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Gross Anatomy Block 4 > Orbit > Flashcards

Orbit Flashcards

1
Q

Long axis of the orbit is directed in what 2 directions

A

Posterior and medially

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2
Q

Anterior opening of the orbit is surrounded by the orbital margin - what is the orbital margin formed by

A

Frontal and zygomatic bones and maxilla

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3
Q

Walls of the orbit:

  1. Superior wall separates orbit from?
  2. Inferior wall separates orbit from?
  3. Lateral separates orbit from?
  4. Medial separates orbit from?
A
  1. Separates orbit from anterior cranial fossa
  2. Separates orbit from maxillary sinus
  3. From middle cranial fossa and temporal fossa
  4. From ethmoidal air cells
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4
Q

Walls of the orbit:

  1. Superior wall is formed by?
  2. Inferior wall is formed by?
  3. Lateral wall is formed by?
  4. Medial wall is formed by?
A
  1. Orbital plate of frontal bone and lesser wing of sphenoid
  2. Orbital surfaces of body of maxilla and zygomatic bone/orbital process of palatine
  3. Orbital surfaces of zygomatic bone and greater wing of sphenoid
  4. Frontal process of maxilla, lacrimal bone, orbital plate of ethmoid, and a small part of body of sphenoid
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5
Q

Optic canal:

  1. Opening between what 2 things?
  2. What nerve and artery does it transmit?
A
  1. Opening between 2 roots of lesser wing of sphenoid

2. Optic nerve and ophthalmic artery

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6
Q

Superior orbital fissure:

  1. Opening between what 2 things?
  2. Transmits what vein?
  3. Transmits what 3 nerves
  4. Transmits branches of what nerve? What 3 branches?
A
  1. Greater and lesser wing of sphenoid 2. Superior ophthalmic vein
  2. CN III, CN IV, and CN VI
  3. Branches of ophthalmic nerve (V1) - frontal, lacrimal and nasociliary
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7
Q

Inferior orbital fissure:

  1. Opening between what 2 things?
  2. Transmits what nerves/vessels (2)
  3. Transmits vein that communicates between what 2 veins?
A
  1. Greater wing of sphenoid and maxilla
  2. Infraorbital nerve/vessels and zygomatic nerve/veins
  3. Communicating inferior ophthalmic vein with pterygoid venous plexus
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8
Q

Supraorbital notch (or foramen):

  1. Located at junction of ?
  2. Transmits what nerve/vessels
A
  1. Medial and middle thirds of superior orbital margin

2. Supraorbital nerve/vessels

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9
Q

Infraorbital groove:

  1. Location?
  2. Continuous anteriorly with __, which opens onto face via ?
  3. These 3 spaces transmit what nerve/vessels
A
  1. Floor of orbit
  2. Infraorbital canal which opens onto face via infraorbital foramen
  3. Infraorbital nerve/vessels
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10
Q

Fossa for lacrimal sac:

  1. Depression located where?
  2. Continuous inferiorly with? (This houses what?)
  3. Communicates orbit with?
A
  1. Anterior part of medial wall of orbit
  2. Nasolacrimal canal which houses nasolacrimal duct
  3. Inferior nasal meatus
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11
Q

Anterior and posterior ethmoidal foramina:

  1. Located along?
  2. Transmits what nerve/vessels?
A
  1. Frontoethmoidial suture

2. Anterior and posterior ethmoidal nerves and vessels

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12
Q

Orbital surface of zygomatic bone:

  1. __ part of lateral wall of orbit
  2. Has small openings for canals that transmit what 2 nerves/vessels
A
  1. Anterior

2. Zygomaticofacial and zygomaticotemporal nerves/vessels

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13
Q

There are 7 extraocular muscles; 6 move the eyeball, 1 does?

A

Elevates upper eyelid

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14
Q

Rectus muscles:

  1. How many are there?
  2. Origin?
  3. Insertion?
  4. Innervation?
A
  1. 4 (superior, inferior, lateral and medial)
  2. Common tendinous ring which surrounds optic canal and inferomedial part of superior orbital fissure
  3. Into sclera, posterior to corneoscleral junction
  4. Lateral rectus= abducens nerve; other 3= oculomotor nerve
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15
Q

Levator palpebrae superioris:

  1. Origin?
  2. Course?
  3. Insertion?
  4. Innervation?
  5. Action?
A
  1. Sphenoid, above optic canal
  2. Passes forward under orbit roof and ends anteriorly in a broad tendon
  3. Into superior tarsus and skin of upper eyelid
  4. Oculomotor
  5. Elevate upper eyelid
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16
Q

