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30 Cards in this Set
- Front
- Back
Palpebral conjunctiva
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Under eyelid
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Bulbar conjunctiva
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Over eyeball
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Lacrimal carnucle at the medial canthus
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Lacrimal carnucle at the medial canthus; tear drainage
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Fornix
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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
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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 |
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Hyperacute conjunctivitis
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Neisseria gonorrhae; severe discharge; can infect corneal epithelium and cause infectious keratitis; Chemosis (conjunctival edema) and preauricular lymphadenopathy with lid swelling
can occur. |
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Acute conjunctivitis
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s. aureus, s. pneumoniae, haemophilus or moraxella catarrhalis;
milder form of hyperacute but w range of presentations; n preauricular lymphadenopathy or corneal involvement noted |
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Adenoviral conjunctivitis demonstrating a yellow pseudomembrane in the inferior fornix of the conjunctiva
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Vernal keratoconjunctivitis; rare condition in children (m 5-10 yrs, resolves at puberty); note horner-tntras dot at the end of the white pointer
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Nerve responsible for sensation on superior palpebral conjunctiva
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Supraorbital nerve (V1 opthalmic)
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Nerve responsible for sensation on superior palpebral conjunctiva
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Infra-orbital nerve (V2 maxillary)
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Interruption of the postganglionic sympathetic axons of the long ciliary nerves (blink reflex) causes what to the pupil
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Miosis; you would also lose sensation to the bulbar conjunctiva
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Interruption of the postganglionic parasympathetic axons of the short ciliary nerves (blink reflex) causes what to the pupil
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mydriaisis
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short ciliary nerves
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postganglionic parasympathetic axons
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long ciliary nerves
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sensory axons from the cornea and postganglionic sympathetic axons
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Where does sensation (pain) fibers carried by the long ciliary nerves from the bulbar conjunctiva ultiamtely terminate?
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Ventral posteriomedial nucleus of thalamus - VPM
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Describe the corneal blink reflex neural loop
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Sensation away from eye is carried afferently by the opthalmic nerve (long ciliary nerves) -> blinking impulse is carried efferently via facial nerve
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Conjunctival telangesctasia; abnormal dilated capillaries on conjunctiva; idiopathic variant of osler-weber-rendu syndrome
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Sturge-Weber Syndrome (encephalotrigeminal angiomatosis)
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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 |
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Note tears flow from gland -> conjunctival sac -> supeiror/inferior lactimal punctum -> lacrimal cannaliculus -> sac> nose
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neuroparalytic keratitis
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facial paralysis prevents closure of the eyelids causing the eye to dry out since the muscles cant propel the lacrimal fluid across the eye
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dacryoadenitis
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inflammation of the lacrimal gland
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Nucleus for lacrimation
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Nucleus for lacrimation
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Superior salivary nucleus in the rostral medulla
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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. |
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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). |
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Nasolacrimal duct obstruction; note tearing, crusting eyelids and erythema of the lower lid
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Trichiasis
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ocular inflammation due to the presence of an eyelash bent back-
wards into the conjunctival sac. |
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Ectropion
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The turning
outward (reversion) of the margin of the eyelid, causing exposure of the palpebral conjunctiva. |
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Entropion
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The turning inward of the
margin of the eyelid, with the tarsal cartilage turned towards the eyeball. |