Block 4 Orbit And Ear

Front 1

Inferior orbital fissure transmits _____ communicating with _____

Back 1

infraorbital n and v; Pterygopalatine fossa & infratemporal fossa

Front 2

Floor of the bony orbit

Back 2

Maxillary sinus

Front 3

Superior orbital fissure connects ___ to ____

Back 3

Middle cranial fossa; orbit

Front 4

Inferior orbital fissure connects ___ to ____

Back 4

Pterygopalatine fossa; bottom of orbit

Front 5

Weakest point of the orbit

Back 5

Floor

Front 6

Lamina papericia

Back 6

"Paper thin" medial wall of orbit; but not thinnest

Front 7

double vision and eye movement

Back 7

Not moving simultaneously

Front 8

Numbness of tip of nose and teeth indicates

Back 8

Infraorbital n.

Front 9

Paranasal air sinuses (3)

Back 9

Maxillar
Ethmoid
Sphenoid

Front 10

CNs going through superior orbital fissure

Back 10

3, 4, v1 & 6

Front 11

CNs going through internal auditory meatus

Back 11

7, 8

Front 12

CNs going through jugular foramen

Back 12

9, 10, 11

Front 13

Eyelids sweep tears medially toward

Back 13

Puncta

Front 14

Tears collect in the nasolacrimal sac through

Back 14

Canaliculi

Front 15

Lacrimal glands secrete ___ tears

Back 15

Watery tears

Front 16

Tarsal glands secrete ____ forming _____

Back 16

Wazy substance; hydrophobic seal

Front 17

Transition from middle cranial fossa goes through ____ to reach back of eye

Back 17

Walls of cavernous sinus

Front 18

Optic canal contains

Back 18

Optic n
Ophthalmic a.

Front 19

Inferior orbital fissure contains

Back 19

Infraorbital n.
Communicating v.
Infraorbital a.

Front 20

Everything coming through superior orbital fissure comes through tendinous ring except

Back 20

CN 4

Front 21

Fracture of orbit or zygomatic bone could interrupt ____ secretion

Back 21

Lacrimation

Front 22

Before foramen rotundume, trigeminal is only ___ fibers, but will pick of ____ fibers after

Back 22

sympathetic; para

Front 23

Anything secreted from top of teeth to bottom of eye are innervated by nerves coming from ____ ganglion

Back 23

Pterygopalatine

Front 24

-Dacryocystitis
-Treat with

Back 24

-Infection of the lacrimal apparatus
-Antibiotics

Front 25

-Sty
-Treatment

Back 25

-Usually involves tarsal glands

Front 26

-Orbital cellulitis
-Symptom

Back 26

-Infection within orbit, behind septum
-Pushes eyeball forward

Front 27

-Blepharitis

Back 27

Infection of eyelid/eye in front of septum

Front 28

Conjunctivitis

Back 28

Allergic, viral, bacterial, edema of conjuctiva; affects blood vessels filing conjunctiva

Front 29

Extraocular eye muscles (6)

Back 29

Superior, inferior, medial, lateral rectus
Superior, inferior oblique

Front 30

Trochlea (of eye)

Back 30

Pulley system for superior oblique muscle (which is innervated by trochlear n.)

Front 31

Abduction of the eye is ___ n.

Back 31

Abducens

Front 32

Superior rectus m.
-O
-I
-A
-N
-V

Back 32

-common tendinous ring
-sclera on the superior eye
-elevates and adducts the eyeball; rotates the superior pole of the iris medially
-oculomotor nerve (III),
-superior division ophthalmic a.
-because this muscle approaches the eye from a medial position, it causes the iris to rotate medially

Front 33

Inferior rectus m.
-O
-I
-A
-N
-V

Back 33

-common tendinous
-sclera on the inferior eye
-depresses and adducts the corneal part of the eyeball; rotates the superior pole of the iris laterally
-oculomotor nerve (III),
-inferior division ophthalmic a.
-because this muscle approaches the eyeball from a medial direction, it has a rotational action on the iris

Front 34

Medial rectus m.
-O
-I
-A
-N
-V

Back 34

-common tendinous ring
-sclera on the medial eye
-adducts the corneal part of the eyeball
-oculomotor nerve (III) (inferior division)
-ophthalmic a.
-this muscle directly opposes the action of the lateral rectus

Front 35

Lateral rectus m.
-O
-I
-A
-N
-V
-Dysfunction of n. will cause

Back 35

-common tendinous ring
-sclera on the lateral eye
-abducts the corneal part of the eyeball
-abducens nerve (VI)
-ophthalmic a.
-loss of function of the abducens nerve will cause the eye to be abducted

Front 36

Inferior Oblique M.
-O
-I
-A
-N
-V

Back 36

-floor of the orbit lateral to the lacrimal groove
-sclera on the inferior eye
-elevates and abducts the corneal part of the eye; rotates the superior pole of the iris laterally; when the eye is adducted, this muscle elevates the cornea
-oculomotor nerve (III), inferior division
-ophthalmic a.

