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Ocular Physiology > The Lacrimal System Part 2 > Flashcards

The Lacrimal System Part 2 Flashcards

1
Q

Normal tear meniscus height at lower lid margin is?

A

0.75mm.

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2
Q

Schirmer’s tear test is what type of test?

A

Quantitative.

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3
Q

What is being tested during a quantitative tear test?

A

Tests quantity of tears.

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4
Q

In Schirmer’s test, producing less than what amount of tears in 5 minutes is considered not normal?

A

<15 mm/5 minutes.

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5
Q

What is being tested during a qualitative tear test?

A

Tests tear film stability.

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6
Q

An example of an invasive qualitative test is?

A

Tear break up time (TBUT) with flourescein.

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7
Q

True or False: people who are 60 years old or older who have 10 mm of tear per 5 minutes is considered normal.

A

True.

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8
Q

An example of a noninvasive qualitative test is?

A

Keratometer mires (looking at cornea reflexion images)

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9
Q

What affects the results of the Schirmer’s test?

A

Placement of the strip, age, effects of anesthesia, reflex tearing, subjective measuring.

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10
Q

What is considered to be normal in a Schirmer’s test?

A

> 15 mm wetting of the paper after 5 minutes.

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11
Q

What is considered to be mild dry eye in a Schirmer’s test?

A

14-9 mm wetting of the paper after 5 minutes.

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12
Q

What is considered to be moderate dry eye in a Schirmer’s test?

A

8-4 mm wetting of the paper after 5 minutes.

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13
Q

What is considered to be severe in a Schirmer’s test?

A

<4 mm wetting of the paper after 5 minutes.

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14
Q

Acinar cells secrete fluid having an electrolyte composition similar to that of what?

A

Plasma.

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15
Q

Water shifts from blood into cell due to the NaK ATPase pump sending what out and what in?

A

Sodium out, Potassium in.

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16
Q

In low flow rate, the fluid is?

A

Hypertonic.

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17
Q

In high flow rate, the fluid is?

A

Isotonic.

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18
Q

Ductal cells modify fluid by secreting a fluid of higher [K] and higher [Cl] compared to plasma. This allows for what to occur?

A

Allow for tears to come out.

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19
Q

What are the nerves that innervate acinar and ductal cells?

A

Not quite sure but peptide and steroid hormone have a lot to do with the secretion.

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20
Q

What is the lacrimal gland innervated by?

A

Parasympathetic nerves, sympathetic nerves, sensory nerves.

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21
Q

Stimulations of what type of nerve results in no change in tear secretion?

A

Sympathetic nervous system.

22
Q

What nerve is responsible for secretion and is the main contributor to tear film?

A

Parasympathetic fibers of CN VII.

23
Q

Tear stimulation and secretion can be cause by what external factors?

A

Light, touch, nerves.

24
Q

The mucous producing tissue that line the ocular surface is known as what?

A

Conjunctiva.

25
Q

Normal conjunctival epithelium contains how many neutrophils and how many lymphocytes?

A

6,000 and 14,000.

26
Q

Conjunctival reactions can be provoked by what 3 things?

A

Infection, inflammation, and allergies.

27
Q

What type of conjunctival reaction is being described?
More commonly found in the upper eyelid, areas of conjunctival hypertrophy, contains eosinophils and neutrophils, presence of blood vessels in the center.

A

Papillae formation.

28
Q

What type of conjunctival reaction is being described?
Clear, fluid filled pockets containing lymphocytes and macrophages, blood vessels passing either above or below but never within.

A

Follicle formation.

29
Q

Eosinophils and neutrophils are only found in epithelium in two diseases which are what?

A

Vernal conjunctivitis and giant papillary conjunctivitis.

30
Q

When a contact lens has dislocated from the cornea and is not visible, it is most likely located where?

A

Superior fornix since it has the greatest depth.

31
Q

What are the two layers of the conjunctiva?

A

Epithelium and stroma.

32
Q

At the limbus, the conjunctival epithelium is continuous with what?

A

Corneal epithelium.

33
Q

Immediately peripheral to the limbus is a region that provides stem cells for the cornea epithelium. What is this region called?

A

Palisades of Vogt.

34
Q

How many epithelial cell layer does the conjunctiva have and cornea have?

A

2-4 layers in conjunctiva epithelium and 5-7 layers in the corneal epithelium.

35
Q

Palisades of Vogt have increase of what type of cells in its epithelium?

A

Wing cells.

36
Q

Unicellular mucin-secreting glands (holocrine) within the conjunctival epithelium are what type of cells?

A

Goblet cells.

37
Q

How wide are goblet cells?

A

11 microns.

38
Q

Goblet cells are more frequent in what part of the conjunctiva?

A

Fornix and palpebral conjunctiva. Sparse in the bulba conjunctiva.

39
Q

What does the stroma consist of?

A

Adenoid layer, deep fibrous layer, rich network of capillaries.

40
Q

Where are mast cells found?

A

Adenoid layer of conjunctival stroma.

41
Q

How many mast cells are found in conjunctiva stroma?

A

6,000 cells per cubic millimeter.

42
Q

True or False: Mast cells, eosinophils, or basophils are found in conjunctival epithelium.

A

False. Normally they are not,

43
Q

How big are mast cells in diameter?

A

20 micrometers.

44
Q

The cytoplasm of the mast cells contains how many metachromatic granules?

A

30-100.

45
Q

Mast cells are responsible for what type of reaction?

A

Immediate hypersensitivity reaction.

46
Q

What happens when mast cells bind to IgE?

A

Physical properties of the mast cell change causing it to be more permeable to calcium ions, leading to edema.

47
Q

Superficial posterior vessels are engorged due to what?

A

Infection of conjunctiva.

48
Q

Deep ciliary vessels are engorged due to what?

A

Keratitis or iritis.

49
Q

Flow of lymph is generally in _______ direction toward _______ extremes of lid, eventually connecting with ________ node.

A

Temporal; lateral; parotid.

50
Q

Which lymph gland does the medial route of conjunctiva lead to?

A

Submandibular lymph gland.

Ocular Physiology (6 decks)

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