eye, orbit, lacrimal apparatus
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ORBIT, EYE & LACRIMAL APPARATUSPART-I
BY
LECTURER
FARIS MUHAMMED AL-HADDAD
M.B.CH.B, F.I.B.M.S ( ANATOMY )
DEPARTMENT OF ANATOMY, COLLEGE OF MEDICINE,
HAWLER MEDICAL UNIVERSITY
ORBIT & EYE
• THE EYE IS THE ORGAN OF VISION & THE PRINCIPLE COMPONENT OF THE VISUAL APPARATUS.
• THE EYE IS LODGED IN THE ORBIT, TOGETHER WITH THE EXTRAOCULAR MUSCLES WHICH MOVE THE EYE, NERVES, LACRIMAL GLAND, FASCIA AND FAT.
BONY SKELETON OF THE ORBIT
THE ORBIT
• A PYRAMIDAL BONY CAVITY
Its lying on its side, having :
1. Apex : is at the back
2. Base : forming the orbital margin on the front of the facial skeleton
ORBITAL MARGIN BONES
SUPERIORFRONTAL BONE
LATERAL PROCESSES OF FRONTAL & ZYGOMATIC BONES
INFERIOR ZYGOMATIC & MAXILLARY BONES
MEDIAL PROCESSES OF FRONTAL & MAXILLARY BONES
ORBITAL WALL BONE
ROOFFRONTAL BONE (ORBITAL PLATE)
LATERAL 1. ZYGOMATIC BONE2. SPHENOID BONE
(GREATER WING)
FLOOR MAXILLARY BONE (ORBITAL PLATE)
MEDIAL(FROM BEFORE BACKWARDS)
1. MAXILLARY BONE (FRONTAL PROCESS)2. LACRIMAL BONE3. ETHMOID BONE (ORBITAL PLATE)4. SPHENOID BODY
OPENINGS IN THE ORBIT POSITION TRANSMITS
ORBITAL OPENING ANTERIORLY 1/6TH OF EYES ARE EXPOSED
SUPRAORBITAL NOTCH ( OR FORAMEN )
SUPRAORBITAL MARGIN SUPRAORBITAL N. & B.V.s
INFRAORBITAL GROOVE & CANAL
ORBITAL PLATE OF MAXILLA ( FLOOR OF ORBIT )
INFRAORBITAL N.( A CONOTINUATION OF MAXILLARY N. )
& B.V.s
NASOLACRIMAL CANALANTERIORLY ON MEDIAL
WALL OF ORBIT NASOLACRIMAL DUCT TO THE INFERIOR
MEATUS OF THE NOSE
OPENINGS IN THE ORBIT
POSITIONTRANSMITS
INFERIOR ORBITAL FISSURE
POSTERIORLY BETWEEN : • MAXILLA • GREATER WING OF
SPHENOID
• MAXILLARY N. & ITS ZYGOMATIC BR. • INFERIOR OPHTHALMIC VEIN • SYMPATHETIC N.s ( IOF COMMUNICATES WITH PTERYGO –PALATINE FOSSA)
OPTIC CANAL POSTERIORLY IN : • LESSER WING OF
SPHENOID
• OPTIC N. • OPHTHALMIC A.(THIS CANAL CMMUNICATES WITH MIDDLE CRANIAL FOSSA)
OPENING INTHE ORBIT
LOCATION TRANSMITS
SUPERIOR ORBITAL FISSURE
POSTERIORLY BETWEEN : • GREATER WING • LESSER WING
OF SPHENOID
UPPER LATERAL PART ABOVE TENDENOUS RING :• LACRIMAL N. • FRONTAL N.s• 4TH C.N.• SUPERIOR OPHTHALMIC VEIN
MIDDLE PART THROUGH THE RING :• UPPER DIVISION OF 3RD C.N.• NASOCILIARY N.• LOWER DIVISION OF 3RD C.N.• ABDUCENT N.
