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Ocular Block 5 > Orbital Anatomy > Flashcards

Orbital Anatomy Flashcards

1
Q

What are the orbital walls

A
  • orbital roof
  • lateral wall
  • floor
  • medial wall
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2
Q

What are the bones of the roof of the orbit?

A

Frontal

Sphenoid

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3
Q

What are the bones of the lateral wall of the orbit?

A

Sphenoid

Zygomatic

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4
Q

What are the bones of the floor of the orbit?

A

Maxillary
Palatine
Zygomatic (MPZ)

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5
Q

What are the bones of the medial wall of the orbit?

A 
Sphenoid
Lacrimal 
Ethmoidal
Maxillary 
(SLEM)
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6
Q

What are the bones of apex of the orbit?

A

Mostly comprised of the greater and lesser wings of the sphenoid bone

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7
Q

Where is the superior orbital fissure?

A

Roof of orbit

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8
Q

Where is the ethmoid sinus in relation to the orbit?

A

Medial to medial wall

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9
Q

What is the most dangerous sinus?

A

Sphenoid sinus

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10
Q

Where does the sphenoid sinus lie?

A

Adjacent to optic nerve and optic canal

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11
Q

Why is the sphenoid sinus dangerous?

A

Infection could cause blindness

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12
Q

Expansion of the sphenoid sinus compresses optic nerve bilaterally and can cause blindness

A

Sphenoid sinusitis

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13
Q

What is the thinnest bone of the orbit and where is it located?

A

Ethmoid bone in the medial wall

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14
Q

Where does the lacrimal sac reside?

A

Lacrimal fossa

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15
Q

What is the a link for some of the pathology for orbital cellulitis?

A

Vessels that go through the foramen in the anterior and posterior ethmoidal foramen

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16
Q

Where are the anterior and posterior ethmoidal foramen?

A

Medial wall

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17
Q

What is the second weakes bone of the orbit?

A

Floor bones: maxillary sinus underneath, fissures, and foramen

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18
Q

What makes the floor a susceptible place for trauma?

A

Thin bone, maxillary sinus underneath, fissures and foramen

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19
Q

What are the sinuses that surround the orbit?

A

-maxillary, frontal, sphenoid

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20
Q

What sinus us between the orbits?

A

Ethmoid sinus

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21
Q

What fissures are in the posterior orbit?

A
  • superior orbital fissure
  • inferior orbital fissure
  • optic canal
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22
Q

What are the foramen and fissures in the anterior orbit?

A
  • supraorbital and infraorbital fissures

- zygomatical and zygomaticotemporal fissures

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23
Q

What is the sensory foramen for sensation to the eyelid and face

A

Zygomaticofacial and zygomaticotemporal

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24
Q

What is the lateral wall for lateral face?

A

Zygomaticofacial and zygomaticotemporal fissures

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25
Q

Importance of fissures and foramen

A

They are where the bones of the orbit connect=weak spots in the orbit
-acts as places for infection to spread and come into orbit

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26
Q

Reasons orbital fractures may occur

A
  • closed compartment
  • limited space (shock waves from hitting orbital rims)
  • weak spots (fissures and foramen)
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27
Q

Major foramen in orbital apex

A
  • supraorbital fissure
  • infraorbital fissure
  • foramen rotundum
  • optic canal
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28
Q

What is the back where everything connects in the back of the orbit called?

A

Annulus of Zinn

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29
Q

What are the nerves that are outside the annulus of zinn?

A
  • lacrimal nerve
  • frontal nerve
  • trochlear nerve (CN IV)

Luscious French tarts

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30
Q

Nerves inside the annulus of zinn

A
  • superior division of oculomotor nerve (CN III)
  • nasociliary nerve
  • inferior divions of oculomotor nerve (CNIII)
  • abducens nerve (CN VI)

Standing naked in anticipation

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31
Q

Thyroid eye disease

A

Can cause muscles to swell in back in the apex and can crush vital structures, can cause motility problems and blindness

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32
Q

Fixed structure in the optic canal

A

Optic nerve

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33
Q

Blunt trauma and the optic nerve

A

Can stretch the optic nerve or cut off blood supply to cause indirect optic nerve injury and blindness

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34
Q

Outer ring of EOMs

A
  • levator palpebrae (eyelid
  • superior oblique (torsion)
  • inferior oblique (torsion)
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35
Q

What is the function of the superior oblique

A

Torsion

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36
Q

What is the most superior EOM?

A

Lavator palpebrae

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37
Q

What is the third superior EOM?

A

Superior oblique

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38
Q

Where does the superior oblique attach?

A

Trochlea

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39
Q

What is the action of the inferior oblique

A

Torsion

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40
Q

What does the inner ring of EOMs consist of?

A
  • superior rectus
  • inferior rectus
  • medial rectus
  • lateral rectus
41
Q

What is the second most superior EOM

A

Superior rectus

42
Q

What EOM attaches at the lacrimal fossa?

A

Inferior rectus

43
Q

What happens in thyroid eye disease?

A

-muscles swell and get enlarged in back of eye

44
Q

How can you release pressure in someone with thyroid eye disease?

A

Making room in the orbit by removing ethmoid bone or ethmoidal tissue

45
Q

What is usually the first EOM impacted by thyroid eye disease?

