Term
roof: frontal bone (some medial wall)
medial wall: ethmoid & lacrimal bone
lateral margin: zygomatic(& lower margin), greater wing of sphenoid
floor: maxillary |
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Definition
| what bones form the orbit? |
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Term
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Definition
| in what bone is the nasolacrimal canal that caries tear from the eye to the nasal cavity? |
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Term
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Definition
| this bone forms the orbital aperature |
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Term
| ethmoidal foramina (anterior-bigger and posterior-smaller or absent, sometimes multiple posterior) |
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Definition
| name the foramina through the fronal bone into the orbit (or through the suture between the frontal and ethmoidal bones) |
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Term
| where the optic nerve enters, the optic canal |
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Definition
| where is the deepest part of the orbit? |
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Term
| opthalmic artery and optic nerve |
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Definition
| what goes through the optic canal? |
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Term
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Definition
| what bone is the optic canal in? |
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Term
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Definition
| name the gap between the greater and lesser wings of the sphenoid |
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Term
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Definition
| this bone holds teeth, forms the hard palate, and the floor of the orbit |
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Term
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Definition
| name the fissure between the maxilla and the greater wing of the sphenoid |
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Term
| they are continuous: The upper one stops at the lateral/inferior bend at the optic canal |
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Definition
| how are the orbital fissures separated? |
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Term
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Definition
| this structure surrounds the optic canal and the inferomedial end of the superior orbital fissure. it is the site of origin for nearly all the extrinsic eye muscles |
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Term
| optic nerve, opthalmic artery |
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Definition
| name the structures that pass THROUGH the annulus tendineus |
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Term
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Definition
| what type of muscle are the extrinsic eye muscles? |
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Term
| levator palpibrae the muscle to the eyelid, that actively opens the eye |
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Definition
| all extrinsic eye muscles insert on the sclera except 1, name it |
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Term
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Definition
| name the 1 extrinsic eye muscle that does not originate on the annulus tendineus |
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Term
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Definition
| this muscle lies in the upper medial part of the orbit and goes through a tendenous sling |
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Term
origin: maxilla on medial side of orbit
insertion: laterally on the eye(deep to lateral rectus) |
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Definition
| where does the inferior oblique originate and insert? |
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Term
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Definition
| list the nerves in the orbit |
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Term
occulomotor CN 3
BONUS: this nerve also does pupil size and lens shape(ciliary muscle) |
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Definition
provides somatic motor innervation to all extrinsic eye muscles except superior oblique & lateral rectus
BONUS: what else does this nerve do? |
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Term
| trochlear nerve CN IV (this muscle belly loops through the trochlea) |
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Definition
| what provides motor innervation to superior oblique? |
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Term
| opthalmic nerve, V1, a branch of the trigeminal n. |
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Definition
| this nerve provides somatic sensory to everything in the orbit |
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Term
| V2 maxillary nerve, a branch of the trigeminal CN V |
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Definition
| this branch of the trigeminal n passes through the floor of the orbit without innervating anything in the orbit |
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Term
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Definition
| provides somatic motor innervation to lateral rectus |
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Term
| the superior orbital fissure |
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Definition
| how do nerves enter the orbit (besides the optic n) |
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Term
| V1: opthalmic nerve (trigeminal) |
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Definition
| what nerve tells you your eyeball is dry or itchy? |
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Term
upper division to superior rectus & levator palpibre
lower division to medial rectus, inferior rectus, inferior oblique
ciliary ganglion hangs off the lower division |
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Definition
| name the branches of the occulomotor nerve, how does it get to the muscles it innervates? |
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Term
| abducens, occulomotor, naosciliary nerve |
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Definition
| these nerves goes through the annulus tendineus and superior orbital fissure to innervate orbit muscles |
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Term
Trochlear CN 4 (crosses behind levator palpibrae)
frontal and lacrimal nerves(branches of the opthalmic) also |
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Definition
| these nerves come through the superior orbital fissure ABOVE the annulus tendineus |
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Term
| they come in with the trochlear nerve |
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Definition
| list the branches of the opthalmic nerve that enter the orbit, and where they come in |
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Term
1)opthalmic nerve(V1)
2)nasociliary nerve is the most important branch of ophthalmic
3) along with long cilliary nerves |
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Definition
| what nerve does somatic sensory to the eye? |
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Term
