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ORBIT
Dr.Prathap Kumar J
The Orbit
Sinuses exist in 4 Orbital Bones
• Air filled
• Mucosa lined
• Lighten bone
• Acustic
• Possible infection
site
a pyramid of four walls
that converge
posteriorly. The medial
walls of the right and
left orbit parallel and
are separated by the
nose.
The basic shape of the orbit is a
pyramid:
The medial walls are parallel
The depth is 1.5 x base
• In each orbit, the
lateral and medial walls
form an angle of 45
degrees, which results
in a right angle between
the two lateral walls.
The orbit is compared
to the shape of a pear,
with the optic nerve
representing its stem.
• volume of the adult
orbit :30 mL
• eyeball occupies only
about one-fifth of the
space. Fat and muscle
account for the bulk of
the remainder.
• The anterior limit of the
orbital cavity is the
orbital septum, which
acts as a barrier
between the eyelids
and orbit
• frontal sinus above, the
maxillary sinus below,
and the ethmoid and
sphenoid sinuses
medially.
• The thin orbital floor is
easily damaged by
direct trauma to the
globe, resulting in a
"blowout" fracture with
herniation of orbital
contents into the
maxillary antrum.
• Infection within the
sphenoid and ethmoid
sinuses can erode the
paper-thin medial wall
(lamina papyracea) and
involve the contents of
the orbit.
• Defects in the roof (eg,
neurofibromatosis) may
result in visible
pulsations of the globe
transmitted from the
brain.
Orbital Walls
• The roof : frontal bone.
Posteriorly, the lesser
wing of the sphenoid
bone containing the optic
canal completes the roof.
• The lacrimal gland is
located in the lacrimal
fossa in the anterior
lateral aspect of the roof.
• The lateral wall is
separated from the roof
by the superior orbital
fissure, which divides the
lesser from the greater
wing of the sphenoid
bone. The anterior
portion of the lateral wall
is formed by the orbital
surface of the zygomatic
(malar) bone. This is the
strongest part of the bony
orbit.
• Suspensory ligaments,
the lateral palpebral
tendon, and check
ligaments have
connective tissue
attachments to the
lateral orbital tubercle.
• The orbital floor is
separated from the
lateral wall by the
inferior orbital fissure.
The orbital plate of the
maxilla forms the large
central area of the floor
and is the region where
blowout fractures most
frequently occur.
• The frontal process of
the maxilla medially and
the zygomatic bone
laterally complete the
inferior orbital rim. The
orbital process of the
palatine bone forms a
small triangular area in
the posterior floor.
• medial wall :
• ethmoid bone ;
lacrimal bone; The
body of the sphenoid (
most posterior aspect
of the medial wall).
the angula r process of
the frontal bone forms
the upper part of the
posterior lacrimal crest.
• The lower portion of the
posterior lacrimal crest is
made up of the lacrimal
bone. The anterior
lacrimal crest is easily
palpated through the lid
and is composed of the
frontal process of the
maxilla. The lacrimal
groove lies between the
two crests and contains
the lacrimal sac
Orbital Apex
• entry portal for all
nerves and vessels to
the eye and the site of
origin of all extraocular
muscles except the
inferior oblique.
• The superior
ophthalmic vein and the
lacrimal, frontal, and
trochlear nerves pass
through the lateral
portion of the fissure
that lies outside the
annulus of Zinn.
•
•
• The superior and
inferior divisions of the
oculomotor nerve and
the abducens and
nasociliary nerves pass
through the medial
portion of the fissure
within the annulus of
Zinn.
•
• The optic nerve and
ophthalmic artery pass
through the optic
canal, which also lies
within the annulus of
Zinn
LR
SO
IRIO
MR
SRLP
Identify the extra-ocular muscles.
