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811 Cards in this Set
- Front
- Back
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EOMs attach to
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sclera
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Compared to skeletal muscle, EOMS are
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better in every way
-denser blood supply -denser nerve supply -faster -fatigue resistant |
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What makes muscle fast
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white fibers
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what makes muscle slow but fatigue resistant
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red fibers
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all recti muscles originate from
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CTR
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Superior rectus origin
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CTR and optic nerve sheath
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superior rectus innervation
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superior division of CN 3
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actions of Superior rectus
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elevation
ADDuction intorsion |
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inferior rectus origin
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CTR
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inferior rectus innervation
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inferior division of CN 3
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actions of IR
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depression
ADDuction extorsion |
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medial rectus origin
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CTR and optic nerve sheath
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innervation MR
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inferior division of CN 3
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MR actions
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ADDuction
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thinnest and longest EOM
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superior oblique
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thickest EOM
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medial rectus bc of convergence
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lateral rectus origin
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CTR and greater wing of sphenoid
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lateral rectus innervation
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CN 6
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lateral rectus action
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ABDuction
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superior oblique origin
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lesser wing of sphenoid
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superior oblique innervation
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CN 4
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what does SO use
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trochlea
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action of SO
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intorsion
depression ABDuction |
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inferior oblique origin
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maxillary bone
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what is special about IO
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only EOM that originates ANTERIOR to globe
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IO innervation
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inferior division of CN 3
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IO actions
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extorsion
elevation ABDuction |
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all superiors
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INTORT
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all obliques
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ABDuct
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lesser wing of sphenoid projects ___ and connects to ___
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anteriorly
frontal b |
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greater wing projects ____ and connects ___
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laterally
zygomatic bone |
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Foramen Rotundum
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V2 (maxillary)
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foramen ovale
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V3 (mandibular)
inferior petrosal n |
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foramen spinosum
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middle meningeal artery
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sella turcia located where; houses what?
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located in body of sphenoid
houses pituitary optic chiasm lies above it |
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pituitary tumor
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compresses nasal fibers OU as cross chiasm
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bitemporal hemianopsia
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pituitary tumor
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CTR
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circular band of CT anterior to SOF
origin of recti muscles |
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SOF
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gap btw wings of sphenoid
anterior to cavernous sinus |
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what passes thru SOF and CTR
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NOA fits thru ring and fissure
Nasociliary N Oculomotor N Abducens N |
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What passes thru SOF mneumonic?
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I Live Free And True Never Say Otherwise
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What passes thru SOF?
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Inferior Opt V
Lacrimal N Frontal N Abducens N Trochlear N Nasociliary N Superior Opt V Ocuolomotor |
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optic canal
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optic n
opt artery |
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carotid canal
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ICA
sympathetic plexus |
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supraorbital foramen
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supraorbital n and vessels
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infraorbital foramen
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infraorbital n and vessel
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mandibular foramen
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inferior alveolar n and vessel
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stylomastoid foramen
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facial n
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how many bones make up orbit
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7
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roof
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frontal bone
lesser wing of sphenoid |
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floor
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My Zilly Pal
Maxillary Zygomatic Palatine |
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medial
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my little eye sits in orbit
maxilla lacrimal ethmoid sphenoid |
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lateral
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zygomatic
greater wing of sphenoid |
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where are you most likely to get injury/dz?
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My pal gets dz on floor
floor of orbit because thats were infraorbital n and maxillary sinus are |
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which is wall is the thinnest
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medial
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which wall is the weakest
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floor
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which wall is the strongest
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lateral
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external carotid supplies
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superficial head/neck and some of the eye
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what are the 2 main branches of ECA that supply the eye?
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facial a
maxillary a |
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The terminal branch of the ECA is
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superficial temporal a
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what does the facial artery supply
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supplies medial canthus via the angular artery
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what does the maxillary artery supply
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supplies orbit as infraorbital a
supplies lower lid and lacrimal sac |
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superficial temporal artery supplies what
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superficial skin/muscle/tissue of face and orbit
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what are the 3 branches of the superficial temporal artery
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TAZ
transverse facial a anterior temporal a zygomatic a |
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how does the ECA and ICA join together
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via transverse facial and anterior temporal arteries which hook up with the supraorbital and supratrochlear a of ICA
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the skin of cheek is supplied by
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transverse facial a
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supplies orbicularis muscle
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zygomatic a
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supplies skin and muscle of forehead
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anterior temporal a
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Giant cell arteritis is
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inflammation of the superficial temporal a that causes damage to one eye and can move to other eye if not treated
loss of vision old ppl |
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how is vision loss in GCA
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short posterior ciliary a (zinn) that supplies the optic dix are damage
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can GCA be treated
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nope, just give strong steroid
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ICA supplies
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INTERNAL structures of cranium and superficial face and orbit via hooking up with ECA
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ICA travels with what nerve through the cavernous sinus
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CN 6
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ICA exits with what nerves
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CN 2 & 3
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what is the first branch of ICA near the orbit
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ophthalmic artery
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how many branches does the opt a have
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7
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what are the 2 terminal branches of opt a
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supratrochlear a
dorsonasal a |
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skin of forehead, scalp, muscles of forehead are supplied by branch of opt a
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supratrochlear a
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supplies lacrimal sac
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dorsonasal a
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medial palpebral arteries
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eyelids
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the 2 terminal branches of opt a gives off
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dorsonasal a
supratrochlear a |
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medial palpebral a arises from
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dorsonasal a
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lateral palpebral a arises from
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lacrimal a
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7 branches of opt a
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1 CRA
2 Lacrimal a 3 Short Posterior Ciliary a 4 long posterior ciliary a 5 ethmoid a 6 supraorbital a 7 muscular a |
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CRA supplies
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inner retina
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lacrimal a supplies
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LR, SR, lacrimal gland
later becomes lateral palpebral a --> lids |
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short posterior ciliary a
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posterior choroid
macula superficial optic nerve via circle of zinn |
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circle of zinn supplies
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optic disc
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circle zinn made up of
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short posterior ciliary a
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long posterior ciliary arteries
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anterior choroid
iris CB MAC when hooks up with anterior ciliary a to supply iris/CB |
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how many SPCA are there
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20
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how many LPCA are there
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2
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MAC is located where
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cb
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MAC supplies
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iris
CB |
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MAC made from
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LPCA and ACA
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MAC vessels are fenestrated or tight
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fenestrated and bc of this helps make AH
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ethmoid a supplies
