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Med Prep > ophtha-lacrimal app, conjunctiva > Flashcards

ophtha-lacrimal app, conjunctiva Flashcards

0
Q

Fundamental part of secretory system of lacrimal app

A

Basic secretors

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1
Q

Lacrimal app is responsible in formation of pre-corneal film which is formed by

A

Deep mucoid
Middle watery
Superficial oily

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2
Q

Basic secretors has no afferent nerve supply

A

True

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3
Q

3 basic secretors

A

Mucin secretors
Lacrimal secretors
Oil secretors

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4
Q

3 mucin secretors

A

Conjunctival goblet cells
Crypts of Henle
Gland of Manz

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5
Q

Depression between follicles in upper .1/3 of upper palpebral conj and lower 1/3 of lower palpebral conj

A

Crypts of Henle

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6
Q

3 lacrimal secretors

A

Microscopic acinotubular gland of Krause (40-50 in upper; 6-8 in lower)
Wolfring gland (3 in upper tarsus; 1 in lower tarsus)
Occasional gland in plica semilunaris or caruncle

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7
Q

3 oil secretors

A

Meibomian gland (25 in upper tarsus; 20 in lower)
Gland of zeiss - at palpebral margin of each eyelid
Gland of molls - at roots of eyelashes

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8
Q

Reflex secretors

A

Main lacrimal gland in upper temporal portion of orbit

Adjacent accessory palpebral gland

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9
Q

Reflex afferent pathway

A

CN5

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10
Q

Reflex efferent pathway for sympa

A

CN7

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11
Q

Always involved primarily on true hypersecretion

A

Reflex secretors

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12
Q

Lacrimal passages

A

Lacrimal puncta
Canaliculi - upper and lower empties in lateral wall of sac
Lacrimal sac
Lacrimonasal duct

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13
Q

The internal common puncta may be preceded by dilation

A

Sinus of maier

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14
Q

Fibers of OO which surrounding the lacrimal sac

A

Horner’s ms

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15
Q

Fold of mucosa which guards the ostium

A

Hasner’s valve

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16
Q

Tears enter the lacrimal sac partly by..

A

Capillary attraction and suction

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17
Q

Drainage of tears is assisted by

A

Pars marginalis of OO or ciliary bundle of riolan

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18
Q

Onward transmission of tears down the duct is due to

A

Forces of gravity and pumping of sac caused by elastic recoil of its wall after act of blinking

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19
Q

Negative/positive pressure exists in lacrimal sac when one blinks

A

Negative pressure

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20
Q

Tear secretion

A
  1. 2% water

0. 8% solid

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21
Q

Excessive tearing

A

Epiphora

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22
Q

Epiphora is due to

A

Hyper secretion - due to emotional influence, local irritants in eyes, nose
Drainage interference - due to displacement of lower puncta, obstruction of lower puncta, Canaliculi, sac or duct

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23
Q

Obstruction of upper puncta does not cause epiphora

A

True

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24
Q

Test for patent drainage

A

Dropping of saccharine or chloramphenicol soln on conj cul-de-sac. If pt experience bitter taste after 5-15min, passage is open

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25
Q

Dryness of eye does not occur even if lacrimal glands are removed.

A

True. As long as basic secretors are normal

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26
Q

Only this secretors are present during sleep.

A

Basic secretors

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27
Q

Clinical condi with dryness of eye

A

Xerophthalmia
Sjögren’s syndrome (keratoconjunctivitis sicca)
Steven-Johnson syndrome - erythema multiforme
Riley-day syndrome

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28
Q

Test to determine adequate lacrimal secretion

A

“Schirmer’s filter paper test”

A filter paper (5x35mm) bent around 5mm at one end and is anchored by hanging over the lower eyelid margin covering the lower puncta. After 5 min, 10mm should be wet.

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29
Q

Infection of lacrimal g due to pyogenic organisms which may lead to Suppuration

A

Dacryo-adentitis

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30
Q

Dacryo-adenitis may occur as complication of..

A

Mumps, measles, influenza, thyroid fever

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31
Q

Bilateral enlargement of lacrimal gland with chronic inflammatory lesion of uveal tract that occurs in asso with bilateral inflammatory swelling with facial palsy (heerfordt’s syndrome)

A

Uveo-parotitis

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32
Q

Non developmental of conj from surface ectoderm. Gland appears as congenital cystic mass which extends posterior to orbital apex.

