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OphthalmologyJaz > Ophth Anatomy > Flashcards

Ophth Anatomy Flashcards

1
Q

uvea = __+__+__

A

choroid
ciliary body
iris

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2
Q

CNs associated with the eye =

A 
II 
III
IV
V
VI
VII
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3
Q

hypermetropia =

need a __ lens to correct otherwise beams meet ___ relative to retina

A

long sighted
() = convex lens
posterior

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4
Q

myopia =

need __ lens to correct otherwise beams meet ___ relative to retina

A

short-sighted
)( = concave lens
anterior

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5
Q

astigmatism =

A

lens/cornea is rugby ball shaped rather than spherical

can cause blurred/distorted vision

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6
Q

presbyopia is due to ___

A

lens proteins stiffen and lose accomodation ability

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7
Q

red reflex can be reduced by __/___

A

retinoblastoma

cataracts

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8
Q

causes of ethmoid orbital plate # are usually ___ and cause a ___ # of the medial orbital wall

A

indirect

blow out #

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9
Q

3 bones that make up the orbital rim

A

maxillary (inf medial)
zygomatic (inf lateral)
frontal (sup)

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10
Q

palpebrae =

components =

A 
eyelids
outer skin
conjunctiva
trasal plate
meibomian glands
orbicularis oculi
levator palpebrae superioris
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11
Q

thickened CT that maintains shape of eyelid

A

tarsal plate

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12
Q

gland in eyelid that secrete oily substance

A

meibomian glands

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13
Q

tears go __>___ across the cornea

drain to ___ > canaliculi > lacrimal sac > ____ > ___ of lateral nasal cavity wall

A 
superolateral
inferomedial
puncta lacrimalia
nasolacrimal duct
inferior meatus
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14
Q

innervation of lacrimal gland =

A

CNVII

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15
Q

orbicularis nerve supply =

A

CNVII

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16
Q

Levator palpebrae superioris innervation =

A

CNIII

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17
Q

3 layers of the eyeball and their components =

A 
outer fibrous (sclera and cornea)
middle vascular pigmented (choroid, ciliary body, iris)
inner nervous (retina)
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18
Q

two smooth muscles of the iris

A

sphincter pupillae

dilator pupillae

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19
Q

sphincter pupillae is arranged ____
used in ___
nerve control =

A

concentrically
bright light and accomodation to constrict the pupil
parasympathetic CNIII

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20
Q

dilator pupillae is arranged ___
used in __+__
nerve control =

A

radially
dim light and fright to dilate pupil
sympathetics from internal carotid plexus

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21
Q

point of best visual acutiy = ____

is a depression in the retina

A

fovea centralis in macula lutea

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22
Q

aqueous space in front of pupil =

A

anterior chamber

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23
Q

posterior chamber of aqueous humour lies between

A

pupil and lens

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24
Q

function of the superior rectus =
innervation =
test =

A

look up and in
CNIII
test = look out and then up

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25
Q

medial rectus function =
innervation =
test =

A

adduct eye
CNIII
adduct eye

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26
Q

inferior rectus function =
innervation =
test =

A

look down and in
CNIII
test = look out then down

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27
Q

lateral rectus function =
innervation =
test =

A

abduct the eye
CNVI
test = abduct eye

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28
Q

superior oblique function =
innervation =
test =

A

look down and out
CNIV
test = look in then down

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29
Q

inferior oblique function =
innervation =
test =

A

look up and out
CNIII
test = look in then up

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30
Q

CN_+++_ have parasympathetic fibres and so can supply glands

A

CN III, VII, IX, X

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31
Q

supraorbital nerve = a branch of ___

passes through the ____ of the ___ bone

A

CNV1

supraorbital foramen/notch of frontal bone

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32
Q

infraorbital nerve = a branch of ___

passes through ___ of __ bone

A

CNV2

infraorbital foramen of maxilla

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33
Q

site of lacrimal gland

A

superior and lateral to eyeball

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34
Q

Supports both eyes in the same vertical plane =

A

Suspensory ligament

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35
Q

Suspensory ligament is attached to ___ + ____

A

Zygoma

Lacrimal bone

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36
Q

If zygoma fracture then eye tends to ____ leading to diplopia

A

Rotate medially towards the orbital floor

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37
Q

General sensory areas of the face supplied by V1 (ophthalmic) =

A

Upper eyelid
Cornea
Conjunctivae
Root bridge. And tip of nose

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38
Q

General sensory areas of the face supplied by V2 (maxillary)

