ophtha-lacrimal app, conjunctiva Flashcards
0
Q
Fundamental part of secretory system of lacrimal app
A
Basic secretors
1
Q
Lacrimal app is responsible in formation of pre-corneal film which is formed by
A
Deep mucoid
Middle watery
Superficial oily
2
Q
Basic secretors has no afferent nerve supply
A
True
3
Q
3 basic secretors
A
Mucin secretors
Lacrimal secretors
Oil secretors
4
Q
3 mucin secretors
A
Conjunctival goblet cells
Crypts of Henle
Gland of Manz
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
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
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
8
Q
Reflex secretors
A
Main lacrimal gland in upper temporal portion of orbit
Adjacent accessory palpebral gland
9
Q
Reflex afferent pathway
A
CN5
10
Q
Reflex efferent pathway for sympa
A
CN7
11
Q
Always involved primarily on true hypersecretion
A
Reflex secretors
12
Q
Lacrimal passages
A
Lacrimal puncta
Canaliculi - upper and lower empties in lateral wall of sac
Lacrimal sac
Lacrimonasal duct
13
Q
The internal common puncta may be preceded by dilation
A
Sinus of maier
14
Q
Fibers of OO which surrounding the lacrimal sac
A
Horner’s ms
15
Q
Fold of mucosa which guards the ostium
A
Hasner’s valve
16
Q
Tears enter the lacrimal sac partly by..
A
Capillary attraction and suction
17
Q
Drainage of tears is assisted by
A
Pars marginalis of OO or ciliary bundle of riolan
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
19
Q
Negative/positive pressure exists in lacrimal sac when one blinks
A
Negative pressure
20
Q
Tear secretion
A
- 2% water
0. 8% solid
21
Q
Excessive tearing
A
Epiphora
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
23
Q
Obstruction of upper puncta does not cause epiphora
A
True
24
Test for patent drainage
Dropping of saccharine or chloramphenicol soln on conj cul-de-sac. If pt experience bitter taste after 5-15min, passage is open
25
Dryness of eye does not occur even if lacrimal glands are removed.
True. As long as basic secretors are normal
26
Only this secretors are present during sleep.
Basic secretors
27
Clinical condi with dryness of eye
Xerophthalmia
Sjögren's syndrome (keratoconjunctivitis sicca)
Steven-Johnson syndrome - erythema multiforme
Riley-day syndrome
28
Test to determine adequate lacrimal secretion
"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.
29
Infection of lacrimal g due to pyogenic organisms which may lead to Suppuration
Dacryo-adentitis
30
Dacryo-adenitis may occur as complication of..
Mumps, measles, influenza, thyroid fever
31
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)
Uveo-parotitis
32
Non developmental of conj from surface ectoderm. Gland appears as congenital cystic mass which extends posterior to orbital apex.
Cryptophthalmos
33
Most common neoplasm of lacrimal gland
Mixed tumor
34
Lymphomatous tumor of lacrimal, parotid and submaxillary gland
Mikulic's disease
35
Fungus infection of Canaliculi
Actinomycosis
36
Streptothrix infection in upper canaliculus with dilatation of canaliculus with purulent discharge that oozes from puncta
Actinomycosis
37
Inflammation of lacrimal sac
Dacryocystitis
38
Dacryocystitis in infant is due to
Incomplete canalizations of lower part of lacrimal duct and/or
Differentiation of valve of hasner in inferior meatal area of nose
39
Chronic primary dacryocystitis is caused by
Streptococci
| Pneumococci
40
Hereditary form in chronic primary dacryocystitis is common
True
41
Chronic primary Dacryocystitis is common in male
Female
42
In chronic primary dacryocystitis, infection may spread into tissues around the lacrimal sac
Peridacryocystitis
43
Can arise from chronic dacryocystitis if infection extends beyond the limits of sac and give rise to abscess.
Acute primary dacryocystitis
44
Due to disease or injury in the neighborhood of lacrimal sac and duct producing interference of tear passage
Secondary dacryocystitis
45
If secondary dacryocystitis is duet to trauma of duct, as in fracture, what is the management?
Dacrycystorhinostomy
46
If secondary dacryocystitis is due to infection of adjacent bone, what is the management?
Excision of inflamed sac
47
Lower puncta comes forward and away from marginal strip of tear fluid and epiphora results
EVersion of lower puncta
48
Eversion of lower puncta is due to
Senile laxity of lids
Chronic blepharitis
Ectropion
49
Palpebral and bulbar conjunctiva is separated by
Fornix
50
Mucous gland is found on epithelium of..
Bulbar and tarsal portion of palpebral conj
51
Only superficial tissue of body where blood vessels can be seen
Conjunctiva
52
Bld supply of conjunctiva
Palpebral branch of nasal and lacrimal artery at lids
| Anterior ciliary artery at limbus
53
Venous drainage of conjunctiva
Drains thru post tarsal venous plexuses of eyelid
54
Conjunctiva has no lymph nodes
Yes. But have lymph vessels.
55
Lymphatic drainage of conjunctiva
Lateral: pre-auricular or superficial parotid lymph node
Medial: submaxillary lymph node
56
Innervation of conjunctiva
Sensory - nasociliary, lacrimal, frontal, infraorbital, ciliary nerve
Sympa- ophthalmic a.
