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Anatomy > ophtho anatomy > Flashcards

ophtho anatomy Flashcards

1
Q

what makes up the roof of the bony orbit?

A

the frontal bone

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2
Q

what makes up the lateral wall of the bony orbit?

A

sphenoid bone and zygomatic bone

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3
Q

what makes up the medial wall of the bony orbit?

A

ethmoid bone
lacrimal bone
frontal bone
maxillary bone

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4
Q

what makes up the floor of the bony orbit?

A

maxillary bone

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5
Q

why is the superior orbital margin more anterior than the inferior orbital margin?

A

allows eyeball to be protected from a blow larger than the diameter of the orbital rim

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6
Q

what is an orbital blowout fracture?

A

when an impact causes the medial wall or floor of the bony orbit to fracture but the orbital rim remain intact

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7
Q

what surrounds the eyeball?

A

periorbital fat

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8
Q

what neurovascular bundle is susceptible to injury in an orbital blow out fracture?

A

infraorbital neurovascular bundle

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9
Q

what muscle surrounds the orbital rim?

A

the orbicularis oculi

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10
Q

what are the 2 parts to the orbicularis oculi?

A

external- orbital part

internal- palpebral part

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11
Q

what is the function of the superior and inferior tarsi?

A

skeleton of the eyelid

give the eyelid it’s half moon shape

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12
Q

what muscle attaches to the superior tarsus?

A

levator palpebrae superioris

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13
Q

what is the function of the levator palpebrae superioris?

A

lifts the upper eyelid

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14
Q

what ligaments anchor the superior and inferior tarsi to the bone?

A

lateral palpebral ligament

medial palpebral ligament

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15
Q

what connective tissue are the tarsal glands within?

A

superior and inferior tarsi

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16
Q

what part of the eye is coloured?

A

iris

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17
Q

what covers the iris?

A

the cornea

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18
Q

what is the white part of the eye?

A

the sclera

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19
Q

what covers the sclera?

A

conjunctiva

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20
Q

what is the name of the opening that lacrimal fluids pass into?

A

punctum

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21
Q

what is the conjunctival fornix?

A

the angle on the lower and upper eyelid where conjunctiva of sclera and conjunctiva of eyelids meet

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22
Q

what duct takes lacrimal fluid from the punctum to the inferior meatus?

A

nasolacrimal duct

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23
Q

which nerve carries parasympathetic fibres to the lacrimal gland?

A

CN VII

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24
Q

what are the 2 parts to the fibrous outer layer of the eye?

A
  • sclera

- cornea

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25
Q

what part of the eye has 2/3 of the refractory power?

A

the cornea

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26
Q

what are the 3 layers of the eye?

A
  • fibrous outer layer
  • uvea (vascular layer)
  • retina
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27
Q

what are the 3 parts of the uvea?

A
  • iris
  • ciliary body
  • choroid
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28
Q

what is the function of the iris?

A

changes the pupil diameter

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29
Q

what is the function of the ciliary body?

A
  • changes shape of the lens

- secretes aqueous humour

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30
Q

what is the function of the choroid?

A

-nutrient and gas exchange

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31
Q

what separates the the anterior and posterior segment?

A

the lens

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32
Q

what are the 2 chambers of the anterior segment?

A

anterior and posterior chamber

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33
Q

what splits the anterior and posterior chambers of the anterior segment?

A

the iris

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34
Q

what fluid does the anterior chamber of the anterior segment contain?

A

aqueous humour

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35
Q

what fluid does the posterior chamber of the anterior segment contain?

A

aqueous humour

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36
Q

what is the function of the aqueous humour?

A

nourishes the lens and cornea because there are no vessels to do so

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37
Q

what fluid does the posterior segment contain?

A

vitreous humour

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38
Q

what is it called when the lens becomes clouded and opaque?

A

cataract

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39
Q

what is the name of the corneoscleral junction?

A

Limbus

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40
Q

where is the aqueous humour reabsorbed?

A

scleral venous sinus (canal of Schlemm) at the iridocorneal angle

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41
Q

what is the fundus?

A

the posterior area of the eye where light is focused

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42
Q

what does the fundus contain?

A

optic disc and macula

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43
Q

what is the centre of the macula?

A

fovea

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44
Q

what is the macula?

A

the area where there is the greatest density of cones

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45
Q

what are the three main layers of the retina?

A

A to P
axons of ganglion cells
ganglion cells
photoreceptors

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46
Q

light from the left visual field is processed in which visual cortex?

