ocular anatomy v.s. 111 uab school of optometry timothy w. kraft, ph.d. 975-2885 [email protected]
TRANSCRIPT
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Goals for the Term
• Solid base of knowledge
• Comfort with Ocular terminology
• Basics of tissue structure & function– At the end of the course you can give
yourself a 3D guided tour of the eye and orbit within your mind’s eye.
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Exam Schedule & Grading
• Midterm 45%
• Lab work sheets & hw (5%)
• Quizzes: Six, pick your best 5 for 10%
• and Final Exam 40%• some of Final is review
There will be 4 or 5 Lab sessions, attendance is mandatory
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Sources of information
• The Human Eye structure and Function by Clyde Oyster
• Hand-outs, outlines including additional figures.
• CD’s of power point presentations for out of class review
Come to Class
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Texts and Supplements
• Oyster (you buy this one) The Human Eye
• Williams & Warwick Functional Neuroanatomy of Man (copy provided)
• Snell & Lemp: Clinical Anatomy of the Eye (copy of selected figures provided)
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Broad-based learning
• Power point presentations– Almost all lectures available on CD
• Hand out outline the lecture
• Study Guides
• When all else fails: RTB
Go to Class
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Overview
• When the structure seems complicated , think FUNCTION– Imaging : OPTICAL CLARITY
– Information processing: pathways, adaptation
– Mobility: balance, strength, speed, MECHANICS
– Biological System: respiration, pain, protection
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Terminology
• Rostral (toward top of head - rooster)
• Caudal (toward tail) cauda equina - horses tail
• Anterior - front - ventral
• Posterior- back - dorsal (dorsal fin)
• Medial (midline) {Nasal}
• Lateral away from midline (Temporal)
• Central -
• Peripheral- away from center
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Basic components of eyeball
Scleral
outer
Vitreal
Inner
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Eyeball: Optical Pathway
• Cornea
• Anterior Chamber
• Iris/Pupil
• Posterior Chamber
• Lens
• Vitreous
• Retina
Figure by Snell & Lemp
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Eyeball: Layered tissues
• Protective epithelium
• Cornea/Sclera
• Choroid
• RPE
– All to protect/nourish the nervous tissue of retina/optic nerve
• Scleral/Vitreal
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Figure by Snell & Lemp
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The Orbit: Bone structuresBones: Those Latin names
Protecting the eye while serving its needs.
•VS111
•Aug 11, 2008
•Lect 1-2
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Reasonable Goals
• Overall function is simple, but the details..– Name the bones,
– Know the construction of the orbit walls,
– Know the strong and weak points,
– What is in the orbit, what holds it there?
– What comes into, goes out of the orbit?
– What are holes (fissures, foramina) used for?
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Skull has 22+ bones
• Cranium
– Parietal (2)
– Occipital
– Temporal (2)
– Sphenoid
– Ethmoid
• Face– Maxillary (2)
– Nasal (2)
– Inferior chonchae (2)
– Lacrimal (2)
– Palatine (2)
– Zygomatic (2)
– Mandible
– Vomer
•Frontal bone is part of both cranium & face
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11 bones make up the orbits
• Single Bones
– Frontal Bone
– Ethmoid Bone
– Sphenoid Bone
• Paired Bones
– Maxillary
– Zygomatic
– Lacrimal
– Palatine
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Bones of the skull
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Lateral View of Skull
• Frontal
• Zygomatic
• Note temoral aspect of Sphenoid
• Maxillary
• Lacrimal
• Ethmoid
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Sinuses exist in 4 Orbital Bones
• Air filled
• Mucosa lined
• Lighten bone
• Acustic
• Possible infection site
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The basic shape of the orbit is a pyramid:
•The medial walls are parallel
•The depth is 1.5 x base
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• The margin of the orbit {VERY STRONG}
– 4 cm wide
– 3.5 cm high
– 3 BONES• Frontal• Zygomatic• Maxillary
•4.5 cm deep
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Terminology
• Fossa: shallow depression in bone
• Foramen (pl. foramina): hole(s) in bone
• Fissure: hole between adjacent bones
• Tubercle: bump attachment site
• Groove, canal, notch (as they sound)