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sphenoid, frontal, ethmoid sinuses
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supraorbital artery supplies
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structures within orbit and superficial scalp and forehead
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supraorbital artery
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SR
SO LPS supply skin and muscles of forehead and scalp |
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muscular artery
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supplies EOMS
2 branches superior: LR, SR, SO, LPS inferior: MR, IR, IO |
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anterior ciliary a
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7 in total - 2 from each recti except LR which has 1
supply conj and combine with LPCA to form MAC |
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MAC is combo of what 2 vessels
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ACA and LPCA
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all veins of the eye drain into what
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either the superior opt vein and/or inferior opt vein
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CRV
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drains CRA
drains into SOV |
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Anterior ciliary veins
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drains all anterior structure including canal of schlemn
drains int SOV and IOV |
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vortex veins
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4 total
drains choroid drains into SOV and IOV |
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SOV and IOV drain into
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cavernous sinus
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cavernous sinus drains into
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IJV --> heart
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what is the cavernous sinus
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large venous channel bordered by sphenoid and temporal bones
posterior to SOF |
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contents of cavernous sinus
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OTOMCAS
oculomotor n trochlear n opthalmic division of V1 maxillary division V2 ICA abducens n sympathetic plexus |
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which is the only CN that runs free with the cavernous sinus
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CN 6
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CN 6 runs with what in the cavernous sinus
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ICA
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which nerve is most affected by ICA aneurysm in the cavernous sinus
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CN 6
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cranial nerve saying
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O, O, O, to touch and feel very good velvet ah heaven
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fxn saying for CN
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some say marry money but my brother says big boobs matter most
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CN 1
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olfactory n
sensory smell |
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CN 2
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optic n
sensory vision |
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CN 3
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OCULOMOTOR N
MOTOR EYE MOVEMENT, ACCOMMODATION, CONSTRICTION OF PUPIL |
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CN 4
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TROCHLEAR N
MOTOR SO |
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CN 5
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TRIGEMINAL
BOTH FACIAL SENSATION AND MASTICATION |
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CN 6
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ABDUCENS
MOTOR LR |
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CN 7
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FACIAL
BOTH FACIAL EXPRESSION, 2/3 TASTE, LACRIMATION, SALIVATION |
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CN 8
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VESTIBULOCOCHLEAR
SENSORY HEARING AND BALANCE |
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CN 9
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GLOSSOPHARYNGEAL
BOTH SWALLOWING, SALIVATION, PAROTID GLAND, POST 1/3 TASTE, CAROTID SINUS |
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CN 10
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VAGUS
BOTH TASTE, SWALLOWING, PALATE ELEVATION, TALKING, VISCERA |
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CN 11
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ACCESSORY
MOTOR HEAD TURNING, SHOULDER SHRUG |
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CN 12
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HYPOGLOSSAL
MOTOR TONGUE MOVEMENT |
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which cranial n begin at midbrain
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3 & 4
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which cranial nerves start at pons
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5, 6, 7
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which cranial nerves start at medulla
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8, 9, 10, 11, 12
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optic n fibers desucate at
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optic chiasm
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optic n fibers reach
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LGN to go to V1
pretectal nucleus superior colliculus |
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oculomotor n (3) is unique bc
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it carries parasympathetic fibers in the EW nucleus for sphincter and CM
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LPS are controlled
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by the same nucleus therefore it is the reason for a BILATERAL PTOSIS
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superior division of CN 3 innervates
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SR, LPS
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inferior division of CN 3 innervates
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MR, IR, IO, short ciliary n
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the only fibers of CN 3 that descuate are
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SR fibers
causes contralateral problems |
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what is speacial about CN 4
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only nerve to leave CNS and travel dorsally and then DESUCATE
innervates contralateral SO muscle |
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what else is special about CN 4 size wise and fxn
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thinnest and uses trochlea
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CN 5 is mostly what
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sensory for eye with small motor component for muscle of mastication via V3
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divisions of V1
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NFL
nasociliary n frontal n lacrimal n |
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nasociliary n supplies
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sensory innervation to cornea, iris, and side of nose
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what are the most important branches of the nasociliary n
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long ciliary n
short ciliary n |
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long ciliary n supplies
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sensory innfervation to cornea, iris, CM, sympathetic fibers to dilator
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frontal nerve has what 2 branches
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supratrochlear
supraorbital |
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supratrochlear n supplies
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skin and muscle of forehead
upper lid conjunctiva |
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supraorbital n supplies
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scalp
forehead upper lid conjunctiva |
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lacrimal n communicates with what n
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zygomatic n
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lacrimal n supplies
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lateral conj
later upper lid |
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V1 is called the
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opthalmic division
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V2 is the
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maxillary division
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V3 is the
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mandibular division
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2 branches of V2
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infraorbital n
zygomatic n |
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infraorbital n supplies
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lower lids, cheeks, upper lip
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zygomaticalfacial supplies
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lateral side of cheek and lateral side of lower lid
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which nerve is involved in lacrimation
|
V2
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V2 receives
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parasympathetic supply from sphenopaplatanie ganglion
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V2 relays info from sphenopalatine ganglion to
|
lacrimal gland
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V3 supplies
|
lower face sensory
motor of muscles of mastication |
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name the muscles of mastication
|
masseter
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CN 6 runs through what structure
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cavernous sinus
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CN6 travels with what
|
ICA
|
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most common nerve affected in ICA aneurysm
|
CN 6
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CN 6 palsy can be due to
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ICA aneurysm and elevated intracranial pressure
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CN 7 is mostly
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motor with some sensory (taste)
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CN 7 provides motor innervation to what
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muscle of facial expression
inner ear (decrease sound( |
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CN 7 provides sensory innervation to what 2 things
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tongue
parasympathetic for facial glands (lacrimal gland) |
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how many roots does CN 7 have
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3
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voluntary motor root
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facial muscles
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sensory root
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taste for anterior 2/3 tongue
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autonomic root
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parasympathetic (invol motor) to facial glands
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CN 7 located in what part of brain
|
frontal lobe
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what structure does CN 7 use to carry taste fibers from tongue and parasymp supply to submandibular/lingual glands
|
chorda tympani
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stapedium muscle is supplied by what and whats its fxn
|
dampen sound
CN 7 |
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where does CN 7 exit thru
|
stylomastoid foramen
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where does CN 7 branch out at
|
parotid gland BUT doesnt innervate it!!!
|
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what are the 5 branches of CN 7
|
Two Zebras Bit My Cat
temporal zygomatic buccal mandibular cervical |
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what do the 5 branches of CN 7 supply
|
muscles of facial expression
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what branches of CN 7 innervates muscles around the eye
|
temporal and zygomatic
|
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what are the muscles around the eye innervated by temporal and zygomatic branch
|
frontalis
procerus corrugator orbicularis |
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List the 4 CN that supply motor innervation to eye
|
3
4 6 7 |
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strokes are due to leasions where
|
S for SUPRANUCLEAR
|
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what fibers are damaged in strokes
|
ipsilateral fibers used for contralateral innervation of lower face
|
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what fibers are spared in strokes
|
contralateral fibers for lid closure and wrinkling of forehead and eye closure
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Strokes patients have
|
contralateral muscle weakness of lower face presenting as mouth drooping
|
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stroke patients can do what
|
wrinkle forehead and close eye firmly
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bell's palsy is due to a lesion where
|
LMN
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bell's palsy damages what fibers
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ipsilateral fibers used for muscles of facial expression
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bell's patients look like what
|
mouth drooping and cant close eye on same side as lesion
|
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name 2 CNs that are parasympatheic innervation
|
3, 7
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CN 3 parasumpathetic fxn
|
miosis and accommodation
|
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EW nucleus is attached to what nucleus
|
CN 3
|
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where do preganglionic cell bodies come from
|
EW nuclei
|
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describe what CN 3 looks like
|
pupil fibers on outside wrapped around EOM and parasympathetic fibers
|
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which fibers of CN 3 are more likely to be damaged by a tumor or aneurysm
|
pupillary fibers because located peripheraly
|
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CN 3 palsy
|
CN 3 innervates SR, IR, IO, MR and parasympathetic fibers for miosis and accommodation therefore if there is a palsy, the eye will be DOWN and OUT and can possibly be DILATED
|
|
|
what must be down if a CN 3 palsy is suspected
|
check the pupils!!!