LOWER MEDIAL PART BELOW THE TENDENOUS RING :• INFERIOR OPHTHALMIC VEIN
FASCIA OF THE ORBIT
ORBITAL FASCIA
• IS PERIOSTEUM
• LOOSELY ATTACHED TO BONES
• CONTINUOUS THROGH THE OPENINGS & FISSURE WITH PERIOSTEUM COVERING OTHER BONES
• ORBITALIS MUSCLE : IS A THIN LAYER OF SMOOTH M., THAT BRIDGES THE INFERIOR ORBITAL FISSURE, IS OF UNKNOWN FUNCTION.
FASCIAL SHEATH OF THE EYEBAL *
• SURROUND EYE BALL FROM OPTIC N. TO CORNEOSCLERAL JUNCTION
• SEPARATES EYEBALL FROM SURROUNDING FAT
• PROVIDES A SOCKET FOR FREE MOVEMENT
• PERFORATED BY TENDONS OF OCULAR M.s & ENSHEATHES THESE M.s
*
• THE SHEATHES OF THE MEDIAL & LATERAL RECTI ARE ATTACHED TO THE MEDIAL & LATERAL WALLS OF THE ORBIT BY THE TRIANGULAR MEDIAL & LATERAL CHECK LIGAMENTS
• THE LOWER PART OF THE SHEATH WHICH PASSES BENEATH THE EYEBALL & CONNECTING CHECK LIGAMENTS IS THICKENED & SUSPENDS THE EYEBALL, ITS CALLED SUSPENSORY LIGAMENT OF THE EYE
NEUROVASCULATURE OF THE ORBIT
NERVE OF ORBIT
ENTERSORBIT
THROUGHORIGIN COURSE IN ORBIT ACTION NOTES
OPTIC N. OPTIC CANAL
RETINAL GANGLION
CELLS
• OPHTHALMIC A. : FIRST LATERAL TO OPTIC N., THEN CROSS OVER IT FROM LATERAL TO MEDIAL
• OPTIC N. RUNS ANTERO -LATERALLY WITHIN CONE OF RECTI M.s
• OPTIC N. PEIRCES SCLERA MEDIAL TO POSTERIOR EYE POLE
• OPTIC N. IS SURROUNDED BY THE THREE MENINGIES, SO C.S.F. IN THE SUBARACH-NOID SPACE REACHES AS FAR AS THE SCLERA.
CONVEYS VISUAL
INFORMA -TION FROM
EYES
A RISE IN C.S.F. PRESSURE IS
TRANSMITTED TO THE BACK OF
THE EYE BY OPTIC N.
LEADING TO PAPILLOEDEMA
NERVE OF ORBIT
ENTERSORBIT
THROUGHORIGIN COURSE IN ORBIT ACTION
LACRIMAL N. UPPER PART OF THE
SUPERIOR ORBITAL FISSURE
OPHTHALMIC DIVISION OF TRIGEMINAL
N.
• PASSES FORWARDS ALONG THE UPPER BORDER OF THE LATERAL RECTUS M.
• ITS JOINED BY A BRANCH OF ZYGOMATICOTEMPORAL N. WHICH ENTERS LACRIMAL GLAND (PARASYMPATHETIC SECRETOMOTOR FIBERS )
• CONVEYSPARASYMPATHETIC SECRETO-MOTOR FIBERS TO LACRIMAL GL.
• SUPPLIES UPPER CONJUNCTIVAL FORNIX
• SUPPLIES SKIN OF UPPER EYE LID
*
*
NERVE OF ORBIT
ENTERSORBIT
THROUGHORIGIN COURSE IN ORBIT ACTION
FRONTAL N. UPPER PART OF SUPERIOR
ORBITAL FISSURE
OPHTHALMIC DIVISION OF
TRIGEMINAL N.
• PASSES FORWARDS ON THE SUPERIOR SURFACE OF LEVATOR PALPEBRAE SUPERIORIS.
