SlideShare a Scribd company logo
The Orbital Region
(Bony Orbit, Ocular Muscles, Lacrimal & Ciliary
Gland And Eyeball)
Dr. Rabia Inam Gandapore
Assistant Professor
Head of Department Anatomy
(Dentistry-BKCD)
B.D.S (SBDC), M.Phil. Anatomy (KMU),
Dip. Implant (Sharjah, Bangkok, ACHERS) , CHPE
(KMU),CHR (KMU), Dip. Arts (Florence, Italy)
Teaching Methodology
 LGF (Long Group Format)
 SGF (Short Group Format)
 LGD (Long Group Discussion, Interactive discussion with the use of models or diagrams)
 SGD (Short Group)
 SDL (Self-Directed Learning)
 DSL (Directed-Self Learning)
 PBL (Problem- Based Learning)
 Online Teaching Method
 Role Play
 Demonstrations
 Laboratory
 Museum
 Library (Computed Assisted Learning or E-Learning)
 Assignments
 Video tutorial method
Goal/Aim (main objective)
 To help/facilitate/augment the students about the:
1. Describe walls and openings in the orbital cavity.
2. Enumerate foramen and fissures in bony orbit and structures passing through it.
3. Explain origin, insertion, nerve supply and action of extra-ocular muscles
4. Discuss lacrimal and ciliary glands.
5. Describe features & relevant clinical anatomy of:
• Outer Coat
• Cornea
• Middle Coat
• Inner Coat
• Aqueous Humour
• Vitreous Body
Specific Learning Objectives (cognitive)
At the end of the lecture the student will able to:
1. Recognize the gross anatomical features of the
Describe walls and openings in the orbital cavity.
2. Enumerate foramen and fissures in bony orbit and structures passing through it.
3. Explain origin, insertion, nerve supply and action of extra-ocular muscles
4. Discuss lacrimal and ciliary glands.
5. Describe features & relevant clinical anatomy of:
• Outer Coat
• Cornea
• Middle Coat
• Inner Coat
• Aqueous Humour
• Vitreous Body
6. Sketch labeled diagram of the Eyeball & tabulated extra-ocular muscles
Psychomotor Objective: (Guided response)
 A student to draw labelled diagram of Eyeball & tabulated extra-ocular muscles
Affective domain
 To be able to display a good code of conduct and moral values in the class.
 To cooperate with the teacher and in groups with the colleagues.
 To demonstrate a responsible behavior in the class and be punctual, regular, attentive and
on time in the class.
 To be able to perform well in the class under the guidance and supervision of the teacher.
 Study the topic before entering the class.
 Discuss among colleagues the topic under discussion in SGDs.
 Participate in group activities and museum classes and follow the rules.
 Volunteer to participate in psychomotor activities.
 Listen to the teacher's instructions carefully and follow the guidelines.
 Ask questions in the class by raising hand and avoid creating a disturbance.
 To be able to submit all assignments on time and get your sketch logbooks checked.
Lesson contents
Clinical chair side question: Students will be asked if they know what is the function of Eyeball
Outline:
 Activity 1 The facilitator will explain the student's to Recognize the
 Gross anatomical features and openings in the orbital cavity.
 Enumerate foramen and fissures in bony orbit and structures passing through it.
 Explain origin, insertion, nerve supply and action of extra-ocular muscles
 Discuss lacrimal and ciliary glands.
 Describe features & relevant clinical anatomy of: • Outer Coat • Cornea • Middle Coat • Inner Coat •
Aqueous Humour • Vitreous Body
 Activity 2 The facilitator will ask the students to make a labeled diagram of the Sketch labeled diagram of
the Eyeball & tabulated extra-ocular muscles
 Activity 3 The facilitator will ask the students a few Multiple Choice Questions related to it with flashcards.
Recommendations
 Students assessment: MCQs, Flashcards, Diagrams labeling.
 Learning resources: Langman’s T.W. Sadler, Laiq Hussain Siddiqui, Snell Clinical Anatomy, Netter’s
Atlas, BD Chaurasia’s Human anatomy, Internet sources links.
Orbital Region
 EYELIDS
 MOVEMENTS OF EYELIDS
Orbital Region
 Orbits are a pair of bony cavities that
contain:
1. Eyeballs
2. Associated muscles, nerves, vessels
3. Fats
4. Lacrimal apparatus.
 Eyelids: Orbital opening is guarded by 2 thin,
movable folds.
 protect eye from injury & excessive light by
their closure
Eyelids
a. Upper eyelid: is larger & more mobile.
 Eye closed: it completely covers cornea of eye.
 Eye open: looking straight ahead it covers upper margin
of cornea.
a. Lower eyelid: smaller & less mobile.
 When eye open: lies just below cornea
 When eye closed: rises only slightly.
 Upper & Lower eyelids: meet at medial & lateral angles.
 Palpebral fissure: elliptical opening between eyelids & is
the entrance into conjunctival sac.
 Superficial surface of eyelids: covered by skin
 Deep surface: covered by mucous membrane called Conjunctiva.
 Eyelashes: short, curved hairs on free edges of eyelids, arranged in double or triple
rows at mucocutaneous junction.
 Sebaceous glands (glands of Zeis): open directly into eyelash follicles.
 Ciliary glands (glands of Moll): modified sweat glands, open separately between
adjacent lashes.
 Tarsal glands: long, modified sebaceous glands that pour their oily secretion onto
margin of lid; their openings lie behind eyelashes. This oily material prevents
overflow of tears & helps make the closed eyelids airtight.
 Lacus lacrimalis: small space which separates more rounded
medial angle from eyeball
 Caruncula lacrimalis: small, reddish yellow elevation in center
of Lacus lacrimalis
 Plica semilunaris: reddish semilunar fold, lies on lateral side of
caruncle.
 Papilla lacrimalis: Near medial angle of eye a small elevation. It
projects into lacus
 Punctum lacrimale: On summit of papilla is a small hole which
leads into canaliculus lacrimalis.
 Punctum & Canaliculus carry tears down into the nose
 Conjunctiva: thin mucous membrane that lines eyelids & is
reflected at superior & inferior fornices onto anterior surface
of eyeball. Its epithelium is continuous with that of cornea.
 Upper lateral part of superior fornix: pierced by ducts of
lacrimal gland.
 Conjunctival sac: Conjunctiva forms potential space, it opens
at palpebral fissure.
 Subtarsal sulcus: Beneath eyelid groove, it runs close to &
parallel with margin of lid. It tends to trap small foreign
particles introduced into conjunctival sac & clinically important
 Framework of eyelids: formed by fibrous sheet, orbital septum. Its attached to
periosteum at orbital margins.
 Tarsal Plates: is thickened at margins of lids to form; superior & inferior tarsal
plates.
 Lateral palpebral ligament: lateral ends of plates are attached by a band to a
bony tubercle just within orbital margin.
 Medial palpebral ligament: medial ends of plates are attached by a band to crest
of lacrimal bone.
 Tarsal glands: are embedded in posterior surface of tarsal plates.
 Orbicularis oculi muscle: superficial surface of tarsal plates & orbital septum are
covered by its palpebral fibers.
 aponeurosis of insertion of Levator palpebrae superioris muscle pierces the
orbital septum to reach anterior surface of superior tarsal plate & skin.
Movements of the Eyelids
 Position of eyelids at rest depends on tone of:
a. Orbicularis oculi muscles
b. Levator palpebrae superioris muscles
c. Position of eyeball.
 Eyelids are closed by:
a. Contraction of: orbicularis oculi muscles
b. Relaxation of: levator palpebrae superioris
muscles.
 Eye is opened by:
a. Levator palpebrae superioris raising upper lid.
 On looking upward:
a. levator palpebrae superioris contracts
b. upper lid moves with eyeball.
 On looking downward:
a. Both lids move
b. Upper lid continues to cover upper part of cornea
c. Lower lid is pulled downward by conjunctiva, its
attached to sclera & lower lid.
Muscles of Eyeball & Eyelids
 ORIGIN
 INSERTION
 ACTION
 NERVE SUPPLY
Extrinsic Muscles
 6 voluntary muscles that run from posterior wall of orbital cavity to eyeball:
1. Superior rectus: to raise cornea upward, inferior oblique muscle must assist
2. Inferior rectus: inferior rectus to depress cornea downward, superior oblique
muscle must assist.
 Superior & inferior recti are inserted on medial side of vertical axis of eyeball, they
not only raise & depress cornea, respectively, but also rotate it medially.
3. Medial rectus
4. Lateral rectus
5. Superior oblique muscles
6. Inferior oblique muscles.
Movements of Eyeball
Center of cornea or pupil: is used as
anatomic “anterior pole” of eye
 Elevation: rotation of eye upward
 Depression: rotation of eye downward
 Abduction: rotation of eye laterally
 Adduction: rotation of eye medially
 Rotatory movements: use upper rim of
cornea (or pupil) as marker. Eye rotates:
a. Medially
b. Laterally.
S.
No.
Muscles Origin Insertion Nerve
Supply
Action
Extrinsic Muscles of Eyeball (Striated Skeletal Muscle)
1. Superior
Rectus
Tendinous
ring on
posterior