|
|
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why is pupillary involvement in a CN 3 palsy important
|
becauses it is a EMERGENCY patient may have a posterior communicating artery at the PCA/ICA junction
|
|
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If pupil is not involved in CN 3 palsy then we are not likely to suspect
|
PCA aneurysm
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____ is highly suspect cause of pupil sparing CN 3 palsy
|
HTN and DM that affect small bv that supply CN 3
|
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where do CM and sphincter fibers synapse
|
ciliary ganglion
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where is the ciliary ganglion located
|
btw optic n and LR muscle
|
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postganglionic fibers synapse at
|
ciliary ganglion
|
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postganglionic fibers leave the ciliary ganglion as
|
short ciliary n
|
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short ciliary n innervates
|
CM and sphincter
|
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the parasympathetic fxn of CN 7 is
|
innervates lacrimal gland, choroid, and inferior muller's muscle
|
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preganglionic parasymp nerves of CN 7 synapse at what ganglion
|
geniculate ganglion
|
|
|
pregang parasymp nerves exit geniculate ganglion as
|
greater petrosal n
|
|
|
greater petrosal n combine with what nerve to form what
|
deep petrosal (symp) n to form carotid plexus
|
|
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vividian n is a combo of what
|
greater and deep petrosal n
|
|
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vividian n carries what type of fibers
|
parasymp and symp
|
|
|
vidian n synapses where
which type |
sphenopalatine(pterygopalatine) ganglion
ONLY PARASYMP FIBERS SYNAPSE HERE |
|
|
the sympathetic fibers courses thru sphenopalatine ganglion and do what
|
join zygomatic n of V2 providing communicating branch to lacrimal n for AUTONOMIC lacrimal gland innervation
|
|
|
sympathetic course begins where
|
begin in HYPOTHALAMUS and go to thorocolumbar region
|
|
|
sympathetic fibers synapse where
|
superior cervical ganglion
|
|
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where do sympathetic fibers leave in CCB
|
ventral root to enter sympathetic chain ganglion
|
|
|
where do sympathetic fibers synapse after they leave the CCB
|
superior cervical ganglion
|
|
|
which type pre or post symp do they become when enter superior cervical ganglion
|
postganglionic
|
|
|
postganglionic fibers for a sympathetic plexus around what structure entering where
|
enter thru carotid canal
wrap around ICA |
|
|
what are the 3 courses the sympathetic system has within the orbit
|
1. follow superior division of CN 3 to innervate MULLERS MUSCLE
2. follow nasociliary nerve and branch with LPCN or SPCN 3. become vividian n to vasoconstrict lacrimal gland |
|
|
LPCN innervates what 2 muscles
|
dilator
CM |
|
|
SPCN innervates
|
choroidal and conj bv
|
|
|
which symp fibers do not synapse at CG
|
SPCN
|
|
|
SPCN originate from
|
ciliary ganglion
|
|
|
SPCN carry what
|
postgang para and symp supply from CG
take sensory info back to eye via CG thru nasociliary n |
|
|
LPCN carries
|
postganglionic symp fibers to eye
take sensory info from eye to trigeminal ganglion |
|
|
sensory info from SPCN and LPCN is taken where
|
trigeminal ganglion
|
|
|
palpebral fissure
|
distance between open eyelids
|
|
|
superior palpebral sulcus
|
divides lid into tarsal portion and orbital portion
|
|
|
portion of lid that contains fat
|
orbital
|
|
|
portion of lid that contains lashes but no fat
|
tarsal
|
|
|
what structure divides the eyelid margin
|
punctum
|
|
|
what are the 2 divisions of the eyelid margin
|
lacrimal
ciliary |
|
|
lacrimal portion of lid margin
|
medial 1/6 of margin
devoid of lashes or meibomian pores |
|
|
ciliary portion of lid margin
|
lateral 5/6 of margin
|
|
|
Name the layers of the eyelid from ant/superficial to post/deep
|
1. Skin
2. Subcutaneous areolar CT 3. Orbicularis 4. Orbital Septum 5. Muscle 6. Tarsal Plate 7. Palpebral conj |
|
|
thin layer of skin containing no fat
|
skin layer
|
|
|
layer containing loose CT btw skin and orbicularis
|
subcutaneous areolar layer
|
|
|
orbicularis oculi is innervated by what n
|
zygomatic branch of CN 7 FACIAL N
|
|
|
name the 2 parts of the orbicularis
|
orbital
palpebral |
|
|
forced lid closure
|
orbital portion of OM
|
|
|
spontaneous and reflex blinking
|
palpebral portion of OM
|
|
|
Ciliary Muscle of Riolan and Horner's Muscle are located where
|
part of palpebral portion of OM
|
|
|
keeps lid tightly apposed to globe
|
Riolan
|
|
|
helps drain tears into lacrimal sac
|
horner's
|
|
|
dense irregular CT layer that serves as a barrier preventing fat from falling and keeps infections localized anteriorly
|
orbital septum
|
|
|
where is the orbital septum attached to
|
posterior lacrimal crest medially
|
|
|
what is important about the lacrimal sac
|
lacrimal sac is not protected by orbital septum bc the sac lies anterior to posterior lacrimal sac
|
|
|
the muscular layer contains what 2 muscles
|
LPS and Muller's
|
|
|
where does the LPS originate
|
lesser wing of sphenoid
|
|
|
what innervates LPS
|
superior division of CN 3
|
|
|
what does the LPS do
|
main retractor of lid
ELEVATES lid |
|
|
fan shaped tendon
|
levator aponeurosis
|
|
|
muller's muscle is what type of muscle
|
smooth
|
|
|
muller's origin
|
superior potion - LPS
inferior - IR |
|
|
muller's fxn
|
maintains lid opening
|
|
|
muller's innervation
|
sympathetic
|
|
|
injury to LPS results in
|
severe ptosis since it is the main retractor
|
|
|
injury to muller's results in
|
slight ptosis bc it isnt the main retractor
|
|
|
dense irregular CT layer that provides rigidity to lids
|
tarsal plate
|
|
|
what is located inn the tarsal plate
|
MG
Lateral and medial palpebral ligaments |
|
|
MG
|
sebaceous glands that make lipid layer of tear film
|
|
|
MG located
|
posterior to cilia
|
|
|
role of lateral and medial palpebral ligaments
|
keep lid against eye during movements
|
|
|
palpebral conjunctiva
|
inner lid linning
|
|
|
name the 2 layers of the palpebral conj
|
stratified epithelial layer
submucosa |
|
|
layer of palpebral conj that is protective and contains goblet cells
|
stratified epithelial layer
|
|
|
loose vascularized CT cotaining a lymph and fibrous layer
|
submucosa of palpebral conj
|
|
|
outer lymphoid layer
|
IMMUNOLOGICALLY ACTIVE
|
|
|
deep fibrous layer
|
connects conj to internal structures
contains accessory lacrimal glands, bv, nerves |
|
|
modified sebaceous glands located in follicles that lubricate lashes
|
Zeis
|
|
|
modified swear glands
|
Moll
|
|
|
accessory lacrimal gland located in subconj CT or fornices
|
Krause
|
|
|
large accessory lacrimal gland that open onto to palpebral conj
|
Wolfring
|
|
|
localized, painless, sterile inflammation of MG
|
chalazion
|
|
|
staph infection of Zeis or Moll with inflammation on skin of lid margin
|
external hordeolum
|
|
|
staph infection of MG with inflammation on conj side of lid margin
|
internal horedolum
|
|
|
do hordeoulums hurt
|
yes, H is for hurt
|
|
|
motor innervation of lids
|
zygomatic branch of CN 7 for orbicularis
sympathetic for Muller's motor for LPS via CN 3 |
|
|
upper lid nerve supply
|
V1 - frontal and lacrimal n
|
|
|
lower lid nerve supply
|
V2 - infraboribtal and zygomaticofacial n
|
|
|
what branch of ICA supplies deep lids
|
lateral and medial palpebral arteries (opt a branches)
|
|
|
peripheral arcades made up of what
|