• DIVIDE IN TO :
1. SUPRAORBITAL N.2. SUPRATROCHLEAR N.
1. BOTH SUPRAORBITAL & SUPRATROCHLEAR N.s WIND AROUND THE UPPER MARGIN OF THE ORBITAL CAVITY TO SUPPLY THE SKIN OF THE FOREHEAD
2. SUPRATROCHLEAR N. ALSO SUPPLIES THE MUCOUS MEMBRANE OF THE FRONTAL AIR SINUS
NERVE OF ORBITENTERSORBIT
THROUGHORIGIN
COURSE IN THE ORBIT
OCCULOMOTOR N. (**)
S.O.F MIDBRAIN
• SUPERIOR RAMUS : SUPPLIES /1. SUPERIOR RECTUS M.2. LEVATOR PALPEBRAE SUPERIORIS M.
• INFERIOR RAMUS : SUPPLIES /1. INFERIOR RECTUS M.2. MEDIAL RECTUS M.3. INFERIOR OBLIQUE M. ( GIVES OFF A BRANCH TO
CILLIARY GANG. CARRYING PARASYMPATHETIC SUPPLY TO SPHINCTER PUPILLAE & CILLIARY M.s)
**
NERVE OF ORBITENTERS ORBIT
THROUGHORIGIN COURSE IN ORBIT
NASOCILIARY N.(*)
TENDEOUS RING OF THE SUPERIOR
ORBITAL FISSURE
OPHTHALMIC DIVISION OF
TRIGEMINAL N
• CROSSES OPTIC N. • RUNS ALONG UPPER
MARGIN OF MEDIAL RECTUS M.
BRANCHES OF NASOCILIARY N.
1. COMMUNICATING
BR. TO CILIARY GANG.
2.LONG CILIARY
3.POSTERIOR ETHMOIDAL
4. INFRATROCHLEAR 5. ANTERIOR ETHMOIDAL
• A SENSORY N.• SENSTION FROM
EYE TRANSMITTED TO CILIARY G. BY SHORT CILIARY AND TO NASOCILIARY N. BY LONG CILIARY N.
• 2-3 IN NUMBER• CONTAINS SYMP-
ATHETIC FIBERS FOR DIALTOR PUPILLAE M. OF THE IRIS.
• PASSES FORWARDS TO SCLERA & CONTINUE BETWEEN SCLERA & CHOROID TO REACH TO THE IRIS
SUPPLIES :• ETHMOIDAL AIR
SINUS• SPHENOIDAL AIR
SINUS
• PASSES FORWARDS BELOW THE PULLEYOF THE SUPERIOR OBLIQUE M.
• SUPPLIES THE SKIN OF THE MEDIAL PART OF THE UPPER EYE LID AND ADJACENT NOSE.
• PASS THROUGH ANTERIOR ETHMO-IDAL FORAMEN
• ENTERS ANTERIOR CRANIAL FOSSA ON UPPER SURFACE OF CRIBRIFORM PLATE.
• ENTERS NASAL CAVITY THROUGH SLIT IN CRISTA GALI
• APPEARS IN FACE AS EXT. NASAL BR.
*1
23
4
5
NASOCILIARY N.
ANT.
POST.
ETHMOIDAL N.
INFRATROCHLEAR N.
LONG CILIARY N.
COMMUNICATING BR. TO CILIARY GANG
NERVE OF ORBIT
ENTERS ORBIT THROUGH
ORIGIN ACTION
1. TROCHLEAR N. UPPER PART OF
S.O.F.MIDBRAIN SUPPLIES SUPPERIOR OBLIQUE
2. ABDUCENT N. LOWER PART OF
S.O.F.PONTOMEDULLARY
JUNCTIONSUPPLIES LATERAL RECTUS
1.2.
CILIARY GANGLION (*)
DEFINITION A PARASYMPATHETIC GANGLION
LOCATION POSTERIOR PART OF THE ORBIT
PREGANGLIONIC FIBERSRECEIVED FROM OCCULOMOTOR N. ( THROUGH ITS N. TO INF. OBLIQUE
M.)