57
Single clue signifying pathology of conj
Foreign body sensation
58
Other symptoms of conjunctival pathology
```
Conjunctival injection
Lacrimation or discharge
Formation of papilla or follicle
Hemorrhage
Ulceration
Growth
```
59
Dilatation of superficial conjunctival blood vessels.
Conjunctival injection
60
Dilatation of deeper ciliary blood vessels near the limbus.
Ciliary injection
61
Vascular reaction charac by neoformation of blood vessels at the center surrounded by lymphoid infiltration
Papilla
62
Lymphatic reaction with neoformation of lymphoid tissue with peripheral vascularization
Follicle
63
Bacterial growth can be prevented by
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
Bacteria that predominates in conj pathology
Strep
Diphtheria
Staph
65
Bacteria that increase in debilitated persons
Pseudomonas aeroginosa
| Enterobacter sp
66
Bacteria that increase in cadaver
```
Beta hemolytic strep
E.coli
Klebsiella pneumonia
Pseudomonas aeroginosa
Flavo bacterium
```
67
Mucoid discharge is produced by
Moxarella-axenfeld diplobacillus
68
Mucoid discharge is common in (canthus)
Lateral canthus (thus called angular conjunctivitis)
69
Purulent discharge in conjunctiva is produced by
Neisseria gonorrhea
| B-streptococcus
70
In addition to purulent discharge, may produce membranous material
Strep conjunctivitis
71
Mucopurulent discharge
```
Hemophilus aegyptius
h. Influenza
Staph aureus
p. Aeroginosa
E. Coli
Proteus mabilis
```
72
Most common org producing mucopurulent discharge
Hemophilus aegyptius
73
3 organisms producing ophthalmia neonatorum
Chlamydia oculogenitalia
Staph aureus
Neisseria gonorrheae
74
Viral conjunctivitis caused by adenopharyngoconjunctival virus (APC8)
Epidemic conjunctivitis
75
Viral conjunctivitis caused by coxsackie 24 or EV70
Acute hemorrhage conjunctivitis
76
Viral conjunctivitis that produces pseudo-membrane in lower and upper palpebral conj
Epidemic conjunctivitis
77
Viral conjunctivitis accompanied by marked febrile symptoms
Pharyngoconjunctival fever
78
Viral conjunctivitis that has conjunctival hemorrhage in upper bulBar conjunctiva
Acute hemorrhagic conjunctivitis
79
Viral conjunctivitis is self limiting for how many weeks
1-2wks
80
Reduces intensity of symptoms and duration of condition by enhancing the immune response even if after onset
Oral Methisoprinol
81
Other virus that cause viral conjunctivitis
Exenthematous virus (.small pox, chicken pox, measles, German measles)
Herpes virus
Myxovirus (mumps, influenza and new castle disease)
82
Chlamydia conjunctivitis
Trachoma
| Inclusion blenorrhea
83
Trachoma is caused by what organism
Chlamydia trachoma
84
Filipino are known to be immune in trachoma and are affected that ends with what stage?
Follicular stage
85
4 stages of trachoma (mcCallan)
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
Trachoma is common in palpebral/bulbar conj
Palpebral conj
87
Inclusion blenorrhea is caused by
Chlamydia oculogenitalia
88
Acquired from venereal contact and swimming in nonchlorinated pool
Inclusion blenorrhea
89
Discharge of blenorrhea
Mucopurulent discharge
90
Inclusion blenorrhea is common in palpebral/bulbar conj
Lower palpebral conj
91
Allergic conjunctivitis most produce ____ and this cells are found in discharge
Most produce chemosis
| Eosinophils found in discharge
92
A keratoconjunctivitis but only can affect bulbar conj
Phlyctenular conjunctivitis
93
Localized whitish nodule with necrotic excavated center surrounded by conj infection
Phlyctenular conjunctivitis
94
Phlyctenular conjunctivitis has immunologic reaction to
Tuberculoprotein
95
Conjunctivitis commonly found on malnourished children and pulmonary TB
Phlyctenular conjunctivitis
96
Recurrent condi affecting upper palpebral conj of both eyes during summer
Vernal conjunctivitis
97
Discharge of Vernal conjunctivitis
Thick syrupy discharge
98
Has big papillae arranged on cobblestone appearance
Vernal conjunctivitis
99
Acute conjunctivitis with marked chemosis ans watery discharge on exposure to certain grasses, plants and trees
Atopic conjunctivitis
100
Triangular yellowish mass at bulbar conjunctiva with base towards the limbus. Aggravated by exposure to wind, dust, and sun.
Pinguecula
101
Pinguecula: bulbar/palpebral?
Bulbar conj
102
Fleshy mass in bulbar conj that invades the cornea at horizontal meridian
Pterygium
103
Pterygium: bulbar/palpebral conj?
Bulbar conj
104
Conjunctival growth covering the corneal marginal ulcer. Can grow from any direction besides nasal and temporal region.
Pseudo-pterygium
105
Pigmented elevated tumor located at bulbar conj
Nevi
106
Nevi: bulbar/palpebral conj
Bulbar conj
107
Flat diffused conjunctival pigmentation that occurs after age of 40. Sometimes asymptomatic
Melanosis
