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Ocular Block 5 > Orbital Vasculature Part I > Flashcards

Orbital Vasculature Part I Flashcards

1
Q

What kind of BV carry oxygenated blood away from the heart

A

Arteries

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2
Q

What blood vessels are under higher pressure?

A

Arteries

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3
Q

What are the layers of the arteries

A
  • external tunic (adventitia)
  • tunica media
  • tunica intima
  • internal elastic lamina
  • external elastic lamina
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4
Q

External tunic (adventitia) of arteries

A

Collage fibers/connective tissue

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5
Q

Tunica media of arteries

A

Composed of smooth muscle and elastic tissue

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6
Q

Tunica intima of arteries

A

Composed of endothelial cells (direct contact with lumen)

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7
Q

Internal elastic lamina of arteries

A

Outer most portion of the tunica intima

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8
Q

External elastic lamina of arteries

A

Inner most portion of the tunica adventitia

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9
Q

Where do arteries drain to

A

Arterioles

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10
Q

Primary site of vascular resistance

A

Arterioles

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11
Q

Where do arterioles drain to

A

Capillaries

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12
Q

What is the tunica media of arterioles like compared to the arteries

A

Thinner

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13
Q

Endothelial cells and their basement membrane

A

Capillaries

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14
Q

What lines the external surface of the capillaries?

A

Pericytes

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15
Q

What is the function of the capillaries

A

exchange of nutrients and metabolic waste

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16
Q

What are venules lined with

A 
Endothelial lining 
Tunica media (thin)
Tunica adventitia
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17
Q

Where do venules drain to

A

Veins

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18
Q

Carry deoxygenated blood to heart

A

Veins

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19
Q

Tunica of veins

A

Same as arteries, but tunica media is much thinner and the tunica adventitia is much thicker. They lack elastic lamina

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20
Q

What does the brachiocephalic artery give rise to

A

The right subclavian and tight common carotid artery

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21
Q

Where do the left common carotid artery and the left subclavian artery branch from?

A

Directly from the Arch of the aorta

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22
Q

When does the common carotid artery bifurcate and what does it bifurcate into?

A

After it enters the carotid sheath, it bifurcate into the internal and external carotid artery

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23
Q

As the internal carotid artery ascends into the neck inside the carotid sheath, what does it carry with it?

A

A plexus of postganglionic sympathetic nerve fibers

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24
Q

Does the internal carotid artery have any branches outside of the skull?

A

No

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25
Q

How does the internal carotid artery enter the skull

A

Through the carotid canal

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26
Q

Where does the internal carotid artery emerge from and into what fossa?

A

Emerges from the petrous portion of the temporal bone and into the middle cranial fossa

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27
Q

How does the internal carotid course?

A

Anterior over the foramen lacerum

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28
Q

What sinus does the internal carotid artery enter after it courses over the foramen lacerum?

A

Cavernous sinus

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29
Q

The ________ nerve sits inferolateral to the internal carotid artery within the cavernous sinus

A

Abducens (CN VI)

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30
Q

What cranial nerves sit lateral to the internal carotid artery and course in the lateral wall of the cavernous sinus?

A
  • oculomotor nerve (CNIII)
  • trochlear nerve (CNIV)
  • ophthalmic and maxillary divisions of the trigeminal nerve (CNV)
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31
Q

Where does the carotid artery exit the roof of the cavernous sinus?

A

Just medial to the anterior clinic process

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32
Q

As the internal carotid artery dips inferior to the optic nerve, what happens?

A

It gives off the ophthalmic artery at the posterior opening of the optic canal

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33
Q

Where does the ophthalmic artery enter the optic canal?

A

Inferior and lateral to optic nerve

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34
Q

How does the ophthalmic artery course in the dural sheath of optic nerve?

A

Anterior, and then pierces dural sheath and lies just lateral to the optic nerve in the orbit

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35
Q

Once the ophthalmic artery pireces the dural sheath of the optic nerve, what does it do?

A

Courses anterior for a shirt distance stalling lateral to the optic nerve, then makes an abrupt medial turn over the optic nerve and is joined by the nasociliary nerve

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36
Q

As the ophthalmic artery joins the nasociliary nerve, how does it run?