POSTGANGLIONIC FIBERS
LEAVES THE GANG. TO THE SHORT CILIARY N.s ENTERS THE EYE BALL
SUPPLYING SPHINCTER PUPILLAE M. & CILIARIS M.
** A NUMBER OF SYMPATHETIC FIBERS PASSES FROM INTERNAL CAROTID PLEXUS INTO THE ORBIT THROUGH THE CILIARY GANG. WITHOUT INTERRUPTION
*
OPHTHALMIC ARTERY
ORIGIN A BRANCH OF INTERNAL CAROTID A. AFTER EMERGING FROM CAVERNUS SINUS
ENTERS THE ORBIT THROUGH OPTIC CANAL WITH OPTC N.
COURSE IN ORBIT RUNS FORWARDS, CROSSES THE OPTIC N.FROM LATERAL TO MEDIAL WALL OF ORBIT
BRANCHESOF OPHTH -ALMIC A.
1. CENTRAL A. OFRETINA
• PIERCES THE MENIGIES OF OPTIC N. • ENTERS & RUNS IN THE OPTIC N. TO
REACH THE EYE BALL AT THE CENTER OF OPTIC DISC.• DIVIDES INTO END ARTERIES SUPPLYING THE RETINA
2. MUSCULAR BR.s -
3. CILIARY A.s• ANTERIOR : SUPPLY EYE BALL AT CORNEOSCLERAL JUNC.• POSTERIOR : ENTERS OPTIC N.
4. LACRIMAL A. SUPPLIES LACRIMAL GLAND
5.SUPRAORBITAL & 6.SUPRATROCHLEAR A.s
-
SUPRAORBITAL BR.
SUPRTROCHLEAR BR.
POSTERIOR CILIARY BR.
OPHTHALMIC A.
LACRIMAL BR.
P.V.P
F.V
1
2C.V
NOTE : NO LYMPHATIC VESSLES ORNODES IN THE EYES
OPHTHALMIC VEINS
1. SUPERIOR OPHTHALMIC VEINS
COMMUNICATES INFRONT WITH
FACIAL VEIN
BOTH VEINS PASS
BACKWARDS THROUGH
S.O.F.
BOTH DRAIN INTO
CAVERNOUS SINUS(C.V.)2.
INFERIOR OPHTHALMIC VEIN
COMMUNICATES WITH
PTERYGOID VENOUS PLEXUS (P.V.P) THROUGH
I.O.F.
MUSCLES OF THE ORBIT
EXTRAOCCULAR MUSCLES OF THE EYE
MUSCLE ORIGIN INSERTION N. SUPPLY
SUPERIORRECTUS
TENDENOUS RING ON THE POSTERIOR WALL OF
THE ORBITAL CAVITY
SUPERIOR SURFACE OF THE EYE BALL JUSTPOSTERIOR TO CORNEOSCLERAL JUNCTION
(JPTCSJ)
CN IIIINFERIOR RECTUS
SAME INFERIOR SURFACE OF THE EYE BALL
(JPTCSJ)
MEDIAL RECTUS
SAME MEDIAL SURFACE OF THE EYE BALL
(JPTCSJ)
LATERAL RECTUS
SAMELATERAL SURFACE OF THE EYE BALL
(JPTCSJ)CN VI
SUPERIOR OBLIQUE
POSTERIOR WALL OF ORBITAL CAVITY
PASSES BENEATH THE PULLEY TO BE ATTACHED TO THE SUPERIOR SURFACE OF THE EYE BALL
BENEATH THE SUPERIOR RECTUSCN IV
INFERIOR OBLIQUE
FLOOR OF ORBITALCAVITY
LATERAL SURFACE OF THE EYE BALL BENEATH THE LATERAL RECTUS
CN III
EXTRAOCCULAR MUSCLE ACTION
SUPERIOR RECTUS RISES CORNEA UP & MEDIALLY
INFERIOR RECTUS DEPRESSES CORNEA DOWN & MEDIALLY
MEDIAL RECTUS ROTATESCORNEA MEDIALLY
LATERAL RECTUS ROTATES CORNEA LATERALLY
SUPERIOR OBLIQUE ROTATES CORNEA INFEROLATERALLY
INFERIOR OBLIQUE ROTATES CORNEA SUPEROLATERALLY
SR
MR
IR
LR
SO
IO
EYELIDS
EYE LIDS
• PROTECTS THE EYES FROM INJURY & EXCESSIVE LIGHT BY THEIR CLOSURE.
