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Fundamentals 1_30_2017

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kuleya's version from 2017-01-30 17:21

Anatomy

Question Answer
how many meibomian glands on lower eyelid?20-29, 30-40 on upper
what attaches to the lateral orbital tubercle?suspensory ligament of eye, lateral rectus, lateral palpebral ligament, and the aponeurosis of the levator
What passes through foramen ovale? rotundum? V3, V2
where are hemidesomsomes on corneal epithelium?attaching to basal lamina
what attaches superficial corneal epithelial cells together?occluding zonules
Bones of orbital floormaxillary, zygomatic, palatine
Bones of lateral orbital wallgreater wing of sphenoid and zygomatic
Bones of orbital rooffrontal, lesser wing of zygomatic
Bones of medial orbital wallmaxillary, lacrimal, ethmoid, lesser wing of sphenoid
Size of foveola350 micron diameter
how many anterior ciliary arteries do the recti have?2 except for lateral
orbital orbicularis is responsible for what?voluntary blinking, reflex is by palpebral
contents of foveola?all cones
refractive power of cornea43.25D
basal tear production done by?glands of wolfring and Krause
reflex tearing from?lacrimal glan
lens capsule contains what kind of collagen?type IV – any basal lamina
where is peripheral arterial arcade?superior border of tarsus
MARGINal artery at theMARGIN
4 in the floorIV collagen in basal shit
collagen types in the corneal stroma?I III V VI
medial eyelid drains to what lymp node?submandibular lateral drains to superficial preauricular then deep cervical
where is the germinative zone of the lens epithelium?pre-equitorial
what makes the lipid layer of the tear film?Zeis and meibomian
what is analogous to whitnalls ligament in the lower lid?lockwoods ligament
what structures pass outside the annulus of Zinn?Lacrimal, Frontal, Trochlear nerves….superior ophthalmic vein
describe the course of the pupillary light reflex from optic nerve to sphincterstarts at ON, decussates at chiasm, travels with tract, splits from tract to reach pretectal nuclei at superior colliculus…efferent fibers decussate and go to edinger westphal nucleus then travel with CN III then inferior division of CN III then ciliary ganglion which the short posterior ciliary nerves emerge from
where is the major arterial circle of the anterior uvea?anterior ciliary body
which muscle has longest tendon and muscle?superior oblique -32 mm and 26 mm respectively, second longest is levator
smallest tendon EOM?inferior oblique
what supplies neutrophils to central corneal wound?tear film
volume of the orbit?30 cm3
where in corneal epithelium are zonula occludens? hemidesmosomes? desmosomes?Zonula occludens – between superficial epithelial cells, hemidesmosomes between basal epithelial cells and basal lamina and (desmosomes between basal epithelial cells)
anterior chamber depth on average is what?3 mm ACD is 3 letters!
what is minimal ACD needed for ICL?3 mm
what does ICL stand for?implantable collimer lens
average volume of anterior chamber? posterior chamber?200 microL and 60 microL
describe microtubule organization of the ziliu,cilium that connects the outer to inner rod and cone segments?this is fucking ridiculous – 9 plus 0
how many short ciliary nerves are there?6-10
how many ciliary processes are there?80
dimensions of adult cornea?12x11 mm vertical shorter
source of descemets?corneal endothelium secretes Type IV collagen
branches of circle of zinn haller supply what part of nerve ?laminar
thickness of adult anterior capsule?14-15/5 micron
volume of AC?200 micro liters
volume of posterior chamber?60 microliters
volume of adult eye?6.5-7 mL
main method of energy production in lens?anaerobic glycolysis
which CN III innervated muscles is supplied by contralateral nucleus?superior rectus
levator palpebrae is innervated how?by midline CN II nucleus
spiral of tillaux shows what distance from the limbus per muscle?MR 5.5, IR 6.5, LR 6.9, SR 7.7
muller cels are located where? where do they extend to?inner nuclear layer – ionic buffer, vitamin A metabolism…. footplates at ILM and XLM
rhodopsin is made of what two molecules?cis-retinaldehyde and opsin
what are axenfeld loops?ciliary neves visible in sclera near limbus
where in optic tract do upper retinal fibers travel?medially
where in the optic tract do the lower retinal fibers travel?laterally
where in the optic tract do the macular fibers travel?dorsolateral
branches of V1 nerve?frontal, lacrimal, and nasociliary nerves…supratrochlear and supraorbital are branches of frontal
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Embryology