A

Cryptophthalmos

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33
Q

Most common neoplasm of lacrimal gland

A

Mixed tumor

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34
Q

Lymphomatous tumor of lacrimal, parotid and submaxillary gland

A

Mikulic’s disease

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35
Q

Fungus infection of Canaliculi

A

Actinomycosis

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36
Q

Streptothrix infection in upper canaliculus with dilatation of canaliculus with purulent discharge that oozes from puncta

A

Actinomycosis

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37
Q

Inflammation of lacrimal sac

A

Dacryocystitis

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38
Q

Dacryocystitis in infant is due to

A

Incomplete canalizations of lower part of lacrimal duct and/or
Differentiation of valve of hasner in inferior meatal area of nose

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39
Q

Chronic primary dacryocystitis is caused by

A

Streptococci

Pneumococci

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40
Q

Hereditary form in chronic primary dacryocystitis is common

A

True

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41
Q

Chronic primary Dacryocystitis is common in male

A

Female

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42
Q

In chronic primary dacryocystitis, infection may spread into tissues around the lacrimal sac

A

Peridacryocystitis

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43
Q

Can arise from chronic dacryocystitis if infection extends beyond the limits of sac and give rise to abscess.

A

Acute primary dacryocystitis

44
Q

Due to disease or injury in the neighborhood of lacrimal sac and duct producing interference of tear passage

A

Secondary dacryocystitis

45
Q

If secondary dacryocystitis is duet to trauma of duct, as in fracture, what is the management?

A

Dacrycystorhinostomy

46
Q

If secondary dacryocystitis is due to infection of adjacent bone, what is the management?

A

Excision of inflamed sac

47
Q

Lower puncta comes forward and away from marginal strip of tear fluid and epiphora results

A

EVersion of lower puncta

48
Q

Eversion of lower puncta is due to

A

Senile laxity of lids
Chronic blepharitis
Ectropion

49
Q

Palpebral and bulbar conjunctiva is separated by

50
Q

Mucous gland is found on epithelium of..

A

Bulbar and tarsal portion of palpebral conj

51
Q

Only superficial tissue of body where blood vessels can be seen

A

Conjunctiva

52
Q

Bld supply of conjunctiva

A

Palpebral branch of nasal and lacrimal artery at lids

Anterior ciliary artery at limbus

53
Q

Venous drainage of conjunctiva

A

Drains thru post tarsal venous plexuses of eyelid

54
Q

Conjunctiva has no lymph nodes

A

Yes. But have lymph vessels.

55
Q

Lymphatic drainage of conjunctiva

A

Lateral: pre-auricular or superficial parotid lymph node
Medial: submaxillary lymph node

56
Q

Innervation of conjunctiva

A

Sensory - nasociliary, lacrimal, frontal, infraorbital, ciliary nerve
Sympa- ophthalmic a.

57
Q

Single clue signifying pathology of conj

A

Foreign body sensation

58
Q

Other symptoms of conjunctival pathology

A 
Conjunctival injection
Lacrimation or discharge
Formation of papilla or follicle 
Hemorrhage 
Ulceration
Growth
59
Q

Dilatation of superficial conjunctival blood vessels.

A

Conjunctival injection

60
Q

Dilatation of deeper ciliary blood vessels near the limbus.

A

Ciliary injection

61
Q

Vascular reaction charac by neoformation of blood vessels at the center surrounded by lymphoid infiltration

62
Q

Lymphatic reaction with neoformation of lymphoid tissue with peripheral vascularization

63
Q

Bacterial growth can be prevented by

A

Low temp
Antibacterial action of lysozyme in tears
Mechanical effect of blinking
Production of antibiotics by some bacteria present in conj
Flushing action of Tear flow

64
Q

Bacteria that predominates in conj pathology

A

Strep
Diphtheria
Staph

65
Q

Bacteria that increase in debilitated persons

A

Pseudomonas aeroginosa

Enterobacter sp

66
Q

Bacteria that increase in cadaver

A 
Beta hemolytic strep
E.coli
Klebsiella pneumonia
Pseudomonas aeroginosa 
Flavo bacterium
67
Q

Mucoid discharge is produced by

A

Moxarella-axenfeld diplobacillus

68
Q

Mucoid discharge is common in (canthus)

A

Lateral canthus (thus called angular conjunctivitis)

