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809 - Exam Block 2 > Orbit, Eye, & Vision Part 1 - Herring > Flashcards

Orbit, Eye, & Vision Part 1 - Herring Flashcards

1
Q

a thickened funnel-shaped fascial layer

A

periorbita

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2
Q

Lateral walls are at a _____° angle which places the axis of orbit at about ___° (to each other)

A

90 ; 45

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3
Q

Optical axis of eyeball is ______ when looking straight ahead (primary position; eye at rest)

A

parallel

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4
Q

_____ and _____ walls of the orbit are thinnest

A

Medial ; inferior

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5
Q

a condition where the eyeball or eyeballs bulge out of the eye socket

A

Exophthalmos (proptosis)

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6
Q

space between upper & lower eyelids

A

Palpebral fissure

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7
Q

Medial & lateral palpebral
commissures (also known as
canthi) at the ______ of the
eye

A

corners

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8
Q

What glands help to keep the eyelids from sticking to each other and prevent evaporation of tears

A

Ciliary glands (which are sebaceous glands)

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9
Q

Between eyeball & inner aspect of eyelids (closed sac when the eyelids are brought together)

A

Conjunctival Sac

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10
Q

What muscle acts as the sphincter of the eyelids (brings eyelids together)

A

Orbicularis oculi

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11
Q

What glands:

Prevent tears from evaporating

Increases surface tension of tears

A

Tarsal glands

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12
Q

Separates superficial fascia of the face from the orbital contents, essentially what acts as a boundary so something like a contact couldn’t go back behind/under the eye

A

Orbital septum

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13
Q

Superior eyelid: Two muscles elevate (open) the upper lid

A

Levator palpebrae superioris

Superior tarsal (Mueller’s) muscle

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14
Q

Levator palpebrae superiori is what kind of muscle

A

skeletal

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15
Q

Levator palpebrae superiori is __________ innervated because it is skeletal muscle

A

Somatically

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16
Q

Superior tarsal (Mueller’s) muscle is ______________ innervated

A

Sympathetically

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17
Q

What muscle is responsible for “tone” of the eyelid

A

Superior tarsal (Mueller’s) muscle

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18
Q

Lesion to the nerve pathway to either Levator palpebrae superioris or Superior tarsal (Mueller’s) muscle results in

A

partial ptosis (drooping) of the upper eyelid

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19
Q

Forms when a ciliary gland of the eyelid is blocked

Typically on the edge of the eyelid near the base of an eyelash

Painful

A

Stye

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20
Q

Forms when a tarsal gland is blocked

Usually deeper in the eyelid –
typically forms on the inner aspect of the upper eyelid

Generally aren’t painful

A

Chalazion

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21
Q

The lacrimal gland produces lacrimal fluid (tears)
which is crucial for corneal health, why is this so?

A

The cornea does not have it’s own blood supply so it relies on the lacrimal fluid

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22
Q

Cleanses

Collects irritants

Drains to medial angle of the
eye

A

Lacrimal fluid of the lacrimal gland

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23
Q

Excretory ducts open into the

A

superior conjunctival fornix

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24
Q

lacrimal gland fluid flows from ______ to ______ within the conjunctival sac by gravity and when we blink

A

lateral ; medial

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25
Q

2 small openings near medial angle of the eye drains fluid from surface of the eyeball

A

Lacrimal puncta

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26
Q

Gets the fluid from the lacrimal puncta and drains it into the lacrimal sac

A

Lacrimal canalicul

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27
Q

Drains fluid from the lacrimal canaliculi to the inferior nasal meatus (inferior to the inferior nasal concha) where it is then drained posteriorly & swallowed

A

Nasolacrimal duct

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28
Q

The eyeball is composed of three layers, what are they

A

fibrous (outer) layer

vascular (middle) layer

inner layer

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29
Q

What consists of the fibrous (outer) layer

A

Sclera
Cornea

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30
Q

What consists of the vascular (middle) layer

A

choroid

ciliary body

iris

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31
Q

What consists of the inner layer

A

Retina

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32
Q

The eyeball is also composed of 3 chambers:

A

Anterior chamber
Posterior chamber
Vitreous chamber

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33
Q

What chamber is between cornea & iris

A

Anterior chamber

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34
Q

what chambers are filled with aqueous humor

A

Anterior and Posterior chambers

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35
Q

What (small) chamber is between the iris and lens

A

posterior chamber

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36
Q

What (large) chamber is between the lens and retina

A

vitreous chamber

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37
Q

what chamber is filled with vitreous body (a gelatinous mass)

A

vitreous chamber

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38
Q

The eyeball has 4 structures involved in the refraction of light

A
  1. Cornea
  2. Aqueous humor
  3. Lens
  4. Vitreous body
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39
Q