A

Courses anterior along the medial wall of orbit between the superior oblique muscle and medial rectus muscle

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37
Q

How does the ophthalmic artery terminate

A

As the supratrochlear and dorsonasal arteries

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38
Q

How many arteries branch from the ophthalmic artery?

A

Eleven branches to supply eye, orbit, and extra orbital structures

Ocular (2)
Orbital (2)
Extraorbital (7) and one sorta

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39
Q

What are all the branches of the ophthalmic artery?

A
  • central retinal artery
  • ciliary arteries
  • Lacrimal artery
  • muscular arteries
  • supraorbital artery
  • posterior ethmoidal artery
  • anterior ethmoidal artery
  • recurrent meningeal artery
  • medial palpebral arteries
  • supratrochlear artery
  • dorsonasal artery
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40
Q

What are the ocular branches of the ophthalmic artery

A
  • central retinal artery

- ciliary arteries

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41
Q

What are the orbital branches of the ophthalmic artery?

A
  • lacrimal artery

- muscular arteries

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42
Q

What are the extra orbital branches of the ophthalmic artery?

A
  • supraorbital
  • posterior ethmoidal
  • anterior ethmoidal
  • recurrent meningeal
  • medial palpebral
  • supratrochlear
  • dorsonasal
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43
Q

What is the first and smallest branch of hte ophthalmic artery?

A

Central retinal artery

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44
Q

Where does the central retinal artery branch off of the ophthalmic artery?

A

Near optic canal and inferior to optic nerve

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45
Q

How does the central retinal artery course after it comes off of the ophthalmic artery?

A

Anterior and pierces the dural sheath of optic nerve 5-15mm from posterior scleral aperture

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46
Q

After the central retinal artery pierces the dural sheath of the optic nerve, what does it do?

A

Obliquely crosses subarachnoid space to enter substance of the nerve and course with the central retinal vein to the lamina cribrosa and enters back of the eye

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47
Q

What supplies the pill meninges surrounding the optic nerve?

A

Small pial branches from the central retinal artery

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48
Q

Where does the central retinal artery emerge inside the ey

A

On nasal side of optic disc just nasal to the central retinal vein

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49
Q

Once the central retinal artery enters the eye, how does it branch?

A

Divides into superior and inferior branches, which bifurcate into temporal and nasal branches

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50
Q

What does each branch of the central retinal artery do once it is in the eye?

A

Provides arterial blood to the inner retinal layers in each respective quadrant

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51
Q

Where does the ciliary artery branch from the ophthalmic artery?

A

As it courses over optic nerve, they arise as medial and lateral trunks that give rise to short and long posterior ciliary arteries

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52
Q

Long posterior ciliary arteries

A
  • medial and lateral
  • pierce sclera medial and lateral to arterial circle of Zinn-Haller
  • travel anterior inside the eye via suprachoroid (perichoroid) space
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53
Q

What does the long posterior ciliary arteries supply blood to

A

Urea anterior to equator

54
Q

Short posterior ciliary arteries

A
  • 10-20 branches

- pierce sclera and form anastomotic loop around optic nerve known as arterial circle of Zinn (Haller)

55
Q

What does the short postioer ciliary arteries supply

A

Blood to urea posterior to equator

56
Q

What can the short posterior ciliary arteries give rise to

A

May give rise to cilioretinal artery

57
Q

Where does the lacrimal artery branch off of the ophthalmic artery?

A

Near optic canal

58
Q

How does the lacrimal artery course?

A

On superior border of lateral rectus, superior and inferior lateral palpebral arteries, and zygomatic artery, which branches into zygomaticotemporal and zygomaticotemporal arteries

59
Q

What does the lacrimal branch of the ophthalmic artery anastomose with

A

Branches of superficial temporal artery (external carotid artery)

60
Q

How does the muscular artery branch from the ophthalmic artery

A

As medial and lateral trunks

61
Q

What does the medial muscular artery supply?

A

Inferior rectus, inferior oblique, and medial rectus

62
Q

What does the lateral trunk of the muscular artery supply

A

SUPERIOR RECTUS, SUPERIOR OBLIQUE, LEVATOR PALPEBRAE SUPERIORIS

63
Q

What do the muscular arteries to the rectus muscles branch into?

A

Anterior ciliary arteries

64
Q

Each muscular artery branches into two anterior ciliary arteries, except the muscular artery to the _______

A

Lateral rectus, this one branches into only one artery.