wall of orbital
cavity
Superior surface of eyeball just
posterior to corneoscleral junction
Oculomotor
nerve (3rd
cranial nerve)
Raises cornea
upward and medially
2. Inferior
Rectus
Inferior surface of eyeball just
posterior to corneoscleral junction
Depresses cornea
downward and
medially
3. Medial Rectus Medial surface of eyeball just
posterior to corneoscleral junction
Rotates eyeball so
that cornea looks
medially
4. Lateral Rectus Lateral surface of eyeball just
posterior to corneoscleral junction
Abducent
nerve (6th
cranial nerve)
Rotates eyeball so
that cornea looks
laterally
5. Superior
Oblique
Posterior
wall of orbital
cavity
Passes through pulley and is
attached to superior surface of
eyeball beneath superior rectus
Trochlear
nerve (4th
cranial nerve)
Rotates eyeball so
that cornea looks
downward and
laterally
6. Inferior
Oblique
Floor of
orbital cavity
Lateral surface of eyeball deep to
lateral rectus
Oculomotor
nerve (3rd
cranial nerve)
Rotates eyeball so
that cornea looks
upward and laterally
Intrinsic Muscles
 Involuntary ciliary muscle
 Constrictor & Dilator pupillae of
iris: take no part in movement of
eyeball
S. No. Muscles Origin Insertion Nerve Supply Action
Intrinsic Muscles of Eyeball (Smooth Muscle)
1. Sphincter pupillae of iris Parasympathetic
via oculomotor
nerve
Constricts pupil
2. Dilator pupillae of iris Sympathetic Dilates pupil
3. Ciliary muscle Parasympathetic
via oculomotor
nerve
Controls shape of
lens; in
accommodation,
makes lens more
globular
Muscles of Eyelids
1. Orbicularis Oculi
2. Levator palpabrae superioris Back of
orbital
cavity
Anterior
surface and
upper margin
of superior
tarsal plate
Striated muscle
oculomotor nerve,
smooth muscle
sympathetic
Raises upper lid
Fascial Sheath of Eyeball
 Surrounds eyeball from optic nerve to corneoscleral junction.
 It separates eyeball from orbital fat & provides it with a socket for free movement.
 It is perforated by tendons of orbital muscles & is reflected onto each of them as a
tubular sheath.
 Sheaths for tendons of medial & lateral recti are attached to medial & lateral walls of orbit
by triangular ligaments called medial & lateral check ligaments.
 Lower part of fascial sheath, which passes beneath the eyeball & connects the check
ligaments, is thickened & serves to suspend eyeball; its called suspensory ligament of
eye & is suspended from medial & lateral walls of orbit, as if in a hammock.
Lacrimal Appratus
 LACRIMAL GLANDS
 LACRIMAL DUCTS
Lacrimal Apparatus
Lacrimal Gland
 consists of:
a. Orbital part: large
b. Palpebral part: small
which are continuous with each other around lateral
edge of aponeurosis of levator palpebrae
superioris.
 It is situated above eyeball in anterior & upper part
of orbit, posterior to orbital septum.
 It opens into lateral part of superior fornix of
conjunctiva by 12 ducts.
 Parasympathetic secretomotor nerve: supply is derived from lacrimal nucleus of
facial nerve.
a. Preganglionic fibers: reaches pterygopalatine ganglion (sphenopalatine
ganglion) via nervus intermedius & its great petrosal branch and via nerve of
pterygoid canal.
b. Postganglionic fibers: leave ganglion & joins maxillary nerve. It then pass into
its zygomatic branch a& zygomaticotemporal nerve. They reach lacrimal gland
within lacrimal nerve.
 Sympathetic postganglionic nerve supply is from internal carotid plexus &
travels in deep petrosal nerve,nerve of pterygoid canal, maxillary nerve, zygomatic
nerve, zygomaticotemporal nerve & lacrimal nerve.
Lacrimal Ducts
 Tears circulate across cornea & accumulate in lacus lacrimalis.
 tears enter canaliculi lacrimales through puncta lacrimalis.
 canaliculi lacrimales pass medially & open into lacrimal sac, which lies in the
lacrimal groove behind medial palpebral ligament & is the upper blind end of the
nasolacrimal duct.
 Nasolacrimal duct: 0.5 in. (1.3 cm) long & emerges from lower end of lacrimal sac.
 Duct descends downward, backward & laterally in a bony canal & opens into
inferior meatus of nose.
 opening is guarded by a fold of mucous membrane known as lacrimal fold. This
prevents air from being forced up the duct into lacrimal sac on blowing nose
The Orbit
 OPENINGS INTO THE ORBITAL CAVITY
 ORBITAL FASCIA
The Orbit
 Pyramidal cavity:
Base: Anterior Apex: Posterior.
 Orbital margin above: frontal bone
 Lateral margin: processes of frontal & zygomatic bones
 Inferior margin: zygomatic bone & maxilla
 Medial margin: processes of maxilla & frontal bone.
Roof: orbital plate of frontal bone (separates orbital cavity from anterior cranial fossa & frontal lobe of
cerebral hemisphere)
Lateral wall: zygomatic bone & greater wing of sphenoid
Floor: orbital plate of maxilla ( separates orbital cavity from maxillary sinus)
Medial wall: before backward by frontal process of maxilla, lacrimal bone, orbital plate of ethmoid
(which separates orbital cavity from ethmoid sinuses) & body of sphenoid
Openings into the Orbital Cavity
Orbital opening: Lies anteriorly. About one sixth of eye is exposed; the remainder is protected by walls of orbit. The
openings into orbital cavity are:
 Supraorbital notch (Foramen): situated on superior orbital margin. It transmits supraorbital nerve & blood vessels
 Infraorbital groove & canal: Situated on floor of orbit in orbital plate of maxilla; they transmit infraorbital nerve (a
continuation of maxillary nerve) & blood vessels.
 Nasolacrimal canal: Located anteriorly on medial wall; it communicates with inferior meatus of nose. It transmits
nasolacrimal duct.
 Inferior orbital fissure: Located posteriorly between maxilla & greater wing of sphenoid; it communicates with
pterygopalatine fossa. It transmits maxillary nerve & its zygomatic branch, inferior ophthalmic vein & sympathetic nerves.
 Superior orbital fissure: Located posteriorly between greater & lesser wings of sphenoid; it communicates with the
middle cranial fossa. It transmits the lacrimal nerve, frontal nerve, trochlear nerve, oculomotor nerve (upper & lower
divisions), abducent nerve, nasociliary nerve & superior ophthalmic vein.
 Optic canal: Located posteriorly in lesser wing of sphenoid; it communicates with middle cranial fossa. It transmits optic
nerve & ophthalmic artery.
Orbital Fascia
 Is periosteum of bones that form walls of
orbit.
 It is loosely attached to bones & is
continuous through foramina & fissures with
the periosteum covering outer surfaces of
bones.
 Muscle of Müller, or orbitalis muscle: thin
layer of smooth muscle that bridges inferior
orbital fissure. Its supplied by sympathetic
nerves & its function is unknown.
The Eyeball
 MOVEMENTS OF EYEBALL
 FACIAL SHEATH OF EYEBALL
 STRUCTURE AND COATS OF THE EYEBALL
a. FIBROUS COAT
b. VASCULAR PIGMENTED COAT
c. NERVOUS COAT
 CONTENTS OF THE EYEBALL
Structure of Eye
 Embedded in orbital fat but is separated from it by fascial sheath of eyeball.
 Eyeball consists of 3 coats:
1. Fibrous coat
2. Vascular pigmented coat
3. Nervous coat.
Coats of Eyeball
1. Fibrous Coat: made up of a
a. Posterior opaque part: Sclera
b. Anterior transparent part: Cornea.
a. The Sclera
 Opaque sclera is composed of dense fibrous tissue & is white.
 Posteriorly, its pierced by optic nerve & is fused with dural sheath of that nerve.
 Lamina cribrosa is area of sclera that is pierced by nerve fibers of optic nerve.
 Its also pierced by ciliary arteries & nerves & associated veins; venae
vorticosae.
 Its directly continuous in front with cornea at corneoscleral junction, or limbus.
b. Cornea
 Transparent cornea is largely responsible for refraction of light entering eye.
 Its in contact posteriorly with aqueous humor.
 Blood Supply: avascular & devoid of lymphatic drainage. Its nourished by
diffusion from aqueous humor & from capillaries at its edge.
 Nerve Supply: Long ciliary nerves from ophthalmic division of trigeminal nerve
 Function of Cornea: refractive medium of eye. This refractive power occurs on the
anterior surface of cornea, where refractive index of cornea (1.38) differs greatly
from that of air. The importance of tear film in maintaining normal environment for
corneal epithelial cells should be stressed.
2. Vascular Pigmented Coat
Consists, from behind forward, of:
a. Choroid: composed of an:
 Outer: pigmented layer
 Inner: highly vascular layer
b. Ciliary body
c. Iris
b. Ciliary Body:
 continuous:
 Posteriorly with choroid
 Anteriorly it lies behind peripheral margin of iris.
 Its composed of:
1. Ciliary ring: posterior part of body & its surface has shallow grooves; ciliary striae.
2. Ciliary processes: are radially arranged folds, or ridges, to posterior surfaces of which
are connected the suspensory ligaments of lens
3. Ciliary muscle: composed of meridianal & circular fibers of smooth muscle.
a. Meridianal fibers: run backward from region of corneoscleral junction to ciliary
