The document discusses the angle of the anterior chamber and aqueous humor dynamics. It covers the anatomy and development of the angle, diagnostic methods for examining the angle like gonioscopy, and grading scales for the angle. It also discusses the production and drainage of aqueous humor, including the roles of the ciliary body and processes, trabecular meshwork, and collector channels. Key functions of the aqueous humor include maintaining eye pressure and providing nutrients to ocular tissues.
A brief presentation on corneal physiology (Functions ,cell shapes, histology ,biochemical compositions, transparency, drug permeability and cell turnover and wound healing )
INTRODUCTIONThe clear fluid filling the space in front of the eyeball between lens and cornea.The aqueous humour supplies nutrition and removes waste from the clear structure in the anterior eye(cornea and lens)The balance between aqueous production and outflow determines the intraocular pressure.
INTRODUCTION
The clear fluid filling the space in front of the eyeball between lens and cornea.
The aqueous humour supplies nutrition and removes waste from the clear structure in the anterior eye(cornea and lens)
The balance between aqueous production and outflow determines the intraocular pressure.
A brief presentation on corneal physiology (Functions ,cell shapes, histology ,biochemical compositions, transparency, drug permeability and cell turnover and wound healing )
INTRODUCTIONThe clear fluid filling the space in front of the eyeball between lens and cornea.The aqueous humour supplies nutrition and removes waste from the clear structure in the anterior eye(cornea and lens)The balance between aqueous production and outflow determines the intraocular pressure.
INTRODUCTION
The clear fluid filling the space in front of the eyeball between lens and cornea.
The aqueous humour supplies nutrition and removes waste from the clear structure in the anterior eye(cornea and lens)
The balance between aqueous production and outflow determines the intraocular pressure.
Let's learn about the relevant anatomy & physiology associated with glaucoma- the angle of the anterior chamber, physiology of aqueous humor circulation, and many more. Happy Learning!
PHYSIOLOGY OF AQUEOUS HUMOUR & IOP REGULATION 3.pptxAkashChaurewar1
This ppt is made available for free to use and modification.
This is made for presentation for PG seminar activity during MS ophthalmology residency 1st year by Dr Akash Chaurewar under guidance of Dr. Shubha Ghonsikar with mentors - Dr. Archana Vare and other faculty.
Anatomy and Physiology of Aqueous Humor Sumit Singh Maharjan
2. Anatomy
3. Angle of anterior chamber
4. Angle of the Anterior chamber
5. Gonioscopic grading of Angle
6. Aqueous Outflow system
7. Trabecular meshwork
8. Functions of Aqueous Humor • Maintenance of Intraocular pressure • Metabolic role cornea lens vitreous and retina • Optical function • Clearing function
9. Physicochemical properties • volume: 0.31ml (0.25ml in Ant. Chamber and 0.06 in post chamber) • Refractive index: 1.336 • Density: slightly greater than water, its viscocity is 1.025-1.040 • Osmotic pressure: slightly hyperosmotic to plasma by 3-5mosm/l • PH: 7.2 • Rate of formation: 2-2.5microliter/min
10. Biochemical composition • Water: 99.9% • Proteins: 5-16mg/100ml • Amino acids: aqueous/plasma concentration varies from 0.08-3.14 • Non colloidal constituents: conc. of ascorbate, pyruvate, lactate in higher am
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Are There Any Natural Remedies To Treat Syphilis.pdf
Aqueous Humor Dynamics.pptx
1. ANGLE OF ANTERIOR CHAMBER
AND AQUEOUS HUMOR DYNAMICS
Dr. GARIYASHEE LAHKAR
2. OUTLINE
1. Introduction.
2. Development of the angle of anterior chamber.
3. Anatomy of the angle of anterior chamber.
4. Diagnostic modalities for angle examination.
5. Grading of the angle of anterior chamber.
6. Developmental anomalies of the angle.
7. Aqueous humor dynamics.
8. Composition, physical properties and functions of aqueous
humor.
