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251 Cards in this Set

  • Front
  • Back
What are the functions of the tears?
1. Optical
2. Protective
3. Lubricative
4. Osmotic
5. Nutritional
How do the tears perform an optical function?
The tear film is spread by the eyelids over a rough surface to for a uniform smooth surface for refraction of light onto the retina
What are the three types protective functions the tears perform?
1. Mechanical-Wash debris and metabolical waste from the surface
2. Antiomicrobial-Contain Bacteriostatic substances as well as antiviral, immunoglobulins and complement as well as mucus
3. Environmental-protects from desiccation, bright light, extreme cold, mechalical stimulation and chemicals.
What are the bacteriostatic substances found in the eye?
lysozyme, lactoferrin and beta lysin
What is the lubricative functions of the tears?
Tears lubricate to allow for the conjuntival and corneal surfaces to slide over each other
What is the osmotic function of tears?
Maintain appropriate corneal hydration levels.
How do the tears perform a nutrional functions?
Oxygen passes through the tears and across the anterior surface of the eye.
What are the three (?) layers of the tears?
Posterior to Anterior: Mucin, Aqueous, and Lipid
What is the source of the Posterior Mucin Layer?
Goblet Cells, Crypts of Henle, Corneal and Conjuntival Epithelial Cells and acinar cells of the main and accessory lacrinmal glands.
Where are goblet cells located?
on the conjuntival epithelium, but not on the cornea. They are most numerous in the superior temporal bulbar region.
Describe the structure of the goblet cells?
They are stratified squamous cells connected by tight juntions with the nucleous displaced towards the bace due to membrane bound mucous packets in secretory granules
How are goblet cells innervated?
Sensory comes from the trigeminal nerve. Also have SNS and PNS innervation.
What happens during the first step of signal transduction?
A NR or other regulatory molecule binds to the plasmalemma receptor.
What are the 3 subunits of a G protein?
Alpha, Beta, Gamma
What molecule binds to the alpha subunit of a G protein? What then occurs?
GTP binds to the alpha subunit and the beta-gamma dissciates. Then the alpha subunit is activated it either activate ir inhibit an effector systems.
What inactivates the activated Alpha Subunit?
GTP is hydrolyzed to GDP.
What is the principal enxymatic effector is beta adrenergic receptor signal transduction?
Adenylyl Cyclase
What does Adenylyl Cyclase do?
catalyzes the conversaion of ATP to cAMP.
What does cAMP do?
Activated protein Kinase A
What is the action of Phospholipace C
It cleavesPhosphatidylonositol bisphosphate(PIP2) to IP3 and DAG
What does cAMP activate?
Protein Kinase A, results in phosphorylation of cellular proteins
What does IP3 do?
Increases Ca outflow from the cell. Also activates Ca dependent kinases.
What does DAG do?
Activated Protein Kinase C
Where are P2Y2 receptors found and what is their function?
respiratory epithelial cells, goblet cells and type II alevolar cells. Stimulation results in salt and water release, hydration of mucus secretions, increase in ciliary beat frequency, and the release of mucin from goblet cells as well as surfactant from alevolar Type II cells.
Descrive the production of Mucous in the Goblet cells
The proetin core is synthesized in the ER, chains of carbs are added in the golgi, then stored in secretory granules and released upon stimulation.
Where are the Crypts of Henle found?
The fornicele Conjunctiva
What type of Mucin do corneal and conjuntival epithelial cells produce?
Mucin that is attached to apircal protion of cells. It is an anchoring mucin.
What are the type of Mucins?
Secreted Mucins and Membrane associated Mucins.
What are the 2 types of secreted mucins?
Gel Forming Mucins, and small soluble mucins.
What type of Mucin in MUC5AC and where is it produced? What is it the mucin of?
a gel forming mucin produced in the conjunctival goblet cells. It is the mucin of lubrication.
What type of Mucin in MUC7
A small soluble secretory mucin.
Where is MUC 7 secreted from?
serous cells such as the lacrimal and the accessory lacrimal galnds.
What are the example of Membrane associated mucins?
What are the functions of Membrane associated mucins?
Anchoring, glycocalyx, disadhesive and regulation of epithelial cell growth.
What amino acids are repeated in the structure of Mucins?
serine and threonine
What type of charge does Mucin have?
IN gel-forming mucous what other amino acid other and serine and threonine is found
What are the functions of the Mucin Layer?
