Organs of head IIOrgans of head II

陳建榮陳建榮

http://web.nchu.edu.tw/~chenjr/index.htm

Accessory Structures of the Eye:Accessory Structures of the Eye:- orbital lig.- orbital lig. 眼眶韌帶眼眶韌帶- periorbital membrance (periorbita)- periorbital membrance (periorbita) 眶骨膜或眼鞘眶骨膜或眼鞘- orbital septum- orbital septum 眼眶隔眼眶隔

a.a. eyelids or palpebraeeyelids or palpebrae 眼臉眼臉b. conjunctivab. conjunctiva 結膜結膜c. third eyelidc. third eyelid 第三眼瞼第三眼瞼dd.. lacrimal apparatuslacrimal apparatus 淚腺組織淚腺組織ee.. extrinsic eye muscles extrinsic eye muscles

a.a. eyelids or palpebraeeyelids or palpebrae 眼瞼眼瞼- palpebral fissure- palpebral fissure 眼瞼裂眼瞼裂- palpebral commissure- palpebral commissure 眼瞼連合眼瞼連合- palpebral ligament- palpebral ligament 眼瞼韌帶眼瞼韌帶

- medial palpebral lig.- medial palpebral lig. 內眼瞼韌帶內眼瞼韌帶- - lateral palpebral lig.lateral palpebral lig. 外眼瞼韌帶外眼瞼韌帶

- the upper eyelid - the upper eyelid levator palpebrae superioris levator palpebrae superioris 上眼瞼舉上眼瞼舉肌肌

- consists of several tissues and structures - consists of several tissues and structures - orbicularis oculi m- orbicularis oculi m.. 眼輪匝肌眼輪匝肌- tarsal plate- tarsal plate 眼瞼板眼瞼板- tarsal glands- tarsal glands 瞼板腺瞼板腺

b. conjunctivab. conjunctiva 結膜結膜- palpebral conjunctiva- palpebral conjunctiva 眼瞼結膜眼瞼結膜- bulbar conjuncitva- bulbar conjuncitva 眼球結膜眼球結膜- conjunctival fornix- conjunctival fornix 結膜穹窿結膜穹窿- conjunctival sac- conjunctival sac 結膜囊結膜囊

眼袋 （眼袋摘除術）

黑眼圈

眼眶隔

Periorbita 眶骨膜或眼鞘

眼球結膜

角膜

眼瞼結膜

上淚點

下淚點

淚阜

半月襞

c. third eyelidc. third eyelid 第三眼瞼第三眼瞼- plica semilunaris - plica semilunaris 半月襞半月襞- lymphatic nodule in bulbar surface- lymphatic nodule in bulbar surface- cartilage of third eyelid- cartilage of third eyelid- superficial gland of the third eyelid- superficial gland of the third eyelid 第三眼瞼淺腺第三眼瞼淺腺

dd.. lacrimal apparatuslacrimal apparatus 淚腺組織淚腺組織- lacrimal gland- lacrimal gland 淚腺淚腺

- lacrimal fossa- lacrimal fossa 淚腺窩淚腺窩- CN VII ( pterygopalatine ganglion- CN VII ( pterygopalatine ganglion 翼腭神經節翼腭神經節 , n. of pterygoid can, n. of pterygoid can

al)al)- lacrimal caruncle- lacrimal caruncle 淚阜淚阜- lacrimal punctum- lacrimal punctum 淚點淚點- lacrimal sac- lacrimal sac 淚囊淚囊- nasolacrimal duct- nasolacrimal duct 鼻淚管鼻淚管

針眼

Muscle of the eyelids - M. levator palpebrae superioris 上眼瞼舉肌

- dorsal of optic canal upper eyelid- function: lift the upper eyelid- CN III

- Orbicularis oculi 眼輪匝肌

眼臉下垂

上眼瞼舉肌

Extrinsic muscles of the eyeball- M. obliquus dorsalis (CN IV) 背斜肌

- Trochea 滑車- M. obliquus ventralis (CN III) 腹斜肌- mm. recti 直肌

- M. rectus dorsalis (CN III) 背直肌- M. rectus ventralis (CN III) 腹直

肌- M. rectus medialis (CN III) 內直肌- M. rectus lateralis (CN VI) 外直肌

- M. retractor bulbi (CN VI) 眼球縮肌

背直肌

內直肌 外直肌

腹斜肌

背斜肌Trochea 滑車

Extrinsic muscles of the eyeball- M. obliquus ventralis (CN III) 背斜肌- M. obliquus dorsalis (CN IV) 腹斜肌- mm. recti 直肌