A

the right visual cortex

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47
Q

light from the right visual field is processed in which visual cortex?

A

the left visual cortex

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48
Q

blood from the ventral vein of the retina will drain to the cavernous sinus via which veins?

A

superior ophthalmic vein

inferior ophthalmic vein

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49
Q

what are the 7 extraocular muscles?

A 
superior rectus
inferior rectus
medial rectus
lateral rectus
superior oblique
inferior obique
levator palpebrae superioris
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50
Q

where do the extraocular muscles insert?

A

all onto the sclera

apart from levator palpebrae superioris which inserts into superior tarsus

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51
Q

where do the 4 rectus extraocular muscles originate from?

A

the common tendinous ring which surrounds the optic canal

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52
Q

what is the motor innervation of the medial rectus?

A

CN III

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53
Q

what is the motor innervation of the lateral rectus?

A

CN VI

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54
Q

what is the motor innervation of the superior rectus?

A

CN III

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55
Q

what is the motor innervation of the inferior rectus?

A

CN III

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56
Q

what is the motor innervation of the superior oblique?

A

CN IV

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57
Q

what is the motor innervation of the inferior oblique?

A

CN III

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58
Q

what is the motor innervation of the levator palpebrae superioris

A

CN III

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59
Q

what is intorsion of the eyeball?

A

medial rotation

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60
Q

what is extorsion of the eyeball?

A

lateral rotation

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61
Q

why do most extraocular muscles of the eye (except medial and lateral rectus) have secondary movements?

A

because the orbit axis is different from the optical axis

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62
Q

how do you test the superior rectus?

A

by asking patient to abduct (using lateral rectus) then asking to look up

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63
Q

how do you test the inferior rectus?

A

by asking patient to abduct (using lateral rectus) then asking to look down

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64
Q

why must you abduct or adduct the eyeball before testing extraocular muscles?

A

to isolate the muscle

rules out secondary functions of the other muscles

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65
Q

how do you test the superior oblique?

A

by asking patient to adduct (using medial rectus) then asking to look down

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66
Q

how do you test the inferior oblique?

A

by asking patient to adduct (using medial rectus) then asking to look up

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67
Q

what extraocular muscle cause medial rotation? (intorsion)

A

superior oblique

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68
Q

what extraocular muscle causes lateral rotation (extorsion)

A

inferior oblique

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69
Q

what extraocular muscles cause pure elevation?

A

superior rectus + inferior oblique

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70
Q

what extraocular muscles cause pure depression?

A

inferior rectus + superior oblique

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71
Q

what ligament holds the eye just above the floor of the orbit?

A

the suspensory ligament

72
Q

why might unilateral orbital trauma cause diplopia?

A

if trauma is associated with zygomatic bone, the suspensory ligament of the eye can be displaced and the eye may be lowered causing diplopia

73
Q

what cranial nerve is the infraorbital nerve a branch of?

A

V2

74
Q

what type of fibres does the infraorbital branch of CN V2 contain?

A

sensory

75
Q

what nerve supplies sensory fibres to the skin of the upper eyelid?

A

CN V1

76
Q

what nerve supplies sensory fibres to the cornea?

A

CN V1

77
Q

what nerve supplies sensory fibres to the conjunctiva?

A

CN V1

78
Q

what nerve supplies sensory fibres to the dorsum of the nose?

A

CN V1

79
Q

what nerve supplies sensory fibres to the skin of the lower eyelids?

A

CN V2

80
Q

what nerve supplies sensory fibres to the skin over the maxilla?

A

CN V2

81
Q

what nerve supplies sensory fibres to the skin of the ala of the nose?

A

CN V2

82
Q

what nerve supplies sensory fibres to the mucosa of the upper lip?

A

CN V2

83
Q

what nerve supplies sensory fibres to the mucosa of the lower lip?

A

CN V3

84
Q

what nerve supplies sensory fibres to the skin over the mandible?

A

CN V3

85
Q

what nerve supplies sensory fibres to the skin over the TMJ?

A

CN V3

86
Q

what nerve supplies sensory fibres to the skin over the angle of the mandible?

A

the great auricular nerve from C2/3

87
Q

what nerves are involved in the blink reflex?

A

V1 and VII

88
Q

what nerve carries the afferent sensory limb of the blink reflex?

A

V1 (in long ciliary nerve)

89
Q

what nerve carries the efferent motor limb of the blink reflex?