processes.
b. Circular fibers: are fewer in number & lie internal to meridianal fibers.
 Nerve supply: ciliary muscle is supplied by
parasympathetic fibers from oculomotor nerve. After
synapsing in ciliary ganglion, postganglionic fibers pass
forward to eyeball in short ciliary nerves.
 Action: Contraction of ciliary muscle, especially meridianal
fibers, pulls ciliary body forward. This relieves tension in
suspensory ligament, & elastic lens becomes more
convex. This increases refractive power of lens
c. Iris & Pupil
 Iris: contractile, pigmented diaphragm
 Pupil: central aperture
 Its suspended in aqueous humor between cornea & lens.
 Periphery of iris is attached to anterior surface of ciliary body.
 It divides the space between lens & cornea into an
1. Anterior Chamber
2. Posterior Chamber
 Muscle fibers of iris are involuntary & consist of circular & radiating fibers.
a. Circular fibers: form sphincter pupillae & are arranged around margin of pupil.
 Nerve supply:
a. Sphincter pupillae: is supplied by parasympathetic fibers from
oculomotor nerve. After synapsing in ciliary ganglion, postganglionic
fibers pass forward to eyeball in short ciliary nerves.
b. Dilator pupillae: is supplied by sympathetic fibers, which pass
forward to eyeball in long ciliary nerves.
 Action:
a. Sphincter pupillae: constricts pupil in presence of bright light & during
accommodation.
b. Dilator pupillae: dilates pupil in presence of light of low intensity or in
presence of excessive sympathetic activity such as occurs in fright.
3. Nervous Coat: The Retina
 Retina consists of an:
a. Outer pigmented layer: contact with choroid
b. Inner nervous layer: contact with the vitreous body
 Posterior 3 quarters of retina is receptor organ.
 Its anterior edge forms a wavy ring; ora serrata, &
nervous tissues end here.
 Anterior part of retina is nonreceptive & consists of
pigment cells, with a deeper layer of columnar epithelium.
It covers ciliary processes & back of iris.
 At the center of posterior part of retina is an oval, yellowish area; macula lutea, which is
area of retina for the most distinct vision.
 It has a central depression; fovea centralis.
 Optic nerve leaves retina about 3 mm to medial side of macula lutea by optic disc.
 Optic disc is slightly depressed at its center, where its pierced by central artery of
retina.
 At optic disc is a complete absence of rods & cones so that it is insensitive to light & is
referred to as the “blind spot.”
 Ophthalmoscopic examination: optic disc is seen to be pale pink in color, much paler
than surrounding retina.
Contents of Eyeball
 consist of:
a. Refractive media
b. Aqueous humor
c. Vitreous body
d. Lens.
a. Aqueous Humor
 Clear fluid that fills anterior & posterior chambers of eyeball .
 It’s a secretion from ciliary processes, via it enters posterior chamber.
 It flows into anterior chamber through pupil & is drained away through spaces at the
iridocorneal angle into canal of Schlemm
 Obstruction: to draining of aqueous humor results in a rise in intraocular pressure
called glaucoma.
 This can produce degenerative changes in retina i.e. blindness.
Function Of Aqueous Humor
 To support wall of eyeball by exerting internal pressure
 maintaining its optical shape.
 It also nourishes cornea & lens
 removes products of metabolism;
Note: cornea & lens do not possess a blood supply.
b. Vitreous Body
 fills eyeball behind the lens & is
a transparent gel.
 Hyaloid canal is a narrow
channel that runs through the
vitreous body from the optic disc
to posterior surface of lens; in
fetus, it is filled by the hyaloid
artery, which disappears before
birth.
Function of vitreous body
 Contribute slightly to magnifying power of eye.
 Supports posterior surface of lens
 Assists in holding neural part of retina against
pigmented part of retina.
C. The Lens
 transparent, biconvex structure enclosed in a transparent capsule.
 Its situated behind iris & in front of vitreous body & is encircled by ciliary processes.
 Lens consists of an elastic capsule, which envelops the structure; a cuboidal
epithelium, which is confined to anterior surface of lens; & lens fibers, which are
formed from cuboidal epithelium at equator of lens.
 Lens fibers make up bulk of lens.
 Elastic lens capsule is under tension, causing lens constantly to endeavor to
assume a globular rather than a disc shape.
 Lens is attached to ciliary processes of ciliary body by suspensory ligament.
 The pull of radiating fibers of suspensory ligament tends to keep the elastic lens
flattened so that eye can be focused on distant objects..
Accommodation of the Eye
 To accommodate eye for close objects, ciliary muscle contracts & pulls
ciliary body forward & inward so that radiating fibers of suspensory ligament
are relaxed.
 This allows elastic lens to assume a more globular shape.
 With advancing age: lens becomes denser & less elastic,& ability to
accommodate is lessened (presbyopia).
 This disability can be overcome by use of an additional lens in form of glasses
to assist the eye in focusing on nearby objects.
 Constriction of Pupil during Accommodation of Eye
To ensure that light rays pass through central part of lens so spherical aberration is
diminished during accommodation for near objects, the sphincter pupillae muscle
contracts so pupil becomes smaller.
 Convergence of Eyes during Accommodation of Lens
In humans, retinae of both eyes focus on only one set of objects (single binocular
vision). When an object moves from a distance toward an individual, the eyes
converge so that a single object, not two, is seen. Convergence of eyes results
from coordinated contraction of medial rectus muscles.
Clinical Correlations
Clinical Testing for Actions of Superior & Inferior
Recti AND Superior & Inferior Oblique Muscles
 Physician tests eye movements: Patient is asked to look vertically upward or
downward. Example: Origins of superior & inferior recti are situated about 23°
medial to their insertions so when the patient is asked to turn cornea laterally, these
muscles raise (superior rectus) or lower (inferior rectus) cornea.
 Test for Superior Oblique: ask patient to look medially & downward at tip of his or
her nose.
 Test for inferior Oblique: asking patient to look medially & upward. Because lateral
& medial recti are simply placed relative to eyeball, asking patient to turn cornea
directly laterally tests lateral rectus & turning cornea directly medially tests medial
rectus.
Eye Trauma
 Eyeball: well protected by bony orbit but provides no protection
from small objects i.e. golf balls & cause severe damage on lateral
side.
 Blowout fractures of orbital floor involving maxillary sinus
occur due to blunt force to face. If the force is applied to eye, the
orbital fat explodes inferiorly into maxillary sinus, fracturing orbital
floor. Not only can blowout fractures cause displacement of
eyeball, but cause double vision (diplopia), injure infraorbital
nerve, producing loss of sensation of skin of cheek & gum on
that side. Entrapment of inferior rectus muscle in fracture may
limit upward gaze.
Strabismus
 Many cases of strabismus are
non-paralytic
 caused by an imbalance in action
of opposing muscles. This type of
strabismus is known as
concomitant strabismus
 common in infancy.
Pupillary Reflexes
 Reaction of pupils to light & accommodation: depend on integrity of nervous
pathways.
1. Direct light reflex:
 Normal pupil reflex contracts when a light is shone into patient’s eye.
 Nervous impulses pass from retina along optic nerve to optic chiasma & optic tract
 Before reaching lateral geniculate body, fibers leave the tract & pass to oculomotor
nuclei on both sides via pretectal nuclei.
 From parasympathetic part of nucleus, efferent fibers leaves midbrain in the
oculomotor nerve & reach the ciliary ganglion via nerve to inferior oblique.
 Postganglionic fibers pass to constrictor pupillae muscles via short ciliary nerves.
2. Consensual light reflex
 Tested by shining light in one eye &
noting contraction of pupil in opposite
eye.
 This reflex is possible because the
afferent pathway just described travels
to parasympathetic nuclei of both
oculomotor nerves.
3. Accommodation reflex
 is contraction of pupil that occurs when a person suddenly
focuses on a near object after having focused on a
distant object.
 Nervous impulses pass from retina via optic nerve, optic
chiasma, optic tract, lateral geniculate body, optic
radiation & cerebral cortex of occipital lobe of brain.
 Visual cortex is connected to eye field of frontal cortex.
From here, efferent pathways pass to parasympathetic
nucleus of oculomotor nerve. From there, efferent
impulses reach constrictor pupillae via oculomotor
nerve, ciliary ganglion & short ciliary nerves.
Horner’s Syndrome
Thank You

