Ocular A&P

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Ocular A&P
2013-03-27 23:27:18
Ocular Midterm

study cards for midterms
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  1. Palpebral Fissure
    opening of the eye 30mmX15mm
  2. Adnexa
    • structures surrounding the eye
    • --> orbit, lacrimal, lids, muscles, nerves, and fat
  3. Both Eyes abbriviation
    OU-- Oculus Uterque
  4. Fornix
    where the conjunctivas come together
  5. Bulbar Conjunctiva
    • -covers the white part of the eye
    • -over sclera of the eye, thin, transparent
  6. Emmotropia
    • "Perfect" eye
    • -24mm long
  7. 7 bones of the eye.
    • 1-Ethmoid 2-Maxilla 3-Sphenoid 4-Frontal
    • 5-Lacrimal 6-Zygomatic 7-Palatine
  8. Fuch's Corneal Distrofy
    • -degeneration of Endothelium, unreplaceable cells (don't regenerate)
    • -more common in wormen then men
    • -get at around the age of 55
    • -kills off cells; causes cornea to swell and become unclear
  9. Ciliary Ganglion
    junction of nerves in muscle cone (annulus of zinn) located behind the eye ball
  10. 4 Sinuses
    • 1-Frontal=under the frontal bone
    • 2-Ethmoid=by the ethmoid
    • 3-Maxillary=under the eyes
    • 4-Sphenoid=behind the ethmoid
  11. Caruncle
    a fleshy mound in the corner of the eyes, located here are the sebaceous and sweat glands
  12. What is the first barrier against infection or a hemorrhage?
    Orbital Septum
  13. Superior & Inferior Punctum
    • used to drain tears
    • -20% drain into superior
    • -80% drain into inferior
  14. Fornix
    created by the junction of the two conjunctiva
  15. Tenon's Capsule
    fibrous, underneath conjunctiva but above the sclera; covers where extra ocular muscle attaches to the sclera
  16. Zinn's Annulus or Annulus of Zinn
    located between optic foramen and superior orbital fissure
  17. Meibomian Glands
    • -found on back of greyline
    • -secrets oil for tears
  18. Wolfring & Krause Glands
    • -produce baseline tears
    • -accessory glands
    • -located in upper eyelid
  19. Main Lacrimal Gland
    • -produce reflex tears
    • -parasympathetic
    • -located in lacrimal fossa (temporal orbit)
  20. Bowman's layer
    10µm all collagen; doesn't regenerate, unclear role 2nd layer of Cornea
  21. Epithelium Layer
    • 5-7 cell layers thick about 50µm thick made of non-keratonized squamous cells; no scars regenerates rapidly takes 28- 48hrs
    • 1st layer of cornea
  22. 5 layers of the cornea
    (anterior to posterior)
    • 1-Epithelium
    • 2-Bowman's
    • 3-Stroma
    • 4-Descemet's
    • 5-Endothelium
  23. Cornea
    • -clear, transparent, convex, reflects, and refracts light
    • -developed by age 2
    • 1mm thick outside about 1,000µm
    • 0.5µm thick center about 500µm
  24. Specular Microscopy
    used to look at endothelium layer
  25. Deturgescence
    used for maintaining hydration of cornea and keeps it clear in Endothelium
  26. Functions of Conjunctiva
    • 1)Reduces friction
    • 2)Provides nutrients to the cornea
  27. Layers of the Eyelid (6)
    • 1-Skin
    • 2-Orbicularis
    • 3-Levator
    • 4-Mueller
    • 5-Tarsus
    • 6-Palpebral Conjunctiva
  28. Plica Semilunaris
    • folds of conjunctiva tissue
    • goblet cells concentrated here
    • corner of the eyes
  29. Mattering in Conjunctiva
    (3 types)
    • contains luekocytes, microorganisms and mucus
    • Allergic- clear, to nature, usually itchy
    • Bacteria- green and yellow
    • Viral- thick, clear, blurs vision
  30. Pachymeter
    used to measure thickness of the cornea through ultrasound; used during refractive surgery
  31. Blood Vessels leak..... (3).....into the conjunctiva
    • 1-Leukocytes
    • 2-Antibodies
    • 3-Nutrients
  32. Schirmer II Test
    anesthetic & Schirmer test done by pulling nose hair to test reflex tearing