A

VII

90
Q

what are the 3 cervical parts of the sympathetic trunk?

A

superior cervical ganglion
middle cervical ganglion
inferior cervical ganglion

91
Q

from what vertebral levels can sympathetic axons leave the spinal cord?

A

T1 to L2

92
Q

the sympathetic fibres of the internal and external carotid nerves come from which ganglion of the sympathetic trunk?

A

superior cervical ganglion

93
Q

the ophthalmic artery is an intracranial branch of which artery?

A

internal carotid artery

94
Q

the inferior cervical ganglion and the first thoracic ganglion often fuse to form what?

A

the stellate ganglion

95
Q

what is the space between the pretrachial fascia and the prevertebral fascia called?

A

the retropharyngeal space

96
Q

what fascial layer of the cervical neck does the vagus nerve sit within?

A

the carotid sheath

97
Q

what cervical ganglion is involved in supplying the orbit with sympathetic supply?

A

superior cervical ganglion

98
Q

which cranial nerves carry parasympathetic axons?

A

CN III, VII, IX, X

99
Q

which cranial nerve relays parasympathetic nerves to the orbit?

A

CN III

100
Q

CN III supplies parasympathetic axons to what?

A

the eye

101
Q

CN VII supplies parasympathetic axons to what?

A

submandibular and sublingual salivary glands

lacrimal gland

102
Q

CN IX supplies parasympathetic axons to what?

A

parotid salivary glands

103
Q

CN X supplies parasympathetic axons to what?

A

organs of neck/chest and abdomen (as far as midgut)

104
Q

CN III supplies parasympathetic axons to which ganglion?

A

ciliary ganglion

105
Q

what are the 2 branches of CN III?

A

superior branch

inferior branch

106
Q

what does the superior branch of CN III supply?

A

superior rectus

levator palpebrae superioris

107
Q

what does the inferior branch of CN III supply?

A

medial rectus
inferior rectus
inferior oblique
ciliary ganglion

108
Q

what within the orbit is under autonomic control?

A

diameter of iris

and shape of lens

109
Q

the long ciliary nerve contains what type of nerve fibres?

A

sympathetic and sensory (from CN V1)

110
Q

the short ciliary nerve contains what type of nerve fibres?

A

parasympathetic (from CN III) and sympathetic

111
Q

both sympathetic and parasympathetic nerve axons pass through the ciliary ganglion, which ones synapse here?

A

parasympathetic axons

sympathetic axons have already synapsed in the sympathetic trunk

112
Q

what reflex causes stabilisation of gaze during head movements?

A

vestibulo-ocular reflex

113
Q

which autonomic system is involved in opening the eyes wider?

A

sympathetic

114
Q

which autonomic system is involved in closing the eyes?

A

parasympathetic function

115
Q

what autonomic system is involved in contracting the pupil?

A

parasympathetic function

116
Q

what autonomic system is involved in dilating the pupil?

A

sympathetic function

117
Q

what autonomic system is involved in focussing on near objects?

A

parasympathetic function

118
Q

what autonomic system is involved in focussing on far objects?

A

sympathetic function

119
Q

what autonomic system is involved in emotional lacrimation?

A

sympathetic function

120
Q

what autonomic system is involved in reflex lacrimation?

A

parasympathetic function

121
Q

what muscles cause the dilation of the pupil?

A

dilatory pupillae fibres

122
Q

what muscles cause the contraction of the pupil?

A

sphincter pupillae fibres

123
Q

the dilator pupillae fibres are under what autonomic control?

A

sympathetic

124
Q

the sphincter pupillae fibres are under what autonomic control?

A

parasympathetic

125
Q

what is the name for a non-physiologically enlarged pupil?

A

mydriatic pupil

126
Q

what is type of drugs induce dilation of the pupil?

A

mydriatic drugs

127
Q

what is a fixed pin point pupil?

A

a pupil which is very constricted and has no response to light

128
Q

what type of drugs cause a fixed pin point pupil?

A

opiate drugs

129
Q

what is the name for a non-physiologically constricted pupil?

A

miotic pupil

130
Q

what is a fixed-dilation pupil?

A

a pupil which is very dilated and has no response to light

131
Q

what pathology does a fixed dilation pupil indicate?

A

CN III pathology

parasympathetic axons are inhibited

132
Q

which nerve carries the afferent limb of the pupillary light reflexes?

A

CN II

133
Q

what connects the ciliary body to the lens?

A

suspensory ligament

134
Q

what happens when the ciliary body contracts?

