OVERVIEW OCULAR CIRCULATION Flashcards
Which specific arteries do the following:
- help supply the iris and ciliary body
- help supply the choroid posterior to the equator
- supply the choroid anterior to the equator
- help supply the sclera
- help supply the laminar part of the optic nerve
- Long Posterior Ciliary Arteries (2) + Anterior Ciliary Arteries (7) (as part of MACOTI)
- Short Posterior Ciliary Arteries (15-20)
- Long Posterior Ciliary Arteries (2) at the Ora Serrata (and recurrent branches of anterior ciliary) (7)
- Short/Long Posterior Ciliary Arteries (all)
- Short Posterior Ciliary Arteries (15-20)
Name 2 structures the central retinal artery supplies. Be specific.
- Central part of the optic nerve from point of entry to posterior border of lamina cribosa
- Inner layers of the retina (up to OPL)
The superior vortex veins drain directly into the
Vortex veins of the superior side of the eye empty directly into the superior ophthalmic vein
The central retinal vein drains directly into _____ or ______
The superior ophthalmic vein or directly into the cavernous sinus via the superior orbital fissure (SOF)
The anterior ciliary arteries are direct branches of the ______
7 muscular arteries supplying the rectus muscles (a pair for each rectus muscle except for Lateral Rectus having one)
The lateral palpebral artery is a direct branch of the _______
Lacrimal artery (which first supplies the lacrimal gland then pierces the orbital septum, then terminates as the lateral palpebral arteries)
The medial palpebral artery are direct branches of the _______
The 2 medial palpebral arteries are direct branches of of the ophthalmic artery (anterior portion, or dorsonasal artery) just below the pulley for the superior oblique
The major arterial circle of the iris is formed by branches of the following arteries:
Long posterior ciliary arteries and anterior ciliary arteries
The short posterior ciliary arteries are direct branches of the
Medial and Lateral Posterior Ciliary Arteries (2 total)
The long posterior ciliary arteries are direct branches of the
Medial and Lateral Posterior Ciliary Arteries (2 total)
While doing a dilated eye exam, you note the following vessel and you realize you are looking at the retina at the equator of the patient’s eyeball
Vortex veins (ampulla)
Name 4 vessels that drain directly into the superior ophthalmic vein
Muscular branches (SO, SR, MR, levator) Supraorbital vein Supratrochlear vein Angular vein Central retinal vein Lacrimal vein Ethmoidal vein Superior vortex veins
(The superior ophthalmic vein then drains directly into the cavernous sinus by passing through SOF above common tendinous ring)
The posterior ciliary arteries directly give rise to the following arteries:
Long posterior ciliary artery and around 7-10 short posterior ciliary arteries
Blood vessels from these ocular structures drain into the vortex veins
Supplied by long and short posterior ciliary arteries (ocular structures include choroid, ciliary body, iris)
(CO) 1. Name the branches of the ophthalmic artery
- Central retinal artery
- Lacrimal artery
- Muscular branches (anterior ciliary)
- Posterior ciliary arteries (long/short)
- Supraorbital artery
- Supratrochlear artery
- Anterior/Posterior ethmoidal arteries
- Meningeal artery
- Medial palpebral artery
- Dorsal nasal artery
(CO) 2. State the direct origin of the medial palpebral and lateral palpebral arteries
(see previous cards)
(CO) 3. State the direct origin of the SPCA and LPCA
Medial Posterior Ciliary Arteries
(CO) 4. Describe the major parts of the eyeball and/or structures in the orbit supplied by the following arteries
- central retinal artery
- lacrimal artery
- medial palpebral artery
- lateral palpebral artery
- infraorbital artery
Central retinal artery: central part of optic nerve from entry to posterior border of lamina cribosa + inner layers of retina
Lacrimal artery: lacrimal gland
Medial palpebral: medial 1/2 of the upper + lower eyelids and conjunctiva (anastomose with lateral palpebral)
Lateral palpebral (2) : (branch from lacrimal gland) supplies skin and conjunctiva of lateral 1/2 of upper + lower eyelids
Infraorbital: inferior rectus/oblique, lacrimal sac
its extension includes anterior superior alveolar artery supplying maxillary sinus and upper teeth
(CO) 5. Describe the path of the short posterior ciliary arteries and what major structures they help supply
“The 15-20 SPCA pierce back of the eyeball in a ring around the optic nerve and run forward in the space between the sclera and the choroid aka suprachoroidal space”
- Helps supply sclera
- Some supply posterior portion of choroid up to equator
- Others anastomose in sclera as circle of Zinn-Haller to supply laminar part of optic nerve
(CO) 6. Describe the path of the long posterior ciliary arteries (and their recurrent branches) and what major structures they help supply
“Like the SPCA, the two LPCA pierce the sclera at the back of the eyeball and run forward in the space between the sclera and choroid.. to the ciliary body.”