Side view
Frontal views
Levator palpebrae
Superior oblique
Inferior rectus
Superior rectus
Lateral rectus (cut)
Inferior oblique
Medial rectus
Optic nerve
LP
SR
SO
IO
IR
MR
LRLR
SO
IRIO
MR
SRLP
Clinical Anatomy
• Muscular Anatomy:
– Inferior Rectus
– Superior Rectus
– Medial Rectus
– Lateral Rectus
– Inferior Oblique
– Superior Oblique
Clinical Anatomy
• Eye Movement Terminology:
– Duction – movement of one eye by itself
– Version – movement of the 2 eyes in the same direction
– Adduction – eye looks toward the nose
– Abduction – eye looks toward the ear
– Dextroversion – both eyes look to the right
– Levoversion – both eyes look to the left
– Supraversion – both eyes upgaze
– Infraversion - downgaze
Clinical Anatomy
• Medial Rectus:
– Strongest of the extra-
ocular muscles
– Most mass of EOMs
– Most anterior insertion
(extra leverage)
– Action – Adduction
(eyes move towards the
nose)
• Lateral Rectus:
– Action - Abduction
Clinical Anatomy
• Superior Rectus:
– Action – elevation,
upward rotation
• Rotation – angles
nasally toward site of
origin
– Tendon of the Superior
Oblique muscle passes
underneath the SR
Clinical Anatomy
• Inferior Rectus:
– Action – depression,
downward rotation,
adduction
Clinical Anatomy
• Superior Oblique:
– Keeps the eyeballs level
as the head tilts
– Longest of the EOMs
– Passes through a “pully”
called the trochlea
• Redirects the action
– Action:
• Abduction of globe
• Depression of globe
• Rotation of globe
Clinical Anatomy
• Inferior Oblique:
– Passes underneath the
inferior rectus
– Action:
• Elevation of globe
• Adduction of globe
• Rotation of globe
• Keeps the eyeballs
level as the head tilts
Muscle Action Origin Insertion Innervation
Inferior
Rectus
Depression,
adduction
extrosion
From a tendinous
ring on posterior
aspect of orbit
Middle of the
inferior aspect of
anterior globe
Oculomotor
Superior
Rectus
Elevation,
adduction
Intorsion
From a tendinous
ring on posterior
aspect of orbit
Middle of the
superior aspect of
anterior globe
Oculomotor
Medial
Rectus
Medial Rotation
(Adduction)
From a tendinous
ring on posterior
aspect of orbit
Middle of the
superior aspect of
anterior globe
Oculomotor
Lateral
Rectus
Lateral Rotation
(Abduction)
From a tendinous
ring on posterior
aspect of orbit
Middle of the
superior aspect of
anterior globe
Abducens
Inferior
Oblique
Abduction,
Elevation of globe,
Rotation of globe
when abducted
extrosion
From the periosteum
of the maxilla
Posterio- superior
quadrant of the
globe
Oculomotor
Superior
Oblique
Abduction,
Depression of
globe, Intorsion
Greater wing of the
sphenoid
Posterio- superior
quadrant of the
globe
Trochlear

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Ocular injury  ppt  Upendra pal  optometrist upums saifai etawahOcular injury  ppt  Upendra pal  optometrist upums saifai etawah
Ocular injury ppt Upendra pal optometrist upums saifai etawah
 

Orbit pkj

  • 3. Sinuses exist in 4 Orbital Bones • Air filled • Mucosa lined • Lighten bone • Acustic • Possible infection site
  • 4. a pyramid of four walls that converge posteriorly. The medial walls of the right and left orbit parallel and are separated by the nose.
  • 5. The basic shape of the orbit is a pyramid: The medial walls are parallel The depth is 1.5 x base
  • 6. • In each orbit, the lateral and medial walls form an angle of 45 degrees, which results in a right angle between the two lateral walls. The orbit is compared to the shape of a pear, with the optic nerve representing its stem.
  • 7. • volume of the adult orbit :30 mL • eyeball occupies only about one-fifth of the space. Fat and muscle account for the bulk of the remainder.
  • 8. • The anterior limit of the orbital cavity is the orbital septum, which acts as a barrier between the eyelids and orbit
  • 9. • frontal sinus above, the maxillary sinus below, and the ethmoid and sphenoid sinuses medially.
  • 10. • The thin orbital floor is easily damaged by direct trauma to the globe, resulting in a "blowout" fracture with herniation of orbital contents into the maxillary antrum.
  • 11. • Infection within the sphenoid and ethmoid sinuses can erode the paper-thin medial wall (lamina papyracea) and involve the contents of the orbit.
  • 12. • Defects in the roof (eg, neurofibromatosis) may result in visible pulsations of the globe transmitted from the brain.
  • 14. • The roof : frontal bone. Posteriorly, the lesser wing of the sphenoid bone containing the optic canal completes the roof. • The lacrimal gland is located in the lacrimal fossa in the anterior lateral aspect of the roof.
  • 15. • The lateral wall is separated from the roof by the superior orbital fissure, which divides the lesser from the greater wing of the sphenoid bone. The anterior portion of the lateral wall is formed by the orbital surface of the zygomatic (malar) bone. This is the strongest part of the bony orbit.