medial and lateral palpebral arcaded
|
|
|
peripheral aracades role
|
main supply for deep id and palpebral conj
|
|
|
peripheral arcades communicate with which vessels
|
ACA
|
|
|
superficial lid supplied by
|
ECA
|
|
|
where does conj lymph drain into
|
lids
|
|
|
lateral lymphatics drain into
|
parotid gland
PAN |
|
|
medial lymphatics drain into
|
submandibular node
|
|
|
facial muscle that raises eyebrows to look surprised
|
frontalis
|
|
|
facial muscle that moves brow medially to look like concentrating
|
corrugator
|
|
|
facial muscle that pulls medial part of brow down to look like menace/aggression
|
procerus
|
|
|
palpebral conj
|
inner lining of lids
|
|
|
forniceal conj
|
lines fornices
|
|
|
bulbar conj
|
lines eyeball
|
|
|
transuluscent layer above sclera
|
bulbar
|
|
|
bulbar contains what 2 layers
|
stratified epi
submucosa |
|
|
which layer of bulbar has microvilli, melanin, and goblet cells
|
stratified eu=pi
|
|
|
submucosa is made up of
|
CT stroma like
|
|
|
conjunctival fold at medial canthus
|
plica semilunaris
vestigial 3rd lid |
|
|
purpose of plica semilunaris
|
provides slack for lateral eye movements
|
|
|
modified mound of tissue containing hair and glands located medial to plica
|
caruncle
|
|
|
blood supply of palpebral conj
|
peripheral arcades
|
|
|
blood supply of forniceal conj
|
peripheral arcades
|
|
|
blood supply of bulbar conj
|
ACA
|
|
|
palpebral conj innervation
|
V1
V2 |
|
|
bulbar conj innervation
|
LPCN
|
|
|
pinguecula
|
modified sunmucosal tissue that is yellow and elevated due to dust, wind, UV
|
|
|
pterygium
|
like pinguecula but has own blood supply and grows onto cornea
|
|
|
name the 4 layers of the tear film
|
Lipid
Aqueous Mucin Epithelium conj |
|
|
lipid layer produced by
|
MG
small bit from Zeiss |
|
|
purpose of lipid layer
|
slow down evaporation of tears
provide smooth surface |
|
|
aqueous layer produced by
|
lacrimal gland
accessory lacrimal glands (k & w) |
|
|
purpose of aqueous layer
|
contains glucose,protein, enzymes, antibacterials (IgA, IgG)
|
|
|
mucin layer made by
|
goblet cells
|
|
|
puprose of mucin layer
|
absorbed by glycoalyx
adhesion of aqueous to cornea |
|
|
meibomianitis
|
lipid deficiency
|
|
|
sjorgrens's, systemic meds
|
aq deficiency
|
|
|
ocular pemphigoid
steven johnson's |
mucin deficiency
|
|
|
TBUT determines
|
lipid problem
|
|
|
shirmer's determines
|
aq problem
|
|
|
how tears drain
|
puncta--> canaliculi --> lacrimal sac --> NLD --> Hasner --> IM
|
|
|
puncta drains into
|
canaliculi
|
|
|
backflow is prevented via what feature of canaliculi
|
angle it takes when entering sac
|
|
|
where does lacrimal sac reside
|
fossa btw maxillary and lacrimal bone
|
|
|
NLD terminates where
|
IM
|
|
|
valve of Hasner is located where
|
at end of NLD
|
|
|
purpose of Hasner
|
prevent backflow of nasal fluid into lacrimal system
|
|
|
main function of cornea
|
refract and transmit light
|
|
|
what is the power of the cornea
|
about 2/3 (of 60) so 45 D
|
|
|
main refracting property of cornea
|
air tear film interface big n difference
|
|
|
where is cornea thickest at centrally or peripherally
|
peripherally
|
|
|
peripheral thickness of cornea
|
.67 um
|
|
|
center thickness of cornea
|
.52 um
|
|
|
cornea is atoric or toric
|
toric
|
|
|
WTR
|
more steeper/power in vertical
|
|
|
ATR
|
more steeper/power in horizontal
|
|
|
radius of curvature of central cornea for anterior surface
|
7.8mm
|
|
|
center of curvature of posterior cornea for poster surface
|
6.5mm
|
|
|
anterior horizontal diameter
|
11.7mm
|
|
|
anterior vertical diameter
|
10.6mm
|
|
|
posterior cornea is
|
spherical
|
|
|
anterior cornea is
|
toric
|
|
|
posterior cornea vertical and horizontal diameter
|
11.7mm
|
|
|
anterior cornea is
|
flatter
|
|
|
posterior cornea is
|
steeper
|
|
|
4 properties of cornea
|
thin
translucent toric avascular |
|
|
name the 5 layers of cornea from anterior to posterior (superficial to deep)
|
epithelium
bowman's stroma descemet's endothelium |
|
|
the K epithelium is what type
|
stratified sqaumous
non keratinized |
|
|
how many layers does the K epithelium have
|
4
|
|
|
name the layers of the K epithelium a-p(s-d)
|
surface
wing basal stem |
|
|
describe the surface layer
|
2 cells thick
nonkeratinized squamous cels |
|
|
what does the surface layer secrete and contain
|
glycocalyx
microvilli |
|
|
what happens to surface cells with age
|
sloughed off into tear film
|
|
|
name the 2 types of jxn found in K epithleium
|
zonular occludens -- tight jxns
desomosomes |
|
|
wings cells communicate with surface cells and basal cells and to other wing cells via
|
desomosomes
|
|
|
basal layer is made up of
|
single layer of columnar cells
|
|
|
what is special about the basal layer
|
only mitotic layer
|
|
|
what does the basal layer secrete
|
its own BM
|
|
|
Basal layer connects to Bowman's via
|
hemidesomosome which attach BM to cell
|
|
|
stem cells are found where
|
at limbus, same level as basal cell
|
|
|
stem cells start off what cascade
|
stem - basal - wing - surface
|
|
|
what type of layer is Bowman's membrane
|
TRANSITIONAL LAYER to the stroma
IT IS NOT A MEMBRANE |
|
|
when is bowman's made and why is this an important factor
|
bowman's is made PRENATALY thus it DOESNT regenerate
BOWman's BOWS OUT |
|
|
stroma makes up what % of cornea
|
90%
|
|
|
stroma is made up of how much water
|
75-80%
|
|
|
what 3 things is the stroma made up of
|
collagen fibrils
fibroblasts ground substances |
|
|
what are the fibroblasts of the cornea called
|
keratocytes
|
|
|
describe keratocytes
|
flattened cells lying w/in and btw collagen fibrils
|
|
|
lamellae
|
200-300 parallely layers of collagen fibrls
|
|
|
which area of stroma is where the collagen fibrils are most organized
|
posterior 2/3
|
|
|
where are the ground substance located
|
btw fibroblasts and keratocytes
|
|
|
what do the ground substance contain
|
GAGs
|
|
|
what are GAGs
|
hydroPHILIC negatively charged carbs that take up water allowing precise spacing btw lamellae
|
|
|
what is the major GAG found in the cornea
|
keratin sulfate
|
|
|
GAGs
|
attract water!
|
|
|
role of stroma
|
uniform spacing and lattice arrangement help the stroma be transparent
|
|
|
Descemet's membrane is what
|
the BM of the endothelium
|
|
|
Descemet's is made by which structure
|
endothelium
|
|
|
what 2 structures are resistant to trauma and damage
|
the MEMBRANES
bowmans's descemet's |
|
|
how are bowman's and descemet's membrane different
|
D3 --> descemet's REGENERATES 3X; true BM
bowman's --> BOWS OUT; DOESNT regenerate; not a true BM, just a TRANSITIONAL layer |
|
|
K endothelium is a single layer containing what speacial structure
|
Na/K ATPase pumps
|
|
|
role of Na/K ATPase pump
|
regulate water and ion flow from aqueous to maintain lamellae spacing and hydration of K
|
|
|
what type of jxn is found in enodthelium
|
Macular occludens (spot jxn)
thus it is weak barrier allowing nutrients from AH to enter K |
|
|
do endothelial cells replicate
|
NOPE
|
|
|
what happens to endothelial cells with age
|
cells wear out and neighboring cells change shape (pleo) and size (poly)to help out but this makes matters worse by decreasing pump effectivity and thus inducing stromal swelling
|
|
|
damaged endothelial cells produce
|
clumps of BM that accummulate in Descemet's
|
|
|
clumps of descemet's located centrally are called
|
Corneal Gutata
|
|
|
clumps of BM located in descemet's are called
|
Hassal Henle bodies
|
|
|
how long does it take for epithelium to turnover
|
7 days
|
|
|
which to layers can regenerate in the cornea
|
epithelium
descemet's |
|
|
which 2 layers can not regenerate in the cornea
|
bowman's