9. Measurement of aqueous outflow.
10. Summary.
3. INTRODUCTION
• ANGLE OF ANTERIOR CHAMBER:
The peripheral recess of
anterior chamber.
Clinically, can be visualized by
gonioscopic examination.
Plays an important role in the
process of aqueous drainage.
Fig: Angle of Anterior
Chamber
4. INTRODUCTION (Contd.)
• AQUEOUS HUMOR DYNAMICS:
The physiological processes concerned with dynamics of
aqueous humor:
1. Production
2. Drainage
Maintains structural integrity of eyeball.
Nourishes cornea and lens.
Provides optically clear media.
5. DEVELOPMENT OF THE ANGLE OF
ANTERIOR CHAMBER
• Formed by loosely arranged mesenchymal neural crest
cells.
• At 7th week cells accumulate near the angle.
• At 5 months, closed cavity of anterior chamber is formed.
• At the end of 3rd trimester, endothelial layer progressively
disappears.
• Development of trabecular spaces and intertrabecular
spaces.
• Normal anterior chamber is not formed uptil 1 year of age.
• Angle deepening continues even after birth.
6. DEVELOPMENT OF THE ANGLE OF
ANTERIOR CHAMBER
Fig: Development of the angle structures
7. ANATOMY OF THE ANGLE OF ANTERIOR
CHAMBER
• Anterior To Posterior:
1. Schwalbe’s Line
2. Trabecular Meshwork
3. Scleral Spur
4. Ciliary Band
8. 1. SCHWALBE’S LINE:
• Anterior limit of the drainage angle.
• Fine scalloped border at the termination of Descemet’s
membrane.
• Lies in the plane of posterior corneal surface.
• Contains collagen fibres intermixed with elastic fibres.
• Also marks transition between corneal endothelium and
trabecular meshwork.
10. 2. TRABECULAR MESHWORK:
• Spongework of connective tissue beams.
• Arranged as superimposed perforated sheets.
• Seen as a broad band just anterior to the scleral spur.
• Usually featureless in unpigmented eye.
• Extends from Scleral spur to Schwalbe’s line.
13. UVEAL MESHWORK
• Innermost layer of trabecular meshwork.
• Comprises of cord like trabeculae.
• 2-3 layers thick.
• The trabecular apertures are of diameter
25-75 micron.
• Extends from ciliary muscles to Schwalbe’s line.
Fig: Trabecular
Meshwork
14. CORNEOSCLERAL MESHWORK
• Forms larger middle portion.
• Consist of flat sheets of trabeculae which
are perforated by elliptical openings.
• Diameter of openings: 5-50micron.
• Extends from scleral spur to lateral
wall of scleral sulcus.
Fig: Trabecular
Meshwork
15. JUXTACANALICULAR MESHWORK
• Forms outermost portion of trabecular
meshwork.
• Mainly responsible for resistance to
aqueous outflow.
• Lies adjacent to inner wall of schlem’s
canal.
• Consist of 2-5 layers of loosely arranged
cells
embedded in an extracellular matrix. Fig: Trabecular
Meshwork
16. 3.SCLERAL SPUR:
• Wedge shaped ridge.
• Posterior portion of scleral sulcus.
• Anterior: trabecular meshwork.
• Posterior: longitudinal fibres of ciliary body.
• Pale, transparent, narrow strip of scleral tissue.
• Composed of 75-85% collagen and 5% elastic tissue.
18. 4. CILIARY BAND:
• Anterior most part of the ciliary body.
• Lies between its attachment to scleral spur
and insertion of iris.
• Forms posterior most landmark of angle
recess.
• Width depends upon the level of iris
insertion.
• Consists of longitudinal fibres.
27. AQUEOUS HUMOR
• Aqueous humor is a transparent ,
colorless solution formed
continuously from the plasma by
the epithelium of the ciliary
processes.
• Continuously circulated from
posterior to anterior chamber.
• Dynamic equilibrium.