Which structure of the eye is involved in fixed refractive power

A

cornea

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40
Q

Which structure of the eye is involved in adjustable refractive power

A

lens

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41
Q

What of the fibrous (outer) layer consists of

Opaque
Posterior 5/6th
Muscle attachment
VASCULARIZED (bloodshot eyes)

A

Sclera

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42
Q

What of the fibrous (outer) layer consists of is

Transparent

Anterior 1/6th

AVASCULAR

Maintained by aqueous humor (posterior surface) & lacrimal fluid (anterior surface)

A

Cornea

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43
Q

The cornea is highly sensitive and is innervated by what branch of CN V

A

CN V1

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44
Q

What part of the VERY VASCULARIZED (middle) Layer

Lines most of sclera

Adherent to retina

Terminates at ciliary body

Supplied by branches of ophthalmic a.

A

Choroid

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45
Q

What part of the Vascular (middle) Layer

Connects choroid to iris

Posterior to corneoscleral junction

A

Ciliary Body

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46
Q

The Ciliary muscle / Ciliaris muscle = smooth fiber is ____________ innervated

A

parasympathetically

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47
Q

Radial fibers make up the ciliary muscle in the vascular (middle) layer which help _______ to change thickness of lens

A

contract

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48
Q

Ciliary processes are covered by ciliary epithelium that produces

A

aqueous humor

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49
Q

Ciliary processes are covered by ciliary epithelium that anchors ________ that attach to the lens

A

zonular fibers

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50
Q

What in the vascular layer has smooth muscle fibers which control the size of the pupil (contractile diaphragm)

A

Iris

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51
Q

2 smooth (involuntary) muscles in the iris control size of the pupil, what are they

A

Sphincter pupillae

Dilator pupillae

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52
Q

Sphincter pupillae - Circular fibers that are __________
innervated

Which CN

A

parasympathetically

CN III

** makes pupil smaller **

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53
Q

Dilator pupillae - Radial fibers that are _______ innervated

A

sympathetically

** makes pupil bigger **

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54
Q

Light hits which layer first in the retina

A

Inner first then outer

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55
Q

Two important layers of the retina, what are they

A

Photoreceptive layer

Ganglion cell layer

56
Q

What layer of the retina is the outer layer and is made up of rods & cones

A

photoreceptive layer

57
Q

what layer of the retina is the inner layer and has 1st order cell bodies for vision that travel to the optic disc & then exit to form CN II

A

Ganglion cell layer

58
Q

Phototransduction occurs at the ______ layer (rods & cones)

A

photoreceptive

59
Q

Light energy is converted to __________

A

electrical potentials

60
Q

Membrane potentials then travel from outer layer (rods & cones) to ______ layer
(ganglion cells)

A

inner

61
Q

Ganglion cell axons of the eyeball then travel to exit the eyeball at the _______ & then form the ________

This is where our __________ neurons for vision are located

A

optic disc

optic nerve (CN II)

1st order

62
Q

Concentrated in the central retina

Color vision

High visual acuity

Photopic vision

In well-lit settings

Require more light to function

A

Cones

63
Q

Concentrated in Peripheral retina

Mostly gray tones

Less visual acuity

Scotopic vision

In low-light settings (night vision)

Very sensitive to light / require less light

A

Rods

64
Q

Site where axons of the ganglion cells converge & leave the eyeball to form CN II

** in the inner layer of the retina **

A

Optic Disc (in the inner layer of the retina)

65
Q

Central a/v of the retina enter/exit here

A

Optic Disc

66
Q

What contains fibers only and no photoreceptor cells (“blind spot”)

A

Optic Disc

67
Q

What is

Lateral to optic disc

Central (detailed) field of vision

A

Macula lutea (in retina)

68
Q

Area of highest visual
acuity

Located in visual
axis (0°)

Only cones (no rods)

A

Fovea Centralis

69
Q

Clear watery fluid in the anterior and posterior chambers of the eyeball is _____ and where is it in the eye?