65
Q

How many solitary arteries are there in total?

A

7 (all muscular arteries have to branches of these except the lateral rectus which only has one)

66
Q

Anterior ciliary muscles

A

Either perforate sclera at tendinous insertions of rectus muscles and join long posterior ciliary arteries to form major arterial circle of iris, or stat superficial and give rise to anterior conjunctival arteries

67
Q

Where does the supraorbital artery branch off of the ophthalmic artery?

A

After the ophthalmic artery crosses the optic nerve

68
Q

How does the supraorbital artery course?

A

Courses with frontal nerve between periorbita and levator palpebrae superioris muscle

69
Q

Where does the supraorbital artery exit the orbit?

A

Supraorbital foramen (notch)

70
Q

What does the supraorbital artery anastomose with?

A

Supratrochlear artery and superficial temporal artery (external carotid)

71
Q

What supplies blood to levator palpebrae superioris, superior rectus, superior oblique, scalp, and upper eyelid?

A

Supraorbital artery

72
Q

How does the postioer ethmoidal artery course?

A

Along the medial wall between the superior oblique and medial rectus

73
Q

What foramen does the postioer ethmoidal artery enter and with what nerve?

A

Enters the postioer ethmoidal canal with the posterior ethmoidal nerve

74
Q

What gives blood supply to the posterior ethmoidal and sphenoid air sinuses?

A

Posterior ethmoidal artery

75
Q

Which is the larger of the two ethmoidal arteries?

A

Anterior ethmoidal artery

76
Q

What Forman does the anterior ethmoidal artery enter and with what nerve?

A

Anterior ethmoidal canal with the anterior ethmoidal nerve

77
Q

What supplies the anterior and middle ethmoidal air sinuses and the sphenoid sinuses?

A

Anterior ethmoidal artery

78
Q

What passes through the cribiform plate of the ethmoid bone to supply the nasal cavity and skin of the nose?

A

Anterior ethmoidal artery

79
Q

How does the recurrent meningeal artery course?

A

Posterior through superior orbital fissure to supply meninges in middle cranial fossa

80
Q

Medial palpebral arteries

A
  • branch of ophthalmic
  • superior and inferior medial palpebral arteries
  • one above and one below medial palpebral ligament
  • anastomose with lateral palpebral arteries
  • supply portion of eye lid
81
Q

What are the two terminal branches of the ophthalmic artery?

A

Supratrochlear and dorsonasal artery

82
Q

Perforated orbital septum above trochlear for superior oblique muscle

A

Supratrochlear artery

83
Q

What does the supratrochlear exit the orbit with

A

Suprartochlear nerve

84
Q

What supplies blood to the skin of the medial forehead and scalp?

A

Supratrochlear artery

85
Q

What does the supratrochlear artery anastomose with

A

Supraorbital artery, contralateral supratrochlear artery, and anterior temporal artery (branch of external carotid)

86
Q

Perforated orbital septum below trochlea for superior oblique muscle, but above medial palpebral ligament

A

Dorsonasal artery

87
Q

How does the dorsonasal artery course and what does it supply?

A
  • courses along the side of the nose
  • supplies lacrimal sac
  • anastomoses with angular artery, a continuation of the facial artery, which is a branch of the external carotid artery
88
Q

Nasofrontal artery

A
  • part of the ophthalmic artery
  • lies outside muscle cone
  • located along medial wall between anterior ethmoidal artery and trochlea of superior oblique muscle
  • gives rise to supratrochlear artery and dorsonasal artery
89
Q

What technically gives rise to the dorsonasal artery and the supratrochlear artery?

A

Nasofrontal artery

90
Q

What are the branches of the external carotid artery that supply the orbit?

A
  • facial
  • infraorbital
  • superficial temporal
91
Q

Facial artery

A
  • branch of external carotid
  • loops around margin of mandible
  • ascends face
  • changes name at all of nose to angular artery
  • supplies lacrimal sac
  • anastomoses with the infraorbital artery and dorsonasal artery at the medial canthus
92
Q

The infraorbital artery is a branch of what?

A

Maxillary artery

93
Q

Where does the maxillary artery give off the infraorbital branch?

A

Inside the pterygopalatine fossa

94
Q

How does the infraorbital artery enter the orbit?

