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105 Cards in this Set

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Bones of the orbital floor
Maxialla, Zygomatic, palantine
Bones of the orbital Medial Wall
Ethmoid, lacrimal, maxillary
Bones of the orbital Lateral wall
Greater wing of shenoid, zygomatic
Bones of the orbital roof
Frontal
Foramen Rotundum
Bones bordering?
Structures passing through?
Bones: G. wing
Structures: Maxillary N of Trigeminal (V)
Foramen Ovale
Bones Bordering?
Structures passing through?
Bones: G wing
Structuers: Mandibular N
Foramen Spinosum
Bones Bordering?
Bones: G wing
Foramen Lacerum
Bones Bordering?
Structures passing though?
Bones: G wing, Temporal, Occipital
Structures: Deep/Greater Petrosal N
Optic Canal
Bones bordering?
Structures?
Bones: L wing
Structures: ON, Ophthalmic A
Superior orbital fissure
Bones Bordering?
Structures?
Bones: L & G wing
Structures: (CN III, VI, Nasociliary N,) IV, Ophthalmic N, lacrimal N, Frontal N
Inferior Orbital Fissure
Bones Bordering?
Srtuctures?
Bones: Sphenoid, Zygomatic, Maxillary, Palantine
Structures: Maxillary N, Inf Ophthalmic V
Jugular Foramen
Bones Bordering?
Structures?
Bones: Temporal Occipital
Structures: CN IX, X, XI
Hypoglossal
Bones Bordering?
Structures?
Bones: Occipital
Structures: CN XII,
Carotid Canal
Bones Bordering:
Structures?
Bones: Petrous Temporal
Structures: Internal Carotid
Internal Acoustic
Bones?
Structures?
Bones: Petrous Temp
Structures: CN VII, VIII
Location of Periorbita
Covers orbital bones
Orbital Septum=Palpebral Facsia=Septum Orbitale
Location?
From orbital margin to tarsal plate. Levator pierces it.
Structures posterior to & anterior to Orbital Septum
Post: L/M check, L palpebral Ligament
Ant: M palpebral ligament, Horner's muscle, Lac sac
Location of Tenon's Capsule=Bulbar Fascia
Surrounds globe, btwn sclera and conj
Globe::Tenon's Capsule
Orbit:: What?
Orbital Septum
Structure:: is protected by
What is the Suspensory Ligament?
Inferior muscle sheaths that run hammock like from M to L orbit to support Globe.
Where are the four bony sinuses located?
Frontal, ethmoid, shenoid, Maxilary
What an where are the structures in the cavernous sinus?
M: ICA, Abducens (VI)
L: III, IV, Ophthalmic N, Maxillary N
Where are the venous sinuses?
Cavernous sinus (above sphenoid), Sagittal, Transverse, Straight, Confluence of Sinuses
Name the sensory nerves of the ocular/orbital structures.
CN II: sight
CN V: Ophthalmic; nasociliary, frontal, lacrimal
Maxillary; infraorbital, zzygomatic
Sensory nerves of the eye lid
Upper: Lac, supraorbital, supratrochlear, infratrochlear
Lower: Zygomatico-facial, infraorbital, infratrochlear
Sensory nerves of the eye ball
Long (also Symp to dilator muscle) and Short ciliary nerves (also symp and para)
CN III
Nuc loc?
Pthwy?
Nuc: Midbrain, ventral to aqueduct, sup colliculi level
Pthwy: Interpeduncular fossa-Sup cerebellar, post cerebral/comm-L cavernous sinus-Sup orbital fissure- SUP: SR, levator INF: IR, IO, MR
CN IV
Nuc loc?
Pthwy?
Nuc Loc: Midbrain, ventral to aqueduct, inf colliculi level
Pthwy: Dorsal midbrain (decussates)> follows III > L Cavernous sinus below III > sup orb fissure (not ctr) > SO
CN VI
Nuc loc?
Pthwy?
Nuc Loc: Pons below 4th ventricle
Pthwy: Exits btwn pons and medulla > base of occ bone > over petrous portion > L Cavernous sinus (L to ICA) > sup orb fissure > LR
CN VII
Nuc Loc?
Pthwy?
