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Ocular Physiology 1.2
Eyelid structure and more
54
Other
Graduate
09/29/2007

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Term
What is chronaxie?
Definition
The time that a current 2x threshold intensity must flow in order to elicit muscle excitability
Term
What is the ratio of the chronaxie of the palpebral orbicularis oculi compared to the orbital orbicularis oculi and what is the significance?
Definition
The palpebral orbicularis oculi's chronaxie is 1/2 the orbital orbicularis oculi. A smaller chronaxie means more rapid movement. The palpebral o.o. is for rapid involuntary eye movement. The orbital o.o. is for slower voluntary eye movement.
Term
What is Sherrington's law of reciprocal innervation and give an example in the eyelid.
Definition
When one muscle contracts, its opposite muscle relaxes. bicep/tricep

When the LPS contracts, the OO relaxes.
Term
The fact that your righ and left LPS and o.o. contract together is an example of what law of innervation?
Definition
Hering's law of equal innervation
Term
Which muscle controls tonic eyelid position in states of arousal in which serum levels of catecholamines are higher through alpha 2 receptors?
Definition
Muellers muscle

Beta 2 receptors is the le"b"ator muscle.
Term
Which muscle lies beneath the levator, 15 mm from the upper tarsal border and inserting on the superior tarsal border?
Definition
Muellers muscle
Term
What division of the nervous system innervates Muellers muscle?
Definition
sympathetic nervous system
Term
What is the only muscle responsible for lower lid depression?
Definition
Mueller's muscle
Term
What is Bell's phenomenon?
Definition
An upward and outward rotation of the globe with forced closure.
Term
What glands secrete the outer lipid layer?
Definition
Meibomian glands, Zeiss, Mol
Term
What glands secrete the outer lipid layer?
Definition
Meibomian glands, Zeiss, Moll, corneal and conjunctival epithelium
Term
What glands secrete the middle aqueous layer?
Definition
Main lacrimal gland, and the accessory glands of
Term
What is Horner's muscle?
Definition
The deep portion of the orbicularis muscle that inserts onto the posterior lacrimal crest (located medially) and though to be important in lacrimal outflow
Term
What is senile entropion and which eyelid does it effect most?
Definition
lower eyelid
Term
What is cicatricial entropion and what does it effect?
Definition
usually upper eyelid, due to
Term
What is spastic entropion?
Definition
overactive septal portion of orbicularis causes override of tarsal portion, same as flaccid ectropion or paralytic ectropion
Term
What is atonic ectropion?
Definition
outward turning of lower eyelid frollowing paralysis of orbicularis oculi muscle
Term
What is ankyloblepharon?
Definition
adhesions of upper and lower lid
Term
What do you call inverted epicanthal folds?
Definition
blepharophimosis
Term
What do you call ankyloblepharon totale?
Definition
cryptopthalmos
Term
What do you call a failed closure of the fetal fissure?
Definition
coloboma
Term
What do you call the loss of eyelid tissue by atrophy? The fold of the tissue hangs over the eyelid. It comes with age or youth following chronic edema. The tonus of the levator is normal. The tissue is what is stretched.
Definition
Belpharochalasis
Term
What do you call it when the brow sags? It's a pseudoptosis because the tissue is drooping not the lid.
Definition
dermatochalasis
Term
What is the inability to close the eyelids?
Definition
lagopthalmos
Term
What is an uncontrolled twitching of the eyelid?
Definition
blepharospasm
Term
What is a lid twitch?
Definition
myokymia
Term
Does Bell's Palsy effect voluntary or involuntary movements more?
Definition
Involuntary movements are usually not effected. It effects CNVII
Term
What are two symptoms of Bell's Palsy?
Definition
1) widened palpebral fissure
2) Lagopthalmos
Term
On what two muscles does the resting lid position depend?
Definition
1) Levator superioris\
2) Mueller's muscle
Term
How much does the lower lid move from the up to the down gaze?
Definition
5 mm
Term
How many mm of opening in the palpebral fissure is due to the LPS?
Definition
15 mm
Term
How many mm of opening of the palpebral fissure is due to the frontalis muscle?
Definition
2-3 mm
Term
What is the biggest clue to pathology of the distance of opening in the palpebral fissure?
Definition
asymetry between right and left eye
Term
In which type of ptosis does the normal lid move lower upon downgaze?
Definition
congenital ptosis
Term
What type of ptosis is associated with leavtor dehiscience, but the levator function is still preserved?
Definition
acquired ptosis
Term
Myasthenia gravis (autoimmune), Horner's (sympatheitic) and CN III dysfunction are associated with what type of acquired ptosis?
Definition
neurological ptosis
Term
Blepharochalasis, Enopthalmos (microopthalmia, phthsis), protective , and retraction of the fellow eye are all examples of what type of ptosis?
Definition
Pseudoptosis
Term
What is the 2nd most common cause of lid retraction. It's a pretectal/dorsal midbrain lesion-posterior commissure disease. Pateints exhibt a characteristic stare. Patient commonnly has an upgaze paresis.
Definition
Collier's sign (symmetric UL retraction)
Term
What is responsible for 90% of eyelid retraction clinically?
Definition
Hyperthyroidism
Term
What is a widening of the palpebral fissure due to excessive tonus of Muller muscle or excessive tonus of the levator palpebrae?
Definition
Dalmrymple's sign
Term
Do patients with a goiter have a wider or smaller palpebral fissure?
Definition
wider, 32% bigger than 19 mm as opposed to only 5% normal people bigger than 19mm
Term
Wat is the inability of the upper lid to follow the movments of the globe in "downgaze". It is often referred to as lid lag. It maybe also due to retraction of the upper eyelid.
Definition
Von Graefe's Sign
Term
What two structures control lid apposition to the globe?
Definition
1. Tarsal plate and the palpebral ligaments
2. Muscle of Riolan
Term
What is a droopin gof the upper eyelid due to paralysis of the oculomotor nerve (N III) or sympathetic nerve or by excessive weight of the upper eyelids
Definition
blepharoptosis
Term
What is an exaggerated reflex blinking?
Definition
blepharoclonus
Term
What is the decreased size of the palpebral fissure, often due to increased distance between the inner canthui (telecanthus, and drooping upper eyelid (blepharoptosis)
Definition
blepharophimosis
Term
Which way does the UL move when the eye closes?
Definition
down (nasal)
Term
When way does the lower lid move when it closes?
Definition
mostly nasal, depresses momentarily when contacted by the upper lid
Term
Which way does the medial canthus move when the lid closes?
Definition
It stays stationary for the most part.
Term
What are three types of blinking?
Definition
1. spontaneous
2. reflex
3. voluntary
Term
How fast can you close an eye?
Definition
twice as fast as you open it
Term
What type of blinking reflex is lost in contact lens wear?
Definition
tactile reflex
Term
Which muscle of the iris is at the pupillary margin?
Definition
Sphincter, dilator is radial and consists of short fibers bound by connective tissue
Term
Which muscle is innervated from the E-W nucleus-Ciliary ganglion synapse?
Definition
Sphincter muscle,

Dilator is Superior cervical ganglion-sympathetic plexus at carotid-sympathtic root pass through the ciliary glaglion-SPCN
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