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49 Cards in this Set

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What are the two sets of glands found in the secretory system?
1. Reflex secretor (aqueous)
2. Basic secretors (liquid, aqueous and mucin)
The lacrimal gland is part of the ______ secretors.
reflex
What does the lacrimal gland secrete?
aqueous
The lacrimal gland is undercontrol of the _______ division of the ANS.
parasympathetic
What side effect can drugs with anticholinergic effects cause?
dry eye
What are the three impulses that cause reflex tearing?
1. emotional center of CNS
2. irritation of trigeminal cranial nerve endings in cornea, conj., and face
3. stimulation of retina by bright light
Basic secretors produce a continuous flow of tears that (increase or decrease) with age.
decrease
What is the purpose of the lipid portion of the tear layer?
stabilize tear film and prevent evaporation
What are the three types of glands that contribute to the lipid tear film layer?
1. Meibomian (primary)
2. glands of Zeis
3. glands of Moll
True or False: Aqueous is the bulk of the tear film layer.
True
What are the three types of glands that contribute to the aqueous layer of the tear film?
1. glands of Krause
2. glands of Worlfring
3. lacrimal gland
All of the three glands that contribute to the aqueous layer of the tear film are under _______ control.
parasympathetic
What is the purpose in the mucin layer of the tear film?
provides absorbing site for aqueous to hydrophobic corneal epithelium and lubricates lids
What are the three structures that contribute to the mucin layer of the tear film?
1. conjunctival goblet cells
2. tarsal crypts of Henle
3. limble glands of Manz
What are the two structures that contribute to the distributing system of the tear film?
1. lids
2. tear meniscus
What is the stimulus for the blink reflex?
tear breakup
What percentage of tear film is drained through the excretory system?
90%-- the other 10% evaporates
Adequate drainage is required to avoid ______.
epiphora (tears rolling onto skin)
What is the average diameter of the puncta?
0.2-0.3mm
Which puncta is more important, inferior or superior?
inferior
What are the dimensions of the canaliculi?
2mm vertical
8mm horizontal
Where do nasolacrimal ducts open into?
inferior meatus... they are then drained over nasopharynx and oropharynx to be swallowed
Secretory problems are typically due to hypersecretion of _____ tears.
reflex
Is is more common for a patient to complain of dry eye or wet eye?
wet eye
Wet eye in an infant is most likely a _____ problem
excretory
Wet eye in a postmenopausal female is most likely a ______ problem.
secretory
What are three systemic health issues that contribute to dry eye?
1. Sjogren's syndrome
2. thryroid-related eye disease
3. allergies
What are eight drugs that decrease aqueous production?
1. anticholinergics
2. antihistamines
3. vitamin A analogs
4. beta blockers
5. phenothiazines
6. antianxiety agents
7. tricyclic antidepressants
8. oral contraceptives (?)
What are three drugs that increase aqueous production?
1. adrenergic agonists
2. antihypertensives
3. cholinergic agonists
Always do sodium fluorescein before ______.
corneal manipulation
A TBUT result of ______ is consistent with dry eye.
<=10 seconds
What does rose bengal and lissamine green stain for?
devitalized epithelial cells of cornea and conj.
Interpalpebral staining with rose benal or lissamine reen is consistent with _____.
KCS
A schirmer tear test with topical anesthetic is _____ or without topical anesthetic is _____.
Schirmer basic secretion test
Schirmer #1 tear test
Where is the Schirmer tear strip placed?
at the medial or lateral third of each lower lid
How long should you allow the Schirmer tear strip to wet?
5 minutes
-or-
1 minute result x 3
If we do not use anesthetic while doing the Schirmer tear test and find a result of <10mm this indicates _____ whereas a result of >10mm indicates _____.
hypo- (KCS)
hypo- (KCS) or normal
If we do use anesthetic while doing the Schirmer tear test and find a result of <10mm this indicates _____ whereas a result of >10mm indicates _____.
hypo- (KCS)
normal
Besides patient comfort, why would a doctor choose to use anesthetic when preforming the Schirmer tear test?
eliminates reflex tearing
What are two reasons lysozyme concentration is reduced?
1. dilution in reflex hypersecretion
2. KCS
When is lactoferrin concentration reduced?
when lysozyme concentration is reduced
Why would we choose to do a lactorferrin assay (lactoplate, touch tear microassay system) over a lysozyme assay?
it is easier and less expensive
How do we determine goblet cell density?
conj. impression "cytology"
How can we reveal decrease airflow through one nostril?
with a mirror
What structure do we pay special attention to when observing the nasal cavity?
inferior meatus for edema or erythema
How do you perform the fluorescein dye appearance test?
instill fluorescein into cul de sac and wait 5 min. then inspect nasal cavity with cobalt filter or have patient blow nose into tissue and inspect tissue with cobalt filter (test each side seperately)
How do you preform the Jones #1 dye test?
similar to fluorescein dye test except cotton tipped wire applicator is used to explore the inf. meatus and reveal absence or prsence of fluorescein drainage at 5 min
What is a positive Jones #1 test?
a negative Jones #1 test?
fluorescein detected
no fluorescein detected
What do you do if Jones #1 test is negative?
perform Jones #2 dye test