The eyelids are covered externally by ______ ______ and internally by the ______ ______, which is continuous with the ______ ______.

thin skin, palpebral conjunctivum, bulbar conjunctivum

The muscular portion of the eyelid is formed by the ______ ______, which is innervated by the ______ nerve, also known as cranial nerve ______.

orbicularis oculi, facial, VII

The edges of the eyelids are lubricated by the ______ glands, also known as ______ glands.

tarsal, Meibomian

In the corneal reflex, the afferent limb is carried by the ______ nerve (CN ______), and the efferent limb is carried by the ______ nerve (CN ______), which contracts the ______ ______ muscle.

trigeminal, V, facial, VII, orbicularis oculi

Loss of the corneal reflex due to ______ nerve injury can lead to ______ damage and eventual ______.

facial, corneal, ulceration

The ______ ______ ______ elevates the upper eyelid and is innervated by the ______ nerve (CN ______).

levator palpebrae superioris, oculomotor, III

Müller’s muscle, also called the ______ ______ muscle, is a ______ muscle innervated by ______ ______ axons from the ______ ______ ______.

superior tarsal, smooth, postganglionic sympathetic, superior cervical ganglion

Paralysis of Müller’s muscle can lead to ______, or ______ of the upper eyelid, which is a feature of ______ ______.

ptosis, drooping, Horner's Syndrome

Müller’s muscle, also known as the ______ ______ muscle, is a ______ muscle located in the ______ eyelid.

superior tarsal, smooth, upper

Müller’s muscle is innervated by ______ ______ axons from the ______ ______ ______.

postganglionic sympathetic, superior cervical ganglion

Tear production by the lacrimal gland is primarily controlled by ______ innervation from the ______ nerve (CN ______), with postganglionic fibers originating from the ______ ______.

parasympathetic, facial, VII, pterygopalatine ganglion

In addition to parasympathetic input, the lacrimal gland also receives ______ innervation, which plays a supporting role in ______ control.

sympathetic, tear

Tears contain ______ and ______, which help protect the eye from infection.

lysozyme, IgA

Tears drain into the ______ ______, then through the ______ into the ______ ______, which empties via the ______ ______ into the ______ ______ ______.

lacrimal puncta, canaliculi, lacrimal sac, nasolacrimal duct, inferior nasal meatus

The orbit is a ______-shaped cavity with its apex located at the ______ ______ in the ______ wing of the ______ bone.

pyramidal, optic canal, lesser, sphenoid

The superior wall of the orbit is formed by the ______ portion of the ______ bone, and the medial wall is formed mostly by the ______ bone.

orbital, frontal, ethmoid

The lateral wall of the orbit is formed by the ______ portion of the ______ bone and the ______ wing of the ______ bone.

frontal, zygomatic, greater, sphenoid

The inferior wall of the orbit is formed mostly by the ______ bone, with additional contributions from the ______ and ______ bones.

maxillary, zygomatic, palatine

at what angle do the orbital axes diverage?

______ deg

45 deg

The apex of the orbit is located at the ______ ______ in the ______ wing of the ______ bone.

optic canal, lesser, sphenoid

A blowout fracture occurs when the ______ walls of the orbit fracture, often involving nearby ______.

thin, sinuses

Medial wall ______ fractures involve the ______ bone and can affect the ______ sinuses.

blowout, ethmoid, ethmoid

Inferior wall blowout fractures involve the ______ bone and can affect the ______ sinuses.

maxillary, maxillary

Superior wall blowout fractures can affect the ______ lobe of the ______.

frontal, brain

Bleeding into the orbit posteriorly after a fracture may cause the eye to protrude, a condition called ______.

exophthalmos

Exophthalmos is the ______ of the ______, which can be caused by various conditions such as bleeding into the ______ ______.

protrusion, eyeball, eye socket

The orbit contains the ______ (periosteum), ______ ______ that provide padding and allow ______ movements, ______ and ______, ______ muscles, the ______ (bulbus oculi), and the ______ apparatus.

