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OPTM 5004 - Head and Neck > The Orbit (Go OD's Go!) > Flashcards

The Orbit (Go OD's Go!) Flashcards

0
Q

What is a blow-out fracture?

A

Fracture of the orbital floor, usually due to blunt or penetrating trauma

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1
Q

What are the seven bones of the orbit?

A 
Ethmoid
Lacrimal
Palatine
Frontal
Sphenoid
Zygomatic
Maxilla
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2
Q

What bones form the superior wall of the orbit?

A

Orbital part of the frontal bone

Less wing of sphenoid

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3
Q

What bones form the medial wall of the orbit?

A

Orbital plate of ethmoid bone
Frontal process of maxilla
Lacrimal bone
Sphenoid bone

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4
Q

What bones form the lateral wall of the orbit?

A

Frontal process of zygomatic

Greater wing of sphenoid

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5
Q

What bones form the inferior wall of the orbit?

A

Maxilla
Zygomatic
Palatine

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6
Q

Which wall of the orbit is the thickest and strongest wall?

A

Lateral wall

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7
Q

Tell me about the orbital septum

A

A fibrous membrane that becomes continuous with the periosteum of the orbital margins. It is crucial to infection prevention into the orbit

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8
Q

The nasolacrimal duct conveys lacrimal fluid from the __________ to the ___________.

A

Lacrimal sac; inferior nasal meatus

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9
Q 
Levator palpebrae superioris
O:
I:
N:
A:
A

O: lesser wing of sphenoid
I: super tarsus and skin of upper lid
N: CN III - superior division
A: elevation of upper eyelid

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10
Q 
Superior Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anterosup half of eye
N: CN III - superior division
A: elevation, intorsion, adduction

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11
Q 
Inferior Rectus
O: 
I:
N:
A:
A

O: common tendinous rings
I: anteroinf half of eye
N: CN III - inferior division
A: depression, Extorsion, adduction

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12
Q 
Medial Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anteromedial half of eye
N: CN III - inferior division
A: adduction

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13
Q 
Lateral Rectus
O:
I:
N:
A:
A

O: common tendinous ring
I: anterolateral half of eye
N: CN VI
A: abduction

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14
Q 
Superior oblique
O: 
I:
N:
A:
A

O: body of sphenoid
I: sclera deep to superior Rectus
N: CN IV
A: intorsion, depression, abduction

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15
Q 
Inferior oblique
O:
I:
N:
A:
A

O: anteromedial floor of orbit
I: sclera deep to lateral Rectus
N: CN III - inferior division
A: extorsion, elevation, abduction

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16
Q

The superior oblique, inferior oblique and lateral Rectus hold the eye where?

A

Abducted

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17
Q

How do the SO and IO keep the eye aligned on its axis?

A

Adducting the eye

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18
Q

How do you test the IO and SO using he H test?

A 
Have patient direct eyes medially
Look UP (IO)
Look DOWN (SO)
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19
Q

How do the SR, MR and IR hold the eye?

A

Adducted

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20
Q

How do the SR and IR keep the eye aligned with its axis?

A

By abducting the eye

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21
Q

How can the H test be used to test the SR and IR?

A 
Patient looks laterally
Look UP (SR)
Look DOWN (IR)
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22
Q

What does RADSIN stand for?

A

Recti adduct; superiors intort

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23
Q

What happens to the eye when there is a CN III nerve palsy? What might be the cause?

A

Eye is down and out
Pupil dilated
Complete ptosis
Suspect aneurism (usually in PCA)

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24
Q

What happens to the eye when there is a CN IV nerve palsy? What is a common cause of this?

A

Eye is hyper
Head tilt to opposite side of palsy
Congenital or traumatic etiology

25
Q

What happens to the eye in a CN VI palsy? What are the common causes of this?

A

Eye is deviated toward nose

Common etiology includes trauma, elevated ICP and ischemia from DM

26
Q

Blood supply to the eye comes from where?

A

The ophthalmic artery which is a branch of the ICA

27
Q

Name the 10 branches of the ophthalmic artery.