    a normal amount would be anything greater than what the baseline tearing was
  33. Stroma
    • 915µm outside and 450µm centrally
    • 90% of thickness, 78% water
    • content goes up cornea becomes cloudy
    • type I collegen about 200-250 fibers
    • 3rd layer of cornea
  34. Zeiss Glands
    • found on back of greyline
    • provide oil to eyelashes
  35. Levator
    • muscle, opens eyes wide
    • moves eyelid 15mm up and down
    • controlled by CN III
    • autonomic
  36. Orbicularis
    • large muscle controls all of the muscle movement
    • operated by CN VII
    • constricts eyes
  37. Tarsus
    • rigid plate of fibrous tissue 
    • muscle
    • gives eye shape
  38. Function of the Eyelids (3)
    • 1-cover,
    • 2-protect,
    • and 3- lubricate the conjunctiva
  39. Desemet's Membrane
    • 3µm when born 
    • 10-12µm thick as elderly
    • type III collegen
    • 4th layer of cornea
  40. Endothelium
    • 4-6µm thick 1 cell layer thick
    • take care of managing water in sclera
  41. Muller's Muscles
    • helps with lid contraction
    • controls eyes opening VERY wide have control over this muscle
  42. Palpebral Conjunctiva
    • covers inside of the eyelid
    • more vascular
    • when inflamed bubbles out
    • moves freely, except at lumbus
  43. Schirmer I Test
    • no anesthetic; Schirmer paper to test 
    • tests baseline AND reflex tearing 
    • 15mm in 5min is healthy
  44. Limbus
    where cornea and conjunctiva meet
  45. Myopia
    nearsidedness; too long of an eye or too steep of a cornea
  46. Hyperopia
    • "farsidedness"
    • eyes are too short
    • don't actually see far away better
  47. Right Eye Abbriviation
    • OD- Oculus Dexter
    • always takes priority
  48. Left Eye Abbriviation
    OS- Oculus Sinister
  49. Subconjunctival Hemorrhage
    • Blood red eye
    • common from: colds, heavy lifting, mostly from a broken blood vessel
  50. Corneal Nourishment (3)
    • 1)tear film and air-outer cornea
    • 2) Conjunctiva- outer cornea
    • 3) Aqueous- inner cornea
  51. Mircrocornea
    a cornea less than 10mm thick
  52. Macrocornea or Meglocornea
    a cornea larger than 13mm thick
  53. 3 layers of a tear
    • 1) Lipid-secreted by Meibomian and Zeiss Glands, prevents evaporation
    • 2)Aqueous- secreted by lacriamal glands, lysozymes found here= kill bacteria
    • 3)Mucus- secreted by goblet cells in the palpebral conjunctiva
  54. Functions of Tears (3)
    • 1)Provide smooth optical surface, light refraction
    • 2)Provide moist environment for epithelium
    • 3)Provide oxygen to the cornea
  55. Keratoconjunctivitis Sicca(KCS)
    under production of tears
  56. Dry Eye Syndrome (DES)
    under production of tears
  57. Basic Secretion Test
    • anesthetic an Schirmer paper used
    • tests baseline tearing
    • put anesthetic in eye and collect Schirmer filter paper 10mm in 5min is healthy
  58. Epiphora
    • over production of tears
    • tears running down the face
  59. Excretion Path of Tears (8)
    • 1-Superior & Inferior Punctum
    • 2-Superior & Inferior Canaliculi
    • 3-Common Canaliculus
    • 4-Rosenmuller's Valve
    • 5-Nasolacrimal Sac
    • 6-Nasolacrimal Duct
    • 7-Hasner's Valve
    • 8-Nasal Cavity
  60. Sclera Functions (4)
    • 1-Protective coat
    • 2-Gives  eye shape
    • 3-Protects and supports structures
    • 4-Acts as a light tight box
  61. Colors of the Sclera (3) and meanings
    • -Blue= in children because its thin and pigment in the eye is showing through
    • -Yellow= in older patients, because of fat deposits in the eye
    • -White="normal" because of hydration of the sclera
  62. Sclera
    • Semirigid, very tough
    • similar to corneal tissue
    • white
    • thinnest where rectimuscles insert .3mm
    • thickest posterity 1mm
