Term
| What is the internal covering of the eyelid? What is it continuous with? |
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Definition
| Palpebral conjunctivum, bulbar conjunctivum |
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Term
| What forms the "skeleton" of the eyelids? What is it made of? |
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Definition
| Tarsal plates, dense fibroelastic tissue |
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Term
| What muscle forms the muscular portion of the eyelids? What innervates it? What reflex is it involved with? |
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Definition
| Orbicularis oculi, Facial nerve, blink reflex |
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Term
| What glands lubricate the edges of the lids? |
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Definition
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Term
| What carries the afferent limb of the corneal reflex? What carries the efferent limb? Loss of this reflex would result in what sort of issues? |
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Definition
| CN V, CN VII, corneal damage and ulceration |
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Term
| What type of muscle is Mullers muscle? What innervates it? What does it do? |
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Definition
| Smooth muscle, sympathetics from the superior cervical ganglion, it helps support the eyelid |
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Term
| Tear production is controlled by innervation from... |
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Definition
| CN VII parasympathetics, also sympathetics from internal carotid plexus |
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Term
| Tears contain what important substances? |
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Definition
|
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Term
| Map the drainage of tears |
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Definition
| -> lacrimal punta -> canaliculi -> lacrimal sac -> nasolacrimal duct -> inferior meatus |
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Term
| What are the 4 walls of the orbit formed by? |
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Definition
| Superior - orbital portion of frontal bone, medial - mostly ethmoid, inferior - mostly maxillary with contributions from zygomatic and palatine bone, lateral - frontal portion of zygomatic and greater wing of sphenoid |
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Term
| The apex of the orbit is at the ______ canal, in what part of what bone? |
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Definition
| optic, lesser wing of sphenoid |
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Term
| What is the angular relationship of MEDIAL walls of the orbits? Lateral walls? Orbital axes diverge at what angle? |
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Definition
| Parallel, perpendicular/90 degrees, 45 degrees |
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Term
| The anterior and posterior ethmoidal foramina are in which bone? |
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Definition
|
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Term
| The optic canal is in which part of which bone? |
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Definition
| The lesser wing of sphenoid |
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Term
| The inferior orbital fissure is primarily formed by a slit between which two bones? |
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Definition
| Greater wing of sphenoid and maxillary |
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Term
| What forms the superior orbital fissure? |
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Definition
| Greater and lesser wings of sphenoid |
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Term
| During a blow-out fracture, breaking the medial wall can involve which spaces? What about involving the floor? |
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Definition
| Ethmoid sinuses, maxillary sinuses |
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Term
| Damage to the roof of the orbit can damage the... |
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Definition
|
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Term
| Bleeding into the orbit can cause the eye to protrude, called... |
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Definition
|
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Term
| The periosteum of the orbit is called... |
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Definition
|
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Term
| Which artery does the major blood supply to the orbit? Where does it come from? What branch leads to blindness if occluded? |
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Definition
| Opthalmic, 1st branch from internal carotid, the central artery of the retina |
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Term
| Describe the path of posterior ciliary arteries. |
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Definition
| Branch from opthalmic, penetrate sclera to supply choroid and outer retina |
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Term
| Opthalmic artery forms an important anastamosis with which other artery? Where does the other artery come from? |
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Definition
| Infraorbital (via the angular artery), from maxillary |
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Term
| Describe venous drainage of the orbit |
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Definition