- M. rectus dorsalis (CN III) 上直肌- M. rectus ventralis (CN III) 下直肌- M. rectus medialis (CN III) 內直肌- M. rectus lateralis (CN VI) 外直肌

- M. retractor bulbi (CN VI) 眼球縮肌- Retract the eyeball- Vagina bulbi 眼球鞘

眼球縮肌

眼球外在肌之作用：

中線

內直肌 外直肌

上直肌

下直肌

腹斜肌

背斜肌內旋：上直肌及背斜肌外旋：下直肌及腹斜肌

Development of eye-Ectoderm 外胚層-Optic vesicle 視泡 - lens placode-Optic cup 視杯

-Outer layer of optic cup -- pigment layer of retina-Secreted vitreous body (secondary)

-Inner layer of optic cup-- other layers of retina

Anatomy of the Eyeball:Anatomy of the Eyeball:a. a. The wall of the eyeball consists of three layers:The wall of the eyeball consists of three layers:

- fibrous - fibrous layerlayer (Sclera) (Sclera) 鞏膜鞏膜- vascular - vascular layerlayer (Choroid) (Choroid) 脈絡膜脈絡膜- neural - neural layerlayer (Retina) (Retina) 視網膜視網膜

b.b. FFibrous ibrous layer layer (Sclera)(Sclera) 鞏膜鞏膜 ::

- anterior cornea- anterior cornea 角膜 角膜 - posterior sclera- posterior sclera 鞏膜 鞏膜 - - iridocorneal angleiridocorneal angle 虹膜角膜角虹膜角膜角- pectinate lig.- pectinate lig. 櫛狀韌帶櫛狀韌帶- - scleral venous sinusscleral venous sinus 鞏膜靜脈竇鞏膜靜脈竇(or canal of Schlemm)(or canal of Schlemm)

c.c. Vascular Vascular layer layer (Choroid)(Choroid) 脈絡膜脈絡膜 ::

- choroid- choroid 脈絡膜脈絡膜- - ciliary bodyciliary body 睫狀体睫狀体- - iris iris 虹膜虹膜- lens - lens 水晶体水晶体

Iris 虹膜-Pupil 瞳孔-Circulation m. of iris (CN III, ciliary g.) pupil ↓-Dilation m. of iris pupil ↑-Pigment epithelium of iris

Light reflex 光反射

Lens:Lens:- transparent, elastic structure- transparent, elastic structure- ciliary body- ciliary body 睫狀体 睫狀体 (smooth m., CN III, ciliary g.)(smooth m., CN III, ciliary g.)- ciliary process- ciliary process 睫狀突睫狀突

- secreted aqueous humor- secreted aqueous humor- - zonular fiberszonular fibers 小帶纖維 小帶纖維 or or suspensory ligamentssuspensory ligaments 懸狀韌帶懸狀韌帶

- anterior fibers- anterior fibers- posterior fibers- posterior fibers

白內障

Ciliary process 睫狀突

Lens : thick thinCiliary body contract tension of suspensory lig.↓ lens thickness ↑Accommodation reflex 適應反射

CChamber of the eye:hamber of the eye:- the lens divides the interior into two cavities:- the lens divides the interior into two cavities:-- anterior cavityanterior cavity 眼房眼房 ::

- contain - contain aqueous humoraqueous humor 房水房水- according the position of iris - according the position of iris

- anterior chamber - anterior chamber 前眼房前眼房- posterior chamber- posterior chamber 後眼房後眼房

-- posterior ( posterior (vitreousvitreous)) cavity cavity 玻璃腔 玻璃腔 vitreous bodyvitreous body 玻璃体 玻璃体 ((contributes to intraocular contributes to intraocular

pressurepressure))vitreous body is not continuously replacedvitreous body is not continuously replaced