  63. Lamina Cribosa
    thinning of the sclera allows retinal nerve fibers to penetrate and form optic nerve
  64. Episcleritis
    • inflammation of episclera can be infront or back of the eye
    • symptoms- very light sensitive; eye becomes very painful with movement
  65. Episclera
    thin, loose, connective, elastic, vascular tissue covering sclera provides vessels
  66. Check Ligament
    starts in tenon's tissue from muscle sheaths forming a fibrous attachment which attaches muscle to the orbit limit movement of the muscles
  67. Lockwoods (suspensory) Ligament
    hammock like structure; supports the bottom part of the eye; supports the globe
  68. Tenon's
    • thin, fibroelastic connective tissue
    • covers from limbus all the way to the optic nerve 
    • at the limbus it fuses with the conjunctiva and the episclera
  69. Functions of Tenon's (3)
    • 1)the smooth inner surface allows sclera and muscles to glide easily
    • 2)keeps sclera around the back from fat
    • 3)keeps muscles in fron from fat
  70. Another name for Tenon's
    Fascia Bulbi
  71. Pupil
    hole, where light enters the eye
  72. Iris
    colored part of the eye
  73. Sclera
    • protective around the retina 
    • thick, white
    • provides rigidity
    • blocks out some light
    • provides structure
  74. Greyline
    • separates the anterior and posterior lines of the lid
    • used for surgery
    • front of greyline- eyelashes
    • back of greyline-zeiss glands and meibomian glands
  75. Shape of pupil and irregularities (4)
    • usually round
    • -if irregular can be:
    • 1-congenital anomalies
    • 2-iritis-posterior and andterior synechiae
    • 3-surgical intervention
    • 4-trama
  76. Essential Aniosocoria
    >1mm difference in pupils usually neurological defect
  77. Physiological Aniosocoria
    • 1mm or less in difference
    • considered normal
  78. Maximum and minimum size of pupils
    • 8mm--mydriasis
    • 1mm--miosis
  79. Pupil Size--vary with refractive error
    • myopes--larger
    • hyperopes--smaller
  80. Pupil Size-- vary with color of iris
    • Blue--relatively larger
    • Brown--relatively smaller
  81. Pupil Size-- vary with age (4)
    • 1-infant about 2mm
    • 2-older in children about 4mm
    • 3-adults about 3mm
    • 4-elderly about 2mm
    •         don't change much in size
  82. Synkinetic Near Reflex
    • three simultaneous but seperate reactions comprised of the fallowing:
    • --Miosis---Convergence---Accommodation
    • Controlled by CN III
  83. Fact: Sypmathetic fibers bypass ganglion
    Fact: Miosis & Mydriasis--requires a balance between the dialator and sphincter muscles; as one contracts the other reflexes
  84. Fact: Pupil fibers leave ciliary ganglion and innervate the unstriated sphincter which contracts and cause miosis
    Fact: Accommodative fibers leave the ciliary ganglion and innervate ciliary muscle which increases the focusing power of the lens
  85. Fact: Efferent pathways for accommodation and pupils are parasympathetic
    Fact: Travel with CNIII and synapse in ciliary ganglion located behind the globe
  86. Synkinetic
    • miosis, accomodation, convergence all in one
    • afferent pathway (eye to the brain)
  87. Edinger- Westphal Subnucleus (E-W)
    sphincter center controls miosis and accomodation
  88. Fact: photo receptors synapse with bipolar cells and then with ganglion cells, which comprise nerve fiber layer 
    80% ganglion axons are for vision
    20% ganglion axons are for pupil function
    • Fact: Pathways for vision and pupil axons are different
    • pupil fibers do not synapse in the lateral geniculate body but they enter the midbrain in vision they do
    • some interneurons cross over for consensual subnucleus
  89. Rods and Cones
    are light receptor organs for vision and pupil function
