Palpebrae

Question 1

Palpebrae function

Answer 1

Protects eye
Senses via lashes
Maintains eye position
Drains / distributes tears
Produces tears
Blinks for tear renewal

Question 2

Palpebral fissure structure

Answer 2

Upper lid, nasal/temporal canthus, lower lid
Caruncle (fleshy protrusion on nasal side)
Plica semilunaris (binds caruncle to sclera)

Question 3

Facial folds of palpebrae

Answer 3

Superior palpebral sulcus (upper lid fold)

Inferior palpebral sulcus (lower lid fold)

Question 4

Palpebrae layers from outside to inside

Answer 4

Skin
Subcutaneous areolar (loose connective tissue) layer (connective tissue with LPS tendons)
Striated muscle
Submuscluar areolar layer
Orbital septum and tarsal plate
Smooth muscle
Conjunctiva

Question 5

Palpebrae skin layer

Answer 5

Has glands of zeis (sebaceous), glands of Moll (sweat), meibomian glands (oil into tear film, whit spots)

Question 6

Subcutaneous areolar layer

Answer 6

Loose connective tissue, pierced by levator palpebral superiors tendon

Question 7

Glands of the palpebrae

Answer 7

Glands of zeis(subaceous), open into lash follicles
Glands of Moll(sweat) open onto lid surface
Meibomian glad, opens where skin meets conjunctiva
Lacrimal gland assistors (krause / wolfring) in conjunctiva

Question 8

Meibomian glands

Answer 8

Sebaceous (oil), in tarsal plate, assists tear film stability (less evaporation), rich innervation.
Small lumps below lash or large in outer lid indicate disorder.

Question 9

Glands of moll

Answer 9

Ciliary glands, sweat behind lash

Question 10

Glands of zeis

Answer 10

Sebaceous, discharge into lash for lash protection.

Question 11

Striated muscle of palpebrae

Answer 11

Orbicularis oculi: outer rings of muscle
Muscle of riolan: ciliary portion (around fissure)
Lateral palpebral raphe: upper eyelid

Question 12

Sub muscular areolar layer of palpebrae

Answer 12

Visible grey section of palpebrae. Oedema on inflammation

Question 13

Muscles in blinking.

Answer 13

Orbicularis oculi muscles with CN VII innervation:
Palpebral - gentle closure
Orbital - forceful closure
Muscle of Riolan - lid margin and globe positioning

Question 14

Muscles in opening and closing eye

Answer 14

Levator palpebrae superioris(LPS) - elevates upper lid via striated muscle with CNIII (oculomotor) innervation.
Muscle of muller - assist lid position / upper lid elevation via smooth muscle, active in flight/fight via sympathetic NS

Question 15

Eyelid malposition’s

Answer 15

Entropion - inward turning of lid
Ectropion - outward turning of lid
Blepharospasm - involuntary contraction
Lid retraction - thyroid eye disease
Jaw winking syndrome - abnormal sunkinesis CN3/5

Question 16

Orbital septum and tarsal plate

Answer 16

Tarsal plate: Central plate in lids with Meibomian glands, anchors palpebral ligaments and LPS.
Orbital septum: Thin peripheral outer layer from tarsal plate, enters orbit, attaching to orbit bones.

Question 17

Palpebral vasculature

Answer 17

Lateral palpebral arteries (branch of lacrimal artery)
Medial palpebral arteries (sup./inf.) branch from ophthalmic artery.
Drained into ophthalmic and angular veins (medial part), and superficial temporal vein (temporal part)

Question 18

Lymphatic drainage of palpebrae

Answer 18

Medial part by submandibular nodes

Lateral part by superficial parotid nodes

Question 19

Smooth muscular layer of palpebrae

Answer 19

Muscle of muller. 
Forms upper (LPS lid elevation assistance) / lower (lowers lid assisting inferior rectus). These are superior and inferior tarsal muscles, attached to tarsal plate with sympathetic innervation.

Question 20

Conjunctiva

Answer 20

Mucous membrane, with goblet cells / crypts of henle / glands of maz.
Continuous with sub muscular areolar, joins cornea near limbus.
Bulbar covers eye, Forniz connects lit to eye, palpebral is on lid.

Question 21

Goblet cells of palpebrae

Answer 21

Secret mucin. Present in crypts of Henle (palpebral conj.) and glands of Manz (limbus)

Question 22

Palpebral vasculature

Answer 22

Lateral palpebral arteries. Drains into ophthalmic vein, to submandibular lymph nodes
Medial palpebral arteries (superior and inferior), run along top and bot lids from ophthalmic artery. Drains into superficial temporal vein into superficial parotid nodes

Question 23

Palpebral innervation

Answer 23

Sensory: 5 branches from CN 5 (trigeminal).
Muscle:
Orbicularis oculi, temporal / zygomatic branches of CN VII (facial)
Muscle of muller, sympathetic NS by superior cervial sympathetic ganglion
Levator palpebrae superioris (LPS), superior division of CN III (oculomotor)

Question 24

Eyebrow muscles

Answer 24

Innervated by CN 7
Frontalis - elevates brow
Orbicularis oculi (orbital part)- lowers brow
Corrugator - contracts down and medially
Procerus - nose wrinkling

Question 25

Monocular eye movement types

Answer 25

Abduction = temporal
Adduction = nasal
Supraduction = elevation
Infraduction = depression
Cycloduction = rotation around Z axis

Question 26

Binocular eye movement versions

Answer 26

Dextroversion - right
Laevoversion - left
Supraversion - up
Infraversion - down
Cycloversion - rotation around Z axis (intorsion nasal or extortion temporal)

Question 27

Binocular eye movement vergences

Answer 27

Convergence = nasal
Divergence = temporal
Cyclovergence = z axis rotation (intorsion and extortion)

Question 28

Types of eye movement speeds

Answer 28

Saccades = fast between points
Pursuits = slow tracking