endothelium |
|
|
can K stromal cells be replaced if damaged
|
yes but will SCAR
|
|
|
neurotrophic keratitis
|
lack of nerve sensation leading to delayed K regeneration
|
|
|
vascularature supply of cornea
|
avascular, no bv in cornea
|
|
|
how does cornea get blood supply
|
diffusion from aqueous
limbal and episcleral bv |
|
|
what nerves innervate cornea
|
V1
|
|
|
at which layer does V1 enter cornea
|
midstroma
|
|
|
when V1 first enters stroma how are the nerves
|
MYELINATED
|
|
|
inside cornea what happens to V1 nerves
|
become UNMYELINATED
|
|
|
once V1 enters stroma where does it go from here
|
the UNMYLEINATED nerves go up into bowman's and epithelium
|
|
|
which layers of the cornea lack n innervation
|
descemet's
endothelium |
|
|
why are the 1st 3 layers of the cornea so sensitive
|
because they are UNMEYLINATED thus naked more exposed thus more sensitive
|
|
|
what is the sclera
|
outer posterior protective CT layer of eye
|
|
|
name the layers of sclera from outer to inner
|
episclera
stroma inner lamina fusca |
|
|
fxn of sclera
|
attachment site for EOMS
|
|
|
where is the sclera thinnest and how thin
|
.3mm
under rectus tendon |
|
|
where is the sclera weakest
|
lamina cribosa posteriorly
|
|
|
where is he sclera thickest and how much
|
1mm
posterior pole |
|
|
what layer is of sclera is continous with suprachoroidal layer
|
lamina fusca
|
|
|
blood supply of sclera
|
AVASCULAR
but some branches of LPCA, episcleral, choroidal vessels |
|
|
scleral nerve supply
|
LPCN
SPCN |
|
|
episclera is what layer and contains what
|
anterior/outer layer
contains capillaries from ACA that surround cornea |
|
|
episcleritis
|
inflammation if CB or iris causes dilation of ACA thereby causing FLUSHING
|
|
|
sclera stroma
|
thick dense CT continous with K CT
|
|
|
sclera stroma architecture
|
RANDOM and IRREGULAR collagen bundles provide strength
less GAGS and fibroblasts |
|
|
compared to the cornea the sclera is
|
DEHYDRATED bc less GAGs
|
|
|
lamina fusca
|
thin dark inner layer filled with melanocytes
inside of the choroid |
|
|
color of sclera
|
white
|
|
|
osteogenesis imperfecta and Ehlers Danlos - CT disorder that does what to sclera
what does liver problems do to color of sclera |
makes it blue
makes it yellow |
|
|
where does the cornea enter the sclera
|
anterior scleral foramen
|
|
|
what is tenon's capsule
|
thin CT sheet that covers globe separating it from retroorbital fat
|
|
|
why is tenon's capsule perforated
|
to allow optic nerve, ciliary vessels, ciliary n, and CTR thru
|
|
|
lamina cribosa
|
scleral tissue with hole that optic nerve passes thru
weakest area of sclear |
|
|
what CT/structure in eye is most likely to be damaged in eye with high IOP
|
lamina cribosa
|
|
|
limbus located
|
1-2mm circular band that encircle cornea
|
|
|
limbus is junction btw what structures
|
cornea & conj AND sclera & cornea
|
|
|
what is the role of the limbus
|
provides nutrition to other structures
passageway for AH drainage |
|
|
Pallisades of Vogt
|
limbal epithelium and limbal stroma that project onto corneal
this is where stem cells originate |
|
|
what changes occur at limbu
|
layers of epithelium increase and become but is still SSNKE
collagen arrangement is irregular bowman's and descemet's terminat conj stroma, episclera, tenon's begin |
|
|
lateral end of descemet's
|
schwalbe's line
|
|
|
average IOP
|
15.5 mm Hg
|
|
|
AC boundaries
|
K endothelium, TM, SS, CB
|
|
|
angle structures from posterior to anterior
|
Iris
CB SS TN SC SL I Can See The Stupid Line |
|
|
scleral spur
|
circular band of collagen
anchors TM sheets and longitudinal CM |
|
|
TM
|
lines circumferance of AC
beginning site of aqueous filtration looks like triangle, apex at SL and base at SS |
|
|
2 divisions of TM
|
corneoscleral meshwork
JXT |
|
|
corneoscleral meshowrk
|
lies closer to AC
sheets run from K to SS |
|
|
JXT
|
lies closer to SC
most resistance to AH outflow |
|
|
where is resistance to AH outflow highest
|
JXT
|
|
|
SC
|
circular venous channel lined by endothelial cells
inner = against SS and TM outer = against limbal sclera |
|
|
IOP must be ___ compared to venous pressure to enetr SC
|
higher than venous pressure
|
|
|
AH outflow
|
TM - SC - external collector channels - deep scleral plexus -- intrascleral v -- episcleral v -- ACV -- Muscular v - SOV/IOV -- cavernous sinus - heart
|
|
|
what drains SC
|
episcleral veins
|
|
|
SL
|
lateral end of descemet;s membrane
outer limit of cornea at limbus |
|
|
why is episcleral venous pressure high
|
so that aqueous can get inside SC
|
|
|
what type of gradient does AH use
|
high to low
|
|
|
is IOP high or low compared to venous pressure
|
IOP is high
venous pressure is low |
|
|
IOP wants to go where
|
from high to low pressure
IOP --> veins |
|
|
iris divides the eye into
|
AC and PC
cornea and iris = AC iris and lens = PC |
|
|
what does pupil do
|
limit light into eye
|
|
|
where is iris thickest
|
collarette
|
|
|
where is iris thinnest
|
iris root
|
|
|
what is the collarette
|
site of attachment for fetal pupil membrane during development
near pupil margin |
|
|
what does collarette divide iris into
|
pupil vs ciliary zones
|
|
|
4 layers of iris
ant - post |
anterior border layer
stroma anterior epithelium and dilator posterior pigmented epithelium |
|
|
what provides the color of iris
|
anterior border layer
|
|
|
what determines eye color
|
number of melanoCYTES in anterior border layer
|
|
|
name 2 cells found in ABL
|
melanocytes
fibroblasts |
|
|
collagen columns that serves as passageway for aqueous to enter stromal gives rough appearance to iris
|
crypts
|
|
|
loose collagen network continous with CB stroma
|
iris stroma
|
|
|
what 3 important things are found in stroma
|
nerves and bv
sphincter pigment cells |
|
|
what innervates iris
|
LCN
SCN |
|
|
iris capillaries are what
|
non fenestrated
|
|
|
does iris vessels contrivute to blood aqueous barrier
|
yes because nonfenestrated
|
|
|
blood supply to iris
|
long anterior ciliary a
ACA |
|
|
where is MAC located
|
CB
|
|
|
what does MAC supply
|
iris and CB
|
|
|
where is minor AC located
|
iris stroma
|
|
|
in what layer is sphincter located
|
stroma
|
|
|
what innervates sphincter
|
SCN of CN 3
|
|
|
what type of muscle is sphincter
|
circular
|
|
|
what does sphincter do
|
constrict pupils
|
|
|
where is anterior iris epi located
|
under stroma
|
|
|
what does the anterior iris epithelium become
|
dilator m
|
|
|
dilator muscle is
|
radial
symp innervated |
|
|
what is the most pigmented part of iris
|
posterior pigmented epithelium
|
|
|
what does the posterior pigmented epi become
|
non pigmented epi of CB
|
|
|
pupillary ruff is made from
|
posterior pigmented epi of iris that curls anteriorly
|
|
|
posterior synchiae
|
posterior iris stuck to anterior lens causes pupil block
|
|
|
peripheral anterior synchiae
|
anterior iris to corneal endothelium or TM
|
|
|
pigment from pigment dispersion syndrome comes from what
|
posterior pigmented epi of iris
|
|
|
what does the CB bound
|
looks like triangle
touches: ora scleral spur PC |
|
|
what does the CB do
|
has the CM for acc
makes AH via NPCE |
|
|
wide anterior region of CB that has ciliary processes
|
pars plicata
|
|
|
what makes aqueous
|
the NPCE of the pars plicata
|
|
|
regions btw ciliary processes
|
valley of kuhnt
|
|
|
flat posterior portion of CB where lens fibers located
|
pars plama
|
|
|
where does pars plan extend to
|
ora to pars plicata
|
|
|
where does CB begin
|
ora
|
|
|
retinal extensions onto pars plana
|
dentate processes
|
|
|
areas of pars plana btw dentate processes
|
oral bays
|
|
|
layers of CB post-ant
|
supracilliaris
CM Stroma epithelium |
|