A

Lower eyelid
Maxillary skin
Nose ala
Upper lip

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39
Q

General sensory areas of the face supplied by V3 (mandibular)

A

Mandible and TMJ skin

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40
Q

General sensory to angle of mandible is supplied by

A

C2+3

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41
Q

Corneal/blink reflex:

Touch cornea>CN__>___ganglion>CN___>pons>CN__motor to ___ part of _____ >blink

A 
V1
Trigeminal
V
VII
Palpebral part of orbicularis oculi
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42
Q

Eyepatch is needed if have a ___ palsy as cant do motor part of blink reflex

A

CNVII

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43
Q

Sympathetics to head:

Presynaptic synapse at. ____ (releasing___) then post synaptic axon travels along ___ and release ___ at target organs

A

Superior cervical ganglion
ACh
I/ECA
NA

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44
Q

Presynaptic sympathetics of the head exit spinal cord at ____ spinal nerve

A

T1

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45
Q

Inferior cervical and 1st thoracic ganglion often fuse to form ____

A

Stellate ganglion

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46
Q

_____ from ____ carries the orbital sympathetics

A

Ophthalmic artery

ICA

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47
Q

CNIII passes through____ in the base of the skull

A

Superior orbital fissure

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48
Q

CN III synapses at ____ in the orbit to supply the eye

A

Ciliary ganglion

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49
Q

Superior branch of CNIII supplies ____ to which structures?

A

Somatic motor
Superior rectus
Levator palpebrae superioris

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50
Q

Inferior branch of CNIII supplies ____ to which structures?

A

Somatic motor

Medial inferior and lateral rectus

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51
Q

Parasympathetics to the eye come from which nerves

A 
CNIII (inferior branch)
VII
IX
X
Sacral Spinal nerves
Short ciliary nerve
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52
Q

CNVII parasympathetics synapse at ____ to supply the lacrimal gland and ____ to supply submandibular and sublingual glands

A

Pterygopalatine

Submandibular

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53
Q

Parasympathetics of CNIX synapse at ____ to supply the ___ salivary gland

A

Otic ganglion

Parotid

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54
Q

Types of fibres in the long ciliary nerve and its function

A

Sympathetic
Somatic sensory
First part of afferent limb of corneal reflex

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55
Q

Short ciliary nerve contains ___+__+___ fibres

A

Somatic sensory, parasymp and symp

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56
Q

Long and short ciliary nerves supply autonomic axons to control __+___

A

Pupil size

Refractive shape of the lens

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57
Q

Autonomic reflexes of the eye (6)

A 
Maximum eyelid elevation (flight/fight)
Pupillary light reflex
Accomodation reflex
Lacrimation
Vestibulo-ocular
Oculocardiac reflex
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58
Q

Vestibulo-ocular reflex involves which CNs

A

8
3
4
6

59
Q

Oculocardiac reflex =

Which nerves?

A

Reflex bradycardia if tension of extraocular muscles or increased eye pressure
CNV1 + X

60
Q

Effects of sympathetics on the eye = (4)

A

Emotional lacrimation
Eyes open wider
Pupils dilate
Focus on far objects

61
Q

Parasympathetic effects on the eye = (4)

A

Reflex/cleaning lacrimation
Orbicularis oculi
Pupils constrict
Focus on near objects

62
Q

In opening the eyes wider sympathetic post synaptic fibres reach the LPS from (4)

A

Superior cervical symp ganglion
Internal carotid nerve
Internal carotid plexus
Axons on ophthalmic artery and its branches

63
Q

LPS type of muscle

A

Smooth and skeletal

64
Q

Fixed and mobile insertions of the dilator pupillae =

A

Fixed - external edge of iris

Mobile - internal edge of iris

65
Q

Non physiologically dilated pupil aka

A

Mydriatic pupil

66
Q

Sphincter pupillae. Is around the ___ of the iris

A

Internal cicumference

67
Q

Non physiologically constricted pupil aka

Component of ___ (pathology)

