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Clinical Human Anatomy: Head and Neck > Orbit > Flashcards

Orbit Flashcards

1
Q

Drainiage via Inferior Orbital Fissure: then to pterygoid plexus

A

Inferior Ophthalmic Vein

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2
Q

Superior Ophthalmic V drains to

A

Superior Orbital Fissure

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3
Q

Special about venous supply of eye?

A

you have arteries coming in one way, but the veins exit a different path

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4
Q

uses optic canal along w/ CN II

*branch of internal carotid

A

Opthlamic Artery

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5
Q

seen when you section optic nerve (pierces it and supplies portions or retina)

A

Central artery of retina

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6
Q

heads superior and medial to lacrimal gland

A

Lacrimal artery

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7
Q

7 branches of Opthalmic artery

A
  1. Central artery of retina:
  2. Lacrimal artery:
  3. Supraorbital artery
  4. Supratrochlear artery: terminal branch
  5. Doral nasal artery: terminal branch
  6. Poster & anterior ethmoidal artery: medially pierce ethmoid bone
  7. Short and long ciliary arteries penetrate sclera of eye
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8
Q

Contributes to eye via branch called Infraorbital artery via infraorbital foramen

A

External Carotid

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9
Q

Two main arterial supplies in eye

A

External Carotid + Opthalmic Artert

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10
Q

Path of External Carotid

A

external carotid branch→ Maxillary Artery branch→ Infraorbital artery

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11
Q

What supplies: inferior rectus

	- inferior oblique
	- lacrimal gland
A

Infraorbital artery

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12
Q

What three branches does Infraorbital artery anastomose with?

A

anastomosis with dorsal nasal artery (thus have anastomosis btwn internal/external carotids via infraorbital artery (external)—Dorsal Nasal artery (internal) and the Facial Artery

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13
Q

How is there an anastomotic connection bewteen external and internal carotids in the orbit?

A

anastomosis with dorsal nasal artery (thus have anastomosis btwn internal/external carotids via infraorbital artery (external)—Dorsal Nasal artery (internal)

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14
Q

Three branches of External Artery in the eye

A

a. Facial~ anastomose w/ Dorsal facial artery
b. Transverse Facial anastomose w/ the infraorbital and lacrimal arteries
c. Infraorbital

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15
Q

Drainage of lacrimal gland

A

Drains→ superior fornix (where conj folds over)

flows inferiorly and medially toward papilla

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16
Q

Passage of lacrimal drainage

A

openings in lacrimal papillae →lacrimal caruncle→lacrimal canaliculi→ lacrimal sac→ nasolacrimal duct→ inferior nasal meatus which extends posteriorly through posterior aspect of cavity→ pharnyxn→ esophagus (too much teasrs = tears out the nose!

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17
Q

Where does nasolacrimal duct lie?

A

w/in nasolacrimal canal

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18
Q

CC to CN II

A

Visual Field Defects

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19
Q

Brach that supplies Somatic Sensory (pain/temp/pressure from globe of eye and highly innervated cornea)
a. From forehead and skin of medially aspect of face~ tip of nose

A

Opthalmic region of the Trigeminal = CN V1

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20
Q

Pathway of V1 sensory branch

A

Peripheral processes trasmit sensation from sense neurons→ through SOF→ through Cavernous Sinus
Synaspse @ NCB in Trigeminal Ganglion→ then transmits central processes Central Processes transmit sensation to Principap Sensory Nucleus and Spinal nucleus of V From here, these central processes will send info to cortex for processing so you can tell where the sensation is located

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21
Q

Special about V1

A

VIP branches of Opthalmic (V1) **ALL SENSORY V1 is SENSORY

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22
Q

Branch of V1 that innervates the lacrimal gland

A

Lacrimal Nerve

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23
Q

Has these three subdivision
Supratrochlear nerve (most medial)
-supraorbital nerve (middle) (divides further to medial and lateral branches)
-nerve to Frontal sinus (dives deep)

A

Frontal nerve

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24
Q

Frontal nerve comes from

A

V1

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25
Q

Branches of Nasociliary nerve

A
  • Anteroior and Posterior Ethmoidal Nerves
  • Infratrochlear nerve
  • Meningeal Nerve
  • Long Ciliary Nerve: pierces sclera
  • Short Ciliary nerve: pierce sclera and goes to ciliary ganglion
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26
Q

Origin of nasociliary nerve

A

V1

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27
Q

Muscles innervated by CN III

A

Levator palpebrae, Superior rectus, Inferior Rectus, Medial Rectus, Inferior Oblique

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28
Q

Location on Pregang NCB of III

A

upper brain stem in oculomotor nucleus = location of NCB

29
Q

Pathway of CN III

A

origintaes in upper brain stem in oculomotor nucleus = location of NCB→

  • emerges near median plane at jnx of midbrain and pons
  • then passes btwn posterior and superior cerebellar arteries→
  • through cavernous sinus→ through SOF of sphenoid bone: has superior and inferior branch
  • Passes w/in tendinous ring where rectus m.s originate
30
Q

Ptosis (eyelid droops), resting eye ‘down and out’ bc of unopposed action of superior oblique and lateral rectus, pupil is fixed and dialated

A

CC to oculumotor

31
Q

Cause of ‘down and out’ eye

A

unopposed action of superior oblique and lateral rectus

32
Q

Location on Pregang NCB of Trochlear IV

A

Neurons in Trochlear nucles in midbrain of brainstem

33
Q

Only nerve to go Dorsally over the midbrain

A

Trochlear

34
Q

Path of Trochlear IV

A

-Neurons in Trochlear nucleus in midbrain of brainstem
-goes dorsally (only one) from midbrain
-enter cavernous sinus→ SOF of sphenoid
-passes OUTSIDE tendinous ring
Muscles: Superior Oblique m.

