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Ocular Anatomy > Vasculature > Flashcards

Vasculature Flashcards

1
Q

What are the branches of the ophthalmic artery?

A

Central Retinal, Lacrimal, Muscular, Short Posterior Ciliary, LPCA, Supraorbital, Ethmoid

Lacrimal - lateral palpebral arcades
Muscular - Anterior Ciliary
Dorsonasal - Medial Palpebral
Supratrochlear

“CL MS LSE” - DS

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2
Q

Which artery does the ophthalmic artery branch off of?

A

Internal carotid

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3
Q

What is the width of the Central Retinal Artery?

A

125 microns, used as a size marker

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4
Q

What is the pathway of the Central Retinal artery?

A

The first branch off of the ophthalmic artery, it travels below the optic nerve (within the dural sheath) before entering the nerve 1 cm behind the globe and passing through the lamina cribrosa to supply blood to the inner retina

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5
Q

What branches come off of the posterior ciliary arteries and what structures do they supply?

A

divided into long and short posterior ciliary arteries: LPCA - travels through suprachoroidal space (one lateral and one medial) and forms MACI, supplying the ciliary body and anterior choroid
SPCA - forms the circle of Zinn and supplies the posterior choroid

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6
Q

Which branch of the ophthalmic artery runs along the upper border of the lateral rectus muscle?

A

Lacrimal artery (to supply the lacrimal gland)

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7
Q

What are the important branches of the lacrimal artery?

A

Recurrent meningeal (joins with middle meningeal a.), muscular (supplies LR), zygomatic (supplies skin), and the superior and inferior lateral palpebral branches (supplying the lateral part of the eyelids and forming palpebral arcades with the medial side)

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8
Q

What is anterior ischemic optic neuropathy (AION)?

A

results from non-perfusion or hypoperfusion of the ciliary blood supply to the ONH (circle of Zinn), and can be separated into superior and inferior portions showing up on VFs

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9
Q

What are the three main branches of the external carotid that are relevant to the eye?

A

Facial, superficial temporal, maxillary

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10
Q

What structures of the eye does the facial artery supply?

A

Facial a. becomes angular a. and supplies the lacrimal sac, lower eyelid, and the skin of the cheek

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11
Q

What artery supplies the orbicularis oculi and where does it branch from?

A

The orbicularis oculi muscles are supplied by the zygomatic artery that branches off the superficial temporal artery from the external carotid

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12
Q

What structures does the infraorbital artery supply and where does it branch from?

A

Infraorbital artery is a branch of the maxillary artery from the external carotid, it supplies the lower eyelid, lacrimal sac, and the IR and IO muscles

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13
Q

What is temporal arteritis (giant cell arteritis)?

A

emergency, systemic inflammatory condition affecting medium-size arteries such as in the temporal and occipital regions, can cause acute loss of blood flow to the optic nerve and cause vision loss!

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14
Q

What are the symptoms of temporal arteritis?

A

headache, tenderness in the temporal area, jaw claudication, weight loss, fever, sudden painless vision loss

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15
Q

Which arteries make up MACI?

A

LPCA and ACA (anterior ciliary arteries)

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16
Q

What is the pathway of the anterior ciliary arteries?

A

branch from the muscular arteries that supply the rectus muscles, the ACAs exit muscles near the tendon insertion, then pierce the sclera behind the limbus to help form MACI, also sending branches to form a loop of anterior conjunctival and episcleral vessels

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17
Q

Which artery passes through the supraorbital foramen/notch and what does it supply?

A

Supraorbital artery, located along the roof of the orbit and supplies the skin/muscle of the forehead, scalp, brow, and upper eyelid, also has branches to SR, SO, and LPS as it travels by
(anastomoses with anterior temporal artery from external carotid)

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18
Q

Which external carotid arteries anastomose with the dorsonasal branch of the ophthalmic artery?

A

Angular artery and infraorbital artery

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19
Q

What is the middle meningeal artery/branch?

A

Branches off of external carotid or maxillary a. travels though foramen spinosum, joins with recurrent meningeal a. from lacrimal a. and supplies the meninges of the middle cranial fossa

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20
Q

What is a major difference between veins in the orbit compared to veins elsewhere in the body?

A

Veins of the orbit have NO valves, (depend on pressure gradients)

21
Q

Where do the superior and inferior ophthalmic veins drain into?

A

the cavernous sinus for both, or inferior vein could also drain into the pterygoid venous plexus (goes through inferior orbital fissure in this case)

22
Q

Which artery goes through the foramen rotundum?

