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Ocular Phys Test 1
Orbit structure
44
Physiology
Professional
09/21/2007

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Term
What forms the bony orbit?
Definition
The mesenchyme surrounding the optic vesicle
Term
What are the 2 types of bone formation (ossification) that occur during the formation of the orbit?
Definition
Endochondral and Membranous
Term
What orbit bones are preformed in cartilage and then ossified?
Definition
Endochondral
Term
What orbit bones are ossified from connective tissue?
Definition
Membranous
Term
The orbital walls originate from what cells?
Definition
Cranial neural crest cells
Term
Early in development the lateral nasal process migrates laterally and fuses with the maxillary process to form what structures?
Definition
The medial, lateral, and inferior orbital walls
Term
What structure forms the orbital roof?
Definition
The capsule of the forebrain
Term
As the globe enlarges, the connective tissue surrounding it condenses and thickens. Within these fibrous plates, what structures develop?
Definition
The bones surrounding the orbit
Term
At 6 weeks gestation, what is the first bone to develop embryologically?
Definition
The maxillary bone
Term
What is the only bone that forms from endochondral and membranous origins?
Definition
The sphenoid bone
Term
Do the greater and lesser wings of the sphenoid develop together spatially or temporally?
Definition
NO - They develop in different locations at different times
Term
When do the greater and lesser wings of the sphenoid join together?
Definition
At 16 weeks
Term
At birth, ossification of the orbital walls is complete except for where?
Definition
The apex
Term
The bony orbit is designed to do what two things for the orbit and soft tissues?
Definition
Protect and Support
Term
What are the seven individual bones that make up the four walls of the orbit?
Definition
Frontal, maxillary, sphenoid, palantine, lacrimal, ethmoid, and zygomatic
Term
The adult orbit is in the shape of what?
Definition
A pyramid
Term
The orbital rim is the thickest and strongest where?
Definition
Laterally
Term
The attachment point of the lateral canthal ligament, the lateral rectus muscle check ligament, and aponeurosis of the levator palpebrae superioris muscle is what? Where is it located?
Definition
The tubercle of the zygomatic bone. It is located just inside the lateral orbital rim
Term
Is the orbital floor thin?
Definition
Yes
Term
What is the orbital floor made from? What shape is it in?
Definition
The orbital plate of the maxillary bone. It is triangular in shape
Term
Where does the orbital floor extend from?
Definition
From the maxillary-ethmoid buttress to the inferior orbital fissure
Term
A depression in the orbital floor is where what muscle originates?
Definition
The inferior oblique muscle
Term
Which area of the orbit is the most susceptible to blunt force trauma?
Definition
The orbital floor
Term
The support of the weak floor is provided by what?
Definition
The maxillary-ethmoid buttress and the infraorbital sulcus/canal
Term
Which thin structure is uniformly supported by the "honeycombed" structure of the ethmoid sinus bony lamina?
Definition
The lamina papyracea of the ethmoid bone
Term
Because of the "honeycombed" support, the medial wall is _______ susceptible to fracture than the orbital floor despite both being extremely thin.
Definition
Less
Term
Blunt force trauma to the cheek can result in a tripod fracture. What are the three fracture points?
Definition
The zygomaticomaxillary suture
The frontozygomatic suture
The zygomatic arch
Term
Contraction of the muscle across the tripod fracture causes this complex to rotate how?
Definition
Medially and inferiorly
Term
These fractures (tripod fracture) need to be reduced and fixated at a minimum of how many locations?
Definition
2
Term
After the fracture the cheek is noted to be depressed and the patient may experience muscle spasm or difficulty opening his/her mouth. Why does this occur?
Definition
Due to the coronoid process of the mandible contracting the rotated zygomatic arch
Term
What is exophthalmos?
Definition
Forward displacement of the globe
Term
What is enophthalmos?
Definition
Retro-displacement of the globe posteriorly into the orbit
Term
What is the forward displacement of any object called?
Definition
Proptosis
Term
The most common cause of exophthalmos in adults is what?
Definition
Thyroid eye disease
Term
What is another name for thyroid eye disease?
Definition
Grave's disease
Term
The muscle and connective tissue swell and increase in fat content and are eventually replaced by what in Grave's disease?
Definition
Scar tissue
Term
Another cause of exophthalmos is craniofacial dystosis. What is another name for this disease and what occurs?
Definition
Crouzon's syndrome - It is a premature fusion of the suture lines of the cranium. As the brain grows it cannot expand like normal due to the closed sutures. As a way to relieve pressure the brain grows forward and causes the eyes to bulge
Term
What else may stimulate exophthalmos because of the enlarged, elongated globe?
Definition
Severe myopia and buphthalmos
Term
What is buphthalmos?
Definition
Infantile glaucoma scenario
Term
What are some of the causes of enophthalmos?
Definition
Trauma, surgery, precious irradiation
Term
Metastatic lesions may lead to what in the contralateral eye?
Definition
Psuedoexophthalmos
Term
How do we measure exophthalmos?
Definition
Hertel Exophthalmometry
Term
What are the normative values for exophthalmometry?
Definition
15-17 mm
Term
In exophthalmometry, a difference of how many mm between eyes is considered significant?
Definition
2 mm
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