A

Inferior rectus

46
Q

What are some characteristics of thyroid eye disease?

A

Dry eye and upper lid retraction

47
Q

What are the motor nerves of the eye?

A

CN III, IV, and VI

48
Q

What muscles does CNIII innervate?

A
  • levator palpebrae
  • superior rectus
  • medial rectus
  • inferior rectus
  • inferior oblique
49
Q

What muscles does CN IV innervate?

A

Superior oblique

50
Q

What muscle does CN VI innervate?

A

Lateral rectus

51
Q

What are the sensory nerves of the eye

A
  • nasociliary
  • zygomaticotemporal
  • zygomaticofacial
  • infraorbital
52
Q

What does the nasociliary nerve innervate?

A

Nose

53
Q

Hutchinson’s sign

A

In shingles, this indicates an impact on nasociliary nerve and a more likely infection with the eye due to relation with muscles

54
Q

What does the zygomaticotemporal and zygomaticofacial nerves innervate?

A

Lateral face

55
Q

What does the infraorbital nerve innervate?

A

Cheek and face

56
Q

What artery gives access to cavernous sinus?

A

Supraorbital artery

57
Q

What allows infection to spread through the ethmoid foramen?

A

Anterior ethmoid artery

58
Q

Blood supply for the eyelid branches off of what?

A

The facial artery

59
Q

Where do veins of the face begin?

A

Cavernous sinus

60
Q

What are veins susceptible to that beceom enlarged and cause eye to bulge

A

Varicoel

61
Q

Why are veins a pathway for infection?

A

Due to communication with each other

62
Q

Orbit is what kind of compartment?

A

Closed. Muscles and blood supply are surrounded by soft tissue to limit their expansion. Diseases or swelling in one area can have impact on the structures immediately adjacent to them

63
Q

Kids and infections

A

Anything that happens in kids happens faster and is more dangerous

64
Q

If there is no up gaze or down gaze, what is it most likely caused by?

A

Orbital cellulitis

65
Q

Canthal tilt

A

Can be indication of underlying pathology

66
Q

Asians eyelids

A

Absence of lid fold because of attachments underneath the orbicularis muscle, important in ptosis and disrupting lid folds

67
Q

Main CT structures giving giving structure and function to the eyelids

A

Tarsal plates

68
Q

Divides to go in front and behind lacrimal fossa

A

Medial canthal tendon

69
Q

What helps direct tear drainage and distribution

A

Tendons

70
Q

What muscles are the protractors of the eyes?

A

Orbicularis muscles

71
Q

Where does the orbicularis muscles attach?

A

Nasally

72
Q

What are the eyelid openers?

A

Lavator palpebrae superioris and others

73
Q

What muscle results in droopy eyelid and blocks vision

A

Lavator palpebrae superioris

74
Q

What is often the thing that gets stretched in the eyelids

A

Aponeurosis connecting muscle to tarsal plate

75
Q

Which eyelid is not very mobile?

A

Lower eyelid

76
Q

What muscle is used for porlonged opening of the eye?

A

Mueller muscle

77
Q

What are the fat compartments of the orbit?

A
  • 2 fat pads on top (not temporal)

- 3 pads on bottom

78
Q

Why is it important to remember that the eyelids are connected to res to the face?

A

For things like Shingles

79
Q

What are the protractor muscles innervated by?

A

Facial nerve

80
Q

What is the paralysis of the face often related to?

A

Bells Palsy of facial nerve

81
Q

What is the secretory system of the eye?

A

Components of the tear film

82
Q

In superior lateral aspect of the orbit. Mostly responsible for aqueous portion of the tear film

A

Lacrimal gland

83
Q

Where is the lacrimal gland located

A

Superior lateral aspect of orbit, lacrimal gland fossa

84
Q

What is the lacrimal gland sometimes confused for?

A

Fat pad

85
Q

Responsible for distributing tear film across the cornea and into the excretory system

A

Distributors system

86
Q

Drainage system of eye

A

Excretory system

87
Q

Tiny holes in each lid

A

Puncta

88
Q

First point of entrance for tears into the excretory system

A

Puncta

89
Q

How does the puncta take in tears?

A

When eyes close, puncta tune in and Crete negative pressure so when eyes open, the pressure sucks in the tears

90
Q

Position of puncta

A

Has to be properly immediately in and adjacent to the eye

91
Q

Tear flow to canaliculus

A

Tears go to vertical canaliculus and then to the horizontal canaliculus

92
Q

What makes the common canaliculus

A

Two horizontal canaliculus join to form this

93
Q

Pathway of tears

A
  • puncta to canaliculus
  • canaliculus to common canaliculus
  • common canaliculus to lacrimal sac
  • lacrimal sac narrows into the nasolacrimal duct which then enters the nose in the inferior meatus
  • tears exit through Hasner’s Valve
94
Q

Where do tears exit

A

Hasners valve

95
Q

What is the most common thing that can mess up the system of tear flow?

A

Makeup

96
Q

How does makeup mess up the flow of tears?

A

Makeup and mucus combine to make stones and block the drain

97
Q

Why do babies tears build up sometimes

A

Hasner’s valve is the last thing to develop in babies, so their tears can build up. Usually resolves itself

98
Q

How can ptosis affect tear flow?

A

Can cause puncta not to separate and stop tears from draining

Ocular Block 5 (8 decks)

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