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Definition
| trigeminal ganglia is purely ____ |
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Term
trigeminal -> (v1)opthalmic -> nasocilliary -> long cilliary -> eyeball
short ciliary branch off nasociliary and pass through the ciliary ganglia (for CN 3) -> eyeball |
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Definition
| some nerves form a ring around the eye and provide somatic sensory innervation, name the nerves that they branch off of starting with the trigeminal nerve |
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Term
| occulomotor CN 3, paraympathetics synapse in the ciliary ganglia (it contains post ganglionic parasympathetic cell bodies |
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Definition
| what nerve provides parasympathetics to the eye? where do they synapse? |
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Term
| short ciliary nerves have post ganglionic parasympathetics from ciliary ganglia, sympathetics from the internal carotid plexus (post ganglionic) and the somatic sensory from the V1 |
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Definition
| what mixed nerves contain occulomotor fibers, sympathetic fibers, and trigeminal nerve fibers to the eye? |
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Term
nasociliary sends branches through from trigeminal origins
sympathetics send branches through from the internal carotid plexus |
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Definition
| name the 2 nerves that pass through the ciliary ganglia and do not synapse |
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Term
parasympathetics from CN 3 that synapse in ciliary ganglia
takes muscular effort to focus on close things especially (accomodation) |
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Definition
| what innervates the ciliary muscle? |
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Term
| parasympathetics from CN 3 occulomotor N |
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Definition
| what innervates constrictor pupillae? |
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Term
| sympathetics from internal carotid plexus |
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Definition
| what innervates dilator pupillae? |
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Term
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Definition
| what kind of innervation goes to intrinsic eye muscles? |
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Term
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Definition
| ring of CT holding the lens |
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Term
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Definition
| this muscle attaches to zonular fibers and when the muscle is relaxed, the zonula fibers are taught so the lens is stretched thin |
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Term
since the ciliary muscle is like a sphincter around the zonular fibers, when it contracts, it makes the rim holding the zonula fibers a smaller diameter, zonular fibers are slackened, and the lens becomes rounded and thicker
like a belt tightening
close objects take muscular strength to focus, far objects rely on passive tautness of CT |
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Definition
| when the ciliary muscle contracts, how does it affect the lens? |
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Term
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Definition
| which is more anterior? pupil or lens? |
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Term
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Definition
| this muscle is a band that runs around the iris that tightens like a belt with fibers like a sphincter |
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Term
| like spokes of a wheel, so when it constricts, it pulls the pupil open |
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Definition
| what direction are the fibers of dilator pupilae? |
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Term
| where there is no muscle activity (straight ahead) |
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Definition
| what position is the eye in, in resting gaze? |
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Term
| looking towards the midline (defined by the pupil) aka medial gaze |
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Definition
| which direction is ADDUCTION of the eye? |
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Term
| looking temporally (laterally) |
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Definition
| ABDUCTION of the eye is looking which way? |
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Term
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Definition
| looking which directions use only 1 muscle? |
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Term
| it is more medial in the orbit (which doesn't matter with the muscle direction/actions) |
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Definition
| where is the optic canal in the orbit? centered? medial, or lateral? |
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Term
| when you cross your eyes (use both medial rectus), or when you are accommodating |
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Definition
| when do you have the same rectus muscles working in each eye? |
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Term
| superior rectus, and inferior oblique |
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Definition
| what muscles are used for elevation? |
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Term
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Definition
| what direction does superior rectus pull the eye on its own? |
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Term
| up and outward (pulls lateral part of eye down) |
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Definition
| what direction does inferior oblique pull the eye on its own? |
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Term
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Definition
| what direction does superior oblique pull the the eye on its own? |
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Term
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Definition
| what direction does inferior rectus pull the eye on its own? |
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Term
| have the patient abduct from the resting position (look laterally) |
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Definition
| how do you test lateral rectus? |
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Term
| have the patient look medially (adduct) |
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Definition
| how do you test medial rectus? |
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Term
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Definition
| which muscle attach to the posterior half of the eye? |
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Term
| medial (then down for superior, and up for inferior) |
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Definition
| to test oblique muscles, which direction must you have the patient move their eye first? |
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Term
| temporally (laterally) then up or down (superior look up, posterior look down) |
