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71 Cards in this Set
- Front
- Back
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Medial Orbital Wall Formed by ______ bone Separates orbital contents from ______ sinuses Fossa for _________ located anteriorly _______ attaches superiorly |
Ethmoid Ethmoid sinuses Lacrimal Sac Trochlea |
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Medial Orbital Wall CLINICAL Susceptible to blowout fracture into ______ ______ |
Ethmoid sinus Transverse into medial wall into orbit |
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Lateral ORBIT wall Formed by process of _________ bone Greater wing of ________ bone *_____& _______ walll Separates orbit from ______ and _____ Fossa
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Zygomatic Bone Sphenoid Bone Strongest and thickest wall middle cranial and temporal |
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What is a tripod fracture? |
Fracture at the junction between the zygomatic arch and maxilla lateral orbital wall fracture |
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Superior Orbital Wall Formed by: Separates orbit from _____ ______ fossa What also contributes to the roof posteriorly? |
Orbital part of the frontal bone Anterior Cranial Fossa Lesser wing of sphenoid |
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Inferior Orbital Wall (FLOOR) Formed mainly by the: Thin wall which separates _______ from ______ sinus Which muscles can it entrap in a blow out fracture? |
Maxilla Orbit from Maxillary Sinus Inferior Rectus and Inferior Oblique Muscles |
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Orbital base and Apex Base is located: Anterior or posterior Site of attachment for ______ ______ |
Base: ANTERIOR Site of attachment for orbital Septum |
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Apex Location What enters/exits here? What is located for the muscle attachment? |
APEX LOCATED POSTERIORLY NEUROVASCULATURE-ENTERS/EXITS COMMON TENDINOUS RING |
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Where is the conjunctival sac located and what forms this sac? |
Eyelids Palpebral and Bulbar conjunctiva |
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Orbicularis Oculi -Function -Motor Innervation: Clinical implication |
Function: closes eye lids Motor Innervation: CN VII Clinical Implication: inability to close eyelids CN VII palsy |
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Levator Palpebrae superioris Function Motor Innervation Clinical |
Elevates the superior eyelids CN III Complete ptosis in CNIII palsy |
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Eyelid Tarsi Tissue acts as _________ Superior tarsal muscle attaches to superior _______ |
Dense connective tissue band within posterior aspect of eye lids
Acts as skeleton Superior tarsal muscle attaches to superior tarus |
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Eyelid Glands: Two types
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Ciliary and Tarsal
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Tarsal Glands: Secrete: Function |
Tarsi lipid secretion keep the eyelids from sticking together provides barrier for lacrimal fluid Lubricates edges of eyelids |
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Inflammation of Tarsal Glands |
Chalazion |
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Ciliary Glands ________ glands associated with eyelashes Clinical: _________ - infection of ciliary glands |
Hordeolum (Stye) |
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Orbital Septum Fibrous membrane extending from __________ ______ to ________. Function Clinical |
Orbital margin to tarsus Limit spread of infection Cellulitis- Pre vs. post |
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Lacrimal Gland Location Function: Secrete lacrimal fluid to protect:
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Superolateral part of orbit cornea and conjunctiva |
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Inhibition/ secretion of lacrimal fluid, match with Parasympathetic or Sympathetic List the cranial nerve |
Lacrimal Gland Inhibition: Sympathetics (internal carotid plexus) Lacrimal Gland stimulation: Parasympathetic (CN7) |
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What leads to dry eyes? |
Inflammation in Siogren syndrome |
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Flow of Lacrimal Fluid |
Excretory duct of lacrimal gland conjunctival sac Lacrimal punctae Lacrimal canaliculi Lacrimal sac Nasolacrimal duct Inferior Nasal Meatus |
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Dacryostenosis |
Obstruction of lateral end of Nasolacrimal duct.