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A key figure of Chap 3
Let me help you get a 3D understanding of the structures summarized by this figure
•Naso
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The orbital ceiling
•Frontal
•Bits of-
Sphenoid
Lacrimal Fossa
Trochlear Fossa
Supraorbital Notch
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The Lateral Wall
•Not shown are:•Zygomatic foramen•Whitnall’s Tubercle
•Zygomatic
•Sphenoid
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Bones of the skull
Now look at the Sphenoid
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The Sphenoid Bone
• Butterfly
• (Owl like)
– Greater Wing
– Lesser Wing
– Pterygoid process
• Many Foramina
– Optic Foramen
– Sup. Optic Fissure
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Lateral View of Skull
• Frontal
• Zygomatic
• Note temoral aspect of Sphenoid
• Maxillary
• Lacrimal
• Ethmoid
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The Sphenoid Bone &
Occipital (at back)
Ethmoid (yellow)
Palatine (small red)
Maxillary(straight on view of structure shown on hand out - page 42)
•Now go back to lateral wall slide
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The Lateral Wall
•Not shown are:•Zygomatic foramen•Whitenalls Tubercle
•Zygomatic
•Sphenoid
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The Medial Wall
• Ethmoid
• Lacrimal
• Sphenoid
• Maxillary
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The Orbit Floor
• Maxillary
• Zygomatic
• Palatine
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Main components of fissures
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Let me help you get a 3D understanding of the structures summarized by this figure
•Fig 3.2
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Weakest bones are in the floor and medial wall of the orbit.
• Transmitted pressure through the tissues(?) or the sturdier bones causes blowout fractures.
•Lamina papyracia
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Blowout fracture of the floor of maxillary bone.
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Blowout fracture of the floor of maxillary bone. CT image
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Blowout fracture of the ethmoid bone. CT image.
•esf ethmoid sinus fracture •mwf medial wall fracture
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Connective tissues in the orbit
• All of the structures within the orbit have a connective tissue sheath– Around the Globe & muscles it’s call Tenon’s capsule
• If the globe is the palm and EOM fingers, then Tenon’s capsule is the glove.
– Lining the bones, it’s the periosteum• periorbita- a special name for orbit bone lining
– nerves, blood vessels have them too
• And they are interconnected making for a web of sheaths.
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Two Views
• Tenon’s capsule
• Periorbita
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A better view
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Terminology
• Fossa: shallow depression in bone
• Foramen (pl. foramina): hole(s) in bone
• Fissure: hole between adjacent bones
• Tubercle: bump attachment site
• Groove, canal, notch (as they sound)
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Soft tissue covering
• Surrounding the sclera is the episclera
– Connective tissue and blood vessels.
• Surrounding the episclera is Tenon’s capsule
– Another layer of connective tissue protecting the globe and making it slippery for movement within the orbit.
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Soft tissue covering
• Check ligaments
– medial and lateral are most prominent but the inferior rectus and levator have them too.
• Superior transverse ligament
– Supports levator muscle (Whitnall’s Ligament)
• Suspensory ligament (of Lockwood)
– Connective tissue underneath the globe
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Orbital infection
• Orbital cellulitis: infection of the tissues and fat pads behind/surrounding the eye, but not the eye itself
– 60% of orbital cellulitus is a secondary infection due to a sinus infection
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Bone development• Dermal Bones, most of orbit
– Foci of osteoblasts differentiated from with the mesoderm
• Cartilage pre-formed bones: ethmoid and part of sphenoid. (Endochondral bone)– Chondrocytes form cartilagenous template of the final
bone
– Osteoblasts invade and differentiate into osteocytes
• Bone can restructure/repair itself– Osteoclast cell can breakdown boney matrix
• Permits growth of the skull and orbits