periorbita, orbital fat, eye, nerves, vessels, extraocular, eye, lacrimal

PONEEL

What is 1?

superior rectus muscle and fascial sheath

What is 2?

lacrimal gland

What is 3?

lateral rectus muscle and fascial sheath

What is 4?

periorbita

What is 5?

sclera

What is 6?

retrobulbar fat (orbital fat body)

What is 7?

inferior oblique muscle and fascial sheath

What is 8?

inferior rectus muscle and fascial sheath

What is 9?

sclera

What is 10?

periorbita

What is 11?

medial rectus muscle and fascial sheath

What is 12?

superior oblique muscle and fascial sheath

What is 13?

levator palpebrae superioris muscle and fascial sheath

The major blood supply to the orbit is the ______ artery, which is the first branch of the ______ ______ artery.

ophthalmic, internal carotid

The ______ artery of the ______ enters the optic nerve; its occlusion can cause ______ in the eye.

central, retina, blindness

What is 1?

supratrochlear artery

What is 2?

supra-orbital artery

What is 3?

anterior ciliary artery

What is 4?

zygomagitcofacial artery

What is 5?

zygomaticotemporal artery

What is 6?

long posterior ciliary artery

What is 7?

central artery of retina

What is 8?

middle meningeal artery

What is 9?

lacrimal artery

What is 10?

internal carotid artery

What is 11?

opthalmic artery

What is 12?

optic nerve (CN II)

What is 13?

short posterior ciliary artery

What is 14?

anterior and posterior

ethmoidal arteries in canals in ethmoid bone

What is 15?

dorsal nasal artery

The ______ artery of the ______ enters the ______ nerve to supply the ______ retina.

central, retina, optic, inner

The ______ ______ arteries penetrate the ______ to supply the ______ and ______ retina, including the pigment epithelium and rods and cones.

posterior ciliary, sclera, choroid, outer

What is 1?

supratrochlear artery

What is 2?

anterior ethmoidal artery

What is 3?

posterior ethmoidal artery

What is 4?

continuation of opthalmic artery

What is 5?

opthalmic artery

What is 6?

internal carotid artery

What is 7?

central retinal artery

What is 8?

posterior ciliary artery

What is 9?

zygomatic branches

What is 10?

supraorbital artery

The ______ artery, a branch of the ______ artery, forms an anastomosis with the ______ artery.

infraorbital, maxillary, ophthalmic

What is 1?

supraorbital artery

What is 2?

supratrochlear artery

What is 3?

opthalmic artery

What is 4?

angular artery

What is 5?

infraorbital artery

What is 6?

maxillarty artery

What is 1?

supra-orbital vein

What is 2?

vorticose vein

What is 3?

superior ophthalmic vein

What is 4?

to cavernous sinus

What is 5?

inferior ophthalmic vein

What is 6?

to pterygoid venous plexus

What is 7?

infra-orbital vein

What is 8?

angular vein

What is 9?

facial vein

What is 1?

pterygoid plexus

What is 2?

inferior ophthalmic vein

What is 3?

cavernous sinus

What is 4?

superior ophthalmic vein

What is 5?

nasofrontal vein

What is 6?

angular vein

What is 7?

facial vein

The following structures pass through the tendinous ring: the ______ nerve (both superior and inferior divisions, CN ______), the ______ nerve, the ______ nerve (CN ______), the ______ nerve (CN ______), and the ______ artery (within the ______ nerve).

oculomotor, III, nasociliary, abducent, VI, optic, II, ophthalmic, optic

The extraocular eye muscles that do not attach to the tendinous ring are the ______ ______ and the ______ ______.

superior oblique, inferior oblique

The muscles that attach to the tendinous ring and their functions are:

• ______ ______: abduction
• ______ ______: downward gaze
• ______ ______: adduction
• ______ ______: upward gaze

lateral rectus

inferior rectus

medial rectus

superior rectus

What is 1?

inferior ophthalmic vein

What is 2?

abducens nerve (CN VI)

What is 3?

lateral rectus

What is 4?

nasociliary nerve

What is 5?

