Region 13 - Orbit, Nasal cavity and Oral Cavity Flashcards
What bone forms the superior border of the base (orbital margin) of the orbit?
Frontal bone
What bone forms the inferior border of the base (orbital margin) of the orbit?
Maxilla
Zygomatic bone
What bone forms the medial border of the base (orbital margin) of the orbit?
Ethmoid bone
Lacrimal bone
Maxilla
What bone forms the lateral border of the base (orbital margin) of the orbit?
Zygomatic bone
Greater wing of sphenoid
What bones form the superior wall of the orbit?
Frontal bone
Lesser wing of sphenoid (near apex)
What bones form the inferior wall of the orbit?
Maxilla (mainly)
Zygomatic bone
Palatine bone:
- In wall of inferior orbital fissure
What bones form the medial wall of the orbit?
Orbital plate of ethmoid bone Contributions from: - Maxilla - Lacrimal bone - Sphenoid
What bones form the lateral wall of the orbit?
Frontal process of zygomatic bone
Greater wing of sphenoid
What structure demarcates the border between the inferior and lateral walls of the orbit?
Inferior orbital fissure
What is the strongest wall of the orbit and why?
Lateral wall
Most exposed to trauma
Where is the apex of the orbit?
At the optic canal in the lesser wing of sphenoid:
- Medial to superior orbital fissure
What are the contents of the orbit?
Eyeball Fat and connective tissues Extraocular muscles Nerves and blood vessels Most of the lacrimal apparatus
What are the tarsal plates?
Dense bands of connective tissue strengthening the upper and lower eyelids
Where do the fibres of the palpebral portion of orbicularis oculi lie in relation to the tarsal plates?
In the connective tissue superficial to the tarsi
What do the tarsal glands in the tarsal plates secrete and what is its purpose?
Lipid secretion:
- Prevents eyelids sticking together when closes
- Forms a barrier that lacrimal fluid cannot cross
How are the tarsal plates joined to the orbital margins?
Medial palpebral ligament
Lateral palpebral ligament
What ligament is the origin of orbicularis oculi?
Medial palpebral ligament
What does the orbital septum span between?
From tarsi to the orbital margins
What is the orbital septum continuous with?
Periosteum
What is the function of the orbital septum?
Keeps orbital fat pad contained
What is the course of the medial check ligament?
From medial rectus
To lacrimal bone
What is the course of the lateral check ligament?
From lateral rectus
To zygomatic bone
What is the function of the check ligaments of the eye?
Limit abduction and adduction of eyeball by resisting pull of medial and lateral recti
What is the name of the ‘sling’ formed by the check ligaments blending with the fascia of the inferior oblique and inferior rectus muscles?
Suspensory ligament of the eyeball
What is the function of the suspensory ligament of the eyeball?
Supports eyeball
How can the outer layer of the eyeball be described?
Fibrous
Describe the sclera.
Tough and opaque Covers posterior 5/6 of eyeball Provides attachment for: - Intraocular muscles - Extraocular muscles
Describe the cornea.
Transparent Covers anterior 1/6 of eyeball Completely avascular Highly sensitive to touch: - CN V1
How can the middle layer of the eyeball be described?
Vascular
Describe the choroid.
Largest part (lines most of sclera) Dark and highly pigmented Vascular bed lies externally in choroid
What is the ciliary body?
A ring-like thickening of the vascular middle layer of the eye
What does the ciliary body lie posterior to?
Corneoscleral juntion
What type of muscle is the ciliary body?
Smooth muscle
What does the ciliary body control the thickness of? How?
Contraction and relaxation of its smooth muscle controls thickness of the lens
Where are the ciliary processes? What do they do?
On internal surface of ciliary body
Secrete aqueous humour
Where is the iris found?
On anterior surface of lens
What is the pupil?
A central aperture of the iris
What is the inner layer of the eyeball?
Retina:
- A sensory neural layer
Why is the optic disc the ‘blind spot’?
No photosensitive cells found here:
- Sensory fibres of CN II and central artery of retina travel out of/into eye here
Where does the macula lutea lie?
Lateral to optic disc
What is the macula lutea?
An area with a high concentration of cone cells:
- High visual acuity
- AKA the fovea
What fluid fills the anterior segment of the eyeball?
Aqueous humour
What is the anterior segment of the eyeball divided into?