  • 16. • Suspensory ligaments, the lateral palpebral tendon, and check ligaments have connective tissue attachments to the lateral orbital tubercle.
  • 17. • The orbital floor is separated from the lateral wall by the inferior orbital fissure. The orbital plate of the maxilla forms the large central area of the floor and is the region where blowout fractures most frequently occur.
  • 18. • The frontal process of the maxilla medially and the zygomatic bone laterally complete the inferior orbital rim. The orbital process of the palatine bone forms a small triangular area in the posterior floor.
  • 19. • medial wall : • ethmoid bone ; lacrimal bone; The body of the sphenoid ( most posterior aspect of the medial wall). the angula r process of the frontal bone forms the upper part of the posterior lacrimal crest.
  • 20. • The lower portion of the posterior lacrimal crest is made up of the lacrimal bone. The anterior lacrimal crest is easily palpated through the lid and is composed of the frontal process of the maxilla. The lacrimal groove lies between the two crests and contains the lacrimal sac
  • 21.
  • 23. • entry portal for all nerves and vessels to the eye and the site of origin of all extraocular muscles except the inferior oblique.
  • 24. • The superior ophthalmic vein and the lacrimal, frontal, and trochlear nerves pass through the lateral portion of the fissure that lies outside the annulus of Zinn. •
  • 25. • • The superior and inferior divisions of the oculomotor nerve and the abducens and nasociliary nerves pass through the medial portion of the fissure within the annulus of Zinn. •
  • 26. • The optic nerve and ophthalmic artery pass through the optic canal, which also lies within the annulus of Zinn
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  • 28.
  • 29. LR SO IRIO MR SRLP Identify the extra-ocular muscles. Side view Frontal views Levator palpebrae Superior oblique Inferior rectus Superior rectus Lateral rectus (cut) Inferior oblique Medial rectus Optic nerve LP SR SO IO IR MR LRLR SO IRIO MR SRLP
  • 30. Clinical Anatomy • Muscular Anatomy: – Inferior Rectus – Superior Rectus – Medial Rectus – Lateral Rectus – Inferior Oblique – Superior Oblique
  • 31. Clinical Anatomy • Eye Movement Terminology: – Duction – movement of one eye by itself – Version – movement of the 2 eyes in the same direction – Adduction – eye looks toward the nose – Abduction – eye looks toward the ear – Dextroversion – both eyes look to the right – Levoversion – both eyes look to the left – Supraversion – both eyes upgaze – Infraversion - downgaze
  • 32. Clinical Anatomy • Medial Rectus: – Strongest of the extra- ocular muscles – Most mass of EOMs – Most anterior insertion (extra leverage) – Action – Adduction (eyes move towards the nose) • Lateral Rectus: – Action - Abduction
  • 33. Clinical Anatomy • Superior Rectus: – Action – elevation, upward rotation • Rotation – angles nasally toward site of origin – Tendon of the Superior Oblique muscle passes underneath the SR
  • 34. Clinical Anatomy • Inferior Rectus: – Action – depression, downward rotation, adduction
  • 35. Clinical Anatomy • Superior Oblique: – Keeps the eyeballs level as the head tilts – Longest of the EOMs – Passes through a “pully” called the trochlea • Redirects the action – Action: • Abduction of globe • Depression of globe • Rotation of globe
  • 36. Clinical Anatomy • Inferior Oblique: – Passes underneath the inferior rectus – Action: • Elevation of globe • Adduction of globe • Rotation of globe • Keeps the eyeballs level as the head tilts
  • 37. Muscle Action Origin Insertion Innervation Inferior Rectus Depression, adduction extrosion From a tendinous ring on posterior aspect of orbit Middle of the inferior aspect of anterior globe Oculomotor Superior Rectus Elevation, adduction Intorsion From a tendinous ring on posterior aspect of orbit Middle of the superior aspect of anterior globe Oculomotor Medial Rectus Medial Rotation (Adduction) From a tendinous ring on posterior aspect of orbit Middle of the superior aspect of anterior globe Oculomotor Lateral Rectus Lateral Rotation (Abduction) From a tendinous ring on posterior aspect of orbit Middle of the superior aspect of anterior globe Abducens Inferior Oblique Abduction, Elevation of globe, Rotation of globe when abducted extrosion From the periosteum of the maxilla Posterio- superior quadrant of the globe Oculomotor Superior Oblique Abduction, Depression of globe, Intorsion Greater wing of the sphenoid Posterio- superior quadrant of the globe Trochlear