A

the maxillary artery from the external carotid

23
Q

Which artery goes through the foramen spinosum?

A

the middle meningeal artery

24
Q

Which artery goes through the foramen ovale?

A

the mandibular artery

25
Q

What is the largest vein of the orbit?

A

Superior ophthalmic vein (formed from the angular and supraorbital veins)

26
Q

Which veins drain into the superior ophthalmic vein?

A

Superior ophthalmic vein receives blood from the central retinal vein. superior vortex veins, ethmoid, muscular, and lacrimal veins

27
Q

Which veins drain into the inferior ophthalmic vein?

A

Inferior ophthalmic vein receives blood from the inferior vortex veins, inferior conjunctiva and lacrimal sac (starts as a plexus near the anterior floor of the orbit)

28
Q

Where does the blood in the vortex veins drain from?

A

vortex veins drain blood from the choroid

29
Q

How does the central retinal vein travel and what does it drain?

A

Central retinal vein collects blood from the capillaries of the retina, exits the optic nerve a centimeter behind the lamina cribrosa (travels with CRA) and then drain into the superior ophthalmic vein or directly into the cavernous sinus

30
Q

Where does venous drainage go after the cavernous sinus?

A

Drains into the petrosal sinuses then drain into the internal jugular vein

31
Q

What is a carotid-cavernous sinus fistula?

A

an abnormal communication between the arterial and venous blood supplies

32
Q

Where does the infraorbital vein empty?

A

empties into the pterygoid venus plexus

do not confuse with the inferior ophthalmic vein

33
Q

What is fluorescein angiography?

A

a type of imaging, serial fundus photography is performed after sodium fluorescein dye has been injected into the patients arm, helps to visualize retinal and choroidal vasculature

34
Q

What are the phases during an FA?

A
  1. choroidal flush (happens within 10 seconds)
  2. arterial filling
  3. early venous filling (laminar flow)
  4. arterial-venous filling
  5. late venous filling
  6. recirculation
35
Q

What are some signs of PDR?

A

microaneurysms, hemorrhages, cotton wool spots, venous beading, neovascularization

36
Q

What are some signs of hypertensive retinopathy?

A

attenuated blood vessels, possibly tortuous, AV nicking, cotton wool spots, hemorrhages, exudates

37
Q

What is CRVO?

A

Central retinal vein occlusion, can be caused by compression of vein by the CRA, results in painless vision loss usually unilateral, hemorrhage in all four quadrants and dilated, tortuous veins (also cotton wool spots, optic disc edema, macular edema, etc.)

38
Q

What is BRVO?

A

Branch retinal vein occlusion, can be caused by compression from an adjacent artery, resulting in a blind spot in the visual field and showing hemorrhage in a sector of the retina along a dilated/tortuous vein

39
Q

What is CRAO?

A

Central retinal artery occlusion, caused by blockage of the central artery, resulting in unilateral, painless vision loss, showing a whitening of the retina with a cherry-red spot in the macula

40
Q

What is BRAO?

A

Branch retinal artery occlusion, caused by blockage of a retinal artery by an emboli, resulting in painless unilateral vision loss, and showing a whitening along an arterial branch

41
Q

What are some causes of retinal hemorrhages?

A

BRVO, CRVO, hypertensive retinopathy, diabetes, anemia, Valsalva retinopathy, aspirin use/blood thinners, idiopathic

42
Q

Branches of ICA

A

OPAAM - ophthalmic a, posterior communicating, anterior cerebral, anterior choroidal, middle cerebral arteries

43
Q

What ECA artery anastomoses with the supraorbital artery branch of the ophthalmic?

A

superior temporal artery (ECA)

44
Q

What are considered the terminal branches of the ophthalmic artery?

A

dorsonasal and supratrochlear

45
Q

what artery supplies the lacrimal sac?

A

dorsonasal

46
Q

What is the “triangle of death”?

A

the area of the face from the corners of the mouth to the bridge of the nose, because infections in this area can gain access to the brain through the cavernous sinus (venous communication bw facial vein and the ophthalmic veins)

47
Q

Which CN is most likely to be affected by an ICA aneurysm due to where it travels in the cavernous sinus?

A

CN6

48
Q

Other venous sinuses of the head?

A

S/I petrosal sinuses, S/I sagittal sinuses, straight sinus (connecting the sagittals), occipital sinus, transverse sinuses, sigmoid sinuses (drain into the internal jugular)

49
Q

Confluence of the sinuses

A

superior sagittal + occipital + transverse

Ocular Anatomy (12 decks)

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