Anterior chamber:
- Between cornea and iris
Posterior chamber:
- Between iris and ciliary body
What is the route of flow of aqueous humour?
Produced in posterior chamber of anterior segment
Passes through pupil
Enters anterior chamber of anterior segment
Drains into scleral venous sinus at corneoscleral junction
Describe the vitreous humour
Embryological
Transparent
Jelly-like
What is the function of the vitreous humour?
Fills the posterior segment of the eyeball
Supports retina
What is the function of the intraocular muscles?
Control size of pupil
How are the fibres of the dilator pupillae arranged?
Radially
What is the function of the dilator pupillae?
Increase diameter of pupil
What is the innervation of dilator pupillae?
SNS controlled:
- Nerve fibres on ophthalmic branch of ICA
How are the fibres of the sphincter pupillae arranged?
Circularly
What is the function of the sphincter pupillae?
Decrease diameter of pupil
What is the innervation of sphincter pupillae?
PNS controlled:
- Nerve fibres from CN III
How do PNS fibres reach the intraocular (sphincter pupillae) muscle?
ENter the ciliary ganglion and reach iris via the short ciliary nerves
How do SNS fibres reach the intraocular (dilator pupillae) muscle?
Travel with nasociliary branch of CN V1 and its long ciliary nerves
What is the ciliary muscle?
A ring of smooth muscle in the middle layer of the eyeball
How does the ciliary muscle behave in the absence of nervous stimulation? What does this cause?
Muscle is relaxed:
- Diameter of muscular ring increases
- Zonular fibres under tension
- Lens stretched and is thinner
- Refracts light for distant vision
How does the ciliary muscle behave in the presence of PNS stimulation? What does this cause?
Muscle contracts:
- Diameter of muscular ring decreases
- Zonular fibres relax
- Lens thickens as less stretched
- Refracts light for near vision
What is the process by which light is refracted for near vision?
Accommodation
What innervates the ciliary muscle?
PNS stimulation from CN III:
- Via short ciliary nerves
What is the origin and insertion of levator palpebrae superioris?
From orbital roof
To upper eyelid
What is the origin and insertion of the recti muscles?
From annular ring To sclera (anterior to equator)
What is the origin and insertion of the superior oblique?
From lesser wing of sphenoid To sclera (posterior to equator)
What is the origin and insertion of the inferior oblique?
From anterior floor of orbit To sclera (posterior to equator)
Why can the eye muscles move eyes in more than one direction?
Due to difference between the optical axis and axis of orbit
What is the angle between the axis of each orbit?
45 degrees
What is the angle between the lateral walls of each orbit?
90 degrees
Why is the lateral side of the eyeball more exposed?
The medial wall extends further anteriorly than the lateral wall
What is the optical axis?
A line passing through the point in the lens at which no refraction will occur
What is the innervation to the extraocular muscles?
Oculomotor nerve: - Levator palpebrae superioris - Superior rectus - Medial rectus - Inferior rectus - Inferior oblique Trochlear nerve: - Superior oblique Abducent nerve: - Lateral rectus
What are the functions of superior rectus?
Elevation
Adduction
Intorsion
What are the functions of inferior rectus?
Depression
Adduction
Extorsion
What is the function of medial rectus?
Adduction
What is the function of lateral rectus?
Abduction
What are the functions of superior oblique?
Depression
Abduction
Intorsion
What are the functions of inferior oblique?
Elevation
Abduction
Extorsion
Where does CN VI run in the cavernous dural venous sinus?
Through the middle
Close to ICA
Where do CNs III, IV, V1 and V2 run in the cavernous dural venous sinus (from superior to inferior)?
In lateral wall of cavernous dural venous sinus
Where does the frontal branch of CN V1 lie?
Superior to eyeball
What are the two branches of the frontal branch of CN V1 and where do they leave to enter onto the forehead?
Supraorbital nerve:
- Leaves via supraorbital notch
Supratrochlear nerve:
- Leaves medial to supraorbital nerve
What are the functions of the lacrimal branch of CN V1?
Sensory to lacrimal gland
Carries PNS secretomotor fibres from pterygopalatine ganglion (greater petrosal nerve of CN VII)
What does the nasociliary branch of CN V1 give sensory fibres to?
Ciliary ganglion
What are the branches of the nasociliary nerve?
Anterior and posterior ethmoidal branches