1. Lubrication
2. coat foreign bodies
3. optical by stabilizing the tear film
4. Moisten epithelium
5. Barrier to pathogens
What are the sources of the Central Aqueous Layer?
1. Lacrimal Gland
2. Accessory Lacrimal Glands of Krause and Wolfring
3. Corneal Epithelium
Where is the lacrimal gland located and what are the two portions?
superotemporal to the globe in the orbit, and there is an orbital and palpebral protion
Describe the structure of the lacrimal gland?
A multi-lobed structure with tubles forming and acinus consisting of a ring of secretory cells.
What is the prupose of the myoepithelial cells in the pyramidal secretory cells of the lacrimal gland?
Function to squeeze the tublues and expel collected secretions
What are the tubules of the pyramidal Secretory Cells?
Secretory tubles from acinar cells empty into the intralobar ducts which empty into the interlobular ducts to secretory ducts onto the conunctival surface
What are the afferent pathways of lacrimal glands
Trigeminal, Optics nerve (dazzle refelx of bright light), Facial Nerve, CN IX, X, Cortex and hypothalmus
What is the path of sympathetic innervation to the lacrimal gland?
Superior cervical ganglion follows the internal carotid to the deep petrosal nerve
What is the pathway of the parasympathetic innervation to the lacrimal gland?
Superior salivatory nucleous of VII Ganglion to the nervus intermedius to the greater superficial petrosal to the Vidian nerve to the sphenopalatine ganglion.
What are most of the fivers that innervate the lacrimal Gland? Are all of the cells innervated? why or why not?
Cholinergic contain ach and VIP. They are bnot all innervated because they are connected by gap juntions.
What type of receptors are the postsynaptic cholinergic (PNS) recreptors of the lacrimal gland?
What second messengers are created in PNS stimulation of the lacrimal gland?
IP3 and DAG
What receptors dooes NorEpi from the SNS systems activate
Alpha 1
What is an alternative to the G Protein in the lacrimal Gland
Epidermal Growth Factor-Tyrosine Kinase
When are EGF levels decreased?
Sjorgren syndrome, aging, and refractive surgery
Where are the glands of krause located?
in the subcojunctival tissue of the upper and lower fornices.
Where are the glands of Woldfring located
over the tarsal plate
What is the corneal epithelium innervated by? What does it secrete? what signal transduction pathway does it use?
Water and electrolytes
What are the component of the central aqueous layer
Whater, electrolytes, low molecular weight organics and high molecular weight organics
What electrolytes are found in the central aqueous layer?
sodium, potassium, chloride, bicarb, calcium
What are the low molecular weight organics of the central aqueous layer?
Glucose and Urea
What are the high molecular weight organics of the central aqueous layer?
Proteins, Glycoproteins and Lipids.
What are the sources of the superfical lipid layer?
Meibomian Glands, Glands of Zeis
Where are Meibomian Glands located?
posterior protion of the eyelid embedded in tarsal platE
What type of glands are the glands of Zeis?
Wht type of secretion do the meibomian glands and the glands of zeis undergo?
What is the defintion of secretion?
transfer of lipid from glandular acini to ducts
what is the definition of deliverY/
Transfer from ducts to the lid margin
What is the defintion of excretion?
loss of lipid from preocular tear film onto the skin and eyelashes.
How are the Meibomian glands and the glands of Zeis regulated?
Neurohormonally: PNS, SNS by blood vessels and androgens
How does the lipid level of the ducts vary throughout the day?
Ducts are full in the morning because lipid is not released due to blinking during sleep.
How is thickness of the lipid layer affect in Meibomian Gland dysfunction?
How is the lipid layer affected in chronic blepharitis
What is the outer layer of the lipid layer composed of?
nonpolar lipids such as wax exters, sterol esters and hydrocarbons.
What is the inner layer of the lipid layer composed of?
What is the function of the tear protein lipcalin
Enhances the spreading and stability of the lipid layer as well as decreses the surface tension of the tears.
What is the function of the lipid layer of the tears?
1. Slows evaporation of tears
2. Prevents tears from spilling over the lid
3. prevents contamination of the tear film by sebum
4. seal apposed lid margin during sleep
5. prevents maceration of the lid margin skin by salty tears
6. provides a smooth surface for refraction
7. lowers the surface tension of the tears.
What are the requirements for proper distribution an wetting?
1. Quantity and composition of mucin
2. adeqeuate fluid volume
3.sufficient blink frequency
4. good lid-to cornea apposition
5.quantity and compostion of lipid
How many microliters of tears are on the..
Corneal surface?