More Related Content

What's hot

2@trachea and larynx
2@trachea and larynx2@trachea and larynx
2@trachea and larynx
Mohanad Mohanad
 
Total number of bones
 Total number of bones Total number of bones
Total number of bones
iqra ali
 
The Skull and Vertebral column
The Skull and Vertebral columnThe Skull and Vertebral column
The Skull and Vertebral column
Seddie Chitamu
 
Base of skull by dr kifayat
Base of skull by dr kifayatBase of skull by dr kifayat
Base of skull by dr kifayat
Kifayat Khan
 
Individual skull bones
Individual skull bonesIndividual skull bones
Individual skull bones
Idris Siddiqui
 
Physiology of pain & withdrawal reflex.pptx
Physiology of pain & withdrawal reflex.pptxPhysiology of pain & withdrawal reflex.pptx
Physiology of pain & withdrawal reflex.pptx
Sai Sailesh Kumar Goothy
 
Bones of the skull
Bones of the skull Bones of the skull
Bones of the skull
KRUPA RAITHATHA
 
Connective tissue
Connective tissueConnective tissue
Connective tissue
Dr. Shameeran Bamarni
 
Anatomy pectoral arm02122010
Anatomy pectoral arm02122010Anatomy pectoral arm02122010
Anatomy pectoral arm02122010
Lawrence James
 
Neck muscles and triangles
Neck muscles and trianglesNeck muscles and triangles
Neck muscles and triangles
Lheanne Tesoro
 
cerebellum MBBS.pptx
cerebellum MBBS.pptxcerebellum MBBS.pptx
cerebellum MBBS.pptx
Reena Gollapalli
 
Nervous System
Nervous SystemNervous System
Nervous System
Rhys Moult
 
Skeleton system
Skeleton systemSkeleton system
Skeleton system
TANTL
 
Physiology last-moment-revisions
Physiology last-moment-revisionsPhysiology last-moment-revisions
Physiology last-moment-revisions
Medvizz institute of medical education
 
Anatomy of meninges, ventricles, cerebrospinal fluid
Anatomy of meninges, ventricles, cerebrospinal fluidAnatomy of meninges, ventricles, cerebrospinal fluid
Anatomy of meninges, ventricles, cerebrospinal fluid
MBBS IMS MSU
 
Introduction to human anatomy
Introduction to human anatomy Introduction to human anatomy
Introduction to human anatomy
NigatuAdmasu2
 
Breast.pptx
Breast.pptxBreast.pptx
Breast.pptx
SonuSharma887555
 
Dr. B Ch 07_lecture_presentation
Dr. B Ch 07_lecture_presentationDr. B Ch 07_lecture_presentation
Dr. B Ch 07_lecture_presentation
TheSlaps
 
Ventricles of the brain
Ventricles of the brainVentricles of the brain
Ventricles of the brain
Dr. Maimuna Sayeed
 
Vertebral artery 360°
Vertebral artery 360°Vertebral artery 360°
Vertebral artery 360°
Murali Chand Nallamothu
 

What's hot (20)

2@trachea and larynx
2@trachea and larynx2@trachea and larynx
2@trachea and larynx
 
Total number of bones
 Total number of bones Total number of bones
Total number of bones
 
The Skull and Vertebral column
The Skull and Vertebral columnThe Skull and Vertebral column
The Skull and Vertebral column
 
Base of skull by dr kifayat
Base of skull by dr kifayatBase of skull by dr kifayat
Base of skull by dr kifayat
 
Individual skull bones
Individual skull bonesIndividual skull bones
Individual skull bones
 
Physiology of pain & withdrawal reflex.pptx
Physiology of pain & withdrawal reflex.pptxPhysiology of pain & withdrawal reflex.pptx
Physiology of pain & withdrawal reflex.pptx
 
Bones of the skull
Bones of the skull Bones of the skull
Bones of the skull
 
Connective tissue
Connective tissueConnective tissue
Connective tissue
 
Anatomy pectoral arm02122010
Anatomy pectoral arm02122010Anatomy pectoral arm02122010
Anatomy pectoral arm02122010
 
Neck muscles and triangles
Neck muscles and trianglesNeck muscles and triangles
Neck muscles and triangles
 
cerebellum MBBS.pptx
cerebellum MBBS.pptxcerebellum MBBS.pptx
cerebellum MBBS.pptx
 
Nervous System
Nervous SystemNervous System
Nervous System
 
Skeleton system
Skeleton systemSkeleton system
Skeleton system
 
Physiology last-moment-revisions
Physiology last-moment-revisionsPhysiology last-moment-revisions
Physiology last-moment-revisions
 
Anatomy of meninges, ventricles, cerebrospinal fluid
Anatomy of meninges, ventricles, cerebrospinal fluidAnatomy of meninges, ventricles, cerebrospinal fluid
Anatomy of meninges, ventricles, cerebrospinal fluid
 
Introduction to human anatomy
Introduction to human anatomy Introduction to human anatomy
Introduction to human anatomy
 
Breast.pptx
Breast.pptxBreast.pptx
Breast.pptx
 
Dr. B Ch 07_lecture_presentation
Dr. B Ch 07_lecture_presentationDr. B Ch 07_lecture_presentation
Dr. B Ch 07_lecture_presentation
 
Ventricles of the brain
Ventricles of the brainVentricles of the brain
Ventricles of the brain
 
Vertebral artery 360°
Vertebral artery 360°Vertebral artery 360°
Vertebral artery 360°
 

Similar to The Orbit & its contents by Dr. Rabia I. Gandapore.pptx

Special senses
Special sensesSpecial senses
Innovative lesson plan anjana devi
Innovative lesson plan anjana deviInnovative lesson plan anjana devi
Innovative lesson plan anjana devi
anjanaraveendran
 
Orbital region
Orbital regionOrbital region
Orbital region
Dr. Haydar Muneer Salih
 
11.eye
11.eye11.eye
11.eye
Reach Na
 
Head and neck
Head and neckHead and neck
Head and neck
mchibuzor
 
Sensory organs
Sensory organsSensory organs
Sensory organs
Pavithra Pavi
 
ANATOMY OF EYE.pptx
ANATOMY OF EYE.pptxANATOMY OF EYE.pptx
ANATOMY OF EYE.pptx
meenupm2
 
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
Nursing Mastery
 
Eyeball 2013
Eyeball 2013Eyeball 2013
Eyeball 2013
Muhammad Azmat
 
anatomy.ppt
anatomy.pptanatomy.ppt
anatomy.ppt
Zelekewoldeyohannes
 
Eye Conditions portable display format for medical students
Eye Conditions portable display format for medical studentsEye Conditions portable display format for medical students
Eye Conditions portable display format for medical students
IbrahimKargbo13
 
Eye Conditions presentation for medical students
Eye Conditions presentation for medical studentsEye Conditions presentation for medical students
Eye Conditions presentation for medical students
IbrahimKargbo13
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
Dr. Rabia Inam Gandapore
 
ORBIT-I complete anatomy and muscle attached
ORBIT-I complete anatomy and muscle attachedORBIT-I complete anatomy and muscle attached
ORBIT-I complete anatomy and muscle attached
vanitachcchhara
 
Eye prosthetic consideration/certified fixed orthodontic courses by Indian d...
Eye  prosthetic consideration/certified fixed orthodontic courses by Indian d...Eye  prosthetic consideration/certified fixed orthodontic courses by Indian d...
Eye prosthetic consideration/certified fixed orthodontic courses by Indian d...
Indian dental academy
 
Sss5
Sss5Sss5
Sss5
Abay Alem
 
structure and fuction of eyes and ears,types of memory,sharpe memory,attention
structure and fuction of eyes and ears,types of memory,sharpe memory,attentionstructure and fuction of eyes and ears,types of memory,sharpe memory,attention
structure and fuction of eyes and ears,types of memory,sharpe memory,attention
UmarKhan422
 
RDP_Special senses-2021
RDP_Special senses-2021RDP_Special senses-2021
RDP_Special senses-2021
rishi2789
 
Advance Special Senses Physiology
Advance Special Senses PhysiologyAdvance Special Senses Physiology
Advance Special Senses Physiology
Ahmadu Bello University, Zaria.
 

Similar to The Orbit & its contents by Dr. Rabia I. Gandapore.pptx (20)

Special senses
Special sensesSpecial senses
Special senses
 
Innovative lesson plan anjana devi
Innovative lesson plan anjana deviInnovative lesson plan anjana devi
Innovative lesson plan anjana devi
 
Orbital region
Orbital regionOrbital region
Orbital region
 
11.eye
11.eye11.eye
11.eye
 
Head and neck
Head and neckHead and neck
Head and neck
 
Sensory organs
Sensory organsSensory organs
Sensory organs
 
ANATOMY OF EYE.pptx
ANATOMY OF EYE.pptxANATOMY OF EYE.pptx
ANATOMY OF EYE.pptx
 
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone by Dr. RIG.pptx
 
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
THE SPECIAL SENCES- Unlocking the Wonders of the Special Senses: Sight, Sound...
 
Eyeball 2013
Eyeball 2013Eyeball 2013
Eyeball 2013
 
anatomy.ppt
anatomy.pptanatomy.ppt
anatomy.ppt
 
Eye Conditions portable display format for medical students
Eye Conditions portable display format for medical studentsEye Conditions portable display format for medical students
Eye Conditions portable display format for medical students
 
Eye Conditions presentation for medical students
Eye Conditions presentation for medical studentsEye Conditions presentation for medical students
Eye Conditions presentation for medical students
 
Superficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptxSuperficial & Deep Fascia of the NECK.pptx
Superficial & Deep Fascia of the NECK.pptx
 
ORBIT-I complete anatomy and muscle attached
ORBIT-I complete anatomy and muscle attachedORBIT-I complete anatomy and muscle attached
ORBIT-I complete anatomy and muscle attached
 
Eye prosthetic consideration/certified fixed orthodontic courses by Indian d...
Eye  prosthetic consideration/certified fixed orthodontic courses by Indian d...Eye  prosthetic consideration/certified fixed orthodontic courses by Indian d...
Eye prosthetic consideration/certified fixed orthodontic courses by Indian d...
 