| Vorticose veins drain the back of the eyeball, superior opthalmic vein goes through superior orbital fissure to the cavernous sinus, inferior opthalmic vein joins superior but also drains to pterygoid plexus via inferior orbital fissure, the anterior portion of the eye can drain inferiorly to the angular vein, which drains into facial |
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Term
| When talking about the spread of infection through the venous system of the face, orbit and brain, what are the 3 main veins involved? What is the sinus and plexus involved? |
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Definition
| Superior and inferior opthalmic veins and facial vein. Cavernous sinus and pterygoid plexus. |
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Term
| What passes INSIDE the tendinous ring? |
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Definition
| optic nerve with opthalmic artery, superior and inferior divisions of the occulomotor nerve, nasociliary nerve and abducens nerve. |
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Term
| What passes ABOVE the tendinous ring? |
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Definition
| Superior opthalmic vein, trochlear nerve, frontal nerve and lacrimal nerve |
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Term
| What travels BELOW the tendinous ring? |
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Definition
|
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Term
| To test superior and then inferior oblique, how should the patient move his eyes? |
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Definition
| Medially, then down, then up |
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Term
| To test the superior and inferior recti, how should the patient look? |
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Definition
| Laterally, then up, then down |
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Term
| Abducens palsy will cause the eye to be pulled _______ when attempting to stare straight ahead. |
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Definition
|
|
Term
| What is hypertopia? What type of nerve palsy is it associated with? |
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Definition
| Eye looks up when patient is asked to stare straight ahead. Trochlear nerve palsy. |
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Term
| What are the symptoms of trochlear nerve palsy? |
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Definition
| Hypertropia, head tilts down and toward normal side, diplopia |
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Term
| What are the effects of CN III damage? |
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Definition
| affected eye looks down and out, eyelid closed, cannot stare at object as it is moved toward the face (impaired adduction), diplopia, pupil dilated on affected side |
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Term
| First sign of eye development begins at what day? Optic vesicles form as an evagination of what? |
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Definition
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|
Term
| The optic vesicles come into contact with surface ectoderm and cause induction of... |
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Definition
|
|
Term
| During development, the intraretinal space is between what? |
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Definition
| The inner and outer layers of the optic cup |
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Term
| Mesenchyme surrounding the outer layer of the optic cup is the primordium of what layers of the eye? |
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Definition
|
|
Term
| Formation of optic cup from optic ______ happens around week ____. |
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Definition
|
|
Term
| What developmental space can be the site of future retinal detachment? |
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Definition
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Term
| The optic or choroid ______ forms as the outer layer of the optic cup becomes the ________ layer. Formation of this fissure allows the ________ to reach the inner chamber of the developing eye. What will this become? |
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Definition
| fissure, pigmented, hyaloid artery, central artery of the retina |
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Term
| The developing lens induces the overlying ectoderm to form the... |
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Definition
| corneal epithelium. (the rest of the cornea is mesodermal in origin) |
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Term
| At what point during development do axons leave the neuroretina via developing optic nerve |
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Definition
|
|
Term
| Choroid is continuous with what layers of the optic nerve? What about sclera? |
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Definition
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Term
| The outermost layer of the eye is the _____ coat, composed of... |
|
Definition
| fibrous, sclera and cornea |
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|
Term
| What is sclera composed of? |
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Definition
| Very dense CT, collagen bundles running parallel to surface of the eye |
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Term
| Describe the cornea layer. |
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Definition
| Anterior, transparent, avascular |
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Term
| Middle layer of the eye is the _______ coat or _______ tract. It consists of what 3 parts? |
