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23 spring: med surg > test 2: lecture 22 orbit > Flashcards

test 2: lecture 22 orbit Flashcards

1
Q

The bony cavity that encloses the eyeball with its associated muscles,
blood vessels and nerves.

A

orbit

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2
Q

compare orbit between dog and horse

A

dog has incomplete orbital rim

horse have complete bony rim

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3
Q

what nerves come from optic foramen

A

optic nerve (CN2)

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4
Q

what nerves come from orbital fissure

A

occulomotor (3)
trochlear (4)
ophthamlic (5)
abducens (6)

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5
Q

what are the 7 extraocular muscles and what do they control

A
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6
Q
A

orbital ligament

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7
Q

The orbital ligament completes the dorsolateral portion of the orbit in the dog and cat and covers the —

A

lacrimal gland

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8
Q

what is red and pink?

A

medial pterygoid muscle
nasal cavity

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9
Q

what is orange and blue

A

zygomatic salivary gland
frontal sinus

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10
Q
A

endorbita (periorbita)

“cone” around the muscles and glands of the eye, blood vessels and optic nerve

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11
Q

4 major clinical signs of orbital disease

A

Exophthalmos- eye buldging
Globe deviation
Lack of retropulsion - can’t get globe to move
Fundus lesion of globe indentation (retrobulbar mass)

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12
Q

protrusion of the globe out of the orbit caused by an increase in orbital content).

A

exophthalmos

(buldging eye)

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13
Q

most frequent types of orbital disease

A

tumor
trauma
abscesses
inflammation/cellulitis

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14
Q

two uncommon causes of orbital disease

A

zygomatic cyst and mucocele
myositis

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15
Q

— are rare causes of orbital disease

A

vascular abnormalities (AV fistula, varices)

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16
Q

diagnostic approach to determine orbital disease

A

history
examine both eyes at a distance
palpate periorbital area
perform complete eye exam
examine oral cavity

extra testing can be FNA, imaging (CT/MRI, ultrasound, xray)

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17
Q

orbital fracture due to trauma is most frequent in —

A

horses
dorsal orbital rim and zygomatic arch

18
Q

trauma to orbit in dogs is most common by

A

penetrating foreign body

through eye or through soft palate

19
Q

Proptosis following blunt trauma is frequent in what type of dogs

A

brachycephalic

hit by car or dog fight

20
Q

what to do in ophthalmic emergency due to trauma

A

Keep cornea lubricated!
Reposition eye as soon as patient is stabilized
Lateral canthotomy
Partial or complete tarsorrhaphy (stents)
Leave room medially for topical drugs.

stabilize and then wait and see

21
Q

clinical signs of orbital abscess or inflammation

A

Orbital signs (Exophthalmos * Globe deviation * Lack of retropulsion* Fundus lesion of globe indentation)

Acute
Unilateral
Pyrexia (fever)
Submandibular adenomegaly
Pain on palpation
Pain on jaw manipulation

22
Q

how to diagnose orbital abscess or inflammation

A

CBC
Imaging – ultrasound, CT, MRI

Skull radiographs not that useful

FNA (or drainage) + cytology + Anaerobic, aerobic, fungal culture

23
Q

what can cause orbital abscess or inflammation

A

Foreign body
Wound

2ary to sinusitis (maxillary, frontal)
2ary to tooth root abscess
2ary to infection of zygomatic or lacrimal gl.

24
Q

how to treat orbital abscess or inflammation

A

Systemic antibiotics for 14-21 days

Use AB directed against anaerobes (eg. amoxycilin + clavulanic acid)

Topical antibiotic/lubrication if cornea exposure and lagophthalmos

Systemic NSAIDs (NO STEROIDS)

Systemic opioids

25
Q

clinical signs of orbital tumor

A

Slow progression in older animals Unilateral
Initially no pain
Exophthalmos (frequent) Enophthalmos (if tumor located rostral to globe)
Variable deviation of the globe
Limited to no retropulsion
Globe indentation (fundus)
Vision often retained (except if optic nerve or meningioma involvement)

26
Q

Most orbital tumors are —

A

primary and malignant

27
Q

how to treat orbital tumor

A

Orbitotomy: open orbit and take out tumor (if benign and visual).

Exenteration: clean everything out- leaving only bone (if malignant) ± chemotherapy ± radiotherapy.

28
Q

clinical signs of zygomatic mucocele/cyst

A

Orbital swelling
Exophthalmos
3rd eyelid protrusion
Protrusion oral mucosa behind last molar
Painless

29
Q

how to diagnose zygomatic mucocele/cyst

A

Imaging : U/S, CT, MRI
FNA: Honeylike liquid

30
Q

how to treat zygomatic mucocle/cyst

A

Surgical excision by one of these 3 approaches:
* transconjunctival
* oral,
* lateral orbitotomy

31
Q

extraocular polymyositis

A

inflammation of the 7 muscles that control movement of the eye

32
Q

clinical signs of extraocular polymyositis

A

inflammation of muscles that move the eyeball
immune-mediated?
acute
bilateral
fever
anorexia
opening mouth is painful/limited

at later stage muscle fibrosis causes mild enophthalmos (eye shrunken in) and strabismus(eye in wrong direction)

33
Q

what types of dogs get extraocular pilymyositis

A

golden retriever

34
Q

what kind of dogs get eosinophilic myositis of the masticatory muscules

A

german shepherd, wimaraner
(golden retriever and lab)

35
Q

clinical signs of eosinophilic myositis of the masticatory muscules

A

Inflammation involves temporal, pterygoid, masseter muscles.
immune-mediated?
acute
bilateral
fever
anorexia
jaw opening painful and limited

at later stage muscle fibrosis causes muscle atrophy and enophthalmos(eye shrunken in)

36
Q

how to treat myositis

A

Immunosuppresive doses of corticosteroids systemically for 3-4 weeks

or

Azathioprine 1-2 mg/kg for 10-14 days then tapered off

used to treat extraocular polymyositis and eosinophilic myositis of the masticatory muscles

37
Q

how to diagnose extraocular polymyositis vs eosinophilic myositis of the masticatory muscles

A

extraocular polymyositis: CT/MRI

eosinophilic myositis of the masticatory muscles: muscle biopsy, elevated CPK

38
Q

remove the globe

A

enucleation

39
Q

remove globe and soft tissue

A

exenteration

40
Q

surgery to open orbit

A

orbitotomy

23 spring: med surg (60 decks)

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