Sss5
Sss5Sss5
Sss5
 
structure and fuction of eyes and ears,types of memory,sharpe memory,attention
structure and fuction of eyes and ears,types of memory,sharpe memory,attentionstructure and fuction of eyes and ears,types of memory,sharpe memory,attention
structure and fuction of eyes and ears,types of memory,sharpe memory,attention
 
RDP_Special senses-2021
RDP_Special senses-2021RDP_Special senses-2021
RDP_Special senses-2021
 
Advance Special Senses Physiology
Advance Special Senses PhysiologyAdvance Special Senses Physiology
Advance Special Senses Physiology
 

More from Dr. Rabia Inam Gandapore

BONE MARKINGS Part 3 by Dr. Rabia Inam Gandapore.pptx
BONE MARKINGS Part  3 by Dr. Rabia Inam Gandapore.pptxBONE MARKINGS Part  3 by Dr. Rabia Inam Gandapore.pptx
BONE MARKINGS Part 3 by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptxLymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptxMUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
Dr. Rabia Inam Gandapore
 
Introduction To General Anatomy (muscle and body systems) Parrt 2.pptx
Introduction To General Anatomy  (muscle and body systems) Parrt 2.pptxIntroduction To General Anatomy  (muscle and body systems) Parrt 2.pptx
Introduction To General Anatomy (muscle and body systems) Parrt 2.pptx
Dr. Rabia Inam Gandapore
 
Introduction To General Anatomy Part 1.pptx
Introduction To General Anatomy Part 1.pptxIntroduction To General Anatomy Part 1.pptx
Introduction To General Anatomy Part 1.pptx
Dr. Rabia Inam Gandapore
 
Cerebral Cortex and clinical correlations.pptx
Cerebral Cortex and clinical correlations.pptxCerebral Cortex and clinical correlations.pptx
Cerebral Cortex and clinical correlations.pptx
Dr. Rabia Inam Gandapore
 
Cerebrum & White Matter and Clinical Correlations.pptx
Cerebrum & White Matter and Clinical Correlations.pptxCerebrum & White Matter and Clinical Correlations.pptx
Cerebrum & White Matter and Clinical Correlations.pptx
Dr. Rabia Inam Gandapore
 
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptxMuscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptxEar and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptxThyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Pictures of Superficial & Deep Fascia.ppt.pdf
Pictures of Superficial & Deep Fascia.ppt.pdfPictures of Superficial & Deep Fascia.ppt.pdf
Pictures of Superficial & Deep Fascia.ppt.pdf
Dr. Rabia Inam Gandapore
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Dr. Rabia Inam Gandapore
 
Temporomandibular Joint By RABIA INAM GANDAPORE.pptx
Temporomandibular Joint By RABIA INAM GANDAPORE.pptxTemporomandibular Joint By RABIA INAM GANDAPORE.pptx
Temporomandibular Joint By RABIA INAM GANDAPORE.pptx
Dr. Rabia Inam Gandapore
 
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptxTemporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
Dr. Rabia Inam Gandapore
 
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptxNose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Dr. Rabia Inam Gandapore
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptx
Dr. Rabia Inam Gandapore
 

More from Dr. Rabia Inam Gandapore (20)

BONE MARKINGS Part 3 by Dr. Rabia Inam Gandapore.pptx
BONE MARKINGS Part  3 by Dr. Rabia Inam Gandapore.pptxBONE MARKINGS Part  3 by Dr. Rabia Inam Gandapore.pptx
BONE MARKINGS Part 3 by Dr. Rabia Inam Gandapore.pptx
 
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptxLymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
Lymphatic System of Human Body by Dr. Rabia Inam Gandapore.pptx
 
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptxMUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
MUSCLES OF HUMAN BODY GENERAL ANATOMY .pptx
 
Introduction To General Anatomy (muscle and body systems) Parrt 2.pptx
Introduction To General Anatomy  (muscle and body systems) Parrt 2.pptxIntroduction To General Anatomy  (muscle and body systems) Parrt 2.pptx
Introduction To General Anatomy (muscle and body systems) Parrt 2.pptx
 
Introduction To General Anatomy Part 1.pptx
Introduction To General Anatomy Part 1.pptxIntroduction To General Anatomy Part 1.pptx
Introduction To General Anatomy Part 1.pptx
 
Cerebral Cortex and clinical correlations.pptx
Cerebral Cortex and clinical correlations.pptxCerebral Cortex and clinical correlations.pptx
Cerebral Cortex and clinical correlations.pptx
 
Cerebrum & White Matter and Clinical Correlations.pptx
Cerebrum & White Matter and Clinical Correlations.pptxCerebrum & White Matter and Clinical Correlations.pptx
Cerebrum & White Matter and Clinical Correlations.pptx
 
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptxMuscles of Mastication by Dr. Rabia Inam Gandapore.pptx
Muscles of Mastication by Dr. Rabia Inam Gandapore.pptx
 
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptxVestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
Vestibulocochlear Nerve by Dr. Rabia Inam Gandapore.pptx
 
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptxEar and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
Ear and its clinical correlations By Dr. Rabia Inam Gandapore.pptx
 
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptxThyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
Thyroid Gland- Gross Anatomy by Dr. Rabia Inam Gandapore.pptx
 
Cervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptxCervical & Brachial Plexus By Dr. RIG.pptx
Cervical & Brachial Plexus By Dr. RIG.pptx
 
Pictures of Superficial & Deep Fascia.ppt.pdf
Pictures of Superficial & Deep Fascia.ppt.pdfPictures of Superficial & Deep Fascia.ppt.pdf
Pictures of Superficial & Deep Fascia.ppt.pdf
 
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptxPharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
 
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptxMaxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
Maxilla, Mandible & Hyoid Bone & Clinical Correlations by Dr. RIG.pptx
 
Temporomandibular Joint By RABIA INAM GANDAPORE.pptx
Temporomandibular Joint By RABIA INAM GANDAPORE.pptxTemporomandibular Joint By RABIA INAM GANDAPORE.pptx
Temporomandibular Joint By RABIA INAM GANDAPORE.pptx
 
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptxTemporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
Temporal, Infratemporal & Pterygopalatine BY Dr.RIG.pptx
 
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptxNose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
Nose-Nasal Cavity & Paranasal Sinuses BY Dr.Rabia Inam Gandapore.pptx
 
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptxGross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
Gross Anatomy and Histology of Tongue by Dr. Rabia Inam Gandapore.pptx
 
Face and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptxFace and Muscles of facial expression.pptx
Face and Muscles of facial expression.pptx
 

Recently uploaded

How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.
Gokuldas Hospital
 
How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.
Gokuldas Hospital
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
NX Healthcare
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
Dr. Nikhilkumar Sakle
 
District Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PGs in India.pptxDistrict Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PGs in India.pptx
CommunityMedicine46
 
Cervical Disc Arthroplasty ORSI 2024.pptx
Cervical Disc Arthroplasty ORSI 2024.pptxCervical Disc Arthroplasty ORSI 2024.pptx
Cervical Disc Arthroplasty ORSI 2024.pptx
LEFLOT Jean-Louis
 
Breast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapyBreast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapy
Dr. Sumit KUMAR
 
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
Université de Montréal
 
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
shruti jagirdar
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
NX Healthcare
 
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USENARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
Dr. Ahana Haroon
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
Planet Ayurveda
 
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
MuskanShingari
 
Introduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptxIntroduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptx
taiba qazi
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
FFragrant
 
All about shoulder Joint ..
All about shoulder Joint .. All about shoulder Joint ..
All about shoulder Joint ..
Aswan University Hospital
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
Gokuldas Hospital
 
Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
Torstein Dalen-Lorentsen
 
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdf
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdfOphthalmic drugs latest. Xxxxxxzxxxxxx.pdf
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdf
MuhammadMuneer49
 
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Jim Jacob Roy
 

Recently uploaded (20)

How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.How to Control Your Asthma Tips by gokuldas hospital.
How to Control Your Asthma Tips by gokuldas hospital.
 
How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.How to choose the best dermatologists in Indore.
How to choose the best dermatologists in Indore.
 
Travel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International TravelersTravel Clinic Cardiff: Health Advice for International Travelers
Travel Clinic Cardiff: Health Advice for International Travelers
 
Pharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and AntagonistPharmacology of 5-hydroxytryptamine and Antagonist
Pharmacology of 5-hydroxytryptamine and Antagonist
 
District Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PGs in India.pptxDistrict Residency Programme (DRP) for PGs in India.pptx
District Residency Programme (DRP) for PGs in India.pptx
 
Cervical Disc Arthroplasty ORSI 2024.pptx
Cervical Disc Arthroplasty ORSI 2024.pptxCervical Disc Arthroplasty ORSI 2024.pptx
Cervical Disc Arthroplasty ORSI 2024.pptx
 
Breast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapyBreast cancer: Post menopausal endocrine therapy
Breast cancer: Post menopausal endocrine therapy
 
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...
 
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7
 
Top Travel Vaccinations in Manchester
Top Travel Vaccinations in ManchesterTop Travel Vaccinations in Manchester
Top Travel Vaccinations in Manchester
 
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USENARCOTICS- POLICY AND PROCEDURES FOR ITS USE
NARCOTICS- POLICY AND PROCEDURES FOR ITS USE
 
Giloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and SynonymsGiloy in Ayurveda - Classical Categorization and Synonyms
Giloy in Ayurveda - Classical Categorization and Synonyms
 
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)
 
Introduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptxIntroduction to British pharmacopeia.pptx
Introduction to British pharmacopeia.pptx
 
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
Demystifying Fallopian Tube Blockage- Grading the Differences and Implication...
 