Tear Prism?
Corneal Surface: 1 microliter
Cul-de-sac: 3 microliters
Tear Prism: 3 microliters
How much higher is the tear volume in the morning compared to the evening
14 %
What is the tear turnover rate
.1-2.0 microliters/min
What is the time it takes for tear replacement?
5-6 min
What are some was to estimate tear flow in the eye?
Schirmer Strip, Prevention of tear drainage, Fluorescein Dye disapearence, and flow of fluorescein
What are the components of the tear drainage cycle?
The upper lid moves downward and the lower lid moves nasally. Tears move into the punta, then canaliculi, lacrimal sac into the nasolacrimal ducts and exit into the inferior meatus
What is dacryostenosis?
A common condition occuring in 2-4% of newborns in which the extreme end of the nasolacrimal duct underneath the inferior turbinate fails to completle its canalization
What is Infantile Dacryocystitis or Mucocele?
Acute inflammation of the lacrimal sac in the neonatal period. Hemophilus influenza is often the cause of the infection and probing in necessary for drainage
What do the lacrimal drainage passages contain at the start of a blink?
tear fluid frm the previous blink
Once the puncta are closed, what does the remainder of the lid closure act to do?
squeezes the canaliculi in order to force out the reamining fluid
How much fluid in in the drainage system when there is complete lid closure?
When the lids begin to open following complete closure, what acts to create a vacuum in the canaliculi?
Compressive action and the elastic walls of the canliculi attempt to expand to their normal shape causing a partial vacuum or suction within the canaliculi.
What happens when the lids open 2/3 following a blink
the punctal region of the lid margins separate when lid separation is sufficient and fluid enters the puncta and is drawn into the canlaculi.
When gravity acts upon the fluid in the nasolacrimal duct, how was drainage and blink rate affected?
Lacrimal drainage was increased and not correlated with blink rate
What effects does the cavernous body have on tear production
If tear components are not absorbed into the cavernous sinus there is no feedback for tear fluid production and dry eye could be initiated.
How much does evaporation account for tear elimination?
What is capillary action? When is it the greatest?
The surface tension of the post-lens tears. Greatest when the lens surface closely parallels the cornea
What does the center of gravity determine?
the tendency for the lens to drop from the centered postion.
When is the center of gravity lessened?
large over all lenses, negative power, small center of thickness or a steep base curve radius. These all move the radius back.
Where does the tear meniscus occur
a pooling of tears around the contact lens
What improves when the lens design includes a large tear meniscus beneath the lens periphery?
tear meniscus
The amplitude of lens movement in is inversely proportional to what?
the area of the lens and tear viscosity
The amplitide of lens movement is directly proportional to what?
lid force, the time the lids act and the thickness of the tear film
What are the three types of movement of a rigid contact lens
Vertical movement
What is the vertical movement of a rigid contact lens
it parallels the upper lid movement
What causes a rigid contact lens to rotate?
the lower mid moving medially
The osmotic pressure of the tears is determined by what?
What is the equivalent percentage NaCl
What is the osmolality of the tears?
318 mOsm/kg
What does the osmolality of the tear vary throughout the day?
The tears are hypotonic in the morning and increase in osmolality towards the hypertonicity at a rate of 1.43 mOSm/hr
What is keratonconjunctivitis Sicca?
Dry Eye
How is tear osmolality typically effected in patients with dry eye?
In rigid contact lenses adaption, what causes a drop in the concentration of many tear constituents?
reflex tearing
What is a result of the reflex tearing during rigid contact lens adaption?
a 3-4% edema of the cornea
After three days of rigid CL adaption, what happens to the osmolality?
sodium levels return to normal and may even become hypertonic
How does osmolality affect contact lens?
reductions can loosen the lens and increases can tighten the lens also affecting lens rotation
Do males for females have a high tear osmolality?
After males and females increase in age, which has an increase in tear osmolality?
What does pH mean?
the log of 1/[H]
What is the pH of the tears?
What is the pH of opthalmic solutions and why is it different the tear pH
CO2 combines with H20 forming HCO3 and H lowering the pH
What effect do the Meibomian glands of have the pH
more acidic in those areas
What is the pH of the tear in the morning as compared with the afternoon/evening? Whay
lower in the morning due to lactic acid
What effect do CL have on the pH of tears and why?
pH is lower because the cornea is undergoing anaerobic metabolism which produced lactic acid.
What effects do ocular surgeries have on tear pH
What is infant tear pH? why?
6.74 because their eyes have been closed.