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Definition
| vascular, uveal. Choroid, ciliary body and iris. |
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Term
| What is the area between the sclera and cornea? Is it vascularized? |
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Definition
|
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Term
| What is the area of transition from 10 to 2 layers of retina? It marks the anterior border of what portion of the retina? |
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Definition
|
|
Term
| What is the 5th corneal layer that contacts aqueous humor? |
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Definition
|
|
Term
| What is the 4th corneal layer? (it contacts the corneal endothelium, and it's named after a dude) |
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Definition
|
|
Term
| What is the thick, middle layer of cornea? |
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Definition
|
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Term
| The second layer of cornea is called what? What two layers does it separate? |
|
Definition
| Bowmann's membrane, separates corneal epithelium from stroma |
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|
Term
| What is the 1st layer of the cornea? |
|
Definition
|
|
Term
| The transparency of the cornea depends on what property of the stroma? |
|
Definition
| arrangement of collagen lamellae and affinity for water |
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Term
| Describe the nerves in the stroma of the cornea, and their path |
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Definition
| Myelinated, become unmyelinated after passing Bowmann's membrane and extend toward surface in the intercellular space of epithelium |
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Term
| What is special about corneal endothelium and its permeability to a specific gas? |
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Definition
| Uses oxygen for various oxidative reactions, particularly glutathione reactions. This also helps get rid of extra oxygen in the cornea. |
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Term
| Which layer of choroid is nearest the sclera? |
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Definition
|
|
Term
| What is the innermost layer of the choroid? |
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Definition
| Brusch's membrane (lamina elastica), which is composed of 5 layers |
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Term
| What are the two inner layers of the choroid? |
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Definition
| Inner choriocapillary layer (essential to outer layers of retina), larger vessel layer |
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|
Term
| What are the 5 layers of Brusch's membrane? |
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Definition
| BL (of pigmented epithelium of retina), collagen, elastin, collagen, BL (of choroidal capillaries) |
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|
Term
| The ciliary body contains what type of muscle? In how many orientations? |
|
Definition
|
|
Term
|
Definition
| The ciliary body suspends the lens by the zonule fibers of the zonule of Zinn |
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|
Term
| What does ciliary epithelium on ciliary processes do? |
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Definition
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|
Term
| The anterior surface of the iris lacks what layer? |
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Definition
|
|
Term
| Describe the lining and stroma of the posterior surface of the iris. What muscle is associated with this? |
|
Definition
| Dual layer of pigmented epithelial cells (continuation from retina). Stroma contains melanocytes and myoepithelial cells, forming dilator pupillae |
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|
Term
| What determines eye color? |
|
Definition
| Number of melanocytes in the iris. Few - blue, Many - brown, Intermediate - green or grey |
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Term
| Constrictor pupillae is what kind of muscle? What is its innervation? Where are the preganglionic neurons? |
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Definition
| Smooth, postganglionic parasympathetics from the ciliary ganglion, EW nucleus |
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|
Term
| Where does the lens get nutrients and oxygen? |
|
Definition
| Surrounding humors, it is avascular |
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|
Term
| Why do the plasma membranes of the lens fibers need to be extremely IMpermeable? |
|
Definition
|
|
Term
| What are the 3 histological layers of the lens? |
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Definition
| Lens capsule, subcapsular epithelium, lens substance |
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Term
| What are cataracts? What are they associated with? |
|
Definition
| Opacities of the lens, old age and diabetes. High glucose/sorbitol levels in lens stroma draws in water. Can also thicken, causing diabetic myopia. |
|
|
Term
| What are the first two layers of neuroretina? |
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Definition
| Pigmented epithelium, layer of rods and cones |
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|
Term
| What are layers 8 through 10 of the neuroretina? |
|
Definition
| Ganglion cell layer, optic fiber layer, inner limiting membrane |
|
|
Term
| What is the 3rd layer of neuroretina? |
|
Definition
|
|
Term
| What are layers 4 - 7 of the neuroretina? |
|
Definition
| Outer nuclear, outer plexiform, inner nuclear, inner plexiform |
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|