• UPPER IS LARGER & MORE MOBILE THAN LOWER LIDS.
• UPPER & LOWER MEET AT MEDIAL & LATERAL ANGLES
• PALPEBRAL FISSURE IS AN ELLEPTICAL OPENING BETWEEN THE LIDS & IS THE ENTRANCE TO THE CONJUNCTIVAL SAC.
MUSLES OF THE EYE LID
MUSCLE ORIGIN INSERTION N. SUPPLY ACTION
LEVATOR PALPEBRAE SUPERIORIS
BACK OF ORBITAL CAVITY
ANTERIOR SURFACE & UPPER MARGIN OF THE
SUPERIOR TARSAL PLATE
• STRIATED :3RD C.N.
• SMOOTH :SYMPATHETIC
RSISES UPPER EYELID
ORBICLARIS OCULI :
1. PALPEBRALPART
2. ORBITAL PART
MEDIAL PALPEBRAL LIG.
MEDIAL PALPEBRAL LIG. & ADJOINING
BONE
LATERAL PALPEBRAL
RAPHAE
LOOPS & RETURN TO ORIGIN
FACIAL N.
FACIAL N.
CLOSES EYE LID & DIALATE LACRIMAL
SAC
PROTECTS EYEBALL
STRUCTURES OF THE EYELID
STRUCTURE DEFINITION
1. SKIN COVERS EYELID SUPERFICIALLY,
2. EYE-LASHESWHICH ARE CURVED HAIR ON FREE EDGE OF EYELID,
ARRANGED IN 2-3 RAWS AT MUCOCUTANE-OUS JUNCTION.
3. GLAND ZEISA SEBACEOUS GL. THAT OPENS DIRECTLY TO THE EYE
LASH FOLLICLES
4. CILIARY GL OF MOLL
MODIFIED SWEAT GL.s THAT OPEN SEPARATELY BETWEEN ADJACEN EYE LASHES
5. TARSAL (MEIBOMIAN) GLANDS
ARE LONG MODIFIED SEBACEOUS GL. THAT POUR THEIR OILY SECRETIONS TO THE MARGIN OF THE LID. THEIR
OPENINGS ARE BEHAND EYE LASHES, PRVENT OVERFLOW OF TEARS & MAKE THE CLOSED EYELIDS
AIRTIGHT
STRUCTURES OF THE EYELID
STRUCTURE DEFINITION
6. LACUS LACRIMALIS SEPARATING THE MEDIAL ANGLE OF
THE EYE LIDS FROM THE EYEBALL
7. CARUNCULA LACRIMALISA REDDISH YELLOISH ELEVATION LIES IN
THE CENTER OF THE LACUS LACRIMALIS
8. PLICA SEMILUNARIS A SEMILUNAR FOLD LIES AT THE
LATERAL SIDE OF THE CARUNCULE
9. PAPILLA LACRIMALISA SMALL ELEVATION ON THE MEDIAL ENDS OF THE EYELID ( MEDIAL ANGLES)
10. PUNCTUM LACRIMLEA SMALL HOLE AT THE SUMMIT OF THE PAPILLA THAT LEADS TO CANALICULUS
LACRIMALIS
6
7
8
9
10
STRUCTURES IN EYELIDS
STRUCTURE DEFINITION
11. COJUNCTIVA
• A MUCOUS MEMBRANE THAT LINES EYE LIDS AND REFLECTED ON THE EYE BALL AS THE SUP. & INF. FORNICES,IT BECOME CONTINU-OUS WITH THAT OF THE CORNEA.
