Orbit Flashcards

1
Q

Which bones make up the roof, floor and lateral wall of the orbit?

A

Roof – orbital plate of frontal bone
Floor – orbital plate of maxillary bone
Lateral wall – greater wing of the sphenoid bone + zygomatic bone

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2
Q

Which bones make up the medial wall of the orbit?

A

Lacrimal bone
Orbital plate of ethmoid
Frontal process of maxilla
Lesser wing of sphenoid

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3
Q

Which structures pass through the optic canal?

A

Optic nerve

Ophthalmic artery

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4
Q

Which structures pass through the inferior orbital fissure?

A

Zygomatic branch of the maxillary division (V2) of trigeminal nerve
Infraorbital vessels

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5
Q

Which structures pass through the superior orbital fissure?

A
Oculomotor 
Trochlear 
Ophthalmic division (V1) of trigeminal 
Abducens 
Ophthalmic veins (superior and inferior) 
Sympathetic fibres
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6
Q

Name the 4 recti muscles and state their origin and insertion.

A

Superior Rectus, Inferior Rectus, Lateral Rectus, Medial Rectus
Origin: common tendinous ring at the back of the eye
Insertion: 5 mm behind the corneal margin (onto the sclera)

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7
Q

State the innervation of the 6 extrinsic eye muscles?

A

Lateral Rectus = Abducens (CN 6)
Superior Oblique = Trochlear (CN 4)
Medial Rectus, Superior Rectus, Inferior Rectus,
Inferior Oblique = Oculomotor (CN 3)

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8
Q

State the origin and insertion of the inferior oblique.

A

Origin: orbital surface of maxilla
Insertion: postero-lateral inferior quadrant of the globe

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9
Q

State the origin and insertion of the superior oblique.

A

Origin: body of sphenoid
Insertion: via the trochlea to the postero-lateral superior quadrant of the globe

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10
Q

Which muscle is responsible for elevating the eyelid?

A

Levator palpebrae superioris

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11
Q

Where is the origin and insertion of LPS?

A

Origin: lesser wing of sphenoid
Insertion: superior tarsal plate and skin of the eyelid

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12
Q

Describe the innervation of LPS

A

Oculomotor and sympathetic to smooth muscle

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13
Q

Describe the isolated muscle action of the oblique muscles.

A

Superior oblique = depresses AND abducts

Inferior oblique = elevates AND abducts

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14
Q

Describe the isolated muscle action of the superior and inferior recti.

A

Superior rectus = elevates AND adducts

Inferior rectus = depresses AND adducts

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15
Q

Describe how you would test the muscle actions of superior rectus and inferior rectus.

A

Superior rectus = make the patient abduct their eye and then elevate it
Inferior rectus = make the patient abduct their eye and then depress it

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16
Q

Describe how you would test the muscle actions of superior oblique and inferior oblique.

A

Superior oblique = make the patient adduct their eye and then depress it
Inferior oblique = make the patient adduct their eye and then elevate it

17
Q

Which nerve axons make up the optic nerve?

A

Retinal ganglion cell axons

18
Q

What types of fibres are found within the oculomotor nerve?

A

Motor fibres to MR, SR, IR, IO and LPS
Parasympathetic fibres
The oculomotor nerve has two rami

19
Q

What are the branches of the ophthalmic division of the trigeminal nerve? Which branch is biggest?

A

Nasociliary
Lacrimal
Frontal – this is the largest

20
Q

What structure do the cranial nerves pass through before reaching the superior orbital fissure?

A

Cavernous sinus

21
Q

Which of the nerves passing through the cavernous sinus, passes through the middle of it rather than passing through the walls?

A

Abducens (CN 6)

22
Q

What are the branches of the branches of the ophthalmic division of the trigeminal nerve?

A

Lacrimal – no branches

Nasociliary
• Branch to ciliary ganglion
• Ethmoidal
• Infratrochlear

Frontal
• Supratrochlear
• Supraorbital

23
Q

What limb of the autonomic nervous system is the ciliary ganglion involved in?

A

PARASYMPATHETIC

24
Q

Which fibres enter the ciliary ganglion and which fibres leave the ciliary ganglion?

A

Fibres entering the ciliary ganglion: preganglionic fibres in the inferior ramus of the oculomotor nerve

Fibres leaving the ciliary ganglion: postganglionic fibres in the short ciliary nerves

25
What do the fibres leaving the ciliary ganglion innervate?
Sphincter pupillae | Ciliary muscle
26
What are the SIX branches of the ophthalmic artery?
``` Supratrochlear Supraorbital Lacrimal Ciliary Muscular branches Central artery of the retina ```
27
Name the two ophthalmic veins and state where they drain.
Superior ophthalmic vein = cavernous sinus | Inferior ophthalmic vein = pterygoid plexus
28
Describe the location of the lacrimal glands.
Anterolateral superior orbit
29
Describe the innervation of the lacrimal glands.
Parasympathetic secretomotor fibres of Facial Nerve (CN 7) from the pterygopalatine ganglion via the zygomaticotemporal and, finally, lacrimal nerves
30
Where do the tears initially drain?
Lacrimal Sac
31
Via which duct do the tears then drain and where does this duct empty?
Nasolacrimal duct – empties into the inferior nasal meatus
32
What is the corneal reflex?
Stimulation of the cornea causes involuntary blinking in both eyes
33
What is Horner’s syndrome and how does it manifest itself in patients?
It is caused by a disorder of the sympathetic nerves in the brainstem or cervical region Presents as: • Ptosis • Miosis • Anhydrosis (lack of sweating around the eye)
34
Where does the nasolacrimal duct drain?
Inferior nasal meatus
35
What is the technical term for abnormal alignment of the eyes (Like lazy eye)?
Strabismus
36
What are the different types of strabismus?
Hypotropia – one eye turns down Hypertropia – one eye turns up Exotropia – one eye turns out Esotropia – one eye turns in