Ocular: Conjunctiva Flashcards by Bella Forster

What is the conjunctiva?

Thin, transparent mucous membrane that lines the inside of the eyelids and covers the sclera

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What tissue makes up the conjunctiva

Stratified columnar epithelium

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Function of conj

Provide protection and lubrication to the eye through production of mucous and tears

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Is the conj vascularized?

YES, very

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3 portion of the conj that are continuous with each other:

-palpebral
-bulbar
-fornix (curl-de-sac)

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Palpebral portion of the conj lines the…

Inside of the eyelids

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Bulbar part of the conj encases the…

Globes anterior sclera

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Fornix (cul-de-sac) conj:

-connects palpebral and bulbar conj

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Where is the most abundant site of conjunctival stem cells?

Fornix (cul-de-sac) conj

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Each part of the conj has a ________ and a ________ but they are slightly different from one another

Epithelium and a stroma

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The conjunctiva is continuous with:

-the cornea at the limbus
-the eyelid skin at the mucocutaneous junction (MC)

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Plica semilunaris is…

Located in the medial canthal region and is a half moon shape of bulbar conj

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Plica semilunaris is a vestigial remnant of the _________ _________

Nictitating membrane

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In lateral gaze, the Plica semilunaris ______ _______

Partially unfolds

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The Plica semilunaris is rich in _______ ______

Goblet cells

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Stroma of the Plica semilunaris contains _____ and _________ _________

Fat and non-striated muscle

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Caruncle is a _________, located _________ to the Plica

Nodule, medial

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What type of tissue is in the caruncle?

Nonkeratinized stratified squamous epithelium

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What is located in the caruncle? (3 things)

-pilosebaceous unit
-accessory lacrimal gland tissue
-sebaceous glands

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Where does caruncle get is vascularization?

Superior palpebral arteries

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Caruncle sensory innervation comes from what?

Infratrochlear nerve

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Conjunctival epithelium contain ________ protruding from them

Microvilli

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Microvilli on the conj epithelium is covered with

Glycocalyx

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Conjunctival epithelium cells a re joined by ____________ and ___________

Zonunla occludens and adherens (desmosomes)

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Conjunctival epithelium contain _______ cells that secrete mucin layer of tear film

Goblet cells

What two other cells are located in the conj epithelium aside from the goblet cells?

-langerhan cells (immune surveillance) -melanocytes (mostly close to limbus)

Conjunctival stroma is also called:

Substantia propria

Conj stroma contains:

-nerves -blood vessels -lymphatic vessels

Conjunctival lymphatics drain into the _______ lymphatics

Eyelid

Blood vessels surrounding the conj stroma are ____ cells and contain __________

Mast cells, histamine

Allergic conjunctivitis is involved with the…

Mast cells that contain histamine on the conjunctival stroma

Palpebral conj epithelium tissue

Stratified columnar that becomes stratified squamous near the lid margin.

Stroma of the palpebral conj contains _______ cells that secrete _____ as well as other lymphocytes

Plasma, IgA

Crypts of henle is a part of the ______

MALT

Mucosal associated lymphoid tissue

Crypts of henle:

-invaginations that trap bacteria and pathogens -also contain goblet cells

Glands of wolfring are located on the…

Edge of tarsus on the fornix side

Lid wiper region of the palpebral conj:

-thickened specialized region contracting the eye during a blink

Lid wiper region of palpebral conj is made up of what tissue?

Stratified cuboidal or columnar epithelium with goblet cells

What muscle holds the lid wiper region of the palpebral conj in place against the globe?

Muscle of riolan

Lid wiper region of palpebral conj function:

Skims debris off the eye and spreads a fine consistent tear film over the globe with each blink

Mucocutaneous junction (MCJ) is also called:

Marx’s line

Does Mark’s line stain with dye?

YES

Marx’s line is a meeting of…

Keratinized squamous epithelium of eyelid epidermis and nonkeritinzed squamous palpebral epithelium of the conj

Where does Marx’s line occur?

Just posterior to meibomian gland openings

Bulbar conj is usually translucent and colorless UNLESS:

The blood vessel become engorged or melanocytes of epithelium

Tissue of bulbar conj epithelium:

Stratified cuboidal/columnar changing to stratified squamous near the limbus

Stroma of the bulbar conj is _________adherent to tissue below EXCEPT within ___mm of the cornea

Loosely, 3mm

Conjunctival fornix epithelium tissue

Stratified columnar

Conjunctival fornix consists of a lot of ______ and _______ cells

Goblet and stem cells

Which vitamin is required for goblet cell development?

Vitamin A

Where does goblet cell concentration increase?

It increases near the fornix and nasally

Where is the vitamin that forms goblet cells found in the eye?

The aqueous layer of the tear film

Which region is void of goblet cells?

Limbus

What happens in a vitamin A deficiency?

A decrease in the mucin layer which leads to keratin build-up on the conj called Bitot’s spots

Where are Bitot’s spots most commoly located ?

Lower temporal region where there is a lower concentration of goblet cells

4 Functions of the conj:

-antimicrobial/protective layer -produces mucin of tear film -permits pain-free blinks and globe movement -palpebral conj vessels provide oxygen for cornea

What assists in pain free blinking and globe movement?

-Plica semilunaris -lid wiper

What assists in providing the physical barrier in the conj?

Zonal occuldens and MALT

MACI is the:

Major arteriole circle of the iris

Anterior conjunctival arteries derive from what arteries?

Anterior ciliary arteries

What do Anterior conjunctival arteries supply?

The bulbar conj 2-3mm posterior to the limbus

Medial half of the eyelid lymphatics drain into:

Submandibular lymph node

Lateral half of the eyelid lymphatics drains into what lymph node?

Pre-auricular lymph node

Sub-conjunctival hemorrhage

Leak from ant conj artery or post conj artery

Conj veins course anteriorly with …

Anterior and posterior conjunctival arteries

Conjunctival veins drain into ______________ or ______________ and then drains into _________

Anterior ciliary veins or palpebral veins, superior or inferior ophthalmic vein

Autonomic parasympathetic conjunctival innervation is via ____________ _________

Pterygopalatine ganglion

Sensory innervation to superior palpebral conj:

Frontal and lacrimal branches of V1

Sensory innervation to inferior palpebral conj:

Lacrimal of V1 and infraorbital of V2

Sensory innervation to bulbar conj:

Nasociliary nerve of V1 via the long ciliary nerve