|
outermost layer of CB continious with suprachoroid
|
supracilliaris
|
|
|
supracilliaris contains what
|
loose CT collagen
|
|
|
smooth muscle of accommodation
|
CM
|
|
|
what innervates CM
|
Para and symp
|
|
|
what does the CM use as an anchor
|
scleral spur
|
|
|
longitudinal fiber of CM
|
most CM fibers
extends into choroid |
|
|
radial fiber of CM
|
ends at ciliary processes
|
|
|
circular fiber of CM
|
least
aka MULLER"S muscle lies closest to lens |
|
|
what happens during accommodation
|
diameter decreases
radius decreases increase curvature of lens lens zonules relax |
|
|
what happens to IOP during acc
|
decreased because the CM pulls on scleral spur which pulls on TM and opens up pores
|
|
|
ciliary stroma has 2 regions what are they continous with
|
anterior = iris stroma
posterior = choroid stroma |
|
|
is the ciliary stroma vascularized
|
yes very
|
|
|
is MAC fenestrated
|
yes this how AH enters blood
|
|
|
how does AH enter blood
|
MAC
|
|
|
pigmented ciliary epithelium is outer or inner
|
outer close to stroma
|
|
|
NPCE is inner or outer
|
inner closer to PC
|
|
|
what makes AH
|
NPCE
|
|
|
pigmented ciliary epi is cont with what
|
anterior iris epi
RPE Bruch's |
|
|
NPCE is cont with what
|
posterior iris epi
ora eventually becomes neural retina |
|
|
where is choroid located
|
btw sclera and RPE
|
|
|
where does choroid extend to
|
ora to ON
|
|
|
where is choroid thickest
|
posterior pole (.2mm)
|
|
|
where is choroid thinnest
|
ora (.1mm)
|
|
|
how many layers does choroid have
|
4
|
|
|
are all the layers of the choroid vascularied
|
no
2 yes 2 no |
|
|
layers of choroid post-ant
|
suprachoroid lamina
stroma choriocapillaris bruch's |
|
|
space btw sclera and bv of choroid
|
suprachoroid lamina
|
|
|
what enters the suprachoroid lamina
|
LPCA
LPCN |
|
|
loose CT with bv, nerves, and melanin
|
choroid stroma
|
|
|
how many layers does the choroid stroma have
|
2
|
|
|
what forms the 2 layers of the choroidal stroma
|
SPCA separates them
|
|
|
2 layers of the choroidal stroma
|
haller's
sattler's |
|
|
posterior to anterior stromal layer
|
H before S
|
|
|
which layer has larger vessels
|
Hallers - HUGE
|
|
|
haller's form what
|
sattler's
|
|
|
which layer has small vessels
|
Satllers- SMALL
|
|
|
vortex veins do what
|
drain the choroid
come from Satllers |
|
|
why are vortex veins unique
|
no valves
|
|
|
what innervates choroid
|
para and symp
|
|
|
symp innervation does what to choroidal bv
|
constriction
|
|
|
where is melanin found in choroid
|
stroma
|
|
|
why do choroidal melanomas form
|
because choroidal is highly vascular and has a lot of melanin
|
|
|
primary intraocular tumor
|
choroidal melanoma because it pushes thru vortex vein to come into eye
|
|
|
choriocapillaris
|
capillary bed with lots of fenestrations highly concentrated around macula
|
|
|
what does choriocapillaris supply
|
outer retina
|
|
|
Choriocapillaris are damaged by
|
DM
|
|
|
bruch's
|
innermost layer of choroid
runs from ON to CB fusion of choriocapillaris and RPE |
|
|
why are breaks in bruch's bad
|
fusion btw choroid and RPE
angiod streak in bruchs can lead to RD retinal detachments!!! |
|
|
how many layers does bruchs have
|
5
|
|
|
layers of bruchs
|
BM of choriocapillaris
outer collagen elastic layer inner collagen BM of rpe |
|
|
what makes up the core of bruchs
|
collagen
|
|
|
pseudoxanthoma elasticu, damages what and causes what
|
CT
causes angiod streaks in bruch's |
|
|
what supplies choroid
|
SPCA for choriocapillaris
LPCA for anterior choroid |
|
|
what innervates choroid
|
LCN
SCN |
|
|
boundary of PC
|
posterior iris, anterior vitreous, CB
|
|
|
canal of hannover
|
contain zonules
PC |
|
|
canal of petit
|
pc
from vitreous to zonules |
|
|
P comes before H
|
Petit, Hannover
|
|
|
vitreous chamber
|
4ml out of 5ml
large spherical |
|
|
bowl like depression of vitreous
|
patellar fossa
|
|
|
what are the main components of vitreous
|
collagen
HA |
|
|
what do collagen and HA do
|
keeps the vitreous gel like
|
|
|
breakdown of HA
|
floaters
|
|
|
strongest attachment of vitreous to ora
|
vitreous base
|
|
|
Weiger's ligament
|
where vit attaches to lens
|
|
|
are btw weigers and lens
|
berger's space
|
|
|
weakest attachment of vitreous
|
retinal vessels
vitreous goes thru ILM to attach to retinal vessels |
|
|
list vitreal attachments from strong to weak mneumonic
|
VPOMR
very pearly oyster made round |
|
|
strong to weak vit attachments
|
vitreous base
posterior lens optic disc macula retinal vessels |
|
|
vitreous cortex lies where and contains what
|
lies next to retina; consists of anterior hyaloid and posterior hyaloid
contains collagen, cells, protein, muco-polysaccharides |
|
|
where is anterior hyaloid located
|
located anteriror to vit base
|
|
|
where is posterior hyaloid located
|
posterior to vit base goes around back of eye
|
|
|
cloquet's canal
|
where hyaloid artery was located
|
|
|
hyaloid artery
|
nourished the lens during development
|
|
|
mittendorf's dot
|
small dot on posterior lens where hyaloid was once attached
|
|
|
bergmiester's papillae
|
small dot on optic disc where hyaloid artery was once attached
|
|
|
where is lens located
|
btw iris and vitreous
|
|
|
what does iris divide eye into
|
AC
VC |
|
|
what is thickest BM in the body
|
lens capsule
|
|
|
what are the lens zonules formed from
|
embryonically from tertiary vitreous
|
|
|
describe lens capsule
|
acellular
elastic transparent1 |
|
|
where is lens capsule thickest
|
anteriorly mid peripheral
|
|
|
where is lens capsule thinnest
|
posteriorly
|
|
|
describe lens epithelium
|
single layer cuboidal epi
lots of organelles gap jxns |
|
|
what part of lens epithelium is not found in adults
|
posterior lens epi
|
|
|
what forms the embryonic nucleus
|
posterior lens epithelium that turn into primary lens fiber and go up thru anterior epi
|
|
|
what fibers form embryonic nucleus
|
primary
|
|
|
all growth after dev of embryonic nucleus is due to what fibers
|
secondary
|
|
|
which lens fibers contain nucleus and organelles
|
the young ones
|
|
|
anterior lens epithelium are what fibers
|
secondary
|
|
|
anterior lens fibers form what from what
|
from secondary fibers form:
adult nucleus fetal nucleus juvenile nucleus lens cortex |
|
|
adult nucleus contains what
|
secondary (anterior) from after birth to puberty
|
|
|
lens cortex
|
secondary (anterior) from after puberty on
|
|
|
summary
|
PLE -- primary lens fibers -- embryonic nucleus
ALE-- secondary lens fibers -- fetal nucleus, adult nucleus, cortex... |
|
|
erect Y suture and inverted Y suture come from
|
secondary lens fiber
|
|
|
y sutures denote what
|
boundaries of fetal nucleus
|
|
|
what nucleus contains no sutures
|
embryonic
|
|
|
what fibers contribute to no sutures
|
primary (PLE)
|
|
|
where are the sutures located
|
fetal nucleus
|
|
|
erect Y sutures are found where
|
anterior fetal nucleus
|
|
|
inverted Y sutures are found where
|
posterior fetal nucleus
|
|
|
3 layers of eye
|
fibrous outer layer - cornea and sclera
vascular inner layer - iris, CB, choroid inner neural layer - retina, RPE |
|
|
inner tunic of eye
|
retina
|
|
|
fxn of retina
|
transform light into chemical energy
|
|
|
what is retina derived from
|
neural ectoderm
|
|
|
retina extends from
|
optic disc to ora
|
|
|
space btw RPE and neural retina
|
subretinal space
|
|
|
layers of the retina going from deep to superficial
|
Retinal Layers (deep-superficial)
In New Generation Its Only Optometrist Examines Patients Retina ILM, NFL, GC, INL, ONL, OPL, ELM, PR, RPE |
|
|
single layer of pigmented cells derived from outer layer of optic cup
|
RPE
|
|
|
describe RPE cells
|
highly active