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Tissues Surrounding Eyeball _____ capsule surrounds eyeball posteriorly _________ conjunctiva overlies eyeball anteriorly continues with ________- to form _____ sac Does NOT extend over the _______ Clinical: |
Tenon Bulbar continues with Palpebral conjunctiva to form conjunctival sac Does not extend over the cornea Conjunctivitis |
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Layer of Eyeball: Fibrous Inner |
Fibrous: Sclera and Cornea Vasucular: Choronoid, Ciliary Bodies, and Iris Inner : Optic and non-visual retina |
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Fibrous: Sclera Site of attachment for: Clinical: |
Extrinsic/Intrinsic Muscle Jaundice |
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What controls the afferent limb of corneal blink reflex? |
CN5 |
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Cornea is transparent and completely _________ The major _______ medium of eye Innervated by: Clinical: Near Sighted vs. Far Sighted |
avascular refractive CNV-1 Near Sighted: myopia Far Sighted: hyperopia |
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Levator Palpebrae Superioris Proximal Attachment: Distal Attachment: Action: Innervation: Paralysis of this muscle leads to _____ |
Lesser wing of sphenoid Superior Tarus Elevates the upper eyelid Cranial nerve 3 Ptosis |
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Lateral Rectus Muscle Proximal Attachment : Distal Attachment: Action: Innervation |
Common tendinous ring Sclera Abducts Eyeball Cranial Nerve 6 |
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Medial Rectus Muscle Proximal Attachment Distal Attachment Action Innervation May get entrapped with ____ ___ ______ blowout fracture |
Common tendinous ring Sclera adducts eyeball Cranial Nerve 3 Medial Orbital Wall |
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Superior Rectus Muscle Action
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Common tendinous ring sclera Elevates and adducts- INTORSION Innervation: CN3
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Inferior Rectus Muscle Clinical: entrapped with |
Common Tendinous Ring- Sclera Depresses and Adducts the eye EXTORSION innervated by CN3 Entrapped with an orbital floor blowout fracture |
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Superior Oblique Muscle ***** PROXIMAL ATTACHMENT Distal Attachment ACTION Innervation |
PA: Body of Sphenoid, superomedial to tendinous ring...not part of common tendinous ring DA: Tendon passes through trochlea and changes direction. Action: primary medial rotation Depresses and Abducts (Intorsion) Innervation: Cranial Nerve 4
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Inferior Oblique Muscle What is unique about the proximal attachment? Distal Attachment Action Innervation |
PA: Anterior wall of the orbit floor (only muscle to originate anteriorly!!) DA: Sclera Action: Elevate and abduct PRIMARY LATERAL ROTATOR CN III |
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When Head tilts to the left both eyes rotate in ______ direction. Right Eye: Left Eye: |
Tilt Head LEFT Right Eye: Extorts Left Eye: Intorts |
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Tests for Lateral and Medial Rectus Lateral: From primary position have patient follow finger- _______ Medial: From Primary Position have patient follow finger- _________ |
Lateral Rectus Muscle: test with following finger laterally
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Test for Superior Rectus 1st Have patient follow finger: 2nd have patient follow finger: With the eyes abducted, what is one action that only the superior rectus can perform? |
Laterally (Abduct) Up (elevate) With the eye abducted only the superior rectus produces elevation |
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With eyes abducted what is the only muscle to elevate the eyes? |
Superior Rectus Muscle |
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With eyes abducted what is the only muscle that can depress the eye? |
Inferior Rectus Muscle |
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Testing the Inferior Rectus Muscle 1st- patient follow finger __________ 2nd- patient follow finger ________ |
Laterally Inferiorly
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Test for Superior Oblique Muscle 1st patient follow finger _________ 2nd Patient follow finger _________ |
Medially inferiorly |
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With the eye adducted only the _____ muscle produces depression |
Superior Oblique muscle |
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Test for Inferior Oblique Muscle 1st have patient follow finger: 2nd have patient _____ eye |
Medially Elevate |
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What is CN II? What travels within it? Section of the optic nerve would lead to:
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Optic Nerve Central Retinal Vessels travels through the optic canal Monocular Blindness and Afferent Pupillary Defect |
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What is CN III? Provides _______ innervation to all extrinsic muscles EXCEPT what two muscles Nerve Fibers Passes Through _______ ______ Fissure |
Oculomotor Nerve Motor innervation (exception- Lateral Rectus and Superior Oblique) Superior Orbital Fissure |
