review of clinical anatomy & physiology of the orbit
DESCRIPTION
REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT. Dr. Ayesha Abdullah 12.09.2012. LEARNING OUTCOME . By the end of this lecture the students would be able to; “correlate the structural organization of the orbit with its functions and clinical significance”. ANATOMY OF THE ORBIT . - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/1.jpg)
REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF
THE ORBITDr. Ayesha Abdullah
12.09.2012
![Page 2: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/2.jpg)
LEARNING OUTCOME By the end of this lecture the
students would be able to;
“correlate the structural organization of the orbit with its functions and clinical significance”
![Page 3: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/3.jpg)
ANATOMY OF THE ORBIT • The orbital cavities are …………
![Page 4: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/4.jpg)
Adult orbital dimensions Entrance height 35
mmEntrance width 40
mmMedial wall length / depth
45 mm
Volume 30 cc
Distance from the back of the globe to the optic foramen
18 mm
45mm
45mm
35mm
![Page 5: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/5.jpg)
SALIENT ANATOMICAL FEATURES • 7 bones• 4 walls• 4 margins• 4 important openings• 6 contents• 5 important relationships
![Page 6: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/6.jpg)
v
![Page 7: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/7.jpg)
MZSFELP
Bones &
walls
![Page 8: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/8.jpg)
IMPORTANT OPENINGS OF THE ORBIT
![Page 9: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/9.jpg)
Which orbit ?
![Page 10: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/10.jpg)
IMPORTANT OPENINGS OF THE ORBIT Optic Foramen• Where?• size?• what passes through?• Clinical significance?Superior orbital fissure• Where? • What passes through? • What is annulus of Zinn?• Clinical significance?Inferior orbital fissure: • Where?• What passes through?• Clinical significance?
![Page 11: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/11.jpg)
Openings of the orbitNasolacrimal canal • Where? • What passes through? • Clinical significanceInferior orbital foramen• Where?• What passes through• Clinical significance?
![Page 12: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/12.jpg)
![Page 13: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/13.jpg)
Orbital walls Roof• Frontal bone and sphenoid lesser wing• Lacrimal gland, trochlea • Superior orbital notch • BrainFloor• Zygomatic, maxilla and palatine bones. • weak part • Infraorbital groove & canal for the
infraorbital nerve • Maxillary sinus.
![Page 14: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/14.jpg)
Medial Wall• lacrimal, maxillary, ethmoid &
sphenoid• Thinnest wall• Lamina papyrecea• It separates the orbit from the nasal
cavity, the ethmoidal and the sphenoidal sinuses
Lateral Wall• Zygomatic & Sphenoid (greater wing) • Stronger wall• It separates the orbit from the
(temporal fossa) and the brain
![Page 15: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/15.jpg)
Roof
![Page 16: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/16.jpg)
Medial wall
Floor
![Page 17: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/17.jpg)
IMPORTANT RELATIONS OF THE ORBIT 1. Brain : Orbit is closely related to the brain in
relation to its roof and lateral wall. 2. Para nasal sinuses: Orbit is intimately
connected to the paranasal sinuses. – Maxillaly sinus via the floor. – Ethmoidal and sphenoidal sinus via the medial
wall. – Frontal sinus at the roof. – Any infection can easily spread to the orbit from
the sinuses. 3. Nasal cavity: Nasal cavity is related to the
orbit at its medial or inner wall & through the nasolacrimal duct
4. Cavernous sinus via the veins of the orbit5. Pterygopalatine fossa via the inferior
orbital fissure
![Page 18: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/18.jpg)
Orbit as seen from above
![Page 19: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/19.jpg)
![Page 20: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/20.jpg)
CONTENTS OF THE ORBIT 1. Eyeball & the optic nerve2. Muscles – To move the eyeball. 3. Nerves –
– To move the muscles ( III, IV, VI). – To carry different sensations ( V)– parasympathetic innervation ( accommodation, pupillary
constriction & lacrimal gland stimulation– Sympathetic innervation ( pupillary dilatation,
vasoconstriction, smooth muscles of the eye lids & hidrosis)4. Blood vessels ( branches of ophthalmic artery, superior &
inferior ophthalmic veins) 5. Fat & orbital fascia – For padding purposes &for smooth
movements 6. Most of the Lacrimal Apparatus ( lacrimal gland & part of
the tear drainage system)
![Page 21: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/21.jpg)
![Page 22: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/22.jpg)
![Page 23: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/23.jpg)
Lacrimal gland and the view of the orbit from
the roof
![Page 24: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/24.jpg)
![Page 25: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/25.jpg)
![Page 26: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/26.jpg)
Orbital fascia
• Periorbita• Orbital septum• Tenon’s capsule• Fascial spaces
intraconal extraconalsubtenon
subperiosteal
![Page 27: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/27.jpg)
Intraconal
extraconal
subtenon
subperiosteal
![Page 28: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/28.jpg)
Extraconal space
Intraconal space
Subperiosteal space
![Page 29: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/29.jpg)
![Page 30: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/30.jpg)
VIEWS : AXIAL VIEWSRADIOGRAPHIC ANATOMY OF THE ORBIT
![Page 31: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/31.jpg)
CORONAL VIEW
![Page 32: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/32.jpg)
SAGITTAL VIEW
![Page 33: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/33.jpg)
![Page 34: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/34.jpg)
![Page 35: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/35.jpg)
AXIAL CT SCAN
![Page 36: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/36.jpg)
![Page 37: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/37.jpg)
![Page 38: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/38.jpg)
Summary • Orbit is the protective casing for the
delicate visual apparatus - the eyeball• It is made up of 7 bones, has 4 margins,
4 walls/ boundaries, 4 important openings , 5 important relations & 6 contents
• Infection can spread to the brain from the orbit directly or through the venous drainage
• Trauma mostly damages the medial wall & the floor ( the weakest parts give way)
• The symptomotology of orbital diseases is reflective of its clinical anatomy
![Page 39: REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT](https://reader035.vdocuments.us/reader035/viewer/2022081420/5681610e550346895dd06512/html5/thumbnails/39.jpg)
References • American Academy of
Ophthalmology.Orbit, eyelids & lacrimal system. American Academy of Ophthalmology; 1997-98
• Jack J Kanski. Clinical ophthalmology a systematic approach. 5th ed;2003:557-89
• Parsons’ diseases of the eye. Diseases of the adnexa-diseases of the orbit. 19th ed. 2004; 505-524
• Remington LA. Clinical Anatomy of the visual system. Bones of the skull & orbit. 1998; 123-35