A

Miotic

Horners

68
Q

Opiates cause a ___ pupil

A

Fixed pinpoint

69
Q

Fixed dilated pupil (aka?) is a sign of _____

A

Blown pupil

CNIII palsy

70
Q

Pupillary light reflex:

Special sensory afferent limb of reflex = ____ >____>bilateral _____

A

Ipsilateral CNII
Thalamus
CNIII motor limb

71
Q

Pupillary light reflex causes a ___ and ____ reflex

A

Direct (stimulated eye)

Consensual

72
Q

Pupillary light reflex involves___ neurons
____ pass via ipsilateral optic nerve to decussate at ____
Then synapse at _____
Next synapse is at ______ then to ___ who’s inferior division synapses at the _____ to ___ to sphincter pupillae

A 
4
Retinal ganglion cells
Optic chiasm
Pretectal nucleus in midbrain
Edinger Westphal nucleus
CNIII
Ciliary ganglion
Short ciliary nerves
73
Q

____ acts like a sphincter around circumference of ciliary body
Is responsible for____

A

Smooth ciliary muscle

Accomodation

74
Q

____ connects lens to ciliary body

A

Suspensory ligament of the lens

75
Q

Ciliary muscle:

____ in near vision (para/symp) ligament ____ and lens shape =

A

Contract
Parasympathetics
Relax
Spherical

76
Q

Ciliary muscle:

___ nerve supply causes it to ____ in far vision, ligament ___ and lens shape =

A

Sympathetic
Relax
Tighten
Flattens

77
Q

3 components to accomodation reflex to near

Nerve involved =

A

Bilateral pupil constriction
Bilateral convergence (medial rotation) of eyes
Bilateral lens relaxation
CNIII

78
Q

Afferent for reflex tears and also the efferent

A

Afferent V1

Efferent VII parasympathetics

79
Q

Parasympathetics to lacrimal:

___ nerve from CN VII>___ganglion > axons carried on ___ then ____

A

Greater petrosal nerve
Pterygopalatine
V2
V1

80
Q

If the drainage of aqueous humour is blocked or it is overproduced =>___

A

Glaucoma

81
Q

Causes of raised ICP

A 
Head trauma
Hydrocephalus
Space occupying lesion
Abscess
Meningitis
Haemorrhage
82
Q

Monro-Kellie hypothesis

A

Total volume of blood, brain and CSF in cranial cavity is constant
Therefore if one increases the other two/one must decrease

83
Q

Sunset sign -

Sign of -

A

Can see whites of the eyes above iris

Hydrocephalus

84
Q

Thick and fibrous meninges
Outer/inner
Names of the two layers

A

Dura mater
Outer
Endosteal and meningeal

85
Q

Outer to inner meninges

A

Dura mater
Arachnoid mater
Pia mater

86
Q

Pia mater is how thick

A

Unicellularly

87
Q

The different dura maters in the skull = (5)

A 
Falx cerebri
Diaphragma sellae
Tentorium cerebelli
Tentorial notch
Falx cerebelli
88
Q

Dura mater that splits two cerebrum hemispheres

A

Falx cerebri

89
Q

Dura mater that splits to cerebellar hemispheres

A

Falx cerebelli

90
Q

Dura mater superior to pituitary

A

Diaphragma sellae

91
Q

Dura mater separating cerebrum from cerebellum

A

Tentorium cerebelli

92
Q

If ICP is raised the brain may be forced into these two spaces

A

Foramen magnum

Tentorial notch in dura mater

93
Q

Parts of the lateral ventricles (4)

A

Body
Ant/frontal horns
Occipital/posterior horns
Temporal/inferior horns

94
Q

Visual problems associated with raised ICP

A 
Transient blurred vision
Diplopia
Loss of vision
Papilloedema
Fixed dilated pupil
95
Q

Why is a fixed dilated pupil an early sign of raised ICP?