What are the buffers of the tears?
Bicarb, ammonium ion, phosphates and proteins
What is the temp of an open eye? Close?
34.5, 36.2
What is the coolest area of the eye
inferior to the geometric center of the cornea
How if the difference in temperature between the limbus and the cornea affected in dry eye patientsq
the different is greater
How does a palpebral size smaller than 7 mm affect the tear temp? blepharospasm?
both increases tear temperature
What is the refractive index of the tears? How do the meibomian glands affects this?
1.33698; increased to 1.46-1.53
What is the defintion of viscosity? What is it measured in and how do increases in lipid and protein effect it?
Resistance to flow, centipose and they increase it.
What is viscosity measured in relation to?
the flow of water
What scale is viscosity measured on?
a scale of 1-5 with 1 being very watyer and 5 being very viscous.
What is hypersecretion of the tears?
excessive production of tears by teh main and accessory lacrimal glands
What are causes of hypersecretion?
psychic stimulation, pns, lacrimal gland, trigemical nerve stimulation, retinal stimulation, faciel nerve stimulation or of central orgin.
What is epiphora?
an overflow of tears into the cheek caused by excessive lacrimation by the obstruction of the lacrimal ducts or ectropiam or other lid abnomalities.
What is the definition of "Dry Eye"
A disorder of the tear film due to tear deficiency or excessive tear evaporation which causes damage to the interpalebral ocular surface and is associated with symptoms of ocular discomfort
What are the five major elements involved in tear film stability?
L-Lipid abnormality
A-Aqueous abnormality
M-Musin Abnormality
B- Base abnormality
S-Surfacing abnormality
When is dry eye referred to as Sjogren's Syndrome?
in the presence of hypergamma-globulinemia, rhematoid arthritis and antinuclear antibody. Usually involved involvement of the salivary glands.
Inflammation cause my Sjogren's Syndrome causes the surface epithelium to lose its ability to do what?
express membrane bound mucin, MUC 1
What aquaproin could be defective in Sjogren's Syndrome?
Describe the Jones I Test
fluroscien is retrived from the nose throat or nasal secretions 5 min after instillation into the eye. if it is not retrived then this indicated a blockage and Jones II will be performed.
What happens in Jones II?
Residula fluorescein is flushed from the eye from the previous Jones I test. Clear saline is instilled into the lacrimal sac after dilation of the punctum. Dye recovery indicated that the upper protion of the was normal. recovery of only saline indicated a blockage of the upper portion prevents dye from entering the lacrimal sac during the jones i
What does the Fluoresceine Dye Disapearence test test for?
Overservation of the rate of dissapearence of a drop of fluorescein from the tear meniscus of the conjunctival sac.
What is the scale for the Fluorescein Dye Disapearence Test?
0-3 with 0 being no fluorescein and 3 being a wide brightly fluorescing tear trip.
What number on the Fluorescein Dye Disapearence test incidcates impairment of flow?
What are the symptoms of dry eye reported in the high frequency?
dryness, gittiness and burning
What is the normal Tear Meniscus Height?
What is the excitation peak of Fluorescein? The emission peak?
490, 515
What are some of the uses of Fluorescein?
TBUT, Jones, assessment of the cornea, forrign body removal, Seidel's Sign, CL fitting, applanation tonometry, Anterior Segment Flurophotmetry, iris angiography, vitreous fluorophotmetry and fluorescein angiography.
What is Seidel's Sign?
The Seidel test is used in evaluating for possible would/aqueous leakage.
What does Flurexon Dye?
dead cells, degenerated cells, mucus.
What does Flurexon not stain hydrogel lens like Fluroscein?
it is twice the size
When is Flurexon used?
in CL fitting especially hybrid lens and piggyback systems.
What does Rose Bengal Dye?
Healthy cells, dead cells
What are some disadvantages to Rose Bengal?
Stains healthy cells and it has intrinsic toxicity
What is the excitation and emission wavelength of Sulforhodamine B?
556(green), 572(orange)
What does Sulforhodamine B Stain?
Corneal Stroma
What can Sulforhodamine B stain better than fluorescein or Rose Bengal?
identifies tear film discontinuities.
What stain can be used as a replacement for rosebengal?
lissamine green
What does lissamine Green stain?
degenerate cells, dead cells and mucus.
What is BUT definaed as?
The interval between the last complete blink and the devlopment of the first randomly distrubuted dry spot in the tear film
What is an abnormal BUT?
less than 10 sec.