A

the suspensory ligament relaxes, and the lens becomes spherical (for short distance)

135
Q

what happens when the ciliary body relaxes?

A

the suspensory ligament tightens and the lens becomes flat (for long distance)

136
Q

what muscle is like a sphincter around the ciliary body?

A

smooth ciliary muscle

137
Q

contraction of the ciliary muscle is under control of what autonomic system?

A

parasympathetic

138
Q

what nerve is involved in the afferent limb of the tear reflex? (in response to mechanical or chemical stimulation)

A

CN V1

139
Q

what nerve supplies parasympathetic fibres to the lacrimal gland?

A

greater petrosal nerve

140
Q

what cranial nerve is the greater petrosal nerve a branch of?

A

the facial nerve

141
Q

what is an early sign of raised ICP which is easy to spot?

A

fixed dilated pupils

142
Q

what are the meninges?

A

membranes that surround the brains:
dura
arachnoid
pia

143
Q

why are the optic nerves considered as CNS extensions?

A

because meninges surround them

144
Q

where is the subarachnoid space found?

A

between the arachnoid mater and the pia mater

145
Q

what are the 2 layers of the dura mater?

A

endosteal layer

meningeal layer

146
Q

what is enclosed between the layers of dura mater?

A

dural venous sinuses

147
Q

what fills the subarachnoid space?

A

CSF,

some blood vessels run through

148
Q

where is the CSF made?

A

choroid plexus of the ventricles

149
Q

the CSF is reabsorbed intot he dural venous sinuses via what?

A

arachnoid granulations

150
Q

what are the 4 ventricles?

A

left lateral ventricle
right lateral ventricle
3rd ventricle
4th ventricle

151
Q

what are ventricles of the brain?

A

CSF filled spaces

152
Q

where is the right lateral ventricle located?

A

within the right cerebral hemisphere

153
Q

where is the left lateral ventricle located?

A

within the left cerebral hemisphere

154
Q

where is the 3rd ventricle located?

A

within the diencephalon

155
Q

where is the 4th ventricle located?

A

betweent the cerebellum and the pons

156
Q

what connects the 3rd and 4th ventricles?

A

the cerebral aqueduct

157
Q

describe the circulation of CSF through the ventricles?

A

secreted in choroid plexus of lateral ventricles, passe into third ventricle then via cerebral aqueduct into the fourth ventricle

158
Q

from the 4th ventricle where does CSF go?

A

mainly into subarachnoid space

some passes into central canal of spinal cord

159
Q

compare the margins of a healthy optic disc to a swollen optic disc?

A

healthy: clear margins
swollen: blurred margins

160
Q

what are the 3 main effects of CN III damage?

A
  • dilated pupil
  • ptosis
  • eye turned inferolaterally
161
Q

why does CN III damage cause a dilated pupil?

A

loss of parasympathetic supply to sphincter pupillae

162
Q

why does CN III damage cause ptosis?

A

loss of levator palpebrae superioris function

163
Q

why does CN III damage cause the eye to be turned inferolaterally?

A

loss of SR, IR, MR and IO function

unopposed action of SO (and LR)

164
Q

what is the main effect on the orbit of CN IV damage?

A

eye cannot move inferomedially

165
Q

why can the eye not move inferomedially with CN IV damage?

A

loss of superior oblique function

166
Q

what is the main effect of CN VI damage?

A

eye cannot move laterally

167
Q

why can the eye not move laterally with CN VI damage?

A

loss of lateral rectus function

168
Q

how many neurones are involved in the pupillary light reflex?

A

4

169
Q

describe the first neurone in the pupillary light reflex?

A

from retina to pretectal nucleus in the midbrain via CN II

170
Q

describe the second neurone in the pupillary light reflex?

A

from pretectal nucleus to edwinger westphal nucleus

171
Q

what is found in the edwinger westphal nucleus?

A

cell bodies of parasympathetic axons of CN III

172
Q

describe the third neurone in the pupillary light reflex?

A

from edwinger westphal nucleus to ciliary ganglion via inferior division of CN III

173
Q

describe the fourth neurone in the pupillary light reflex?

A

from cililary ganglion to sphincter pupillae muscles via short ciliary nerve

174
Q

which neurones in the pupillary light reflex are unilateral?

A

1st neurone

175
Q

which neurones in the pupillary light reflex are bilateral?

A

2nd, 3rd, 4th neurones

Anatomy (4 decks)

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