Superior tarsal muscle (of Muller)

  1. Extends from where to where?
  2. Innervation
  3. Action
A
  1. Extends from inferior surface of levator palpebrae superioris to superior tarsus
  2. Sympathetic fibers from superior cervical ganglion
  3. Elevates upper eyelid
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17
Q

Superior oblique muscle:

  1. Location
  2. Origin?
  3. Course?
  4. Tendon changes direction and goes where?
  5. Insertion?
  6. Innervation
A
  1. In superomedial part of orbit
  2. Sphenoid (superior and medial to optic canal)
  3. Passes anteriorly and becomes continuous with a tendon, tendon passes thru trochlea attached to anteromedial part of orbital roof
  4. Passes posteriorly and laterally, under superior rectus muscle
  5. Into sclera of superior posterolateral aspect of eyeball
  6. Trochlear nerve
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18
Q

Inferior oblique muscle:

  1. Location
  2. Origin
  3. Course
  4. Insertion
  5. Innervation
A
  1. Inferior to eyeball, close to orbital margin
  2. Orbital surface of maxilla, just lateral to fossa for lacrimal sac
  3. Passes posteriorly and laterally, below inferior rectus muscle
  4. Inserts into sclera of inferior posterolateral aspect of eyeball
  5. Oculomotor nerve
19
Q

What position does the eyeball have to be in to test the following muscles clinically

  1. Lateral rectus
  2. Medial rectus
  3. Superior rectus
  4. Inferior rectus
  5. Inferior oblique
  6. Superior oblique
A
  1. Eye abduction
  2. Eye adduction
  3. Elevation of abducted eye
  4. Depression of abducted eye
  5. Elevation of adducted eye
  6. Depression of adducted eye
20
Q

Which muscle do you lose function of in Horners syndrome?

Symptoms?

A

Superior tarsal muscle

Ptosis, anhydrosis, and miosis

21
Q

Why does the eye have to be abducted in order to test the inferior rectus and superior rectus

A

Once the eye is abducted, the inferior rectus is a pure depressor of the eye and the superior rectus is a pure elevator of the eye

22
Q

Optic nerve:

  1. Formed by?
  2. Begins at?
  3. Leaves orbit and enters ? Via?
  4. What is the optic nerve surrounded by? These fuse where?
  5. What causes swelling of the optic disc (papilledema)
A
  1. Axons of ganglion cells of retina
  2. Optic disc
  3. Middle cranial fossa via optic canal
  4. Pia, arachnoid, and dura mater which fuse with sclera
  5. Increased pressure of CSF within cranial cavity
23
Q

Optic nerve is myelinated by __ cells

So optic nerve is commonly affected by what disease?

A

Oligodendrocytes

Mulitple sclerosis

24
Q

Oculomotor nerve:

  1. Contains what 2 types of motor fibers
  2. Emerges from?
  3. Runs forward in?
  4. Divides into superior and inferior branches that enter orbit via
  5. Inferior branch supplies which muscles(3)?
  6. Also gives a short branch to __
A
  1. Somatic motor and visceral motor (preganglionic parasympathetic)
  2. Midbrain
  3. Lateral wall of cavernous sinus
  4. Superior orbital fissure
  5. Medial rectus, inferior rectus, and inferior oblique
  6. Ciliary ganglion (contains preganglionic parasympathetic fibers)
25
Q

Ciliary ganglion:

  1. What type of fibers?
  2. Located between?
  3. Receives preganglionic fibers from which nerve?
  4. Axons of the postganglionic (after synpase) fibers go where? To do what?
A
  1. Parasympathetic*
  2. Between optic nerve and lateral rectus muscle (so posterior part of orbit)
  3. Inferior branch of oculomotor nerve
  4. Pierce sclera to enter the eye and innervate ciliary muscle and sphincter pupillae muscle
26
Q

Ciliary ganglion

  1. Receives general sensory fibers from which nerve
  2. Receives post-ganglionic sympathetic fibers from where
  3. Do they synapse at the ciliary ganglion?
A
  1. Ophthalmic nerve
  2. Superior cervical ganglion
  3. No, these fibers pass thru and get incorporated into short ciliary nerves
27
Q

Trochlear nerve:

  1. Contains what type of fibers
  2. Where does it attach
  3. Runs where?
  4. Enters orbit thru?
  5. Innervates which muscle?
A
  1. Somatic motor fibers
  2. Posterior aspect of brainstem (only CN that attaches here)
  3. Forward in lateral wall of cavernous sinus
  4. Superior orbital fissure
  5. Superior oblique muscle
28
Q

Abducens nerve:

  1. Contains what type of fibers
  2. Attaches to?
  3. Runs ?
  4. Enters orbit via
  5. Innervates which muscle
A
  1. Somatic motor fibers
  2. Medullopontine sulcus (close to midline)
  3. Forward inside cavernous sinus
  4. Superior orbital fissure
  5. Lateral rectus muscle
29
Q

Contents of the cavernous sinus?