oculomotor nerve (CN III), superior division

What is 6?

trochlear nerve (CN IV)

What is 7?

superior ophthalmic vein

What is 8?

superior orbital fissure

What is 9?

frontal nerve

What is 10?

lacrimal nerve (CN V1)

What is 11?

superior rectus

What is 12?

levator palpebral superioris

What is 13?

optic nerve (CN II)

What is 14?

superior oblique

What is 15?

medial rectus

What is 16?

ophthalmic artery

What is 17?

common tendinous ring

What is 18?

inferior rectus

What is 19?

oculomotor nerve (CN III), inferior divison

What is 1?

supratrochlear nerve

What is 2?

medial rectus muscle

What is 3?

superior oblique muscle

What is 4?

infratrochlear nerve

What is 5?

nasociliary nerve

What is 6?

trochlear nerve (IV)

What is 7?

ophthalmic nerve (V1)

What is 8?

oculomotor nerve (III)

What is 9?

trochlear nerve (IV)

What is 10?

abducens nerve (VI)

What is 11?

tentorium cerebelli

What is 12?

tentorial nerve (meningeal) branch of ophthalmic nerve

What is 13?

trigeminal (semilunar) ganglion

What is 14?

maxillary nerve (V2)

What is 15?

frontal nerve

What is 16?

lateral rectus muscle

What is 17?

lacrimal nerve

What is 18?

superior rectus muscle

What is 19?

levator palpebral superioris muscle

What is 20?

lateral branch of supraorbital nerve

What is 21?

medial branch of supraorbital nerve

The extrinsic eye muscles and their innervation are:

• ______ nerve (CN ______): superior rectus, medial rectus, inferior rectus, inferior oblique, and levator palpebrae superioris
• ______ nerve (CN ______): superior oblique
• ______ nerve (CN ______): lateral rectus (abducts eye)

oculomotor, III

trochlear, IV

abducens, VI

What is 1?

superior oblique muscle

What is 2?

medial rectus muscle

What is 3?

inferior rectus muscle

What is 4?

common tendinous ring

What is 5?

leavtor palpebrae superioris muscle

What is 6?

superior rectus muscle

What is 7?

optic nerve

What is 8?

lateral rectus muscle

What is 9?

superior rectus muscle

What is 10?

levator palpebrae superioris muscle

What is 1?

superior oblique

What is 2?

superior rectus

What is 3?

medial rectus

What is 4?

inferior rectus

What is 5?

lateral rectus

What is 6?

inferior oblique

action of medial rectus?
_____ _____

adduct eyeball

action of lateral rectus?

_____ _____

abducts eyeball

The ______ ______ elevates the eyeball and has secondary actions of ______ and ______ rotation.

superior rectus, adduction, medial

The ______ ______ depresses the eyeball and has secondary actions of ______ and ______ rotation.

inferior rectus, adduction, lateral

The ______ ______ depresses the eyeball and also ______ and ______ rotates it. It is the primary ______ rotator.

superior oblique, abducts, medially, medial

The ______ ______ elevates the eyeball and also ______ and ______ rotates it. It is the primary ______ rotator.

inferior oblique, abducts, laterally, lateral

what is the primary medial rotator of the eyeball?

______ ______

superior oblique

what is the primary lateral rotator?

______ ______

inferior oblique

how do you clinically test superior rectus?

have patient look ______ , then ______

have patient look laterally, then up

how do you clinically test inferior rectus?

have patient look ______ , then ______

have patient look laterally, then down

how do you clinically test superior oblique?

have patient look ______ , then ______

have patient look medially, then down

how do you clinically test inferior oblique?

have patient look ______ , then ______

have patient look medially, then up

how do you clinically test medial & lateral recti?

look ______ (medial oblique) & ______ (lateral oblique)

look medially (medial oblique) & laterally (lateral oblique)

What is 1?

superior rectus (III)

What is 2?

lateral rectus (VI)

What is 3?

inferior rectus (III)

What is 4?

inferior oblique (III)

What is 5?

medial rectus (III)

What is 6?

superior oblique (IV)

What is 7?

superior rectus (III)

What is 8?

lateral rectus (VI)

What is 9?

inferior rectus (III)

With abducens nerve palsy, during ______ gaze, the affected eye is pulled ______ due to unopposed action of the ______ ______, because the ______ ______ is denervated.

primary, medially, medial rectus, lateral rectus

what nerve has been damaged/affected?

abducent nerve (CN VI) palsy

In abducent nerve (CN ______) palsy, during ______ gaze, the affected eye is pulled ______ due to unopposed ______ ______.