lots of organelles melanocyted lipofuscin for phagocytosis |
|
|
Basal side of RPE attaches to
|
bruch's membrane
|
|
|
apical side of RPE attaches to
|
retina
|
|
|
where are RD likely to occur
|
btw RPE and retina
|
|
|
which attachment of RPE is strongest
|
attachment to bruchs
|
|
|
which attachment of RPE is weakest
|
attachment to retina
|
|
|
what are the 2 types of PR
|
cones
rods |
|
|
what do PR do
|
change light energy into chemical energy
|
|
|
what part of PR absorbs light
|
photopigment
|
|
|
how many rods are there
|
120 million
|
|
|
how many cones are there
|
6-8 million
|
|
|
outer segment of PR does what
|
makes the discs that hold the photopigment
|
|
|
what is the photopigment of rods called
|
rhodopsin
|
|
|
what is the photopigment of cones called
|
iodopsin
3 types all 11-cis = blue, green, red |
|
|
what does the inner segment do
|
makes the photopigments
|
|
|
what do the discs made in the outer segment do
|
house the photopigments
|
|
|
once photopigments are made in ____ they are taken to ___ to be incorporated into ____
|
inner seg
outer seg discs |
|
|
2 regions of inner segment are called
|
myoid
ellipsoid |
|
|
where is the myoid located
what does it do |
inner layer of inner seg
location of protein synthesis thus has rER and golgi |
|
|
where is the ellipsoid located
what does it do |
outer layer of inner seg
e for energy thus lots of mitochondria |
|
|
rods are used for
|
scotopic vision
|
|
|
cones are used for
|
photopic vision
|
|
|
which PR are used for color vision
|
cones
|
|
|
max scotopic sensitivity
|
507nm
|
|
|
max photopic sensitivity
|
555nm
|
|
|
where is the density of rods greatest
|
5mm away from fovea
|
|
|
where is the density of cones greatest
|
at fovea
|
|
|
where are there the fewest cones
|
in the periphery
|
|
|
within 1 degree of fovea what PR are there
|
red and green cones only
no rods or blue cones |
|
|
the fovea is ___ to optic nerve
|
temporal and inferior
|
|
|
external limiting membrane
|
not a true membrane
contains no cells |
|
|
role of ELM
|
structural
acts as barrier for large metabolites |
|
|
ONL
|
contains PR cell bodies
|
|
|
OPL
|
where rods and cones synapse with horizontal and bipolar cells
|
|
|
where do synapses occur in rods
|
spherule
|
|
|
where do synapses occur in cones
|
pedicles
|
|
|
which is larger spherules or pedicles
|
pedicles
|
|
|
which is the only type of bipolar cells rod synapse with
|
ROD BIPOLAR CELLS
|
|
|
where does the first synapse in visual pathway occur
|
OPL
|
|
|
inner nuclear layer
|
cell bodies of:
horizontal cells bipolar cells amacrine cells muller cells interplexiform cells |
|
|
what happens at the INL
|
horizontal cells go down towards RPE from here
amacrine and IPC go up towards vitreous from here |
|
|
what do horizontal cells synapse with
|
PR, Bipolars, Horizontal cells
|
|
|
what do horizontal cells do
|
lateral inhibition
|
|
|
what is lateral inhibition
|
modification of info that reaches bipolar cells performed by horizontal cells
|
|
|
IPL
|
synapse btw 1st and 2nd order neurons in visual pathway
|
|
|
what synapses occur in IPL
|
ganglion with bipolar
modified by amacrine cells providing temporal input and increased resolution |
|
|
what can amacrine cells synapse with
|
bipolars
ganglion cell bodies and dendrites amacrine IP cells |
|
|
rule of thumb for amacrine and bipolar cells effects on ganglion cells
|
they have the opp effect
bipolar increase stimulation of GC amacrines decrease stimulation of GC |
|
|
ganglion cell layer
|
ganglion cell bodies
|
|
|
how many axons do GC have
|
1
|
|
|
where can GC axo termintae
|
LGN or midbrain
|
|
|
most common GC that extends to parvolayer of LGN; has 1 dendrite, common in fovea
|
Midget P1 GC
|
|
|
ganglion cells with branced dendrites that extends to parvolayer of LGN
|
midget P2 GC
|
|
|
m type ganglion cell that projects to magnocellular layer of LGN, jas many dendrites, located in perpiphery
|
diffuse ganglion cells
|
|
|
midget GC synapse with
|
midget bipolar cell
1:1 |
|
|
NFL
|
GC axons, form optic nerve
|
|
|
where is the NFL thickest
|
at ONH
|
|
|
where do GC axons enter optic nerve
|
ONH
|
|
|
where is NFL thinnest
|
macula
|
|
|
NFL fibers that extend from macula to disc
|
papillomacular bundle
|
|
|
ILM
|
innermost boundary of retina made up of footplates of Muller's cells
|
|
|
where are Muller's cells at
|
macula
|
|
|
where are astrocytes at
|
optic disc
|
|
|
what is ILM cont with
|
ILM of CB
|
|
|
the optic nerve is like what
|
a bottleneck thru which all visual info must past
|
|
|
cells that provide nutrients to retina; located in ELM to ILM with cell bodies in INL and some in GL
|
Mullers
|
|
|
phagocytic cells that respond to inflammation or injury found anywhere in retina
|
microglial cells
|
|
|
fibrous cells providing structure to nerve fibers and capillaries
|
astrocytes
|
|
|
name 3 neuroglial cells
|
Mullers
microglial astrocytes |
|
|
role of neuroglia
|
structure
support protection |
|
|
outer retina receives blood from
|
choroid
|
|
|
inner retina receives blood from
|
CRA
|
|
|
where does the CRA vessels travel thry
|
INL and NFL
|
|
|
nourishes macula and found in 15-20% of population
|
cilioretinal a
|
|
|
cilioretinal a comes from
|
choroid
|
|
|
why is cilioretinal a special
|
because in CRAO it allows macula to be sparred
|
|
|
what does the macula look like
|
small darkly pigmented
|
|
|
where is the macula located
|
posterior pole
|
|
|
what is the purpose of macula
|
central vision - color and detail
|
|
|
size of macula
|
5.5mm
|
|
|
regions of macula
|
fovea, parafovea, perifovea
|
|
|
depression in center of macula formed by laterally displaced retinal cells, contains cones
|
fovea
|
|
|
width of forvea
|
1.5mm
|
|
|
the center of fovea is what
|
avascular
|
|
|
center of fovea diameter
|
.40-.50mm
|
|
|
purpose of FAZ
|
minimal light scattering
|
|
|
what is the center of fovea
|
foveola
|
|
|
diameter of foveola
|
.35mm
|
|
|
whats located in foveola
|
1:1 cones:GC
|
|
|
highest concentration of cones
|
foveola
|
|
|
which layers are found in foveola
|
rpe,pr, elm, onl,henles, ilm
|
|
|
Henle's layer contains
|
PR axons
|
|
|
Henle's layer is also known as
|
OPL within macula
|
|
|
what provides the FAZ
|
choriocapillaris via SPCA
|
|
|
zone surrounding forvea containing all retinal layers
|
parafovea
|
|
|
diameter of parafovea
|
.5mm
|
|
|
surrounds parafovea
|
perifovea
|
|
|
diameter of perifovea
|
1.5mm
|
|
|
what happens at perifovea
|
rods are most dense here
begins where GC is 4 layers and ends when GC is 1 layers |
|
|
optic nerve is made up of
|
GC axons
|
|
|
where do GC axons travel to
|
midbrain
LGN superior colliculus |
|
|
can the ON regenerate
|
no
|
|
|
ON is myelinated at
|
after lc
|
|
|
ON is unmyelinated at
|
before lamina cribosa
|
|
|
cells that provide myelin to ON
|
oligodendrites from CNS
|
|
|
cells that provide structural support to ON
|
astrocytes
|
|
|
does ON contain Schwann cells
|
no
|
|
|
what surrounds ON
|
pia
arachnoid dura |
|
|
subarachnoid space is continous with the intracrainal subarachnoid space and contains
|
CSF
|
|
|
where does ophthalmic a enter
|
optic canal w/i dural sheath
|
|
|
where does the optic nerve enter the eye
|
sclera and choroid
|
|
|
prelaminar
|
ON anterior to lamina
|
|
|
are prelaminar part of ON myelinated
|
no but are supported by astrocytes
|
|
|
sieve like area of sclera where GC leaves globe
|
lamina cribosa
|
|
|
postlaminar
|
optic nerve posterior to lamina
|
|
|
is postlaminar part of ON myelinated
|
yes
|
|
|
transition btw retina and CB located .5mm anterior to equator
|
ora
|
|
|
where is the optic disc located
|
nasal retina
|
|
|
where is the optic disc larger