Front 37

Superior Oblique M.
-O
-I
-A
-N
-V

Back 37

-apex of the orbit above the optic canal
-sclera on the posterior superior eye
-depresses and abducts the eyeball; rotates the superior pole of the iris medially
-trochlear nerve (IV)
-ophthalmic a.
-passes through a fibrocartilagenous pulley known as the trochlea; when the eye is adducted, this muscle moves the cornea inferiorly

Front 38

Testing function of inferior oblique m.

Back 38

-ask the patient to look toward the bridge of the nose to test the function of this muscle

Front 39

M. pulls up and out

Back 39

Superior rectus

Front 40

Pulls down and out

Back 40

Inferior rectus

Front 41

Adducts

Back 41

Medial rectus

Front 42

Abduction

Back 42

Lateral rectus

Front 43

Down and in

Back 43

superior oblique

Front 44

Pulls up and in

Back 44

Inferior oblique

Front 45

Pt. says can't walk downstairs, abducting & double vision, dizziness, think ___ lesion

Back 45

4

Front 46

During convergence eyes move in

Back 46

Disconjugation

Front 47

Most vulberable nerve of extraocular nerves

Back 47

Abducens

Front 48

If pt. can't look out, CN ___ is damaged

Back 48

6

Front 49

If pt. can't look in, CN ___ is damaged

Back 49

3

Front 50

If pt. can't look down & out, CN ___ is damaged

Back 50

4

Front 51

Parasympathetics for sphincter pupilae run with CN

Back 51

3

Front 52

Nerves and arteries in orbit (branches of opthlamic division)
Men-Lac-Front-Nose

Back 52

Meningeal
Lacrimal
Frontal
Nasociliary

Front 53

Branches of frontal

Back 53

Supratrochlear
Supraorbital
Nasociliary

Front 54

4 veins of facial areas that communicated; route for spread of infection

Back 54

Face
Cranial cavity
Infratemporal fossa
Maxillary sinus

Front 55

-Inferior ophthalmic v --> ____ fissure ---> fossa/sinus
-Superior ophthalmic --> ____ fissure --> ____ fossa/sinus

Back 55

-Inferior orbital fissure; infratemporal fossa
-Cavernous sinus

Front 56

Hit in the eye, numbness of upper teeth, double vision =

Back 56

Blowout of the orbit floor

Front 57

Numbness of upper teeth caused by ___ n.

Back 57

Infraoribtal

Front 58

Right optic nerve lesion =

Back 58

Amaurosis fugax

Front 59

Amaurosis fugax only lasting for a little while on one side, think ____

Back 59

Stroke

Front 60

Visual fields (2)

Back 60

Temporal and nasal

Front 61

Temporal visual field projected to ___ retinal field

Back 61

Nasal

Front 62

Nasal visual field projected to ___ retinal field

Back 62

Temporal

Front 63

Objects coming from lateral go to ____ retinal field

Back 63

Nasal

Front 64

Objects coming from medial go to ____ retinal field

Back 64

Temporal

Front 65

Which retinal fields cross

Back 65

Nasal

Front 66

Amaurosis fugax

Back 66

short-lived episode of blindness in one eye

Front 67

Lesion of right optic tract would result in

Back 67

Left hemianopia

Front 68

Left hemianopia

Back 68

Without vision of half of left side

Front 69

Lesion of chiasm would result in

Back 69

Bitemporal hemianopa

Front 70

Bitemporal hemianopa

Back 70

Lost peripheral field (temporal visual fields)

Front 71

Chiasm lesion could be caused by ____ tumor

Back 71

Pituitary

Front 72

Light strikes pupil, goes through visual pathway to _____ bilaterally

Back 72

Midbrain

Front 73

Preganglionic parasympathetic efferent fibers come from _____ (ganglion)

Back 73

Edinger Westphal - visceral nucleus of oculomotor n.

Front 74

Parasympathetic pregangs travel with ____; synapse in ____

Back 74

Division of CN III; ciliary ganglion

Front 75

Postganglionic parasympathetic fibers travel to _____ m. along ____ nn.