All about shoulder Joint ..
All about shoulder Joint .. All about shoulder Joint ..
All about shoulder Joint ..
 
Skin Diseases That Happen During Summer.
 Skin Diseases That Happen During Summer. Skin Diseases That Happen During Summer.
Skin Diseases That Happen During Summer.
 
Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024Physical demands in sports - WCSPT Oslo 2024
Physical demands in sports - WCSPT Oslo 2024
 
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdf
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdfOphthalmic drugs latest. Xxxxxxzxxxxxx.pdf
Ophthalmic drugs latest. Xxxxxxzxxxxxx.pdf
 
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...
 

The Orbit & its contents by Dr. Rabia I. Gandapore.pptx

  • 1. The Orbital Region (Bony Orbit, Ocular Muscles, Lacrimal & Ciliary Gland And Eyeball) Dr. Rabia Inam Gandapore Assistant Professor Head of Department Anatomy (Dentistry-BKCD) B.D.S (SBDC), M.Phil. Anatomy (KMU), Dip. Implant (Sharjah, Bangkok, ACHERS) , CHPE (KMU),CHR (KMU), Dip. Arts (Florence, Italy)
  • 2. Teaching Methodology  LGF (Long Group Format)  SGF (Short Group Format)  LGD (Long Group Discussion, Interactive discussion with the use of models or diagrams)  SGD (Short Group)  SDL (Self-Directed Learning)  DSL (Directed-Self Learning)  PBL (Problem- Based Learning)  Online Teaching Method  Role Play  Demonstrations  Laboratory  Museum  Library (Computed Assisted Learning or E-Learning)  Assignments  Video tutorial method
  • 3. Goal/Aim (main objective)  To help/facilitate/augment the students about the: 1. Describe walls and openings in the orbital cavity. 2. Enumerate foramen and fissures in bony orbit and structures passing through it. 3. Explain origin, insertion, nerve supply and action of extra-ocular muscles 4. Discuss lacrimal and ciliary glands. 5. Describe features & relevant clinical anatomy of: • Outer Coat • Cornea • Middle Coat • Inner Coat • Aqueous Humour • Vitreous Body
  • 4. Specific Learning Objectives (cognitive) At the end of the lecture the student will able to: 1. Recognize the gross anatomical features of the Describe walls and openings in the orbital cavity. 2. Enumerate foramen and fissures in bony orbit and structures passing through it. 3. Explain origin, insertion, nerve supply and action of extra-ocular muscles 4. Discuss lacrimal and ciliary glands. 5. Describe features & relevant clinical anatomy of: • Outer Coat • Cornea • Middle Coat • Inner Coat • Aqueous Humour • Vitreous Body 6. Sketch labeled diagram of the Eyeball & tabulated extra-ocular muscles
  • 5. Psychomotor Objective: (Guided response)  A student to draw labelled diagram of Eyeball & tabulated extra-ocular muscles
  • 6. Affective domain  To be able to display a good code of conduct and moral values in the class.  To cooperate with the teacher and in groups with the colleagues.  To demonstrate a responsible behavior in the class and be punctual, regular, attentive and on time in the class.  To be able to perform well in the class under the guidance and supervision of the teacher.  Study the topic before entering the class.  Discuss among colleagues the topic under discussion in SGDs.  Participate in group activities and museum classes and follow the rules.  Volunteer to participate in psychomotor activities.  Listen to the teacher's instructions carefully and follow the guidelines.  Ask questions in the class by raising hand and avoid creating a disturbance.  To be able to submit all assignments on time and get your sketch logbooks checked.
  • 7. Lesson contents Clinical chair side question: Students will be asked if they know what is the function of Eyeball Outline:  Activity 1 The facilitator will explain the student's to Recognize the  Gross anatomical features and openings in the orbital cavity.  Enumerate foramen and fissures in bony orbit and structures passing through it.  Explain origin, insertion, nerve supply and action of extra-ocular muscles  Discuss lacrimal and ciliary glands.  Describe features & relevant clinical anatomy of: • Outer Coat • Cornea • Middle Coat • Inner Coat • Aqueous Humour • Vitreous Body  Activity 2 The facilitator will ask the students to make a labeled diagram of the Sketch labeled diagram of the Eyeball & tabulated extra-ocular muscles  Activity 3 The facilitator will ask the students a few Multiple Choice Questions related to it with flashcards.
  • 8. Recommendations  Students assessment: MCQs, Flashcards, Diagrams labeling.  Learning resources: Langman’s T.W. Sadler, Laiq Hussain Siddiqui, Snell Clinical Anatomy, Netter’s Atlas, BD Chaurasia’s Human anatomy, Internet sources links.
  • 9. Orbital Region  EYELIDS  MOVEMENTS OF EYELIDS
  • 10. Orbital Region  Orbits are a pair of bony cavities that contain: 1. Eyeballs 2. Associated muscles, nerves, vessels 3. Fats 4. Lacrimal apparatus.  Eyelids: Orbital opening is guarded by 2 thin, movable folds.  protect eye from injury & excessive light by their closure
  • 11. Eyelids a. Upper eyelid: is larger & more mobile.  Eye closed: it completely covers cornea of eye.  Eye open: looking straight ahead it covers upper margin of cornea. a. Lower eyelid: smaller & less mobile.  When eye open: lies just below cornea  When eye closed: rises only slightly.  Upper & Lower eyelids: meet at medial & lateral angles.  Palpebral fissure: elliptical opening between eyelids & is the entrance into conjunctival sac.
  • 12.
  • 13.  Superficial surface of eyelids: covered by skin  Deep surface: covered by mucous membrane called Conjunctiva.  Eyelashes: short, curved hairs on free edges of eyelids, arranged in double or triple rows at mucocutaneous junction.  Sebaceous glands (glands of Zeis): open directly into eyelash follicles.  Ciliary glands (glands of Moll): modified sweat glands, open separately between adjacent lashes.  Tarsal glands: long, modified sebaceous glands that pour their oily secretion onto margin of lid; their openings lie behind eyelashes. This oily material prevents overflow of tears & helps make the closed eyelids airtight.
  • 14.
  • 15.
  • 16.  Lacus lacrimalis: small space which separates more rounded medial angle from eyeball  Caruncula lacrimalis: small, reddish yellow elevation in center of Lacus lacrimalis  Plica semilunaris: reddish semilunar fold, lies on lateral side of caruncle.  Papilla lacrimalis: Near medial angle of eye a small elevation. It projects into lacus  Punctum lacrimale: On summit of papilla is a small hole which leads into canaliculus lacrimalis.  Punctum & Canaliculus carry tears down into the nose
  • 17.
  • 18.
  • 19.  Conjunctiva: thin mucous membrane that lines eyelids & is reflected at superior & inferior fornices onto anterior surface of eyeball. Its epithelium is continuous with that of cornea.  Upper lateral part of superior fornix: pierced by ducts of lacrimal gland.  Conjunctival sac: Conjunctiva forms potential space, it opens at palpebral fissure.  Subtarsal sulcus: Beneath eyelid groove, it runs close to & parallel with margin of lid. It tends to trap small foreign particles introduced into conjunctival sac & clinically important
  • 20.
  • 21.  Framework of eyelids: formed by fibrous sheet, orbital septum. Its attached to periosteum at orbital margins.  Tarsal Plates: is thickened at margins of lids to form; superior & inferior tarsal plates.  Lateral palpebral ligament: lateral ends of plates are attached by a band to a bony tubercle just within orbital margin.  Medial palpebral ligament: medial ends of plates are attached by a band to crest of lacrimal bone.  Tarsal glands: are embedded in posterior surface of tarsal plates.  Orbicularis oculi muscle: superficial surface of tarsal plates & orbital septum are covered by its palpebral fibers.  aponeurosis of insertion of Levator palpebrae superioris muscle pierces the orbital septum to reach anterior surface of superior tarsal plate & skin.
  • 22.
  • 23. Movements of the Eyelids  Position of eyelids at rest depends on tone of: a. Orbicularis oculi muscles b. Levator palpebrae superioris muscles c. Position of eyeball.  Eyelids are closed by: a. Contraction of: orbicularis oculi muscles b. Relaxation of: levator palpebrae superioris muscles.  Eye is opened by: a. Levator palpebrae superioris raising upper lid.  On looking upward: a. levator palpebrae superioris contracts b. upper lid moves with eyeball.  On looking downward: a. Both lids move b. Upper lid continues to cover upper part of cornea c. Lower lid is pulled downward by conjunctiva, its attached to sclera & lower lid.
  • 24. Muscles of Eyeball & Eyelids  ORIGIN  INSERTION  ACTION  NERVE SUPPLY
  • 25. Extrinsic Muscles  6 voluntary muscles that run from posterior wall of orbital cavity to eyeball: 1. Superior rectus: to raise cornea upward, inferior oblique muscle must assist 2. Inferior rectus: inferior rectus to depress cornea downward, superior oblique muscle must assist.  Superior & inferior recti are inserted on medial side of vertical axis of eyeball, they not only raise & depress cornea, respectively, but also rotate it medially. 3. Medial rectus 4. Lateral rectus 5. Superior oblique muscles 6. Inferior oblique muscles.
  • 26. Movements of Eyeball Center of cornea or pupil: is used as anatomic “anterior pole” of eye  Elevation: rotation of eye upward  Depression: rotation of eye downward  Abduction: rotation of eye laterally  Adduction: rotation of eye medially  Rotatory movements: use upper rim of cornea (or pupil) as marker. Eye rotates: a. Medially b. Laterally.