35
Q

Superior Oblique m. innervated by

A

Trochlear IV

36
Q

Can’t look down when eye is adducted→ causes Diplopia d/t cavernous sinus injury

A

CC to Trochlear IV

37
Q

lateral rectus = abducts the eyeball innervated by:

A

Abducent VI

38
Q

Location of NCB of Abducent VI

A

NCB in the abducent nucleus and emerge at median plane near medulla/pons

39
Q

Pathway of Abducent VI

A

NCB in the abducent nucleus and emerge at median plane near medulla/pons→
-pass through Cavernous Sinus and SOF of sphenoid
-passes w/in tendinous ring
Muscle: Lateral Rectus Muscle

40
Q

Horizontal diplopia (double vision), imparied eye Abduction, eye turns medially

A

CC to Abducent

41
Q

← straight that way

testing:

A

Right Lateral Rectus (VI)

Left Medial rectus (III)

42
Q

→straight that way

testing:

A

Right Medial rectus (III)

-Left lateral recuts (VI)

43
Q

Patient look Laterally first

-patient looks up =

A

Superior Rectus

44
Q

Patient look Laterally first

-patient looks down =

A

Inferior Rectus

45
Q

Patient Look Medially first (Goofy one)

-patient looks up=

A

Inferior Oblique

46
Q

Patient Look Medially first (Goofy one)

-patient looks down=

A

Superior Oblique

47
Q

Truly testing Superior Recuts muscle CN III

A

align axis of gaze with muscle thus have them look laterally to be in line with the long line of the super rectus muscle—thus we wipe out help from inferior oblique muscle (it can’t help when eye is in this position)

48
Q

Truly testing the Inferior rectus muscle

A

align axis w/ muscle so that is’ lateral then you know you knock out help from Superior Oblique
-then we can test the ability of the inferior rectus muscle to depress the eye

49
Q

Action of Superior Oblique muscle (IV)

A

depression, abduction, intorsion

50
Q

Truly testing Superior obliuque muscle

A

aling w/ long axis of muscle by having patient looking medially so that the tension of Superior oblique is aligned and now can depress up eyeball towards nose

51
Q

Truly testing Inferior rectus

A

patient looks medially and then can they look up. If they can then we know that inferior oblique is in good condition to elevate the eye

52
Q

*Ptosis
Explanation: paralysis of Levator Palpebrae Sup.
*A resting eye that’s ‘Down and Out’
Explanation: paralysis of Medial Rectus and Superior Rectus→ unopposed action of lateral rectus m and Superior Oblique m.

A

CC of CN III

53
Q

Causes of CN III

A
  • Intracranial aneurysm
  • trauma
  • inflammation (syphallis, diabetic neuopathy)
  • Cav.Sin thrombosis
54
Q

Inability to look down(depression) and Nasally (Adduction)

A

CN IV injury

55
Q

Cause of CN IV injury

A

trauma or cavernous sinus thrombis

56
Q

Explanation of CC IV injury manifestations

A

Explanation: paralysis of Superior Oblique m.
*Head tilt
Explanation: (pt tilts head to shoudler opposite affected eye)
Injured eye is extroted, tiliting head toward opp side of injury→intorsion of normal eye→ realignment of gaze

57
Q

Impaired eye Abduction

*Tendancy for eye to turn medially

A

CC to CN VI

58
Q

Explanation for CN VI clinical symptoms

A

Explanation: paralysis of Lateral Rectus m. →unopposed action of medial rectus m.

59
Q

Cause of injury to CN VI

A

Cavernous sinus injury

60
Q

Horners Syndrome

A

-pupil constriction (Miosis)
→ d/t ≠dilator pupillae→ unopposed sphincter pupillae m
-ptosis (drooping eyelid)
→ d/t ≠superior tarsal m.
-Anhydrosis (lack of sweating)
→d/t loss of head and neck sweat gland innervation
-Erythematosis (blushing skin)
→ d/t blood vessel dialation (PNS takes over)

61
Q

Horners syndrome is damage to what?

A

SNS of ANS

62
Q

CNVII (involving Greater Petrosal N)→

A

loss of Lacrimation (dry cornea)

63
Q

CNIII

Parasympathetic fibers knocked out

A

-pupil dialation
→d/t paralysis of sphincter pupilae w/ unopposed dialator pupillae m
-Pupil fixation/loss of accomidation to light reflex
→d/t paralysis of ciliar m. and sphincter pupillae m.

64
Q

Symptom: -Pupil fixation/loss of accomidation to light reflex

A

→d/t paralysis of ciliar m. and sphincter pupillae m.

65
Q

Symptom: pupil dialation

A

→d/t paralysis of sphincter pupilae w/ unopposed dialator pupillae m

66
Q

Symptom: -pupil constriction (Miosis)

A

-pupil constriction (Miosis)

→ d/t ≠dilator pupillae→ unopposed sphincter pupillae m

67
Q

Symptom: -ptosis (drooping eyelid)

A

→ d/t ≠superior tarsal m.

68
Q

Symptom: -Anhydrosis (lack of sweating)

A

→d/t loss of head and neck sweat gland innervation

69
Q

Symptom-Erythematosis (blushing skin)

A

→ d/t blood vessel dialation (PNS takes over)

Clinical Human Anatomy: Head and Neck (12 decks)

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