Download lacrimal， ocular

Ocular
anatomy
SectionⅠ
Eyeball
Orbit
Lacrimal apparatus
Extraocular muscles
visual organ & visual pathway
Vascular supply to the eyeball
Eyeball
Orbit
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Frontal
Zygomayic
Maxillary
Ethmoidal
Sphenoid
Lacrimal
Palatine
Lacrimal apparatus
1. Lacrimal gland
2. Lacrimal
passages
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Lacrimal puncta
Lacrimal canaliculi
Lacrimal sac
Nasolacrimal duct
Extraocular muscles
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Medial rectus
Inferior
Lateral rectus
Superior rectus
Superior oblique
Inferior oblique
Extraocular muscles
visual organ
outer：cornea，sclera
Wall
Eyeball
media：iris，ciliary，choroid
inner：retina
content：aqueous humor，lens，vitreous body
visual
organ
visual retina
Optic
Optic
Optic
pathway
nerve
chiasm
tract
Lateral
optic
occipital lobe
geniculate body radiation
optical center
appendages：eyelid，conjuncliva，lacrimal， ocular，orbitalis
apparatus muscles，
visual pathway
Vascular supply to the eyeball
Artery
• Central retinal artery,CRA
• Ciliary artery,CA
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Short posterior CA
Long posterior CA
Anterior ciliary CA
vein
1. Central retinal vein,CRV
2. Vortex vein
3. Anterior ciliary vein
Vascular supply to the eyeball
SectionⅡ
Cornea
Sclera
Iris
aqueous humor
Lens
Choroid
Vitreous body retina
Ciliary body
Cornea
• Oval
– transverse：11.5～12mm
– vertical：10.5～11mm
• curvature：anterior：7.8mm
posterior：6.8mm
• antisymmetry
• thickness：centre：0.5～0.55mm
periphery:1mm
• Refractive index：1.3771
Cornea
Refractive power: 43D
2／3 of total
Cornea
Histologic structure：
Epithelium
Basement layer
Bowman’s
membrane
Stroma
Descemet’s
membrane
endothelium
Cornea
1.Epithelium ：
2.Bowman’s membrane :
– 50μm
• 12 μm
– 5～6 layers
• Squamous cell
• No cell
• Aliform cell
• Collagen ，matrix
• Basal cell
– Renewing cycle≈7 days
• Scar
Cornea
3.Stroma ：
4.Descemet membrane：
– 500 μm
– 10～12 μm
– 2～3％ corneal cell
– No structure
– 1％matrix（GAGs)
– Fibrous lamina
• 200～250 layers
• Parallel to surface
• Parallel collagen fiber
• Ordered arrangement
– Scar
– elasticcity
– Secreted by endothelial
cell
– Basal membrane of
endothelial cell
– regeneration
Cornea
5.Endothelium ：
– 5 μm
– Monolayer hexagen
• 500 000 cells
• Stop miosis
• Tight junction
• Pump
Cornea
• Blood vessel:
– Limbus vascular
net
• Innervation :
– One of the most full
tissue
– ophthalmic nerve of
Trigeminal nerve(N5)
– Inner avascularity
• Sensory nerve
– Less nutrition
• Parasympathetic
nerve
– demyelination
– Available when edema
Physiology
• Enegy
• Transparency maintaining
Physiology
– Anatomy
• avascularity，no pigment
• Epithelium ordered arrangement ，no
keratinization
• Stroma ordered arrangement
• Endothelium ordered arrangement
– Tight junction of endothelium
– Related hydration
• pump
• Hydration of stroma
Sclera
• Posterior 5／6 of fibrous mem
• White , firm
• Forward connect cornea-corneoscleral limbus
• Backward :optic nerve
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–
Sheath
Cribriform plate
• Thickness
Muscle attachment：0.3mm
Nerve surrounding：1.0mm
Sclera
Histology
– Episclera ：vascular contain
– Sclera stroma：collagen fiber
– Plate layer：pigment cell
Sclera
Physiologic function：
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Appearance maintaining
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Content protection
•
refraction
Corneoscleral limbus
• Transition zone:
– ant：bowman`s terminal-descemet terminal
– pos：scleral spur／iris root vertical plane
• 1.5～2.0mm width
• appearance
– Semitransparant zone
– White sclera
• Angle of AC
Angle of anterior chamber
• Ant-lateral：corneoscleral limbus
• Pos-medial：anterior ciliary and iris root
• Include:
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Schwalbe line
–
trabecular reticulum
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Schlenm cannel
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Scleral spur
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Ciliary zone
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Iris root
iris
• Disc
• Chamber separation
• Puple ：2.5～4.0mm
• whorl
– Puple area
– Ciliary zone
iris
Histology
• Anterior surface layer
• Stroma layer
• chromocyte
• sphincter muscle of pupil——parasympathetic
nerve
• dilator muscle of pupil——sympathetic nerve
• Pigmentary epithelium
iris
pupil
– Regulation of incident light
volumn
– Depth of focus and aberration
Ciliary body
• Connect iris root and choroid
• Triangle
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corona：2mm
• Ciliary process：40～80个
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Pars plana：4mm
• Muscle ——parasympathetic nerve
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meridional fibers
Radial fibers
Circular fibers
Ciliary body
contraction:
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Accomodation
• Ring muscle contraction
• Suspensory ligament internal traction，loose
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IOP
• meridional fibers contraction
• Choroid shift forward，scleral spur draw backward
– Open AAC/scleral vein
– Choroid blood volumn↑
– Ciliary blood volumn↓
aqueous humor
•
Full filled
•
0.2ml
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Refractive index：1.3774
•
Drainage path
– ciliary
posterior chamber
pupil
anterior chamber
trabecular
Schlemm
canal
collection canal
aqueous vein
ciliary veins
– choroid
aqueous humor
•
physiology
– dioptric media
– IOP maintain
– Uniform RI of
conea
– metabolism
– accomodation
choroid
•
ora serrata ——
optic disc
•
Full of pigment
and BV
•
Bruch membrane
•
nutrition，dark
room
Histology
10 inner limiting membrane
09 nerve fiber layer
08 ganglion cell layer
07 inner plexiform layer
06 inner plexiform layer
05 external plexiform layer
04 external;nuclear layer
03 outer limiting membrane
02 retinal rod and cone cell layer
01 RPE
Lens
•
Transparent ，double convex mirror
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Between pupil-iris and vitreous body
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Diopter ：19D
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ant：10mm
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pos：6mm
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Axis length：4mm
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D：9mm
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RI：1.4371
Lens
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Nonuniform RI
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Elasticcity body
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Accomodation
intracapsular——RI
Vitreous body
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Transparent colloid
4.5ml
RI:1.3360≈aqueous humor
Tight junction site:
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Disc egde
Fovea surrounding
Basement of vitreous body
Posterior capsular（youth）
Cloquet canal
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Lens posterior pole——in front of disc
Primary vitreous
Retina
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Transparent ,thin
Anterior rim：ora serrata
macula／fovea
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Posterior pole
Keen
RPE-pigment
optic disk
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Disc form
Nasal side of macula: 3mm
1.5×1.75mm
optic cup C/D < 0.3
Retina
Special side:
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Optic disc
• Only optic nerve fiber
• Physiological blind spot
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macular
• thinnest
• Only rod —— photopic
vision，colour vision
• Other layers abscent
• Neuron singlet link
• keen