How are BUT and blink frequency related?
A person with a high BUT has a low blink frequency and vice versa
What is Non-Invasive Assessment of Tear Film Stability?
Usuing an nstrument with a grid of white lines on a black background. The elapsed time between the last completle blink and the first disconinuity if the NIBUT
What is a normal NIBUT?
greater than 30 seconds
How does Fluorescein affect NIBUT
What is the Tear Thinning Time
The time between the last blink and the distortion of the keratometer more is the TTT
What is a normal TTT
35.5 sec
What indicated hyposecretion in the Schirmer Test?
less than 10 mm after 5 min
What is a normal result for the pehnol thread test? How long is it tested for
less than 10 mm in 15 seconds
What does impression cytomolgy measure?
Determines goblet cell densities
How do goblet cells change in dry eye?
epithelial cells become latger and polygonal rather than small and round
How are lactoferrin and lysozyme levels effects in KCS patients?
What does a reduced tear film turnover do to the osmolalaity of the tears and why?
these tears remain on the eye longer and undergo more evaporation causing the tears to become hyperosmotic
How does sleep effect evaporation?
decreses due to decreased evaporation
What are the four pattern types of the mucus ferning test
Type I-IV, with III and IV becing associated with KCS.
What are lactoferrin and Lysozyme?
Tear proteins
Where are Lactoferrin and lysozume synthesized?
The lacrimal Gland
How are the levels of Lactoferrin and Lysozyme affected in patients with KCS
What is a normal tear lactoferrin value? What is the cut off value?
1.42 g/l
90 mg/l
What is considered the typical tear volume in a patient with dry eye?
4.8 microliters
In KCS patients where is the tear osmolality the greatest?
on the ocular suface and the tear prism as opposed to the cal-de-sac
Wht effects does hyperosmolality have?
reduction in intercellular connections, loss of microplicae, disruptions in cell membranes and cellular swelling as well as cell desquamation and a reduction in goblet cells
What is fluorophotometry?
Instillation of a small amount of fluroscein into the tear film, the fluorophotmeter measures the decrease of tear film fluorescein concentration over time. The clearance of tear film fluorescein, the tear film turnover rate and the amount of tear production are all measured.
How does the tear film turn over rate correlate with circadian rhythm?
the rate is higher in the morning and lower in the afternoon.
How does temperature differ horizantally?
the conjunctival locations are warmer than the limbal positions which are warmer than the center of the cornea.
How would a steep cornea affect temperature different between the limbus and the center of the cornea?
it will be greater
How will a KCS patients temperarture variation change as you move across the surface>
there will be a much greater temperature variation
What is the force acting on a surface of liquid tending to minimize the area of the surface?
Surface Tension
What is the force of static friction between two bodies? The tendency due to intermolecular forces for matter to cling to other matter>
what is the tendency of parts of a body of a like composition to hold together as a result of intermolecular forces (attraction of molecules in a liquid for each other)
what is the angle between the liquid surface and the solid surface?
Contact angle
What is the contact angle an indication of?
Adhesion and Cohesion
What is the ability of any solid surface to be wetted when in contact with a liquid, that is, the surfcae tension of the liquid is reduced so that the liquid spreads over the surface
what is the fluid containing angle between the tangent to the surface of a drop of fluid and the tengent to the optical surface on which it rest as measure at the intersection of the two surfaces?
Wetting Angle
What is the surface tension of tears?
46 dynes/sec
What is the adhesion force of the cornea?
28 Dynes/cm
How does proteins and protein/mucus affect the surface tension?
How does the action of the lids affect surface tension?
What do hyrophilic groups bound to the epithelium do to adhesive forces?
What type of contact angles do hyrdophilic surfaces have?
What is critcal surface tension?
When drops of fluid have a surface tensions before a certain value and form a zero contact angle and will wet the surface
What is advancing contact angle
liquid added to a srop already on a surface advances and covers previously unwetted surfaces
What happens when the mucin layer of the tear film comes into contact with lipids from the lipid layer resulting in the aqueous layer coming into contact with the hyrdrophobic layer of the cornea
Tear Film Rupture
How will a reduction of the aqueous layer affect the flux of lipids to the mucin layer
What is surface tension gradient driven flower?
Marangoni Flow
What is the main electrolyte of the tears?
What are the main electrolytes of the tears?
Sodium, Potassium, Chloride, Bicarb, Calcium and Magnesium
What are the low molecular weight organics of the tears?
