Unit 7 - 2 Anatomy

Front 1

Palpebral conjunctiva

Back 1

Under eyelid

Front 2

Bulbar conjunctiva

Back 2

Over eyeball

Front 3

Lacrimal carnucle at the medial canthus

Back 3

Lacrimal carnucle at the medial canthus; tear drainage

Front 4

Fornix

Back 4

Fornix = right under the white part of the eye where the palpabral conjunctiva is reflected up to form the bulbar conjunctiva; fornix = bridge arch where prostitutes would ply their wares

Front 5

Back 5

Subconjunctival hemorrhage demonstrating bright red blood beneath the
conjunctiva. As the hemorrhage reabsorbs, the edges may spread, become
feathery and turn yellowish (blue arrow). Subconjunctival hemorrhage is a cause
of acute ocular redness. It can be produced by trauma. It can also occur
spontaneously in bleeding disorders, hypertension, and treatment with
anticoagulants. No pain or vision impairment is associated with this disorder.
No specific treatment is needed for the hemorrhage, which will resolve itself in
time. However, an underlying condition such as hypertension should be
investigated

Front 6

Hyperacute conjunctivitis

Back 6

Neisseria gonorrhae; severe discharge; can infect corneal epithelium and cause infectious keratitis; Chemosis (conjunctival edema) and preauricular lymphadenopathy with lid swelling
can occur.

Front 7

Acute conjunctivitis

Back 7

s. aureus, s. pneumoniae, haemophilus or moraxella catarrhalis;

milder form of hyperacute but w range of presentations; n preauricular lymphadenopathy or corneal involvement noted

Front 8

Back 8

Adenoviral conjunctivitis demonstrating a yellow pseudomembrane in the inferior fornix of the conjunctiva

Front 9

Back 9

Vernal keratoconjunctivitis; rare condition in children (m 5-10 yrs, resolves at puberty); note horner-tntras dot at the end of the white pointer

Front 10

Nerve responsible for sensation on superior palpebral conjunctiva

Back 10

Supraorbital nerve (V1 opthalmic)

Front 11

Nerve responsible for sensation on superior palpebral conjunctiva

Back 11

Infra-orbital nerve (V2 maxillary)

Front 12

Interruption of the postganglionic sympathetic axons of the long ciliary nerves (blink reflex) causes what to the pupil

Back 12

Miosis; you would also lose sensation to the bulbar conjunctiva

Front 13

Interruption of the postganglionic parasympathetic axons of the short ciliary nerves (blink reflex) causes what to the pupil

Back 13

mydriaisis

Front 14

short ciliary nerves

Back 14

postganglionic parasympathetic axons

Front 15

long ciliary nerves

Back 15

sensory axons from the cornea and postganglionic sympathetic axons

Front 16

Where does sensation (pain) fibers carried by the long ciliary nerves from the bulbar conjunctiva ultiamtely terminate?

Back 16

Ventral posteriomedial nucleus of thalamus - VPM

Front 17

Describe the corneal blink reflex neural loop

Back 17

Sensation away from eye is carried afferently by the opthalmic nerve (long ciliary nerves) -> blinking impulse is carried efferently via facial nerve

Front 18

Back 18

Conjunctival telangesctasia; abnormal dilated capillaries on conjunctiva; idiopathic variant of osler-weber-rendu syndrome

Front 19

Sturge-Weber Syndrome (encephalotrigeminal angiomatosis)

Back 19

port wine stain; glaucoma, seizures, retardation, ipsilateral leptomeningeal angiomas

Proliferation of arteries in the brain results in AVM on the same side of the brain as the nevus

Front 20

Note tears flow from gland -> conjunctival sac -> supeiror/inferior lactimal punctum -> lacrimal cannaliculus -> sac> nose

Back 20

Front 21

neuroparalytic keratitis

Back 21

facial paralysis prevents closure of the eyelids causing the eye to dry out since the muscles cant propel the lacrimal fluid across the eye

Front 22

dacryoadenitis

Back 22

inflammation of the lacrimal gland

Front 23

Nucleus for lacrimation

Front 24

Nucleus for lacrimation

Back 24

Superior salivary nucleus in the rostral medulla

Front 25

Back 25

PARASYMPATHETIC PATHWAY FOR LACRIMATION. Note the facial nerve (FN)
containing preganglionic oarasympathetic fibers derived from the nervus intermedius.
Note the greater (superficial) petrosal nerve (GSPN) exiting from the facial nerve at the external genu (Latin knee)(EGFN). Note the deep petrosal nerve (DPN) containing postganglionic sympathetic fibers joining with the greater superficial petrosal nerve to form the nerve of the pterygoid (Vidian) canal (NPGC). Note the pterygopalatine ganglion (PPG), the site of the second cell body in this two-neuron pathway. Note the zygomatic nerve (ZN), a branch of the maxillary nerve V2 . Note the connection between the zygomatic nerve and the lacrimal nerve, a branch of the ophthalmic nerve V1. Note the synapse of the lacrimal nerve with the glandular elements of the lacrimal gland.

Front 26

Back 26

Canaliculitis; The inferior lacrimal canaliculus (the duct between the
lacrimal punctum and the lacrimal sac) on the inferior eyelid is swollen (“pouty punctum”). Note the whitish discharge from the lacrimal punctum
(red arrow).

Front 27

Back 27

Nasolacrimal duct obstruction; note tearing, crusting eyelids and erythema of the lower lid

Front 28

Trichiasis

Back 28

ocular inflammation due to the presence of an eyelash bent back-
wards into the conjunctival sac.

Front 29

Ectropion

Back 29

The turning
outward (reversion) of the margin of the eyelid, causing exposure of the palpebral
conjunctiva.

Front 30

Entropion

Back 30

The turning inward of the
margin of the eyelid, with the tarsal cartilage turned towards the eyeball.