69
Q

Purulent discharge in conjunctiva is produced by

A

Neisseria gonorrhea

B-streptococcus

70
Q

In addition to purulent discharge, may produce membranous material

A

Strep conjunctivitis

71
Q

Mucopurulent discharge

A 
Hemophilus aegyptius 
h. Influenza
Staph aureus 
p. Aeroginosa 
E. Coli
Proteus mabilis
72
Q

Most common org producing mucopurulent discharge

A

Hemophilus aegyptius

73
Q

3 organisms producing ophthalmia neonatorum

A

Chlamydia oculogenitalia
Staph aureus
Neisseria gonorrheae

74
Q

Viral conjunctivitis caused by adenopharyngoconjunctival virus (APC8)

A

Epidemic conjunctivitis

75
Q

Viral conjunctivitis caused by coxsackie 24 or EV70

A

Acute hemorrhage conjunctivitis

76
Q

Viral conjunctivitis that produces pseudo-membrane in lower and upper palpebral conj

A

Epidemic conjunctivitis

77
Q

Viral conjunctivitis accompanied by marked febrile symptoms

A

Pharyngoconjunctival fever

78
Q

Viral conjunctivitis that has conjunctival hemorrhage in upper bulBar conjunctiva

A

Acute hemorrhagic conjunctivitis

79
Q

Viral conjunctivitis is self limiting for how many weeks

80
Q

Reduces intensity of symptoms and duration of condition by enhancing the immune response even if after onset

A

Oral Methisoprinol

81
Q

Other virus that cause viral conjunctivitis

A

Exenthematous virus (.small pox, chicken pox, measles, German measles)
Herpes virus
Myxovirus (mumps, influenza and new castle disease)

82
Q

Chlamydia conjunctivitis

A

Trachoma

Inclusion blenorrhea

83
Q

Trachoma is caused by what organism

A

Chlamydia trachoma

84
Q

Filipino are known to be immune in trachoma and are affected that ends with what stage?

A

Follicular stage

85
Q

4 stages of trachoma (mcCallan)

A
  1. Formation of follicles
  2. Presence of papillary hypertrophy and transformation of follicles into “sago grain” struc
  3. Beginning of scarring
  4. Period of cicatricization when all inflammatory activity end
86
Q

Trachoma is common in palpebral/bulbar conj

A

Palpebral conj

87
Q

Inclusion blenorrhea is caused by

A

Chlamydia oculogenitalia

88
Q

Acquired from venereal contact and swimming in nonchlorinated pool

A

Inclusion blenorrhea

89
Q

Discharge of blenorrhea

A

Mucopurulent discharge

90
Q

Inclusion blenorrhea is common in palpebral/bulbar conj

A

Lower palpebral conj

91
Q

Allergic conjunctivitis most produce ____ and this cells are found in discharge

A

Most produce chemosis

Eosinophils found in discharge

92
Q

A keratoconjunctivitis but only can affect bulbar conj

A

Phlyctenular conjunctivitis

93
Q

Localized whitish nodule with necrotic excavated center surrounded by conj infection

A

Phlyctenular conjunctivitis

94
Q

Phlyctenular conjunctivitis has immunologic reaction to

A

Tuberculoprotein

95
Q

Conjunctivitis commonly found on malnourished children and pulmonary TB

A

Phlyctenular conjunctivitis

96
Q

Recurrent condi affecting upper palpebral conj of both eyes during summer

A

Vernal conjunctivitis

97
Q

Discharge of Vernal conjunctivitis

A

Thick syrupy discharge

98
Q

Has big papillae arranged on cobblestone appearance

A

Vernal conjunctivitis

99
Q

Acute conjunctivitis with marked chemosis ans watery discharge on exposure to certain grasses, plants and trees

A

Atopic conjunctivitis

100
Q

Triangular yellowish mass at bulbar conjunctiva with base towards the limbus. Aggravated by exposure to wind, dust, and sun.

A

Pinguecula

101
Q

Pinguecula: bulbar/palpebral?

A

Bulbar conj

102
Q

Fleshy mass in bulbar conj that invades the cornea at horizontal meridian

103
Q

Pterygium: bulbar/palpebral conj?

A

Bulbar conj

104
Q

Conjunctival growth covering the corneal marginal ulcer. Can grow from any direction besides nasal and temporal region.

A

Pseudo-pterygium

105
Q

Pigmented elevated tumor located at bulbar conj

106
Q

Nevi: bulbar/palpebral conj

A

Bulbar conj

107
Q

Flat diffused conjunctival pigmentation that occurs after age of 40. Sometimes asymptomatic

Med Prep (52 decks)

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