  • 27. S. No. Muscles Origin Insertion Nerve Supply Action Extrinsic Muscles of Eyeball (Striated Skeletal Muscle) 1. Superior Rectus Tendinous ring on posterior wall of orbital cavity Superior surface of eyeball just posterior to corneoscleral junction Oculomotor nerve (3rd cranial nerve) Raises cornea upward and medially 2. Inferior Rectus Inferior surface of eyeball just posterior to corneoscleral junction Depresses cornea downward and medially 3. Medial Rectus Medial surface of eyeball just posterior to corneoscleral junction Rotates eyeball so that cornea looks medially 4. Lateral Rectus Lateral surface of eyeball just posterior to corneoscleral junction Abducent nerve (6th cranial nerve) Rotates eyeball so that cornea looks laterally 5. Superior Oblique Posterior wall of orbital cavity Passes through pulley and is attached to superior surface of eyeball beneath superior rectus Trochlear nerve (4th cranial nerve) Rotates eyeball so that cornea looks downward and laterally 6. Inferior Oblique Floor of orbital cavity Lateral surface of eyeball deep to lateral rectus Oculomotor nerve (3rd cranial nerve) Rotates eyeball so that cornea looks upward and laterally
  • 28.
  • 29.
  • 30. Intrinsic Muscles  Involuntary ciliary muscle  Constrictor & Dilator pupillae of iris: take no part in movement of eyeball
  • 31. S. No. Muscles Origin Insertion Nerve Supply Action Intrinsic Muscles of Eyeball (Smooth Muscle) 1. Sphincter pupillae of iris Parasympathetic via oculomotor nerve Constricts pupil 2. Dilator pupillae of iris Sympathetic Dilates pupil 3. Ciliary muscle Parasympathetic via oculomotor nerve Controls shape of lens; in accommodation, makes lens more globular Muscles of Eyelids 1. Orbicularis Oculi 2. Levator palpabrae superioris Back of orbital cavity Anterior surface and upper margin of superior tarsal plate Striated muscle oculomotor nerve, smooth muscle sympathetic Raises upper lid
  • 32. Fascial Sheath of Eyeball  Surrounds eyeball from optic nerve to corneoscleral junction.  It separates eyeball from orbital fat & provides it with a socket for free movement.  It is perforated by tendons of orbital muscles & is reflected onto each of them as a tubular sheath.  Sheaths for tendons of medial & lateral recti are attached to medial & lateral walls of orbit by triangular ligaments called medial & lateral check ligaments.  Lower part of fascial sheath, which passes beneath the eyeball & connects the check ligaments, is thickened & serves to suspend eyeball; its called suspensory ligament of eye & is suspended from medial & lateral walls of orbit, as if in a hammock.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40. Lacrimal Appratus  LACRIMAL GLANDS  LACRIMAL DUCTS
  • 41. Lacrimal Apparatus Lacrimal Gland  consists of: a. Orbital part: large b. Palpebral part: small which are continuous with each other around lateral edge of aponeurosis of levator palpebrae superioris.  It is situated above eyeball in anterior & upper part of orbit, posterior to orbital septum.  It opens into lateral part of superior fornix of conjunctiva by 12 ducts.
  • 42.
  • 43.  Parasympathetic secretomotor nerve: supply is derived from lacrimal nucleus of facial nerve. a. Preganglionic fibers: reaches pterygopalatine ganglion (sphenopalatine ganglion) via nervus intermedius & its great petrosal branch and via nerve of pterygoid canal. b. Postganglionic fibers: leave ganglion & joins maxillary nerve. It then pass into its zygomatic branch a& zygomaticotemporal nerve. They reach lacrimal gland within lacrimal nerve.  Sympathetic postganglionic nerve supply is from internal carotid plexus & travels in deep petrosal nerve,nerve of pterygoid canal, maxillary nerve, zygomatic nerve, zygomaticotemporal nerve & lacrimal nerve.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49. Lacrimal Ducts  Tears circulate across cornea & accumulate in lacus lacrimalis.  tears enter canaliculi lacrimales through puncta lacrimalis.  canaliculi lacrimales pass medially & open into lacrimal sac, which lies in the lacrimal groove behind medial palpebral ligament & is the upper blind end of the nasolacrimal duct.  Nasolacrimal duct: 0.5 in. (1.3 cm) long & emerges from lower end of lacrimal sac.  Duct descends downward, backward & laterally in a bony canal & opens into inferior meatus of nose.  opening is guarded by a fold of mucous membrane known as lacrimal fold. This prevents air from being forced up the duct into lacrimal sac on blowing nose
  • 50.
  • 51.
  • 52.
  • 53. The Orbit  OPENINGS INTO THE ORBITAL CAVITY  ORBITAL FASCIA
  • 54. The Orbit  Pyramidal cavity: Base: Anterior Apex: Posterior.  Orbital margin above: frontal bone  Lateral margin: processes of frontal & zygomatic bones  Inferior margin: zygomatic bone & maxilla  Medial margin: processes of maxilla & frontal bone. Roof: orbital plate of frontal bone (separates orbital cavity from anterior cranial fossa & frontal lobe of cerebral hemisphere) Lateral wall: zygomatic bone & greater wing of sphenoid Floor: orbital plate of maxilla ( separates orbital cavity from maxillary sinus) Medial wall: before backward by frontal process of maxilla, lacrimal bone, orbital plate of ethmoid (which separates orbital cavity from ethmoid sinuses) & body of sphenoid
  • 55. Openings into the Orbital Cavity Orbital opening: Lies anteriorly. About one sixth of eye is exposed; the remainder is protected by walls of orbit. The openings into orbital cavity are:  Supraorbital notch (Foramen): situated on superior orbital margin. It transmits supraorbital nerve & blood vessels  Infraorbital groove & canal: Situated on floor of orbit in orbital plate of maxilla; they transmit infraorbital nerve (a continuation of maxillary nerve) & blood vessels.  Nasolacrimal canal: Located anteriorly on medial wall; it communicates with inferior meatus of nose. It transmits nasolacrimal duct.  Inferior orbital fissure: Located posteriorly between maxilla & greater wing of sphenoid; it communicates with pterygopalatine fossa. It transmits maxillary nerve & its zygomatic branch, inferior ophthalmic vein & sympathetic nerves.  Superior orbital fissure: Located posteriorly between greater & lesser wings of sphenoid; it communicates with the middle cranial fossa. It transmits the lacrimal nerve, frontal nerve, trochlear nerve, oculomotor nerve (upper & lower divisions), abducent nerve, nasociliary nerve & superior ophthalmic vein.  Optic canal: Located posteriorly in lesser wing of sphenoid; it communicates with middle cranial fossa. It transmits optic nerve & ophthalmic artery.
  • 56.
  • 57. Orbital Fascia  Is periosteum of bones that form walls of orbit.  It is loosely attached to bones & is continuous through foramina & fissures with the periosteum covering outer surfaces of bones.  Muscle of Müller, or orbitalis muscle: thin layer of smooth muscle that bridges inferior orbital fissure. Its supplied by sympathetic nerves & its function is unknown.
  • 58. The Eyeball  MOVEMENTS OF EYEBALL  FACIAL SHEATH OF EYEBALL  STRUCTURE AND COATS OF THE EYEBALL a. FIBROUS COAT b. VASCULAR PIGMENTED COAT c. NERVOUS COAT  CONTENTS OF THE EYEBALL
  • 59. Structure of Eye  Embedded in orbital fat but is separated from it by fascial sheath of eyeball.  Eyeball consists of 3 coats: 1. Fibrous coat 2. Vascular pigmented coat 3. Nervous coat.
  • 60.
  • 61. Coats of Eyeball 1. Fibrous Coat: made up of a a. Posterior opaque part: Sclera b. Anterior transparent part: Cornea.
  • 62. a. The Sclera  Opaque sclera is composed of dense fibrous tissue & is white.  Posteriorly, its pierced by optic nerve & is fused with dural sheath of that nerve.  Lamina cribrosa is area of sclera that is pierced by nerve fibers of optic nerve.  Its also pierced by ciliary arteries & nerves & associated veins; venae vorticosae.  Its directly continuous in front with cornea at corneoscleral junction, or limbus.
  • 63.
  • 64. b. Cornea  Transparent cornea is largely responsible for refraction of light entering eye.  Its in contact posteriorly with aqueous humor.  Blood Supply: avascular & devoid of lymphatic drainage. Its nourished by diffusion from aqueous humor & from capillaries at its edge.  Nerve Supply: Long ciliary nerves from ophthalmic division of trigeminal nerve  Function of Cornea: refractive medium of eye. This refractive power occurs on the anterior surface of cornea, where refractive index of cornea (1.38) differs greatly from that of air. The importance of tear film in maintaining normal environment for corneal epithelial cells should be stressed.
  • 65.
  • 66. 2. Vascular Pigmented Coat Consists, from behind forward, of: a. Choroid: composed of an:  Outer: pigmented layer  Inner: highly vascular layer b. Ciliary body c. Iris
  • 67. b. Ciliary Body:  continuous:  Posteriorly with choroid  Anteriorly it lies behind peripheral margin of iris.  Its composed of: 1. Ciliary ring: posterior part of body & its surface has shallow grooves; ciliary striae. 2. Ciliary processes: are radially arranged folds, or ridges, to posterior surfaces of which are connected the suspensory ligaments of lens 3. Ciliary muscle: composed of meridianal & circular fibers of smooth muscle. a. Meridianal fibers: run backward from region of corneoscleral junction to ciliary processes. b. Circular fibers: are fewer in number & lie internal to meridianal fibers.