A 
Lacrimal a
Central retinal a
Long/short posterior ciliary aa
Supra orbital
Supra trochlear
Medial palpebral aa
Ant/post ethmoidal
Dorsal nasal
28
Q

Where does the lacrimal artery supply blood too?

A

To lacrimal gland

29
Q

Where does the central retinal artery supply blood to and from what structure does it pierce?

A

Pierces CN II and perfuses the retina

30
Q

Where does the long posterior ciliary arteries supply blood too?

A

Ciliary body and iris

31
Q

Where does the short posterior ciliary arteries supply blood too?

A

Choroid

32
Q

Where do the supra orbital and supra trochlear arteries supply blood too?

A

Forehead and anterior scalp

33
Q

Where do the medial palpebral arteries supply blood too?

A

Contribute to arcades in upper and lower eyelids

34
Q

Where does the anterior ethmoidal artery supply blood too?

A

Ethmoidal air cells
Frontal sinus
Nasal cavity
External nose

35
Q

Where does the posterior ethmoidal artery supply blood too?

A

Ethmoidal sinuses and nasal cavity

36
Q

Where does the dorsal nasal artery supply blood too?

A

Terminal branch to root of nose and lacrimal sac

37
Q

What is the venous drainage of the eye?

A

The superior and inferior ophthalmic veins

38
Q

List the 3 layers of the eyeball and their main components

A

Fibrous layer: sclera and cornea
Vascular layer: choroid, ciliary body, iris
Sensory layer: retina

39
Q

What do the superior and inferior ophthalmic veins drain into?

A

The cavernous sinus

40
Q

Map the pathway of aqueous humor from creation to drainage.

A

Ciliary processes secrete > posterior chamber > pupil > anterior chamber > trabecular Meshwork > scleral venous channels

41
Q

In what way do dilator pupillae fibers oriented?

A

A radial manner

42
Q

What is the dilator pupillae innervated by?

A

By the sympathetic system thus causing mydriasis

43
Q

In what way are the sphincter pupillae fibers oriented?

A

Circumferentially

44
Q

How is the sphincter pupillae innervated?

A

It is innervated by postganglionic parasympathetic fibers causing miosis.

45
Q

What is the intraocular lens composed of?

A

Water and proteins

46
Q

What component of the lens breaks down in cataracts?

A

Breakdown of the lens proteins

47
Q

The vitreous is mainly composed of what?

A

Water and collagen

48
Q

What does the vitreous have none of!

A

BLOOD VESSELS!!!!!

49
Q

What is the anterior chamber located between?

A

The iris and the cornea

50
Q

How does the central retinal vein drain the eye?

A

Drains retina > leaves through CN II > drains into sup. ophthalmic vein

51
Q

How do the Vorticose veins drain the eye?

A

Usually four in number, one for each quadrant of the choroid. Pierced the sclera and drains into the sup and inf ophthalmic veins

52
Q

Map the pathway of lacrimal gland innervation (efferent)

A

GE fibers travel from CN II > greater petrosal > n of pterygoid canal > pterygopalatine ganglion > hitchhike with v2 branch > infraorbital fissure > lacrimal (v1) > lacrimal gland

53
Q

What happens when the ciliary muscle contracts?

A

The size of the ciliary body decreases, causing a loosening of the zonular fibers, causing the intraocular lens to thicken for accommodation.

54
Q

What are the three types of tears?

A

Basal
Reflex
Emotional

55
Q

What is the purpose/cause of basal tearing?

A

Lubrication
Cleaning
Removal of bacteria

Normal parasympathetic stimulation

56
Q

What is the purpose/cause of reflex tearing?

A

Irritation
Wash irritants from cornea

Afferent = trigeminal
Efferent = facial
58
Q

What is the purpose/cause of emotional tearing?

A

Emotional stress

Cause unknown

59
Q

What happens to lacrimation when there is a lesion of CN VII proximal to the geniculate ganglion?

A

All lacrimation is lost but sometimes the lubrication can be maintained via tarsal, sebaceous and conjunctival glands

60
Q

What will happen to lacrimation when there is a legion at CN V?

A

Reflex lacrimation is gone

OPTM 5004 - Head and Neck (15 decks)

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