A

Through inferior orbital fissure where it passes through the inferior orbital fissure as the infraorbital artery

95
Q

How does the infraorbital artery run?

A
  • Follows infraorbital nerve through the inferior orbital groove and canal
  • emerges on the maxillary bone via infraorbital foramen
96
Q

What does the infraorbital artery supply?

A

Inferior rectus, inferior oblique, lower lid and cheek

97
Q

What does the infraorbital artery anastomose with?

A

Angular artery and dorsonasal artery

98
Q

What is the terminal branch of the external carotid artery?

A

Superficial temporal artery

99
Q

How does the superficial temporal artery course

A

Upward behind the ramus of the mandible to the temporal fossa

100
Q

What does the superficial temporal artery give off

A

The anterior temporal artery that will anastomose with branches from the supraorbital and supratrochlear arteries

101
Q

What does the superficial temporal artery supply

A

Lateral region around the orbit

102
Q

Ocular and orbital venous drainage system

A
  • tortuous
  • no valves
  • freely anastomose
  • direction of blood flow is related to head posture and gravity
103
Q

What is different about veins in the head compared to the rest of the body?

A

They do not have veins, blood flow is related to head posture and gravity

104
Q

What drains the retina

A

Central retinal vein

105
Q

How does the ventral retinal vein exit the eye

A

Through the optic disc via the lamina cribrosa
, travels in center of optic nerve, crosses subarachnoid space and pierces the dura of optic nerve and exits with central retinal artery

106
Q

Where does the central retinal artery drain to?

A

Superior ophthalmic vein or cavernous sinus

107
Q

What drains the choroid?

A

Vortex veins

108
Q

How many vortex veins are there?

A

4-7 vortex veins located just posterior to the equator

-at least one vortex vein per quadrant

109
Q

What drains the bulbar conjunctiva?

A

Anterior ciliary veins

110
Q

Where does the anterior ciliary vein drain into?

A

Muscular veins, which in turn drain to superior ophthalmic vein

111
Q

What drains the lower cheek and lower eyelid?

A

Infraorbital vein

112
Q

How does the infraorbital vein enter the skull

A

Via the infraorbital foramen

113
Q

How does the infraorbital vein drain

A

Via the inferior orbital fissure to the pterygoid venous plexus

114
Q

What is the largest vein in the orbit?

A

Superior ophthalmic vein

115
Q

How is the superior ophthalmic vein formed?

A

By joining of supraorbital and angular vein

116
Q

How does the superior ophthalmic vein course

A

Posterior in orbit picking up numerous tributaries central retinal vein and upper two vortex veins and crosses lateral under superior rectus

117
Q

Where does the superior ophthalmic vein exit?

A

Above lateral rectus muscle and annular tendon of Zinn via superior ethmoidal orbital fissure

118
Q

Where does the superior ophthalmic vein drain to

A

Cavernous sinus in middle Cranial Fossa

119
Q

This forms from tributaries on the floor of the orbit

A

Inferior ophthalmic vein

120
Q

What does the inferior ophthalmic vein drain?

A

Inferior rectus, inferior oblique, lateral rectus, lower conjunctiva, lacrimal sac, and lower vortex veins

121
Q

Course of inferior ophthalmic vein

A

Varies as it may drain to the pterygoid venous plexus, superior ophthalmic vein, or cavernous sinus

122
Q

This anastomoses with supraorbital and supratrochlear veins and drains to the facial vein

A

Angular vein

123
Q

When does he angular vein become the facial vein

A

After it passes the ala of the nose

124
Q

Facial vein drains where

A

Picked up tributaries from veins of face, including infraorbital vein and drains into internal jugular vein

125
Q

Dural venous sinus situated on both sides of the body of the sphenoid bone

A

Cavernous sinus

126
Q

How does the cavernous sinus run

A

From the superior orbital fissure (anterior) to the petrous portion of the temporal bone (temporal)

127
Q

What does the cavernous sinus receive

A

Superior and inferior ophthalmic veins

128
Q

Where does the cavernous sinus drain to

A

Internal jugular vein via the jugular foramen

129
Q

Ocular lymphatic drainage

130
Q

Orbital lymphatic drainage

A
  • lacrimal gland only

- follows lymphatic pathway from lateral part of palpebrae to preauricular lymph nodes

Ocular Block 5 (8 decks)

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