Back 75

Sphincter pupillae m. (in iris); short ciliary nerves

Front 76

Parasympathetics affect on pupil
Sympathetics affect

Back 76

Constriction
Dilation

Front 77

Dilation of pupil driven by ___ sympathetic preganglionic fibers to the ___ ganglion

Back 77

T1; superior cervical ganglion

Front 78

Postganglionic sympathetics course from ___ ganglion to ____ plexus to ____ m.

Back 78

Superior cervical; Carotid plexus; Dilator pupilae

Front 79

Anisocoria
-If adduction also impaired, possible ____ n. problem

Back 79

Unequal pupil size
-CN III

Front 80

Coloboma

Back 80

Defect in bottom of iris

Front 81

Accommodation reflex
-Affect on medial recti
-Affect on pupils
-Affect on Lens

Back 81

-Contraction to bring eye
-Constrict to increase depth field
-Round up for close vision

Front 82

Affect When zonular fibers around lens relax

Back 82

It rounds out

Front 83

Closer objects need ___ lens

Back 83

Round

Front 84

Presbiopia

Back 84

Harder to see close up because lens stays more oval

Front 85

Visual disturbance with dysmenorrhea +/- headache, think ___

Back 85

pituitary

Front 86

Thrombus or infection of cavernous sinus most likely to affect
-May cause __ symptoms

Back 86

-Abducens n.
-Double vision on lateral gaze

Front 87

Function of ear (3)

Back 87

1. Convert sounds from waves to neural signal
2. Sense of balance vs. instability
3. Coordinate eye and neck movements

Front 88

___ parts of ear are air filled; ___ fluid filled

Back 88

External and middle; inner

Front 89

External ear is from ____ to ____

Back 89

External tympanic membrane to pinna

Front 90

Wax (cerumen) produced in

Back 90

Lateral 1/3 of external ear

Front 91

Single complex plate formed from embryological primordis

Back 91

Auricular cartilage

Front 92

Pinna aka

Back 92

Auricle

Front 93

Inferior canal is longer because

Back 93

Tympanic membrane tilt

Front 94

Tilt of tympanic membrane causes cone of light to be ___ to ___

Back 94

Anterior - inferior

Front 95

Motion of tympanic membrane moves ____

Back 95

Malleolus

Front 96

Tension pull in middle of tympanic membrane

Back 96

Umbo

Front 97

___ allows handle of malleolus to vibrate with tympanic membrane

Back 97

Pars flaccida

Front 98

Tympanic membrane held to the petrous portion of the tempral bone by

Back 98

Limbus

Front 99

Ability to equalized pressure in middle ear and throat accomplished by

Back 99

Auditory tube

Front 100

Middle ear is from ___ to ____

Back 100

Tympanic membrane; Internal auditory meatus

Front 101

___ sits in oval window

Back 101

Stapes

Front 102

Malleus is attached to

Back 102

Umbo

Front 103

Head of malleus fits into

Back 103

Incus

Front 104

Incus communicates with

Back 104

stapes

Front 105

Tympanic membrane attached to what bone

Back 105

Malleus

Front 106

Malleus --> ___ bone ---> bone

Back 106

Incus; stapes

Front 107

Chorda tympani crosses what bone

Back 107

handle of Malleus

Front 108

Facial n. exits ___ foramen

Back 108

Stylomastoid

Front 109

Roof of the middle ear =

Back 109

Tegmen tympani

Front 110

Cochlea and vestibular apparatuses are imbedded in

Back 110

Petrous portion of temporal bone

Front 111

Fluid filled part of ear important in eye movemebt

Back 111

Chochlea

Front 112

Oval window communicates with

Back 112

vestibule of inner ear

Front 113

The "second tympanic membrane"

Back 113

Round window at end of scala tympani

Front 114

____ adjust for head and neck movement

Back 114

Semicircular canals

Front 115

Active labyrinth:

Back 115

Semicircular canals

Front 116

Static labyrinth

Back 116

Utircle, saccule

Front 117

Cavernous sinus contents O TOM CAT

Back 117

Occulomotor nerve (III)
Trochlear nerve (IV)
Ophthalmic nerve (V1)
Maxillary nerve (V2)
Carotid artery
Abducent nerve (VI)
T: When written, connects to the T of OTOM.

Front 118

When ear pain isn't ear pain

Back 118

TMJ
Greater auricular referring angina

Front 119

Otitis externa will have tenderness around

Back 119

External auditory meatus