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Definition
| to test the superior and inferior rectus muscles, which direction must you have the patient look first to test the eyes? |
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Term
| the posterior superior, lateral surface of the eye (so it pulls from an anterior, superior, and medial position) |
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Definition
| where on the eye does the superior oblique attach? |
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Term
| the inferior, posterior, lateral surface of the eye (so it pulls from medial, anterior, and inferior) |
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Definition
| where on the eye does the inferior oblique attach? |
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Term
| on the frontal bone, medially |
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Definition
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Term
you get lateral strabismus because lateral rectus is unopposed
BUT you also get SLIGHT down and inward rotation because superior rectus is unopposed, SO
overall, lateral strabismus and slight downward tilt |
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Definition
| if there is an occulomotor nerve lesion, what muscles are unaffected? what direction will the eye move? |
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Term
turn their head to the side that is normal and tilt their head to the affected side
this puts the other eye medial so it is in the natural corresponding medial location to re-align the eyes) |
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Definition
| if there is an occulomotor nerve lesion, how can the patient prevent seeing blurry? |
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Term
you get medial strabismus, because medial rectus takes over
turn head to affected side to re-align the eyes (and prevent blurred vision) |
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Definition
| if there is an abducens nerve lesion, what does the eye do? how would you align their eyes? |
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Term
blurred vision, especially when looking down, because inferior rectus takes over pulling the eye up and lateral (so one eyes is stuck up as the other looks down)
tilt head to affected side to prevent blurring |
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Definition
| what happens to the eye when you have a trochlear nerve lesion? how would you prevent blurring? |
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Term
| when looking down like at stairs, or reading a book |
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Definition
| when is a trochlear nerve lesion most noticeable? |
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Term
| look at the glare (the light reflex) on both pupils to see if they are in the same place |
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Definition
| whats the easiest way to tell someone's eyes are aligned? |
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Term
| the optic nerve has a pia mater, an arachnoid mater, and a dura mater |
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Definition
| the eyes are an outgrowth of the brain, what does this mean in regards to the meninges? |
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Term
through the subarachnoid space around the optic nerve
the eye is also a CSF drainage route |
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Definition
| how does meningitis reach the eye? |
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Term
| the dura around the nerve fuses to the periosteum of the optic canal |
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Definition
| what prevents the optic nerve from sliding back and forth? |
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Term
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Definition
| name the periosteum lining the orbit |
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Term
no, it is in a giant ball of fat
(thats why people who have lost a lot of weight have sunken looking eyes) |
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Definition
| does the eye contact bone? |
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Term
there is a periscleral fascial cleft, then a layer of Fascia bulbi
muscles pierce the fascia and bridge the cleft |
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Definition
| what lines the eye from behind (outside the sclera)? |
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Term
| to the smooth muscle of the upper eyelid, sweat glands, and vasculature (the V1 dermatome) |
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Definition
| where else do sympathetics from the internal carotid plexus go besides the short ciliary nerves to the dilator pupilae? |
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Term
| they come with the facial nerve through the inferior orbital fissure and form the lacrimal nerve to innervate the lacrimal gland |
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Definition
| where do parasympathetic that travel through the orbit go that don't do intrinsic eye muscles? |
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Term
| it is contained inside the epineurium(dura) of the nerve, but sits inferior to the nerve fibers |
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Definition
| where is the opthalmic artery in relation to CN 2? |
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Term
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Definition
| what artery feeds the opthalmic artery? |
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Term
1) posterior ciliary arteries
2) central artery to the retina
3) lacrimal artery (and anterior ciliary)
4) supraorbital artery
5) posterior/anterior ethmoidal
6) splits to infratrochlear, and
7) supratrochlear |
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Definition
| list the branches of the opthalmic artery |
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Term
| lacrimal artery (branch of opthalmic) |
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Definition
| this artery goes along the upper, lateral wall of the orbit to the lacrimal gland |
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Term
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Definition
| name the branch of the lacrimal artery that supplies the external eye tissue (the outer layers of sclera, not retina) |
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Term
| posterior ciliary arteries (usually 2) |
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Definition
| these arteries form a ring round the optic nerve to supply posterior sclera after traveling on either side of the optic nerve |
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Term
| starts inferior to the optic nerve, comes lateral and superior, then goes medially (crossing over the top of the optic nerve) |
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Definition
| describe the path of the opthalmic artery through the orbit |
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Term
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Definition
| supplies skin above the orbit, branches off the opthalmic artery once it is superior and medial to the optic nerve and travels OVER the eye |
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Term