A

Aqueous Humor - Cornea

70
Q

Provides nutrients and removes metabolites from cornea and lens

A

Aqueous Humor - Cornea

71
Q

Produced continually by the ciliary processes and passes from the posterior chamber into the anterior chamber via the pupil

A

Aqueous Humor - Cornea

72
Q

Aqueous Humor - Cornea is drained away through spaces at the _________ (filtration angle)

A

iridio-corneal angle

73
Q

The iridio-corneal angle drain into the

A

scleral venous sinus (canal of Schlemm)

74
Q

Blockage of the venous canal can be one cause of

A

glaucoma

75
Q

Transparent biconvex structure held within a transparent capsule

A

Lens

76
Q

Surrounded by the ciliary processes from which the highly elastic, radially-arranged suspensory ligaments of the lens (zonular fibers) arise

A

Lens

77
Q

Fills the eyeball posterior to the lens (vitreous chamber

A

Vitreous body

78
Q

Holds retina in place & supports the lens

Jelly-like matrix (gelatinous mass) with a fine meshwork of collagen fibers

A

Vitreous body

79
Q

Not continually replaced (present at birth) and that’s what you have for life

A

Vitreous body

80
Q

Leading cause of blindness in the world

A

Cataracts

81
Q

2nd leading cause of blindness in the world

A

Glaucoma

82
Q

Glaucoma = ______-angle (typically gradual onset)

A

Open

83
Q

Glaucoma = ______-angle (typically sudden onset)

A

closed

84
Q

Due to increased volume:

Increased secretion / production AND/OR

Obstructed drainage of aqueous humor

A

Glaucoma

85
Q

Branch of ICA

Principal blood supply to orbit

Travels superior to optic nerve (CN II)

Travels through medial aspect of orbit

A

Ophthalmic Artery

86
Q

The ophthalmic artery gives rise to this artery that pierces CN II and is the primary blood supply of the inner retina, what is it?

A

Central artery of the retina

87
Q

What artery pierces CN II and is the primary blood supply to the inner retina

A

central artery of the retina

88
Q

Superior & inferior ophthalmic veins communicate with:

angular vein ________

cavernous sinus _________

pterygoid venous plexus _______

A

anteriorly ; posteriorly ; inferiorly

89
Q

Superior ophthalmic vein travels from the superomedial aspect of the orbit anteriorly to the superolateral aspect posteriorly to exit through the _____

A

superior orbital fissure

90
Q

CN V1 is purely

A

sensory

91
Q

CN V1 divides into what 3 nerves

** NFL from M –> L **

A

nasociliary

frontal

lacrimal

92
Q

What nerve suspends ciliary ganglion

A

nasociliary nerve

93
Q

What ganglion is associated with short ciliary nerves but not with long ciliary nerves

A

Ciliary Ganglion

94
Q

What nerve is:

Sensory fibers from eyeball to nasociliary nerve

Pass through the ciliary ganglion

Fibers hitching a ride:
- PostGPS
- PostGS

A

Short ciliary nerves

95
Q

What nerve is:

Sensory fibers from eyeball to nasociliary nerve

Do not go through ciliary ganglion

Fibers hitching a ride:
- PostGS

A

Long ciliary nerves

96
Q

The Anterior & Posterior Ethmoidal nerves are __________ branches carrying information from sphenoidal & ethmoidal sinuses and anterosuperior nasal cavity

A

sensory

97
Q

Corneal Reflex - Sensory Limb

Short and long ciliary nerves to CN _____

A

V1

98
Q

Corneal Reflex - Sensory Limb

** mostly conveys pain and temperature **

Where are the 1st order cell bodies? and these axons travel in the spinal trigeminal tract

A

Trigeminal ganglion

99
Q

Corneal Reflex - Sensory Limb

Where are the 2nd order cell bodies? and the axons project ________ to facial motor nucleus and superior salivary nucleus aka the ______ limb

A

Spinal trigeminal nucleus bilaterally
motor

100
Q

Corneal Reflex - Motor Limb = __________ nucleus sends axons ipsilaterally as part of CN VII to orbicularis oculi to do what ?

A

facial motor ; blink

101
Q

Corneal Reflex - Motor Limb =

For the tearing component of the corneal reflex (lacrimal reflex), axons from 2nd order neurons project to the ______________ nucleus (preGPS cell bodies) which projects to the __________

A

superior salivatory nucleus ; lacrimal gland

102
Q

What nerve:

sensory information from forehead

has the supratrochlear and supraorbital nerves as its terminal branches

A

Frontal nerve

103
Q

What nerve:

Has sensory ONLY innervation from skin near lacrimal gland

If this nerve is damaged, there is no disruption to the lacrimal gland

A

Lacrimal Nerve

104
Q

PreGPS cell bodies of the lacrimal gland are in the

A

superior salivary nucleus

105
Q

PreGPS fibers of the lacrimal gland travel out of CN _____ and then branch off of it as _________ nerve

A

CN VII and greater petrosal

106
Q

PostGPS cell bodies of the lacrimal gland are in the

A

pterygopalatine ganglion

107
Q

PostGPS fibers of the lacrimal gland travel on the distal portion of CN ____ to get to the lacrimal gland