A

CNIII para fibres that supply sphincter pupillae lie on the outside of the nerve and so are compressed first => unopposed action of dilator pupillae

96
Q

Symptoms of papilloedema

A 
Transient visual obscurations (greying out)
Transient flickering
Blurry
Constriction of visual field
Decreased colour perception
97
Q

Grade 1 papilloedema =

A

C shaped halo blurring disc edge

98
Q

Stage 2 papilloedema

A

Circumferential halo with blurred edges

99
Q

Stage 3 papilloedema

A

Vessels on edge of disc disappear

100
Q

Stage 4 papilloedema

A

Loss of major blood vessels on the disc

101
Q

Stage 5 papilloedema

A

Extremely blurred disc and total/partial obscuration of vessels on disc

102
Q

Sensory supply of dura mater =

A

CNV

103
Q

Level a lumbar puncture is taken at

A

IV disc L3/4 or L4/5

104
Q

Subarachnoid space ends here in spinal column

A

S2

105
Q

Signs of CNIII damage

A

Lose pupillary light reflex
Ptosis
Eye turns inferolaterally

106
Q

Signs of CNIV damage

A

Inferior oblique unopposed so cant move eye inferomedially

Diplopia on down gaze

107
Q

Signs of CNVI damage

A

Cant move eye laterally in horizontal plane

108
Q

3 cardinal signs of Horners syndrome

A

Ptosis
Miosis
Anhydrosis

109
Q

Causes of follicles on lower eyelid -

A

Viral

Chlamydia

110
Q

Down and out eye with ptosis =

A

Complete CNIII palsy

111
Q

3 things to consider when describing the appearance of an optic disc

A

Cup colour contour

112
Q

Rough diameter of the iris

A

11-12mm

113
Q

Eye rough diameter

A

24mm

114
Q

Where the eye meets the medial epithelium =

A

Plica semilunaris

115
Q

2 muscles involved in the eye opening

A

Lps

Mullers muscle

116
Q

In horners if this muscle is affected (as it has sympathetic control) it causes ptosis

A

Mullers muscle

117
Q

Orbitsl septum originates from ___, blends with ___ superiorly and inserts into ___ inferiorly

A

Orbital periosteum
LPS tendon
Tarsal plate

118
Q

Cellulitis in front and behind orbital septum are called?

A

Preseptal

Orbital (sight threatening)

119
Q

Layers of cornea deep to superficial

A 
Endothelium
Descemet's membrane
Stroma
Bowmans membrane
Epithelium
120
Q

Part of cornea that contains regularly spaced collagen fibres

A

Stroma

121
Q

Function of the endothelium in the cornea

A

Maintains transparency by pumping fluid out of the stroma

122
Q

Lens is attached to ciliary body by ___

A

Zonules

123
Q

___ in tension of zonules allows for near focus

A

Decrease

124
Q

Contraction of ciliary muscle causes the tension of the zonules to ___

A

Decrease

125
Q

CNIII is vulnerable to ____ aneurysms at it lies close to it

A

Posterior communicating artery

126
Q

Why does a lesion of the CNIV cause a palsy on the contralateral side muscle?

A

Attaches to brain at pons and crosses over

127
Q

Position of the trochlear nucleus of CNIV

A

Inferior to cerebral aqueduct

128
Q

CNIv enters eye via __

A

Superior orbital fissure

129
Q

Palsies of CNVI are usually caused by ___

A

Raised ICP stretching it

130
Q

CNVI passes through the middle of ____

Nucleus is in the ____

A

Cavernous sinus

Pons

131
Q

Rectus muscles all arise from the ____ which is also attached to the ____ therefore optic neuritis often causes____

A

Common tendinous ring
Optic nerve sheath
Pain on eye movements

132
Q

Strongest and thickest rectus muscle

A

Medial

133
Q

Blowout fracture typically entraps the____

A

Inferior rectus

134
Q

Epithelium that makes up the retina

A

Pigmented cuboidal

135
Q

Blind spot lies ____ in the visual field

A

15degrees temporally

136
Q

Vascular tunic that supplies the outer retinal layer -

A

Choroid

137
Q

Superior ophthalmic vein leaves eye via ___ and drains to ____

A

Superior orbital fissure

Cavernous sinus

138
Q

Long and short ciliary nerves become part of _____

A

CNVs nasociliary nerve

139
Q

Retina has no ___ sensation

A

Pain

140
Q

Thinnest orbital wall

A

Medial

141
Q

Orbital wall most vulnerable to blunt trauma

A

Inferior

142
Q

Supraorbital nerve and vessels pass through the ___

A

Supraorbital notch

143
Q

Blowout fractures usually cause pain on ___

A

Upgaze

OphthalmologyJaz (13 decks)

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