76
Q

On which side of cellular surface is glycocalyx found?

A

apical plasma membrane of the superficial cell layer.

77
Q

What is the purpose of glycocalyx layer?

A

Serve as a barrier to pathogens.

Allows the mucous layer to move over the ocular surface.

78
Q

What does the carbohydrate side chains of glycocalyx hold?

A

Water!!!

79
Q

What does the mucous layer backbone consist of?

A

Gel-forming mucin MUC5AC, synthesized and secreted by conj goblet cells.

80
Q

Which mucin is the glycocalyx layer composed of?

A

MUC1, 4, 16

81
Q

IN what structure does the aqueous layer play a big role in?

A

Tear film

98%

82
Q

What is the purpose of the anterior lipid layer?

A

Prevent evaporation of the water component.

Reduces evaporation to about 10% of that found in the fluid systems without a lipid surface.

83
Q

Which interface does the outer non-polar and inner polar components of anterior lipid layer consist of?

A

Outer nonpolar: air interface

Inner polar: aqueous interface

84
Q

What electrolytes are found in the Basic Tear Solution?

A 
NaCl
KCl
CaCl
MgCl
NaCHO3-
NaPO3-
85
Q

What are not essential in BTS

A

Glucose and large molecules

86
Q

What are the four possible origins of tear proteins?

A

Proteins from ocular surface blood vessels
Lacrimal gland proteins
-Proteins from ocular surface epithelium
-Proteins from ocular mucus.

87
Q

What are the two types of lacrimal gland proteins?

A
  1. Consitutively secreted proteins

2. Regulated proteins

88
Q

What are the three proteins from ocular surface blood vessels?

A

IgG
Albumin
Transferrin

89
Q

What are the two consitutevely secreted proteins?

A

IgA

IgM

90
Q

What are the four Regulated Proteins?

A

Lactoferrin
Lipocalin
Lysozyme
Peroxidase

91
Q

What differentiates constitutively secreted proteins from regulated proteins?

A

Cons sec proteins will get reduced with reflex tearing while Regulated proteins will get increased with reflex tearing.

92
Q

What are the three predominant serum proteins?

A

albumin
transferrin
IgG

93
Q

Are the proteins from ocular surface blood vessels found in high or low levels in tears?

A

Very low levels in tears.

They are found at its highest in nonstimulated tears and decline with stimulation of tearing.

94
Q

Of the three proteins from ocular surface blood vessels, which are found the most in the ocular surface blood vessels?

A

Albumin

95
Q

Albumin is responsible for….

A

Osmotic pressure in the capillary and draws water in

Transports small molecules through the plasma and extracellular fluid.

96
Q

Transferrin is responsible for….

A

Iron transport

97
Q

IgG is responsible for

A

Immunity against blood-borne diseases.

98
Q

What are the consituteively secreted proteins secretion controlledy by?

A

The rate of protein synthesis.

It is independent of the rate of fluid secretion.

99
Q

Who is the major constitutively secreted lacrimal gland protein?

A

Secretory IgA

100
Q

Who has the largest immunoglobulin?

A

Tear IgM

101
Q

What is IgM responsible for….

A

Detects early immune response
Enchances phagocytosis
Fixes complement

102
Q

What is IgA responsible for?

A

Protect mucosal surfaces of the eye by….
Immunologic barrier to the adherence
Colonization
Cellular entry of microbial organisms and antigenic marcromolecules

103
Q

What is the IgG/IgA ratio in tears?

A

1:1.

In plasma it is 7:1

104
Q

What is the role of secretory component?

A

Facilitates the transport o fthe IgA dimer and protects it from proteolytic digestion in the tear secretions.

105
Q

who produces secretory component?

A

Conj epithelium.

Not produced by corneal epithelium.

106
Q

What does a flourescein stain reveal?

A

Disruption of cell-cell junctions

107
Q

What does Rose begnal staining reveal?

A

Insufficient protection by preocular tear film

108
Q

How many seconds constitute an abnomral TBUT?

A

10 seconds

109
Q

What is the purpose of Dilation of bulbar and limbal vasculature?

A

Detects ocular irritation

110
Q

Purpose of non-invasive TBUT?

A

Measures tear stability

111
Q

Purpose of Fluoresceint TBUT akorn DET

A

Measures tear stability

112
Q

Purpose of phenol red thread test?

A

Measures tear volume

113
Q

Purpose of tear film osmolality?

A

Increased osmolality in dry eye conditions

114
Q

Purpose of tear lactoferrin

A

Decreased in dry eye conditions

115
Q

Purpose of Tear IgE?

A

Increased in dry eye condition

116
Q

Purpose of impression cytology?

A

Squamos metaplasia seen in dry eyes

117
Q

Purpose of lisssamine green?

A

Indicates integrity of conj cells.

Oc Physio (7 decks)

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