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Definition
| this artery runs over the tendon of the superior oblique to supply skin on the midline around the eye |
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Term
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Definition
| this artery goes to skin...somehwere and travels below the trochlea to the bridge of the nose |
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Term
| anterior and posterior ethmoidal arteries |
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Definition
| these arteries go through the medial wall of the orbit through foramina that share their name |
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Term
| central artery of the retina |
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Definition
| this artery is essential to supplying the retina, branches off the opthalmic then tunnels into the core of the optic nerve to get into the eye |
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Term
1) supratrochlear(medial) and supraorbital(lateral) from the ICA
2) superficial temporal (from ECA)
3) posterior auricular (ECA)
4) occipital artery (ECA) |
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Definition
| these arteries contribute to the blood supply of the scalp and anastamose, name the arteries and what major vessel they branch off |
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Term
| no, it is where the dura stretches over a depression in the bone |
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Definition
| is the cavernous sinus associated with a dural fold? |
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Term
ICA
cranial nerves 3,4,5,6 |
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Definition
| name the structures in the cavernous sinus |
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Term
the sinus starts where the ICA crosses the foramen lacerum and turns up
it then goes anterior and lateral to make a u turned sideways in a sagittal plane
it exits the cavernous sinus when it turns vertical and posterior |
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Definition
| what directions does the ICA go while in the cavernous sinus? |
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Term
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Definition
| name the nerves in the cavernous sinus from superior to inferior |
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Term
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Definition
| where are the cranial nerves in relation to the ICA in the cavernous sinus? |
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Term
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Definition
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Term
| VI (abducens), so its function is lost first |
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Definition
| which nerve in the cavernous sinus is surrounded by blood on all sides and would be most affected by increased pressure in the cavernous sinus? |
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Term
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Definition
| this nerve lies superior and lateral to the ICA in the cavernous sinus |
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Term
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Definition
| this nerve is inferior and medial to CN 4 and 5 in the cavernous sinus |
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Term
| face dura laterally, so they dont lose functions as fast as the abducens with increased pressure in the sinus |
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Definition
| CN 3, 4, and V1 medially face the cavernous sinus, what do they face laterally? what does this mean? |
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Term
1) facial vein (drains medial eye and jawline) but connected to orbital veins which prefer to flow back to the sinus
2) opthalmic veins (sup and inf)
3) |
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Definition
| what drains to the cavernous sinus? |
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Term
1) primarily drain straight down to infratemporal fossa (pterygoid plexus
2) superiorly to superior petrosal sinus
3) inferior to inf. petrosal sinus then internal jugular |
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Definition
| what drains the cavernous sinus? |
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Term
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Definition
| if there is an increase in BP, why does blood flow in reverse in the cavernous sinus? |
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Term
| a triangle formed by connecting the corners of the mouth to the bridge of the nose |
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Definition
| where is the danger area of the face? |
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Term
facial vein, but these are connected to opthalmic veins in the orbit, so they can get into the cavernous sinus
therefore an infected pimple can spread infectious material back and get caught up in the fibers in the cavernous sinus |
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Definition
| what drains the danger zone of the face? |
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Term
| cavernous sinus thrombosis |
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Definition
| what condition can result from to much infectious material clogging up the cavernous sinus by getting caught in the webby material in it? |
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Term
1) medial strabismus (abducens compression)
2) eventual paralysis of all extrinsic eye muscles (fixed eye-rest of nerves knocked out)
3) pupil fixation (compression of autonomics of the IC plexus)
4) edema of the eyelid and pulsating exopthalmos (lymph drains to opthalmic veins)
5) parasthesia of the V1 dermatome
6) Horner syndrome (compression of sympathetics) |
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Definition
| describe the clinical signs of cavernous sinus thrombosis in order they would appear after the pressure increases |
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Term
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Definition
| what artery causes pulsating exophthalmos in cavernous sinus thrombosis? |
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Term
| a collection of symptoms that occurs when sympathetic innervation is disrupted to the head (in cavernous sinus thrombosis this is restricted to the V1 dermatome) |
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Definition
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Term
1) paralysis of dilator pupilae (constricted pupil)
2) ptosis - paralysis of smooth musc of upper eyelid
3) loss of sweating (anhydrosis)
4) flushing of skin (paralysis of smooth muscle that constricts cutaneous arterioles) |
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Definition
| what are the symptoms of horner syndrome? |
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Term
1) ethmoiditis
2) periorbital edema
3) proptosis
4) meningitis
5) infection around the pterygoid muscles
6) diplacement of dura in the lateral wall
7 compresion of the ICA |
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Definition
| what symptoms of cavernous sinus thrombosis can be seen with a CT of the head? |
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