- Helps supply sclera
- In ciliary body, anastomose together and with anterior ciliary to form DISCONTINUOUS arterial ring (major arterial circle of the iris) to supply iris and ciliary body
- 3-5 RECURRENT BRANCHES at ora serrata pass directly back to supply choroid anterior to equator
(CO) 7. Describe the path of the anterior ciliary arteries (and their recurrent branches) and what major structures they help supply
-state the direct origin of the anterior ciliary arteries
“Originate from muscular arteries (7) supplying four rectus muscles. After supplying the muscles, the muscular arteries continue anteriorly as anterior ciliary arteries, passing forward and bifurcating so that some branches continue forward beneath bulbar conj., others pierce sclera, become part of MACOTI in CB”
-RECURRENT BRANCHES (8-12) pass directly back to supply choroid anterior to equator
(CO) 8. Describe what arteries supply the:
- choroid (including choroid anterior to equator vs. posterior to equator)
- central part of optic nerve behind the lamina cribosa
- laminar part of the optic nerve
- inner retinal layers
- iris
- ciliary body
- sclera
- eyelids
Choroid: anterior (Long Posterior Ciliary Arteries (2) at the Ora Serrata (and recurrent branches of anterior ciliary) (7)), posterior (Short Posterior Ciliary Arteries (15-20)
Central part of optic nerve behind lamina: Central retinal artery
Laminar part of optic nerve: Short Posterior Ciliary Arteries (15-20)
Inner Retinal layers: Central retinal artery
Iris/Ciliary Body: Long Posterior Ciliary Arteries (2) + Anterior Ciliary Arteries (7) (as part of MACOTI)
Sclera: Short/Long Posterior Ciliary Arteries (all)
Eyelids: Medial/Lateral Palpebral Arteries
(CO) 9. Discuss the major veins of the eye and orbit discussed in class (central retinal vein, superior ophthalmic vein, inferior ophthalmic vein, vortex veins) in terms of:
- vessels and or structures they receive blood from (omit muscular veins)
- what venous structure they drain directly into, including associated foramina used to exit the orbit
Central Retinal Vein
- drains capillaries supplying inner layers of the retina
- drains into superior ophthalmic vein or directly into cavernous sinus via SOF
Superior Ophthalmic Vein
- drains blood from muscular branches (SO, SR, MR, levator palpebrae), supraorbital/supratrochlear/angular/central retinal/lacrimal/ethmoid veins and superior vortex veins (choroid)
- drains directly into the cavernous sinus through SOF above common tendinous ring
Inferior Ophthalmic Vein
- drains blood from muscular branches (IR/IO/LR), angular/inferior vortex veins, inferior conjunctiva and lacrimal sac
- drains directly to cavernous sinus passing through SOF below common tendinous ring and the pterygoid venous plexus via IOF
Vortex Veins
- drains areas supplied by long and short posterior ciliary arteries including choroid, CB, iris
- drain into superior/inferior ophthalmic vein
(CO) 10. Describe what the vortex vein ampulla is and what anatomical part of the eyeball it is a landmark for when seen during a dilated examination of the retina
.The “ampulla” of a vortex vein is the dilated beginning of the vortex vein readily visible on a dilated patient (with BIO)
- choroidal veins drain into the ampulla
- vortex ampulla is located at the equator of the eyeball (vortex veins exit eyeball 6mm posterior to equator)
(CO) 11. State which ocular structures’ blood vessels drain into the vortex veins
LPCA, SPCA, choroid, portions of CB and iris