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Oculomotor Nerve (CNIII) Clinical Implication Affected eye looks ______ and _______ Due to unopposed pull of ________ and ______ muscle Ptosis _____ pupil |
DOWN AND OUT (Eye abducts and depresses) Lateral rectus Muscle and Superior Oblique muscle Dilated Pupil |
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What is CN IV? Passes through: Innervates __________ Muscle
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Trochlear Nerve Superior Orbital Fissure Superior Oblique Muscles |
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CN IV CLINICAL IMPLICATION IN CN IV Palsy- patient tilts head in which direction? Patient cannot ______ the eye in _____ Position |
CNIV Palsy: patient tilts the head away from the affected side
Patient cannot depress the eye in adduction position |
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What is Cranial Nerve VI? Passes through: Innervates: Clinical: How will patient present? Due to unopposed pull of: |
Abducent Nerve Superior Orbital Fissure Lateral Rectus Muscle Patient present will adduction of eye Due to unopposed pull of Medial Rectus Muscle |
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What is CN-V1? What is it responsible for in Orbits, nasal cavity, paranasal sinuses, and skin? Clinical: responsible for |
Opthalmic Nerve Sensory Afferent Limb of Corneal Blink Reflex |
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What are the branches of Opthalmic Nerve? ****One of the branches provides sensory root to ....? |
Nasocilliary- external nasal nerve and infratrochlear nerve. Sensory root to Ciliary Ganglion. iC Frontal Nerve: Supraorbital and Supratrochlear Lacrimal Nerve: carries out autonomics to lacrimal gland |
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Ciliary Ganglion Three Roots: SHORT CILIARY |
1. General Sensory: CN V-1 2. Parasympathetic: CN III PRE-Synaptic 3. Sympathetic: Internal Carotid Plexus Post-Synaptic except intraocular vessels |
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Long Ciliary Nerve- Post-Synaptic Sympathetic to: Sensory to: |
Post-Synaptic Sympathetic to Dilator Pupillae Sensory to: Cornea |
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BOTH long and shot ciliary nerves carry _________ and _______ fibers |
Sensory and Sympathetic fibers |
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Parasympathetics are ONLY carried by: |
Short Ciliary Nerves |
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Parasympathetics In orbit goes to _____ muscle and Sphincter _________ |
Ciliary muscle Sphincter Pupillae |
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Ciliary Muscle and Sphincter Pupillae: 1. Pre-Synaptic- 2. Ganglion- 3. Post Synaptics- 4. Action of Ciliary Muscle and Sphincter Pupillae |
1. CN III 2. Ciliary 3. Short Ciliary nerve 4. Ciliary muscle: Accomadation Sphincter Pupillae: pupillary constriction
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Lacrimal Gland List the order of Pre-Synaptics |
CN 7 Greater petrosal nerve Nerve of Pterygoid canal |
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Lacrimal Gland: Ganglion |
Pterygopalatine (PT) ganglion |
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Lacrimal Gland: Post Synaptics |
Zygomatic nerve CNV2 Lacrimal Nerve CNV1 Lacrimal Gland |
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Action of Lacrimal Gland |
Stimulate secretion of lacrimal fluid |
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Sympathetics in Orbit -Internal Carotid Plexus |
Dialator Pupillae Intraocular vessels Superior Tarsal Muscles Lacrimal Gland |
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Dialator Pupillae |
Travel to target via LONG ciliary nerve action: dilate the pupil |
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Intra-ocular vessels |
Travel via short ciliary nerve action: Vasoconstriction
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Superior Tarsal Muscle |
travels along CN3 to target Elevate superior eye lids
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Lacrimal Gland sympathetic NERVE PATHWAY |
Deep Petrosal nerve to nerve of pterygoid canal PT GANGLION: Pterygopalatine ganglion Zygomatic nerve Lacrimal Nerve Action: Decrease Lacrimal fluid secretion |
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What is the main arterial supply to orbit? where does it supply the blood. Occlusion to this artery can lead to what? |
Central Artery of Retina: supplies of neural layer of retina except rods and cones. Occlusion to this artery can lead to blindness |
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What is the blood supply to choroid and rodes and cones of retina? |
Short posterior ciliary arteries |
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What supplies the ciliary body and iris? |
Long posterior Ciliary arteries |
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Opthalmic Vein Dialation can cause (2 things) |
Cavernous Sinus Thrombosis Cartoid Cavernosus fistula |
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Superior Opthalmic vein drains into: Inferior Opthalmic Vein drains into: Both Communicate with: _____ Vein Anteriorly and _____ posteriorly |
Cavernous Sinus Pterygoid Venus Plexus Facial Nerve anteriorly and each other posteriorly |