青光眼

玻璃體混濁 （飛蚊症 ）

Circulation of aqueous humor

Retina:Retina:- pars optica retinae- pars optica retinae 視部網膜視部網膜

- - tapetum lucidumtapetum lucidum 透明帶 透明帶 (no pigment layer)(no pigment layer)- nontapetal area - nontapetal area 暗帶暗帶

- pars ceca retinae- pars ceca retinae 盲部網膜盲部網膜- pars ciliaris retinae- pars ciliaris retinae 睫狀体部網膜睫狀体部網膜

- - ora serrataora serrata 鋸齒緣 鋸齒緣 -- ciliary process ciliary process - pars iridica retinae- pars iridica retinae 虹膜部網膜虹膜部網膜

- ciliary process -- ciliary process - behind the iris behind the iris

central fovea 視網膜中央窩(macula lutea 黃斑 )blind spot 盲點 (optic disc)

視網膜剝離

BBlind spotlind spot

腦壓

BBlind spotlind spot test test盲點測試盲點測試

TThe retina has three layers of retinal neurons:he retina has three layers of retinal neurons:-- photoreceptor layer:photoreceptor layer:

- rods- rods 桿狀細胞 桿狀細胞 (95%) (95%) shape, night vision shape, night vision- cones- cones 錐狀細胞 錐狀細胞 (5%) (5%) color color-- bipolar cell layerbipolar cell layer 雙極細胞層雙極細胞層-- ganglion cell layerganglion cell layer 神經節細胞層神經節細胞層

- horizontal cells- horizontal cells 水平細胞 水平細胞 and amacrine cellsand amacrine cells 無軸無軸索細胞索細胞

Photoreceptor cells 感光細胞(Rod or cone cells)

│↓

Bipolar cell 雙極細胞│↓

Ganglion cell 神經節細胞↓

Opitc nerve

Horizontal cell modified

Amacrine cell modified

Outer limitingmembrane

Inner limitingmembrane

Rod cell Cone cell

Cone cellCone cell 錐狀細胞 錐狀細胞 (5%) (5%) Color Color- high resolution, acute vision- high resolution, acute vision- spectral peaks: 429nm and 555nm- spectral peaks: 429nm and 555nm

Rod cellRod cell 桿狀細胞 桿狀細胞 (95%) (95%) Light and dark Light and dark- highly sensitive to light, poor resolution - highly sensitive to light, poor resolution

Photoreceptor cells of dog

Spectra of photopigments

Photoreceptor cells of human

Protanopia赤綠色盲(red / green)

Deuteranopia赤綠色盲(red / green)

Tritanopia藍黃色盲(blue / yellow)

全色盲

色盲、色弱

緣皮囊

耳輪腳

耳舟

對輪

耳珠

對珠

珠間切跡

耳輪腳

耳輪棘

Anterior

Cartilage of external earAuricle 耳殼 -Auricular cartilage 耳殼軟骨

-Helix 耳輪-Medial and lateral crura of the helix 內、外耳輪腳-Anhelix 對輪-Scapha 耳舟-Tragus 耳珠-Antitragus 對珠-Marginal cutaneous sac or pouch 緣皮囊

-Scutiform cartilage 楯狀軟骨-Annular cartilage 環形軟骨

External ear canal 外耳道-Tympanic membrane 鼓膜

耳殼軟骨

環形軟骨

對珠

對珠

珠間切跡耳珠

耳輪腳

耳輪腳

耳輪棘

對輪

耳舟

楯狀軟骨

Middle ear:-Tympanic cavity 鼓室

-Tympanic membrane 鼓膜-Oval window 卵圓窗-Round window 圓窗-Auditory tube 耳咽管

-Auditory ossicles-Malleus 鎚骨-Incus 砧骨-stapes 鐙骨

-Ossicular muscles-Tensor tympani m. 鼓膜張肌-Stapedius m. 鐙骨肌

Movie

Inner ear:-Bony labyrinth - perilymph-Membranous labyrinth - endolymph-Semicircular cannal and ampulla-Utricle and saccule-Cochlea