• THE UPPER LATERAL PART OF SUP. FORNIX IS PEIRCED BY THE DUCTS OF THE LACRMAL GL.
• IT FORMS A POTENTIAL SPACE CALLED THE COJUNCTIVAL SAC, WHICH OPENS AT PALPEBRAL FISSURE
12. SUBTARSALSULCUS
• A GROOVE BENEATH THE EYE LID, RUNS CLOSE & PARALLEL TO THE LID MARGIN,
• TRAPPS FOREIGN BODIES ENTERRING CONJUNCTIVAL SAC ( SO ITS IMPORTANT CLIN-ICALLY ).
FRAMEWORK OF EYELID
STRUCTURE DEFINITION
1.ORBITALSEPTUM
A FIBROUS SHEET THAT IS ATTACHED TO THEPERIOSTEUM OF THE ORBITAL MARGINS,
2. TARSAL PLATES
ARE SUP. & INF. THICKENINGS OF THE ORBITAL SEPTUM AT MARGINS OF THE LIDS, TARSAL GL.s ARE EMBEDDED IN THE POSTERIOR SURFCAE OF TARSAL PLATES.
3. LATERAL PALPEBRAL LIGAMENT
A BAND ATTACHES LATERAL ENDS OF TARSAL PLATES TO A BONY TUBERCLE JUST WITHIN ORBITAL MARGIN
4. MEDIAL PALPEBRAL LIGAMENT
A BAND ATTACHES MEDIAL ENDS OF TARSAL PLATES TO LACRIMAL CREST OF THE MEDIAL ORBITAL MARGIN
1
2
1
23 4
1. ORBICULARIS OCULI (PALPEBRAL PART) :
COVERS THE SUPERFICIAL SURFACE OF
THE TARSAL PLATE & ORBITAL SEPTUM.
2. LEVATOR PALPEBRAE SUPERIORIS :
ITS INSERTION APPONEUROSIS PEIRCES
THE ORBITAL SEPTUM TO REACH THE
ANTERIOR SURFACE OF THE SUPERIOR
TARSAL PLATE & SKIN.
2
1
1
LACRIMAL APPARATUS
LACRIMAL APPARATUS
PARTS LOCATION NOTES
1.LACRIMAL GLAND
A. PALPEBRAL ( LARGE ) PART
B. ORBITAL ( SMALL ) PART
ABOVE THE EYE BALL IN ANTERIOR & UP. PART OF ORBIT POSTERIOR TO ORBITAL SEPTUM
• BOTH PARTS ARE CONTINUOUS AROUND THE LATERAL MARGIN OF LEV. PALP. SUP. APPONEUROSIS
• OPENS TO LATERAL PART OF SUP. FORNIX BY 12 DUCTS.
2. LACRIMAL DUCTS
1A. LACUS LACRIMALIS
TEARS ACCUMULATES HERE
2B. PUNCTA LACRIMALIS
THROUGH IT TEARS ENTER L. CANALICULI
3C. LACRIMAL CANALICULI
DIRECTS TEARS MEDIALLY TO L. SAC
4D. LACRIMAL SAC
LACRIMAL GROOVE BEHIND MEDIAL PALPEBRAL LIG.
IT’S THE UPPER BLIND END OF THE NASOLACRIMAL DUCT
5E. NASOLAC-RIMAL DUCT
1.3 CMs FROM LOWER END OF L. SAC DESCENDS DONWARDSIN A BONY CANAL TO OPEN IN INFERIOR MEATUS OF NOSE
6F. LACRIMAL FOLDS
GUARDS THE NLD OPENING IN INF. MEATUS
PREVENT AIR FROM BEING FORCED UP THE N.L.D TO L. SAC DURING BLOWING THE NOSE
Deep petrosal N.
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