A

V1

108
Q

Parasympathetic Eyeball muscles are involved in ________ innervation of the pupil and ____ accommodation (changes shape of the lens for near vision)

A

parasympathetic ; lens

** protects pupil **

109
Q

Sympathetic eyeball muscles are involved in _______ of the pupil and has _____ role in lens accommodation

A

dilation ; no

110
Q

PS pathway of the eyeball =

PreGPS cell bodies are in the

A

Edinger-Westphal nucleus

111
Q

PS pathway of the eyeball =

PreGPS fibers exit as CN

A

III

112
Q

PS pathway of the eyeball =

PostGPS cell bodies are in and synapse on the _______ ganglion

A

ciliary

113
Q

PS pathway of the eyeball =

PostGPS fibers travel on _____ ciliary nerves of CN ________

A

short ; V1

114
Q

PS pathway of the eyeball targets

A

constrictor (sphincter) pupillae & ciliary muscle

** this is what changes tension on the zonular fibers which changes the shape of the lens for lens accommodation **

115
Q

S pathway of the eyeball =

PreGS Cell bodies are in

A

IML T1

116
Q

S pathway of the eyeball =

PreGS fibers ascend in the ____________ to the ___________ ganglion

A

sympathetic trunk ; superior cervical

117
Q

S pathway of the eyeball =

PostGS cell bodies are in and synapse on the __________ ganglion

A

spuperior cervical

118
Q

S pathway of the eyeball =

PostGS fibers are in the _____________ to the internal carotid artery plexus to ophthalmic artery plexus to ______ and ______ ciliary nerves

A

cephalic artery ramus ; short ; long

119
Q

S pathway of the eyeball target

A

dilator pupillae muscle

120
Q

What muscle of the eyeball muscle is involved in

Sympathetic control

Radial arrangement of smooth muscle dilates pupil
* Low light

A

Dilaor pupillae

121
Q

What muscle of the eyeball muscle is involved in

Parasympathetic control

Circular arrangement of smooth muscle constricts pupil
* Bright light

A

Sphincter (constrictor) pupillae

122
Q

What muscle acts like a sphincter and suspends lens by zonular fibers

A

ciliary muscle

123
Q

Lack of nerve stimulation aka no parasympathetic stimulation

Tension on zonular fibers pulls on lens

Lens stretches (becomes thinner) = distance vision

Means the ciliary muscle is ______ and has what kind of diameter

A

relaxed ; large

124
Q

Parasympathetic stimulation

Decreased tension on zonular fibers

Lens becomes more spherical = near vision

Means the ciliary muscle is ______ and has what kind of diameter

A

Contracted ; small

125
Q

What part of the conjunctiva is inside the eyelid

A

Palpebral

126
Q

What part of the conjunctiva is reflects on the eyeballs

A

Bulbar

127
Q

Ganglion cells cannot convert to _____ directly

A

LIGHT

128
Q

What 2 targets would the postGPS fibers hitching a ride on the short ciliary nerves have

A

sphincter pupillae

ciliary muscle

129
Q

What target would the postGS fibers hitching a ride on the short ciliary nerves have

A

dilator pupillae

130
Q

What would we see if we damage V1 to the right eye and we touch it?

A

No blinking in either eye because no perception of something touching the right eye

131
Q

What would we see if we damage right V1 and touch the left eye?

A

blinking in both eyes

132
Q

What if we damage CN VII on the right side and touch the right eye? what about the left eye?

A

Same answer for both

Nothing in the right eye but the left eye would blink and have tear production

133
Q

PostGPS fibers hitch a ride on the very ______ aspect of V1

A

distal

134
Q

Because postGPS fibers hitch a ride on the very distal aspect of V1, if we cut the lacrimal nerve or damage it close to the lacrimal fossa of the frontal bone or close to the lacrimal gland itself, we lose ?

A

Sensory to the upper lateral part of the eye/orbit AND innervation to the lacrimal gland

135
Q

Because postGPS fibers hitch a ride on the very distal aspect of V1, if damage the lacrimal nerve as it’s branching off V1 near the apex of the orbit or V1 itself, we lose?

A

only sensory loss to the superolateral skin of orbit

** nothing happens to the lacrimal gland **

136
Q

if you damage short ciliary nerves of the eyeball, what 3 things do we lose? clarify if partial or complete

A

partial sensory loss (because we have the long ciliary nerves)

partial sympathetic loss (because we have the long ciliary nerves)

complete loss of the parasympathetic pathway

137
Q

Damaging the short ciliary nerves of the eyeball results in complete loss of the parasympathetic eyeball, what symptoms do we see?

A

dilated pupil and issues with lens accommodation

809 - Exam Block 2 (14 decks)

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