GROSS ANATOMY:Orbit and Eye

Ref: Gray’s Anatomy for Students, 2nd editionPages 878 – 902

**Please note there are multiple errors in Table 8.8**

Compare and Contrast:What glands are blocked?

Patient A

Patient B

Extraocular Muscles: Actions and Testing

Lets Play, Guess my Lesion!

Look straight ahead.

Look to the RIGHT.

Look to the LEFT.

Lets Play, Guess my Lesion!

Lets Play, Guess my Lesion!

A 28-year-old male presents with the chief complaint of a swollen eye and face, headaches and a fever. His history is significant for a oral abscess.

What does his presentation have to do with the orbit?

A 34-year-old female with a 3-year history of systemic lupus presents as shown.

Corneal Reflex

Touch the cornea with a wisp of cotton and the patient should blink their eye.

What nerves/cell bodies/ganglia are involved in this important reflex?

Orbital portion of orbicularis oculi muscle, innervated by the facial nerve, snaps the eye shut forcefully

Sensory is from the opthalimic division of V1, which will pick up the sensation; senses the cotton swab, sends impulses through the Trigeminal ganglion

Nervous LayerVisualization of the retina – the only ARTERY you can visualize!

??

A 50-year-old female presents with headaches and a recent seizure. Physical exam reveals:

A 14-year-old male presents with sudden blindness after getting hit in the head during a game of dodge ball. Physical

exam reveals:

Pupillary Light Reflex: NORMAL

Pupillary Light Reflex: LESION #1:

Compression of the right CN III by an aneurysm of the

internal carotid in the cavernous sinus.

Pupillary Light Reflex: LESION #2:

An apical lung tumor that erodes the right sympathetic chain.

What other signs and symptoms would be present on physical examination of the previous patient?

[Horner Syndrome]

The “NEAR TRIAD”

Pop Quiz (from 2006)