28. AQUEOUS HUMOR DYNAMICS
The physiological processes concerned with dynamics of
aqueous humor:
1. Production
2. Drainage
29. ANATOMY OF THE CILIARY BODY
Can be broadly divided into
1. Pars plana
2. Pars plicata
Consists of:
1. Ciliary epithelium:
pigmented and non-pigmented
2. Ciliary body stroma
3. Ciliary muscle
31. PRODUCTION
• Site of production: ciliary processes
• LEBER’S THEORY
• Three Processes:
1. Diffusion
2. Ultrafiltration
3. Secretion
32. ULTRAFILTRATION
• Dialysis under hydrostatic pressure
• Plasma filtrate
• From capillary wall and loose
connective tissue
• Accumulates behind pigmented and
non-pigmented epithelium of ciliary
process.
33. SECRETION
• Active process.
• 80-90% of aqueous humor formation.
• Active transport of ions against
concentration gradient.
• Substances actively transported
to posterior chamber.
34. DIFFUSION
• Occurs due to osmotic gradient.
• Rate of movement is determined by
FICK’S LAW: RATE=K(C1-C2)
• Sufficient diffusional exchange also
occurs with the surrounding structures.
38. AQUEOUS HUMOR DRAINAGE
Mainly by two pathways:
1. Conventional/ Trabecular Pathway
2. Unconventional/Uveoscleral Pathway
39. ANATOMY OF THE OUTFLOW
SYSTEM
1. Trabecular Meshwork
2. Schlemn’s Canal
3. Collector Channels:
• Direct
• Indirect
40. 2. SCHLEMM’S CANAL:
• Narrow circular tube.
• Endothelial lined oval channel.
• Present circumferentially in the
scleral sulcus.
• Conducts aqueous humor from
Trabecular meshwork to
Episcleral venous network.
41. 3. COLLECTOR CHANNELS
• 2 Intrascleral System.
1. Direct : Large calibre vessels.
Short intrascleral course.
Drains directly into episcleral
system.
2. Indirect: Finer channels.
Forms intrascleral plexus
before
draining into episcleral veins.
Fig: Collector Channels
42. DIRECT SYSTEM
Aqueous Veins
Episcleral Veins Conjunctival Veins
Anterior Ciliary Vein Palpebral And Angular Veins
Superior Ophthalmic Vein Superior Ophthalmic Vein Or
Facial Vein
Cavernous Sinus
49. AQUEOUS HUMOR DRAINAGE
PUMP MECHANISM FOR AQUEOUS
OUTFLOW:
Transient fall of IOP during cardiac diastole
Trabecular meshwork retracted inwards
Opening of aqueous valve
Flow of aqueous into Schlemm’s canal
50. PUMP MECHANISM FOR AQUEOUS
OUTFLOW
Transient rise of IOP during cardiac systole
Outward movement of Trabecular meshwork
against Schlemm’s canal
Closure of aqueous valve
Movement of aqueous humor into aqueous
veins via collector channels
56. SUMMARY
• The angle of anterior chamber plays an important role in
the process of aqueous drainage.
• Gonioscopy is most reliable for assessment of angle
structures.
• A number of structural changes are observed in the angle
with advancing age that causes increased resistance in
ageing eyes.
• The aqueous humor fills the anterior and posterior
chamber of the eye.
• The aqueous humor remains in a state of dynamic
equilibrium by continuous process of production and
drainage.
57. REFERENCES
• Allingham, R. Rand. Shields Textbook of Glaucoma, 6th Ed.
2011
• Anthony J. Bron. Wolff’s Anatomy of the Orbit, 8th Ed.
1997, p 279-282
• Brad Bowling. Kanski’s Clinical Ophthalmology, 8th Ed.
2016, p 306-316
• Myron Yanoff, Jay S Duker. Yanoff Duker Ophthalmology,
5th Ed. 2019
• Leonard A. Levin, Siv F. E. Nilson, James Ver Hoeve, Samuel
M Wu. Adler’s Physiology of the Eye, 11th Ed. 2003, p 274-
307
Editor's Notes
Close contact immersion technique
Provides 2D high resolution gray scale images of ocular structures anterior to pars plana.