Nuc: Pons
Pthwy: exit pons > int ac. foramen > Canal in temp > stylomastoid foramen > over mandibular ramus > TEMP/ZYGOMATIC: frontalis, procerus, corrugator, orbicularis
Presenting: Ipsi eye out, dilated. Contra eye no elevation in abd, no depress in add. Both eyes ptosis
Lesion in midbrain affecting nuc of III and IV
Presenting: Adduction and incomplete closure of lid
Lesion in Pons affecting VI, VII
Presenting: pupil dilated, exotropia, no mvmt in abduction, Ptosis
CN III palsy
Intracranial: anueryms of sup cerebellar, post cerebral/comm
Fracture of skull base or inc IOP affect what nerve most commonly?
Abducens
Presenting: Only Lateral Rectus is left functioning
CN III and CN IV are damaged
Lateral wall of Cavernous sinus involved
Aneurysm of Carotid Artery most likely affects which cranial nerve in the cavernous sinus?
Abducens
Injury in the muscle cone affects which nerves?
III, VI, nasociliary
Injury above the musclce cone affects which nerves?
IV, Frontal, Lacrimal
What is the corneal blink reflex pthwy?
Touch cornea > Trigeminal N > edingerwestphal nuc activates sphinctor
> comm w/facial nuc activates orbicularis
What is the lamina cribrosa?
Network of scleral fibers through which the ON exits the eye
Blood supply of the ON
Laminar: Unfenestrated peripapillary choroidal network Post Laminar: Circle of Zinn (ophthalmic) Intracranial: Anterior cerebral/Comm, ICA
Blood supply of Chiasm
Ant comm/cerebral, Post comm/cerebral, ICA
Blood supply of optic tract
Ant choroidal, middle cerebral
Blood supply of LGN (external GN)
post/Ant choroidal
Blood supply of Optic radiations
Middle Cerebral deep optic branch, post cerebral calcarine fissure
Blood supply of Striate Cortex
Post cerebral calcarine branch
Function of LGN
Relay visual info to Cortex, some processing
Striate cortex horizontal organization: magno vs parvocellular
Magno: motion low spatial frequency
Parvo: Color and detail
Striate cortex vertical organization
Ocular dominance columns and Columns for stimulus orientation (edges)
Where do Superior fibers exit the optic chiasm into the optic tract?
Medially
What is the papillomuscular bundle?
Retinal Fibers that connect to the macula and the optic disc
Which LGN layers recieve info from the ipsilateral eye?
M2, P3, P5
(M1, P4, P6 receive contralateral)
Which fibers cross-over in the optic chiasm?
Nasal fibers (Temporal field)
A homonymous defect indicates a lesion where?
Post chiasmal
A heteronymous (mirror img) defect indicates a lesion where?
Chiasm
Binasal=ICA pressure
Bitemporal- pituitary adenoma
Visual Field defects: Congruency tends to increase in which direction relative to the chiasm?
away from the chiasm, towards the striate cortex
A unilateral altitudinal defect indicates a lesion where?
Prechiasmal
Bilateral altitudinal: Calcarine fissure
Name 6 types of scotoma.
Central, paracentral, pericentral (around fixation), cecal (blind spot), centrocecal, Arcuate (Glaucoma)
A central defect (OD) and a pie in the sky (OS) indicates what?
Anterioir junction syndrom of the Right Junction
Homonymous Quadrantonopia VF defects indicate a lesion where?
Opitc radiations
A homonymous VF defect that does not include the macula
Macular sparing (Cortex)
A lesion in the anterior 2/3 of the Optic Tract will most likely cause..
homonymous hemianopic defect with pupillary reactions affected
A lesion in Meyer's loop will most likely cause...
a superior homonymous defect
Pathway of Sympathetic fiber (pre/post ganglion)
Pregang neuron in lateral horn of spinal chord > exits ventrally > Symp chain gang
Post gang fiber goes to target (Iris dilator, BV's, mullers muscle, ciliary muscle, lacrimal gland)
Pathway of parasympathetic fiber (pre/post gang)
Pregang nueron in brainstem/sacral spinal chord >ganglion near target
Post ganglion (short)> (iris sphinctor, ciliary body, lac gland)
ANS stimulation of Sympathetic nervous system causes what in regrads to the ocular system?
Mydriasis, BV constriction, Eyes widen, less lac secrection
ANS stimulation of Parasympathetic nervous system does what in regards to the ocular system?
Miosis, accommodation, tear production
Name 2 direct acting adrenergic agonists
Epinephrine, phenylephrine
How do cocaine and hydroxyamphetamine work?