Question Answer
Fetal alcohol syndrome causes what ocular abnormalitiesoptic nerve hypoplasia, strabismus, ptosis, epicanthus, cataract, PFV, axenfeld
Most common nucleotide deletion in lebers optic neuropathy?11778
Three classic lebers optic neuropathy findings?elevation of dic, peripapillary telangiectasia, retinal arteriolar tortuosity
describe the development of vitreous (3 stages)primary vitreous (hyaloid artery, vasa hyaloidea propia, mesenchymal cells, tunica vasculosa lentis), 9th week → secondary vitreous replaces primary, tertiary vitreous (consists of zonular fibers which hold the lens in place)
what week has most optic nerve neurons?16 weeks, 3.7 million
rubella infection has what effects in what trimesters?1st – cataract, deafness, cardiac issues….2nd trimester – salt and pepper fundus
findings in Kearn SayreCPEO, retinal pigmentary changes, cardiomyopathy
Findings in Lowe Syndromeglaucoma, cataract, MRDD, progressive renal tubular dysfunction
Weill marchesani causes what? gene?ectopia lentis, microspherakia, stiff joint, heart defect, brachycephaly…. ADAMTS10…do prophylactic laser PI
hyaloid artery comes from what?primitive dorsal ophthalmic
which side vascularizes first – nasal or temporal in the fetus, what week?nasal first at 36 weeks, temporal at 40 weeks, retinal vascularization matures at 3 months of age
what is the enzyme deficiency in leber hereditaryy optic neuropathy?NADH dehydrogenase, gene 11778
genetics of WAGR?sporadically inherited PAX6 mutation
describe the sutures of the lens? at what week do they form?Y sutures erect anteriorly and inverted posteriorly… forms at 8 weeks of gestation
what is temporal scleral derived from?mesoderm
what is corneal stroma derived from?neural crest
what is corneal endothelium derived from?neural crest
what is corneal epithelium derived from?surface ectoderm
what part of cornea is not derived from the same embryologic tissue as the rest?corneal epithelium
what is the hallmark of first trimester rubella infection?cataracts, deafness, cardiac…does not typically develop glaucoma if they get cataracts
when are tears first made in a baby6 weeks
why does ___ capsule enlarge with age and the ____ capsule does not?anterior capsule enlarges with age bc posterior primary lens fibers stop dividing after forming lens nucleus of embryo while anterior fibers remain…posterior capsule does not grow with age
inferonasal lens dislocation inhomocystinuria
what percentage of people have macular cilioretinal arteries?15%
iris strands have what origin?anterior pupillary membrane remnants vascular
remnant of tunica vascular lentis anterior?mittendorf dots
remantns of hyaloid artery at disc?bergmeister papilla
first wave of neural crest cells makecorneal endothelium
second wave of neural crest cells makeiris and pupillary membrane
third wave of neural crest cells makecorneal stroma (keratocytes) and sclera
largest number of neurons in optic nerve during development? when?3.7 million at week 16
enzyme that is deficient in LHON?NADH dehydrogenase of mitochondria
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Pharmacologic principles

Question Answer
what is benefit of valacyclovir vs acyclovir?higher bioavailability
famciclovir is prodrug for what?penciclovir
how much carbonic anhydrase needs to be inhibited before IOP lowering occurs?99%
epithlium of cornea is hydro or lipo-philic?lipophilic
pilocarpine does what refractive change?induces myopia
what is the volume of the tear lake?10 micro L, a drop is 50 microL
what two stupid fucking things do you need to know about echothiophate?should not be given with succinylcholine (prolonged paralysis) … chronic use causes iris cyst formation (prevented by co-administration with phenylephrine)
when is iopidine used for IOP?apralonidine is used for prevention of IOP spike after laser iris procedures like LPI
what anesthesia should not be used for ruptured globe repair?fuckin succ
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Cornea

Question Answer
curve of endothelial cell count over years?4000 at birth, 3000/mm2 as young adult, 2500/mm2 at 60… loss rate slows after age 60
bowmans is made up of what kind of collagen?Type I and V
What is the main metabolic substrate of the cornea? where does it come from?glucose from the aqueous
ATP made in lens via?anaerobic glycolysis in anterior portion of lens, lens has no mitochondria
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Retina

Question Answer
Rhodopsin is located on what chromosome number? most common mutation is in what disease?chromosome 3…. AD retinitis pigmentosa (P23H) defect is in folding leading to accumulation in rough ER….
Why are color deficient patients men? What color lost?L and M cones on chromosome X responsible for red/green deficiency
how does rhodopsin work?combination of opsin and 11-cis retinaldehyde… light photolyzes 11-cis to 11- trans… transducin activated leading to hyperpolarizioation
diameter of fovea1.5 mm
AREDS and ____ increase the risk of ___ cancer?beta-carotene and lung cancer
what is the basis of the EOG?trans RPE potential from apical NA/K-ATPase transporting ions from subretinal space into RPE cells
blue light leads to formation of _________ which damages ___ ___ and leads to RPE death. thought to be mechanism of dry ARMD.A2E damages cytochrome oxidase and leads to RPE death
What meds absorbs blue light?carotenoids luitein, zeaxanthin
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