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Ebopras > periorbital region board > Flashcards

periorbital region board Flashcards

1
Q

What is analogous to the levator palpebrae superioris aponeurotica in the lower eyelid?

A

Capsulopalpebral fascia

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2
Q

What is the cause of senile ptosis?

A

Attenuation of the levator aponeurosis.

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3
Q

What is the cause of classic congenital ptosis?

A

Inadequate/nonexistent levator function

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4
Q

What is the most appropriate procedure for congenital ptosis?

A

Frontalis sling

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5
Q

In senile ptosis, what happens to the supratarsal crease?

A

The crease becomes cephalically displaced because of adhesion between the levator aponeurosis and dermis. The
superior crease moves with attenuation of the aponeurosis.

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6
Q

What is the classic treatment of senile ptosis?

A

Levator advancement/reinsertion

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7
Q

What is the most common cause of postsurgical lower ectropion?

A

The combination of lower eyelid laxity with scarring/traction on the capsulopalpebral fascia-septum interface

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8
Q

What is the preferred treatment of lower eyelid ectropion?

A

Canthoplasty with capsulopalpebral spacer graft (AlloDerm, autologous dermis, palate mucosa, etc).

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9
Q

What is the most commonly injured muscle in a blowout fracture?

A

Inferior oblique muscle, the only extraocular muscle to insert into bone directly

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10
Q

Where is the apex of the brow?

A

The lateral limbus of the eye in forward gaze.

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11
Q

What is considered an abnormal Schirmer’s test?

A

Less than 10 mm

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12
Q

What does correction of ptosis in one eye do in a bilateral case?

A

Correction will make the noncorrected side more ptotic, due to dual innervation—Hering’s law

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13
Q

How much of the eyelid can be sacrificed and primarily closed?

A

Up to 25% total lid loss can be primarily closed

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14
Q

What nerve travels in the floor of the orbit?

A

Infraorbital nerve

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15
Q

What muscles are responsible for medial brow retraction?

A

Corrugator, depressor supercili, and, to lesser extent, orbicularis oculi.

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16
Q

How many fat compartments are in the upper lid?

A

Two

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17
Q

How many fat components are in the lower eyelid?

A

Three

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18
Q

What separates the lower eyelid central and nasal fat pads?

A

Arcuate extension of Lockwood’s ligament.

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19
Q

What nerve opens the eye?

A

Cranial nerve III

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20
Q

What nerve closes the eye?

A

Cranial nerve VII

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21
Q

What findings make up Horner syndrome?

A

Blepharoptosis, pupil miosis, and facial anhidrosis

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22
Q

What is lagophthalmos?

A

Inability to close the eye

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23
Q

What is chemosis?

A

Edema of the conjunctiva

24
Q

What is the mucous spot test?

A

A subjective measure of dry eye, absence of a film layer on the eye surface indicating chronic dry eye.

25
Q

What nerve can be found adjacent to the sentinel vein?

A

Temporal branch of the facial nerve

26
Q

Should the lacrimal gland be excised if ptotic?

A

No

27
Q

What reconstructive technique is typically used for a central (full-thickness) upper eyelid with 50% defect?

A

Semicircular skin/muscle flap rotation or Tenzel flap

28
Q

What flap is commonly used for total lower eyelid loss?

A

Mustarde flap—large skin muscle cheek rotation flap

29
Q

What is the most common skin cancer on the eyelid?

A

Basal cell cancer

30
Q

What is a Hughes flap?

A

A tarsoconjunctival flap from the upper eyelid, used to reconstruct >50% lower lid defects, for posterior lining
only

31
Q

What is the second most common eyelid cancer?

A

Squamous cell cancer

32
Q

What is the third most common eyelid cancer?

A

Sebaceous cell carcinoma

33
Q

What is the recovery rate for Bell palsy?

A

Approximately 84%

34
Q

What is the arcus marginalis?

A

Periosteal thickening at the orbital rim, where the orbital septum attaches

35
Q

What is the lymphatic drainage for the eyelid?

A

Medial—submaxillary lymph nodes, lateral—parotid lymph nodes

36
Q

What is the function of the procerus?

A

The muscle is continuous with the frontalis and inserts into the nasal bone to create horizontal wrinkles of the glabella

37
Q

What are the oil-secreting glands of the eyelid?

A

Meibomian and zeis

38
Q

What produces the aqueous layer of the eyelid?

A

Lacrimal gland

39
Q

What is the anterior lamellae?

A

The skin and orbicularis

40
Q

What is the posterior lamellae?

A

Conjunctiva and Mueller’s muscle in the upper eyelid. Conjunctiva and capsulopalpebral fascia in the lower
eyelid

41
Q

What branches of the external carotid artery supply the lid?

A

Facial, internal maxillary, and superficial temporal

42
Q

What is the vascular supply to the eyelid, from the internal carotid system?

A

Dorsal nasal, supratrochlear, supraorbital, lacrimal, and terminal branch of the ophthalmic artery

43
Q

What is SOOF?

A

Suborbicularis oculi fat pad

44
Q

What is ROOF?

A

Retro-orbicularis oculi fat pad

45
Q

What autologous structure is useful in reconstruction of the posterior lamellae?

A

Hard palate mucosal graft

46
Q

What fascia is commonly used to perform frontalis sling?

A

Tensor fascia lata

47
Q

How many bones make up the orbit?

A

Seven

48
Q

What is the distance from the orbit rim to the apex?

A

40 to 45 mm

49
Q

Where does the nasolacrimal duct drain?

A

Beneath the inferior turbinate.

50
Q

What is the globe malposition associated with orbital blowout?

A

Enophthalmos

51
Q

What sites are involved in a zygomaticomaxillary complex (ZMC) fracture?

A

(1) Zygomaticofrontal, (2) zygomaticomaxillary, (3) zygomatic arch, (4) inferior orbital floor, and (5) anterior wall
of the maxilla

52
Q

What is an entropion?

A

Inward rotation of the eyelid margin

53
Q

What is a cause of pseudoptosis?

A

Enophthalmos

54
Q

If myasthenia gravis is suspected, what test should be ordered?

A

Tensilon test—edrophonium injection leading to short-term improvement of ptosis

55
Q

When are symptoms of ptosis worse in myasthenia?

A

Later in the day

Ebopras (8 decks)

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