Indirectly acting Agonists. Cocaine inh uptake of NE. Hydroxyamphetamine stimulates release of NE.
Name a directly and indirectly acting cholinergic agonist
Dir: Pilocarpine
Indir: Physostigmine (inh AChE)
Name an adrenergic antagonist used to reverse phenylephedrine induced mydriasis
Dapiprazole, blocks NE receptors
Name a cholinergic antagonist used to dilate
tropicamide, atropine, cyclopentolate
What is the near pt rxn pathwy?
Afferent: eyes to cortex
CNS: cortex to EW nuc and Frontal eye fields (temporal)
Efferent: III to MR, Parasymp to Ciliary and sphinctor
What is the pupillary light response pathway?
Afferent: Eyes to pretectal nuc in midbrain (exit 2/3 down Optic tract)
CNS: Pretectal to EW. 1/2 cross via post commisure
Efferent: Parasymp from EW
Causes of APD could be...
ON compression, neuritis (MS)
Optic tract (first 2/3), usually accompianied by a homonymous VF defect
Presentgin: normal near response, poor light response
Argyll Robertson: Midbrain
What causes Argyll robertson
Diabetes, syphilis, alcohol neuropathy
Adie's pupil syndrome is characterized by what?
Anisocoria (eye cant constrict), poor dir/cons, slow near response, decreased corneal sensitivity, cholinergic supersensitivity, anisocoria greater in light
What drug is used to test for Adies?
0.125% pilocarpine, will cause miosis
What syndrome is associated with ptosis, anisocooria (eye cant dilate), and anhydrosis?
Horner's syndrom
What drugs are used for horner's pupil diagnosis?
Cocaine=no dilation
Hydroxyamphetamine= dilation if pregangliionic lesion
Where do the posterior arteries go?
Short: Choroid, circle of Zinn (10-20)
Long: Major circle of the iris (2)
Where do the muscular arteries go?
Lat/sup/levator
Med/inf
Anastomoses w/ major circle of iris
Where do the ethmoid arteries go>
nasal cavity
Ant: Ethmoid/Frontal sinus
Post: Frontal/shenoid sinus
Where does the lacrimal artery go?
Lac gland and anastomoses w/ middle palpebral to form palpebral arcades (eyelid) and Ext carotid
Where does the supraorbital artery go?
SO, SR, levator, forehead, orbicularis, anastomoses a/ Ext Carotid
Describe the cilioretinal artery
Branches from short ciliaries of circle of zinn. Goes to choroid then retina, can spare macula if CRA is damaged
Where does the Supratrochlear artery go?
Through prbital septum to forehead, anastomoses w/ ext carotid
Where is the major circle of iris located?
In the ciliary body, but it supplies the iris.
Where does the dorsonasal artery go?
lac sac, anastamoses with the angular artery of the external carotid
List the branches of the ext carotid artery
Facial (angular artery), Superficial temp (orbicularis, anastomososes to supply forehea), Maxillary (enters inf orb fissure, exits infraorbital foramen)
Squamous, cuboidal, columnar, simple, and stratified describe what type of tissue?
Epithelial
What 3 components make up Connective tissue?
Cells (fibroblast, macrophages, mast, lymphocytes, chromatophores), fibers (collagen, elastic, reticular), ground substance
What makes up the matrix in CT?
Ground substace and fibers
What are the 3 classifcations of CT?
Aerolar (loose), Dense (corneal), Adipose (chicken wire)
Describe the 3 type of muscle tissue
Cardiac, smoothe, striated
What are the two types of nervous tissue?
Neurons (-"polar") and Glia (-"-cyte". -"glia", schwann)
Structure and function of fibroblast
Cell in CT that produces CT components
Describe structure and function of schwann cell
Glial cell that wraps around cell axon (myelin) for insulation
Describe structure and function of astrocytes
glial cell that provides framework and nutrition
function of microglia
Glial cell that phagocitizes
Oligodendrocyte structurew and function
Myelin in the CNS can myelinate more than one cell axon.
Name the three layers of BV's
Tunica intima (squamous)
Tunica media (smooth mus)
Tunica Adventia (CT)
Describe layers of Arteries, Veins, and cappilaries
A: thin adventia, thick media
V. thin media, thick adventia
C: 1 endothelial cell thick