Term
| The inner plexiform layer has communications between which cells? |
|
Definition
| Ganglion cells, bipolar and amacrine cells |
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|
Term
| The outer plexiform layer has communications between which cells? |
|
Definition
| Rods and cones, bipolar and horizontal cells |
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|
Term
| What are the 3 important functions of the pigmented epithelium of the retina? |
|
Definition
| 1. absorb light, 2. store and release vitamin A, 3. phagocytose the turned-over membrane from photoreceptor lamellae |
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Term
| Failure of the pigmented epithelium to remove the membranous debris from the photoreceptor lamellae may be involved in what human disease? |
|
Definition
|
|
Term
| The pigmented epithelium is a single layer of cells that have what shape? |
|
Definition
|
|
Term
| Are there more or less rods compared to cones? What type of vision are rods involved with? Where are they located? |
|
Definition
| More (130 mil), twilight vision, throughout the retina |
|
|
Term
| What does the inner segment of a rod contain? How is it connected to the outer segment? |
|
Definition
| many mitochondria, by a thin neck |
|
|
Term
| What does the outer segment of the rod contain? How is it shaped? |
|
Definition
| ~1000 bound lamellae (discs), containing rhodopsin. Outer segment is cylindrical in shape. |
|
|
Term
| Most cones are found in what region? |
|
Definition
|
|
Term
| Cones are important for what type of vision? Describe their lamellae. |
|
Definition
| Color vision and acuity. Taped outer segment has infoldings of plasma membrane, these are lamellae. |
|
|
Term
| On the retinal side of the lamina cribosa, what is MISSING? |
|
Definition
| There are NO oligodendroglia, no myelin |
|
|
Term
| After the lamina cribosa, in the optic nerve, is there myeline? |
|
Definition
| Yes, from oligodendroglia |
|
|
Term
| What is the blood vessel you might see (histologically) on the retinal side of the lamina cribosa? |
|
Definition
| Central artery of the retina |
|
|
Term
| What are the two sources of blood supply for the retina? |
|
Definition
| Outer layers (pigmented epithelium and receptors) - from the capillaries in the choroid layer. Inner layers - branches of the central retinal artery |
|
|
Term
| Occlusion of the central retinal artery causes blindness by killing which cells? |
|
Definition
| Ganglion cells of the retina |
|
|
Term
| What are the two types of ARMD? What do they BOTH accomplish? Which is more common, and which is most severe? |
|
Definition
| Wet and Dry, they both separate the photoreceptors from their blood supply. Dry is much more common, wet is more severe |
|
|
Term
| How does Dry ARMG happen? |
|
Definition
| Drusen accumulates between Brusch's membrane (of choroid) and pigmented epithelium of the retina. |
|
|
Term
| What does dry ARMD retina look like on exam? |
|
Definition
| Light spots (poor blood supply) |
|
|
Term
| How is Wet ARMD different from Dry? |
|
Definition
| New vessels from the choroid push up against the pigmented epithelium and cause further separation. |
|
|
Term
| What does the Amsler grid test for? |
|
Definition
|
|
Term
| What happens with detached retina? |
|
Definition
| Detachment occurs between pigmented epithelium and photoreceptors, photoreceptors are then deprived of oxygen and die |
|
|
Term
| How does increased ICP affect the eye? |
|
Definition
| Optic disc bulges in - papilladema. On exam, the optic disc margins are very blurred. |
|
|
Term
| What are the boundaries of the anterior chamber of the eye? What happens at the lateral boundary? |
|
Definition
| Cornea anteriorly, lens posteriorly. Laterally - angle or limbus occupied by trabecular meshwork where aqueous humor drains to the canal of Schlemm. |
|
|
Term
| What are the boundaries of the posterior chamber? |
|
Definition
| Anteriorly - iris, posteriorly - lens and zonule, peripherally - ciliary processes |
|
|
Term
| Map the flow of aqueous humor |
|
Definition
| Ciliary processes -> posterior chamber -> anterior chamber -> trabecular meshwork -> canal of Schlemm -> external collecting channels -> scleral plexus -> aqueous veins -> episcleral veins |
|
|
Term
| What is the most common type of glaucoma? Who is more likely to develop it? |
|
Definition
| Primary open-angle, people with myopia (near-sightedness) and DM |
|
|
Term
| In primary open-angle glaucoma, how does the angle of the anterior chamber appear? What causes the problem, and how does it progress? |
|
Definition
| Normal, slow blockage of canal of Schlemm, gradually |
|
|
Term
| What is the rare type of glaucoma that has a rapid onset and presents an emergency situation? |
|
Definition
| Primary closed-angle (narrow angle) glaucoma |
|
|
Term
| What happens in primary closed-angle glaucoma? How does it present? |
|
Definition
| The angle of the anterior chamber is blocked by the iris when pupil is DILATED. Occular pain, blurred vision, and halos around lights. |
|
|
Term
| Optic cupping results from what? Why is it bad? What does the disk look like. |
|
Definition
| Increased IOP. Pale, enlarged optic disc. Can lead to retinal atrophy and neuronal death. |
|
|
Term
| Vitreal body is made of what? What synthesizes some of the contents? |
|
Definition
| 99% water, also collagen and glycosaminoglycans from hyalocytes |
|
|
Term
| What are vitreal floaters? |
|
Definition
| Protein aggregates that are usually not noticeable, but sudden onset of many could indicate serious disease. |
|
|
Term
| What is the removal of cloudy or bloody vitreous humor called? What is it replaced with? Why? |
|
Definition
| Vitrectomy, saline, to maintain shape of eye and keep retinal in its position |
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