A

ICA and CN III, IV, V1, V2, IV

30
Q

What innervates the ciliary muscle and sphincter pupillae muscle?

A

Post-ganglionic parasympathetic fibers that arise from the ciliary ganglion

31
Q

Lesion of oculomotor nerve:

  1. Eye will be in what direction
  2. 4 symptoms
A
  1. Turned down and out

2. Double vision, dilated pupil, palpebral ptosis, loss of accommodation/light reflex in affected eye

32
Q

Lesion of trochlear nerve

  1. Eye will be in what direction
  2. *Will result in inability of eye to do what
  3. Symptom? What makes this symptom improve
A
  1. Extorsion (outward rotation of the eye) and elevation of affected eye
  2. Inability to depress adducted eye on side of lesion
  3. Double vision which worsens when looking down (can’t go down stairs); improves when tilting your head away from affected eye
33
Q

Lesion of abducens nerve

  1. Inability to do what motion
  2. Location of affected eye
  3. Symptom
A
  1. Abduct affected eye
  2. Medially deviated
  3. Double vision
34
Q

Ophthalmic nerve (V1)

  1. Contains what kind of fibers
  2. Origin
  3. 4 branches?
  4. Runs ?
A
  1. General sensory fibers
  2. Trigeminal ganglion
  3. Tentorial (meningeal), frontal, lacrimal, and nasociliary nerves
  4. In lateral wall of cavernous sinus
35
Q

Tentorial branch of V1 supplies?

A

Dura mater of tentorium cerebelli

36
Q

Lacrimal nerve branch of V1:

  1. Runs?
  2. Receives communicating branch from?
  3. Supplies?
  4. Its terminal branches supply?
A
  1. Along superior border of lateral rectus muscle
  2. Zygomaticotemporal nerve
  3. Lacrimal gland
  4. Lateral part of upper eyelid
37
Q

Zygomaticotemporal nerves contains what kind of fibers

A

Post-ganglionic parasympathetic fibers for lacrimal gland

38
Q

Frontal nerve branch of V1

  1. Location
  2. Divides into what 2 nerves
A
  1. Immediately above levator palpebrae superioris

2. Supraorbital and supratrochlear nerves

39
Q

Supraorbital nerve:

  1. Passes through?
  2. Innervates what 4 things?
A
  1. Supraorbital notch

2. Mucosa of frontal sinus, central part of upper eyelid, forehead, and anterior scalp

40
Q

Supratrochlear nerve:

  1. Passes above?
  2. Innervates what 2 things?
A
  1. Trochlea of superior oblique muscle

2. Medial part of upper eyelid and medial forehead

41
Q

Nasociliary nerve of V1

  1. Course?
  2. Divides into what 2 terminal branches?
A
  1. Passes above optic nerve and then runs anteriorly along medial rectus
  2. Anterior ethmoidal and infratrochlear nerves
42
Q

Branches of nasociliary nerve:

  1. Communicating branch has?
  2. Long ciliary nerves innervate?
  3. Posterior ethmoidal nerve innervates?
  4. Infratrochlear nerve ?
  5. Anterior ethmoidal nerve
A
  1. Ciliary ganglion; general sensory fibers
  2. General sensory innervation to eyeball
  3. Mucosa of ethmoidal air cells and sphenoidal sinus
  4. Lacrimal sac, medial part of upper eyelid, and adjacent part of nose
  5. Ethmoidal air cells
43
Q

Long ciliary nerves supply general sensory to eyeball and also contain what kind of fibers for what muscle?

A

Post-ganglionic sympathetic fibers for dilator pupillae muscle

44
Q

Anterior ethmoidal nerve:

  1. After supplying ethmoidal air cells, nerve enters where?
  2. Divides into what 2 branches?
  3. What do these branches supply
A
  1. Nasal cavity (near side of crista galli)
  2. Internal and external nasal branches
  3. Internal= mucosa of anterior parts of lateral wall and septum; External= skin of lower part of nose

Gross Anatomy Block 4 (14 decks)

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