|
vertically (1.88mm) than horizontally (1.76mm)
|
|
|
what is the optic disc
|
blind spot
|
|
|
what is the optic disc devoid of
|
photoreceptors
|
|
|
how many degrees from fixation is optic disc located
|
15
|
|
|
what type of neuroglial cells does the optic disc contain
|
axons and glial cells for support
no Mullers |
|
|
thin layer of astrocytes covering ONH
|
ILM of Elsching
|
|
|
blood supply to optic disc
|
Circle of Zinn
|
|
|
why can elevated intracranial pressure affect ON
|
becuase the subarachnoid space of ON is cont with that of cranium
|
|
|
space occupying mass that cause build up of intracranial pressure causing CSF to be pushed against optic disc resulting in blurry disc margins
|
papilledema
|
|
|
ON fibers can go to which 3 places
|
superior colliculus
visual fibers to LGN to go to V1 pretectal nucleus |
|
|
superior colliculus
|
saccades
|
|
|
LGN
|
goes to striate cortex (v1)
|
|
|
pretectal nucleus
|
pupils
|
|
|
papillomacular bundle comes from
|
macula
|
|
|
fibers that enter disc temporally
|
papillomacular bundle
|
|
|
fibers that enter disc nasally
|
nasal fibers
|
|
|
fibers that enter disc superiorly
|
superior fibers
|
|
|
fibers that enter disc inferiorly
|
inferior fibers
|
|
|
what fibers cross at chiasm
|
nasal fibers
|
|
|
anterior knee of willbrand
|
where IN fibers loop into optic tract of contralateral side before crossing
|
|
|
posterior knee of willbrand
|
where SN fibers loop into optic tract of ipsilateral side before crossing
|
|
|
Mneumonic for anterior knee of willbrand
|
AW, INC
Anterior knee of Willbrand inferior nasal contralateral |
|
|
mnuemonic for posterior knee of willbrand
|
SNIP
posterior superior nasal ipsi |
|
|
what surround the optic chiasm
|
CSF
meminges |
|
|
what lies inside chiasm
|
circle of willis
|
|
|
what lies anterior to chiasm
|
anterior cerebral a
anterior communicating a from circle of willis |
|
|
what lies superior to chiasm
|
floor of 3rd ventricle
|
|
|
what lies inferior to chiasm
|
pituitary
|
|
|
what lies on each lateral side of chiasm
|
ICA
posterior communicating a |
|
|
what is the optic tract
|
group of fibers that travel from chiasm to LGN
|
|
|
what does the optic tract contain
|
crossed and uncrossed fibers OU
superior, inferior, macular |
|
|
where do macular fibers not run in optic tract
|
middle
|
|
|
right optic tract contains what superior fibers
|
right ST
left SN |
|
|
right optic tract contains what inferior fibers
|
right IT
left IN |
|
|
left optic tract contains what superior fibers
|
left ST
right SN |
|
|
left optic tract contains what inferior fibers
|
left IT
right IN |
|
|
superior fibers travel on what side of optic tract
|
medially
|
|
|
course laterally thru optic tract
|
inferior fibers
|
|
|
course in middle of optic tract
|
macular
|
|
|
where is the LGN located
|
dorsal lateral side of thalamus
|
|
|
role of LGN
|
processesing and relay center
|
|
|
how many layers dose LGN contain
|
6
|
|
|
each layer receives input from
|
one eye
|
|
|
magnocellular layers of LGN
|
1 and 2
|
|
|
parvocellular layers of LGN
|
3-6
|
|
|
object located on right side of each eye will cause LGN on what side of brain to respond
|
left
opposites |
|
|
which receive contralateral fibers
|
1, 4, 6
nasal |
|
|
which layers recive ipsilateral fibers
|
2, 3, 5
temporal |
|
|
optic radiations
|
travel from LGN to V1
|
|
|
inferior radiations
|
inferior retinal fibers that travel to V1 indirectly
|
|
|
temporal fibers always remain
|
ipsilateral
|
|
|
superior radiations
|
superior retinal fibers from medial aspect of LGN that course directly to V1
|
|
|
blood supply of optic radiations
|
middle cerebral a
anterior choroidal a |
|
|
V1 aka
|
striate cortex
broadmann area 17 V1 |
|
|
V1 fxn
|
takes info from LGN and analyzes it taking info about contour and bv before sending it to higher enters
|
|
|
located on lateral aspect of occipital cortex, higher area
|
broadman area 18, 19
|
|
|
receives input from V1 and fibers that exit posterior optic tract; controls saccades, visual orientation, foveation, but not involved in perception
|
superior colliculus
|
|
|
recives info soley from V1 located in frontal lobe and controls conjugate eye movements, pupil response for near objects and vol and reflex eye movements
|
frontal eye fields
|
|
|
where is V1 located
|
parieto-occipital
|
|
|
posterior anterior division of visual cortex within occipital lobe
|
calcarine fissure
|
|
|
where do macular fibers project
|
superficial surface of occipital lobe
|
|
|
what does the calcarine fissure divide the internal posterior portion of the occipital lobe into
|
cuneus gyrus
lingual gyrus |
|
|
superior portion of occipital lobe where superior retinal fibers terminate
|
cunues gyrus
|
|
|
inferior portion of occipital lobe where inferior retinal fibers terminate
|
lingual gyris
|
|
|
inferior retinal fibers course --- to become ___ before ending at ____
|
Laterally
myer's Loop Lingual gyrus inferior = equals = Low = LLL |
|
|
macular fibers make up what % of V1
|
50%
|
|
|
superior macular fibers project to
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cuneus gyrus
|
|
|
inferior macular fibers project to
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lingual gyrus
|
|
|
what supplies V1
|
posterior cerebral a * main
middle cerebral a |
|
|
post chiasmal lesions cause
|
homonomyous VF defects
|
|
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homonymous
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same side of VF affected in both eye
ex. right side of right eye right side of left eye |
|
|
the more congrous the defect the more ___ the post chiasmal lesion
|
posterior
bc fibers become closer together more posteriorly thus damaged together |
|
|
congrous
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how similar the homo defect is btw the 2 eyes
|
|
|
lesions of what lobe cause congrous VF defects
|
occipital lobe
|
|
|
incongrous
|
homo defects that are not similar in appears
|
|
|
temporal lobe lesions cause what type of VF lesions
|
superior
Pie in the Sky |
|
|
temporal lobe damage affects what fibers
|
inferior retinal fibers in myers loop
|
|
|
parietal lobe lesions cause what type of VF defect
|
inferior
pie on the floor |
|
|
parietal lobe damage affects what fibers
|
superior retinal fibers
|
|
|
macular sparing homo hemianopsia
|
due to stroke affecting either middle or posterior cerebral a but not both
|
|
|
macular involving homo hemi
|
tumor compressing middle and posterior cerebral a to macula
|
|
|
for VA to be reduced what two blood supply to macula must be cut off
|
middle and posterior cerebral a
|
|
|
optic chiasm lesions cause what VF defects
|
bitemporal hemianopsias
junctional scotoma |
|
|
bitemporal hemi
|
pituitary tumor compressing nasal fibers of both eyes
|
|
|
junctional scotomas
|
lesion of chiasm and nerve
loss of central vision in one eye and loss of inferior nasal fibers of the other; eye with lesion behind it loses vision and other gets minimal damage because the anterior knee loops up into lesion |
|
|
VF defects respecting horizontal are located where
|
anterior to chiasm
|
|
|
VF defects respecting vertical are located
|
posterior to chiasm
|
|
|
strokes are the most common cause of
|
post chiasmal VF defects
90% homo hemi are due to strokes |
|
|
what type of homo hemi do strokes not cause
|
macular involving homo hemi
|
|
|
ON lesions
|
asymetric VF loss
respect horizontal bilateral but not congrous APD if large and monocular loss respects nerve fiber bundles: papillomacular, arcuate, nasal fibers |
|
|
retinal lesions
|
asymetric btw eyes
do not respect horiz or vertical bilateral, not congrous |