VI, primary, medially, medial rectus

In trochlear nerve palsy:

• ______ occurs, where the affected eye looks ______ in primary gaze due to denervated ______ ______
• ______ occurs, where the eye is rotated ______
• Patients experience ______
• They tilt their head ______ and ______ from the affected eye to compensate

hypertropia, upward, superior oblique

extorsion, laterally

diplopia

downward, away

what nerve has been damaged/affected?

trochlear nerve (CN IV) palsy

In oculomotor nerve palsy:

• The affected eye is positioned ______ and ______ due to unopposed actions of the ______ ______ and ______ ______ muscles
• The patient cannot ______ the upper eyelid
• The patient cannot ______ the eye to follow an object toward the face (impaired ______)
• ______ is present
• The pupil on the affected side is ______ due to unopposed ______ stimulation of the ______ ______ muscle

down, out, lateral rectus, superior oblique

elevate

adduct, adduction

diplopia

dilated, sympathetic, dilator pupillae

What is this?

oculomotor nerve palsy

What is 1?

lacrimal canaliculi

What is 2?

lacrimal sac

What is 3?

nasolacrimal

What is 4?

inferior nasal meatus

Axons from the _____ act as the afferent part of pupillary reflexes.

retina

Pupillary reflexes axons terminate in the _____ area and the _____ _____

pretectal

superior colliculus

Some retinal ______ cell axons bypass the ______ ______ nucleus and terminate in the ______ area and the ______ ______. At least some of these axons are involved in ______ reflexes.

ganglion, lateral geniculate, pretectal, superior colliculus, optic

In the pupillary light reflex, shining a light into one eye causes the ______ to ______, testing the integrity of ______ innervation to the pupil.

pupil, constrict, parasympathetic

The consensual reflex refers to constriction of the pupil in the ______ eye when light is shined into the ______ eye.

contralateral, opposite

The consensual reflex is the ______ of the pupil in the ______ eye when light is shined into the ______ eye.

constriction, contralateral, opposite

In the accommodation reflex, when a patient looks at a ______ object, the pupils ______ bilaterally.

near, constrict

During the accommodation reflex, the ______ muscles contract to allow the ______ to thicken for ______ vision.

ciliary, lenses, near

Dilated pupils that do not respond to light suggest unopposed action of the ______ ______ muscle, which is innervated by the ______ nervous system.

dilator pupillae, sympathetic

Non-reactive dilated pupils may indicate brainstem damage involving the ______ -______ nucleus.

Edinger-Westphal

In presbyopia, the ______ loses its ______ and can no longer ______, making it difficult to focus on ______ objects.

lens, flexibility, thicken, near

Under parasympathetic control, the ______ muscles contract, the ______ thickens, and the ______ constrict.

ciliary, lens, pupils

The test used to detect Marcus Gunn pupil (afferent pupillary defect) is the ______ ______ test.

swinging light

When shining a light into a normal eye during the swinging light test, the pupil in that eye ______ and the pupil in the other eye ______ (consensual light reflex).

constricts, constricts

In a normal swinging light test, when the light is swung to the other eye, that pupil should ______ more.

constrict

If during the swinging light test the pupil ______ when the light is shined in that eye, it indicates an ______ defect, often due to an ______ nerve problem.

dilates, afferent, optic

Argyll Robertson pupils are characterized by small, irregular pupils that fail to ______ to ______ but do constrict during ______.

Argyll Robertson pupils are associated with ______

constrict, light, accommodation

neurosyphilis