  90. Pupil
    • center of iris
    • adjust amount of light entering the eye
    • bright light constrict the pupil(miosis) by sphincter muscle
    • dim light conditions pupil dialate(mydriasis) by dialator muscle
  91. Choroid
    • between sclera and retina
    • in continuity with iris and ciliary body
    • most vascular tissue in human body
    • Bruch's membrane--inner layer
  92. Choroidal Neovascularization
    seperation of Bruchs(inner layer of choroid) and the out layer of the retina
  93. Presbyopia
    after age 40 the lens is less able to change its shapes for increasing focusing power for close work, the lens hardens
  94. Ciliary Body
    • composed of ciliary process and ciliary muscle
    • anterior portion is folded and bumpy
  95. Ciliary Body Functions (2)
    • produces aqueous
    • causes accommodation
  96. Steps for Accomodation
    • 1) ciliary muscle contracts
    • 2)zonular fibers relax
    • 3)anterior capsule of the lens bulges forward
    • ****accommodation increases the power of the lens from +19D at rest; to +33D for close work
  97. Ciliary Muscle
    Controls accommodation
  98. Pars Plana
    posterior portion of Ciliary body is flat used for eye surgery and injections
  99. Pigment Based on Eye color
    • Blue=lesser amount of pigment
    • Dark=darker the eye the greater the pigment
  100. Iris Margin
    Rests on lens acting like a one-way valve preventing aqueous from flowing into posterior chamber
  101. Iris
    • most anterior structure of uvea, forms the pupil
    • anterior has many ridges and furrows
    • seperates posterior chamber from anterior chamber
  102. Iris Dialator
    • goes completely around the pupil
    • --miosis--constriction of pupil
    • --collerate--change in pigment can help locate sphincter
  103. Uvitis
    inflammation of iris, ciliary body, and choroid
  104. uvea
    • consists of 
    • 1-iris 2-ciliary body 3-choroid
  105. Posterior Synechiae
    posterior iris attaches to anterior lens
  106. Peripheral Anterior Synechiae
    Side of iris attaches to posterior of cornea
  107. Anterior Synechiae
    anterior of iris attaches to posterior of cornea
  108. Synechiae
  109. Glacoma (treated with...4)
    • 1-given eye drops--slow down creation of aqueous
    • 2-given drops to open trebecular meshwork
    • 3-laser to poke holes in meshwork
    •     argon laser also called ALT trebeculoplasy
    •     SLT selective laser trebeculoplasy
    • 4-trebeculeotomy-cutting a pieve out creating a second drainage 
    • BLEB-- located underneath upperlid filtering out aqueous*result of a trebeculectomy
  110. Glaucoma (definition and causes)
    • increase pressure of the eye causing damage to the retina
    • caused by:
    • 1-ciliary over production of aqueous
    • 2-trebecular meshwork gets clogged
  111. the flow of Aqueous (7 Steps)
    • 1-secreted by ciliary process in posterior chamber
    • 2-passes from posterior chamber through pupil by lifting up the iris and into the AC
    • 3-Flows towards the angle
    • 4-enters trabecular meshwork and filters through it
    • 5-enters canal of schlemm
    • 6-enters collector channels
    • 7-enters episcleral venous blood leaving the eye and returning to the heart
  112. Posterior Chamber
    Everything behind the iris
  113. Anterior Chamber
    Everything in front of iris
  114. What are the 2 parts ciliary body?
    • Ciliary process 
    • Ciliary Muscles
  115. Why is the angle not visible in a slit lamp?
    when the angle of incidence exceeds the critical angle we have TIR
  116. Angle (consists of 5)
    • ocular tissues posterior to the cornea and anterior to the iris
    • consists of=
    • 1-iris root 2-anterior portion of ciliary body     3-Schwalbe's line (end of Descements)          4-canal of schlemm 5-trabecular meshwork