  • 68.
  • 69.
  • 70.  Nerve supply: ciliary muscle is supplied by parasympathetic fibers from oculomotor nerve. After synapsing in ciliary ganglion, postganglionic fibers pass forward to eyeball in short ciliary nerves.  Action: Contraction of ciliary muscle, especially meridianal fibers, pulls ciliary body forward. This relieves tension in suspensory ligament, & elastic lens becomes more convex. This increases refractive power of lens
  • 71.
  • 72. c. Iris & Pupil  Iris: contractile, pigmented diaphragm  Pupil: central aperture  Its suspended in aqueous humor between cornea & lens.  Periphery of iris is attached to anterior surface of ciliary body.  It divides the space between lens & cornea into an 1. Anterior Chamber 2. Posterior Chamber  Muscle fibers of iris are involuntary & consist of circular & radiating fibers. a. Circular fibers: form sphincter pupillae & are arranged around margin of pupil.
  • 73.
  • 74.
  • 75.
  • 76.  Nerve supply: a. Sphincter pupillae: is supplied by parasympathetic fibers from oculomotor nerve. After synapsing in ciliary ganglion, postganglionic fibers pass forward to eyeball in short ciliary nerves. b. Dilator pupillae: is supplied by sympathetic fibers, which pass forward to eyeball in long ciliary nerves.  Action: a. Sphincter pupillae: constricts pupil in presence of bright light & during accommodation. b. Dilator pupillae: dilates pupil in presence of light of low intensity or in presence of excessive sympathetic activity such as occurs in fright.
  • 77.
  • 78. 3. Nervous Coat: The Retina  Retina consists of an: a. Outer pigmented layer: contact with choroid b. Inner nervous layer: contact with the vitreous body  Posterior 3 quarters of retina is receptor organ.  Its anterior edge forms a wavy ring; ora serrata, & nervous tissues end here.  Anterior part of retina is nonreceptive & consists of pigment cells, with a deeper layer of columnar epithelium. It covers ciliary processes & back of iris.
  • 79.
  • 80.
  • 81.  At the center of posterior part of retina is an oval, yellowish area; macula lutea, which is area of retina for the most distinct vision.  It has a central depression; fovea centralis.  Optic nerve leaves retina about 3 mm to medial side of macula lutea by optic disc.  Optic disc is slightly depressed at its center, where its pierced by central artery of retina.  At optic disc is a complete absence of rods & cones so that it is insensitive to light & is referred to as the “blind spot.”  Ophthalmoscopic examination: optic disc is seen to be pale pink in color, much paler than surrounding retina.
  • 82.
  • 83.
  • 84. Contents of Eyeball  consist of: a. Refractive media b. Aqueous humor c. Vitreous body d. Lens.
  • 85. a. Aqueous Humor  Clear fluid that fills anterior & posterior chambers of eyeball .  It’s a secretion from ciliary processes, via it enters posterior chamber.  It flows into anterior chamber through pupil & is drained away through spaces at the iridocorneal angle into canal of Schlemm  Obstruction: to draining of aqueous humor results in a rise in intraocular pressure called glaucoma.  This can produce degenerative changes in retina i.e. blindness.
  • 86. Function Of Aqueous Humor  To support wall of eyeball by exerting internal pressure  maintaining its optical shape.  It also nourishes cornea & lens  removes products of metabolism; Note: cornea & lens do not possess a blood supply.
  • 87. b. Vitreous Body  fills eyeball behind the lens & is a transparent gel.  Hyaloid canal is a narrow channel that runs through the vitreous body from the optic disc to posterior surface of lens; in fetus, it is filled by the hyaloid artery, which disappears before birth.
  • 88.
  • 89. Function of vitreous body  Contribute slightly to magnifying power of eye.  Supports posterior surface of lens  Assists in holding neural part of retina against pigmented part of retina.
  • 90. C. The Lens  transparent, biconvex structure enclosed in a transparent capsule.  Its situated behind iris & in front of vitreous body & is encircled by ciliary processes.  Lens consists of an elastic capsule, which envelops the structure; a cuboidal epithelium, which is confined to anterior surface of lens; & lens fibers, which are formed from cuboidal epithelium at equator of lens.  Lens fibers make up bulk of lens.  Elastic lens capsule is under tension, causing lens constantly to endeavor to assume a globular rather than a disc shape.  Lens is attached to ciliary processes of ciliary body by suspensory ligament.  The pull of radiating fibers of suspensory ligament tends to keep the elastic lens flattened so that eye can be focused on distant objects..
  • 91.
  • 92.
  • 93. Accommodation of the Eye  To accommodate eye for close objects, ciliary muscle contracts & pulls ciliary body forward & inward so that radiating fibers of suspensory ligament are relaxed.  This allows elastic lens to assume a more globular shape.  With advancing age: lens becomes denser & less elastic,& ability to accommodate is lessened (presbyopia).  This disability can be overcome by use of an additional lens in form of glasses to assist the eye in focusing on nearby objects.
  • 94.  Constriction of Pupil during Accommodation of Eye To ensure that light rays pass through central part of lens so spherical aberration is diminished during accommodation for near objects, the sphincter pupillae muscle contracts so pupil becomes smaller.  Convergence of Eyes during Accommodation of Lens In humans, retinae of both eyes focus on only one set of objects (single binocular vision). When an object moves from a distance toward an individual, the eyes converge so that a single object, not two, is seen. Convergence of eyes results from coordinated contraction of medial rectus muscles.
  • 96.
  • 97. Clinical Testing for Actions of Superior & Inferior Recti AND Superior & Inferior Oblique Muscles  Physician tests eye movements: Patient is asked to look vertically upward or downward. Example: Origins of superior & inferior recti are situated about 23° medial to their insertions so when the patient is asked to turn cornea laterally, these muscles raise (superior rectus) or lower (inferior rectus) cornea.  Test for Superior Oblique: ask patient to look medially & downward at tip of his or her nose.  Test for inferior Oblique: asking patient to look medially & upward. Because lateral & medial recti are simply placed relative to eyeball, asking patient to turn cornea directly laterally tests lateral rectus & turning cornea directly medially tests medial rectus.
  • 98.
  • 99. Eye Trauma  Eyeball: well protected by bony orbit but provides no protection from small objects i.e. golf balls & cause severe damage on lateral side.  Blowout fractures of orbital floor involving maxillary sinus occur due to blunt force to face. If the force is applied to eye, the orbital fat explodes inferiorly into maxillary sinus, fracturing orbital floor. Not only can blowout fractures cause displacement of eyeball, but cause double vision (diplopia), injure infraorbital nerve, producing loss of sensation of skin of cheek & gum on that side. Entrapment of inferior rectus muscle in fracture may limit upward gaze.
  • 100. Strabismus  Many cases of strabismus are non-paralytic  caused by an imbalance in action of opposing muscles. This type of strabismus is known as concomitant strabismus  common in infancy.
  • 101. Pupillary Reflexes  Reaction of pupils to light & accommodation: depend on integrity of nervous pathways. 1. Direct light reflex:  Normal pupil reflex contracts when a light is shone into patient’s eye.  Nervous impulses pass from retina along optic nerve to optic chiasma & optic tract  Before reaching lateral geniculate body, fibers leave the tract & pass to oculomotor nuclei on both sides via pretectal nuclei.  From parasympathetic part of nucleus, efferent fibers leaves midbrain in the oculomotor nerve & reach the ciliary ganglion via nerve to inferior oblique.  Postganglionic fibers pass to constrictor pupillae muscles via short ciliary nerves.
  • 102.
  • 103. 2. Consensual light reflex  Tested by shining light in one eye & noting contraction of pupil in opposite eye.  This reflex is possible because the afferent pathway just described travels to parasympathetic nuclei of both oculomotor nerves.
  • 104. 3. Accommodation reflex  is contraction of pupil that occurs when a person suddenly focuses on a near object after having focused on a distant object.  Nervous impulses pass from retina via optic nerve, optic chiasma, optic tract, lateral geniculate body, optic radiation & cerebral cortex of occipital lobe of brain.  Visual cortex is connected to eye field of frontal cortex. From here, efferent pathways pass to parasympathetic nucleus of oculomotor nerve. From there, efferent impulses reach constrictor pupillae via oculomotor nerve, ciliary ganglion & short ciliary nerves.

Editor's Notes

  1. Note: that the tendon of the superior oblique muscle passes through a fibro-cartilaginous pulley (trochlea) attached to the frontal bone. The tendon now turns backward and laterally and is inserted into the sclera beneath the superior rectus muscle.