Glucose, Urea, Lactate and Amino Acids
How will mechanical irritation and osmotic stimuli affects glucose levels in the tears?
cellular breakdown results in the realease of intracellular glucose increasing levels
How will non-mechanical irritation such as onion vapor affect the glucose levels in the tears?
decrease dur to reflex tearing
Are lactate levels high or lower in the tears than teh rest of the body?
What are the three predominant serum proteins in the tears?
albumin, transferrin and immunoglobulin G
What is the function of transferrin in the tears?
iron transport
What is the function of ceruloplasmin
Transports copper
How are ceruloplasm and IgG in the tears affected with age
Where are IgA's secreted from?
lacrimal gland
Where do IgG's arise from
Ocular Surface Blood Vessels
How is the secretion of regulated proteins such as lactoferrin, lipocalin and lysozyme correlated with the fluid secretion rate?
it increased with increasing fluid secretion rates
What are the three main lacrimal gland proteins?
lactoferrin, lipocalin, and lysozyme
What is the function of lactoferrin?
iron-complexing protein that has antobacterial properties
What is the function of lipocalin?
bind and transports lipid molecules such as vitamin E
What is the function of lysozyme?
Kills Gram + Bacteria
What is the most abundant of the regulated proteins from the lacrimal gland?
What protein levels are elevated with various types of allergic conjunctivitis?
What enzyme is analyzed in for decting carriers of Tay-Sach's Disease, Fabry's disease and fucosidosis?
Lysosomal Acid Hydrolases
What are the functions of the eyelid?
Reduction of Visual Stimuli
Prevention of Xerosis
Corneal Nurtiion
Gas Exchange
What is Xerophthalmia?
Dry eye
Wht BV provide oxygen to the cornea during lid closuer?
palpebral conjunctival blood vessels?
What are the boundries of the eye lid
Eyebrow and cheek
What are the 2 portions of the eye lid?
Orbital and Palpebral
What structures are in the medial canthus?
lacrimal caruncle and the plica semilunaris
What is the function of the muscle of Riolan?
keeps eyelid right up against surface
The tarsal plates are the location of what embedded on the orfice of the lid margin
Meibomian Glands
What nerver carries the sensory information from the eyelid?
What zone of the eye lid has the highest tough sensitivity? the lowest?
marginal, tarsal
What muscles of the eyelid are innervated by the sympathetic nervous system?
superior and inferior tarsal muscles (palpebral muscles of Muller)
In the oculosympathetic pathway, what is the path of the first neuron?
descends from the hypothalmus via the anterolateral columns to the ciliospinal center of Budge and Waller in the intermediolateral column of the spinal cord
What is the oculosympathetic pathway of the second neuron?
the second neuron leaves the ciliospinal center of Budge via the ventral root and white rami communcanted and ascends through the stellate and middle cervical ganglion to synapse in the superior cervical ganglia between the internal carotid arter and the jugular vein.
What is the path of the long ciliary nerves?
The third nerve follows the internal carotid artery, then follows the ophthalmic branch of the trigeminal and run into the nasociliary branch to the globe
Where do postganglionic fiber of the oculosympathic pathway go to?
dilator muscle
ciliary body
ciliary muscle
muscles of muller
lacrimal galnd
sweat glands
blood vessles
Where does motor innervation of the orbicularis oculi come from?
Cranial Nerve VII (Facial)
Where does motor innervation of the LPS come from?
CN III (occulomoter)
What areas of the brain does the information for eyelid elevation arise?
Area 8 alpha, beta delta
How does fatigue affect the eye lids
stimulation of the occulomoter nerve decreases resulting in the drooping of eyelids (from LPS)
What area of the brain in responsilbe for lid closure?
area 4
What will lesions in the precentral motor cortes result in
paralysis of the contralateral facial musculature with sparing of the frontalis
What contains the parasympathetic efferent secrtomotor fibers for the submandibular, sublingual, lacromal glands?
superior salivatory nucleous
What will result from a supranuclear lesion of the facial nerve?
lower portion of the contralateral face will have paralysis while the upper half is spared
What does a nuclear lesion of the facial nerve result in?
all structures supplied by the facial nerve
What is a result of a infranuclear lesion of the facial nerve?
Bell's Palsy
What phenomenon is it when there is ptosis in abdcution and excessive widening of the paplebral aperture in adduction?
Psuedo-Graafe Phenomenon
What phenomenon is it when ptosis is relieved when the jaw is moved away from the affected eye and there is opening and shutting of the eye upon chewing?
Marcus Gunn Phenomenon