Head and Eyes - H&P

the skull is composed of what bones

temporal

parietal

frontal

occipital

base of skull

occipital

Vertex of head

the top of the head, the crown; the highest point; the top or apex of something

coronal suture

the suture between the parietal and frontal bones of the skull

lamboidal suture (Skull)

between occipital and parietal bones

zygomatic arch of temporal bone

cheek bone

sphenoid bone

forms part of the base of the skull and parts of the floor and sides of the orbit

styloid process skull

pole-like process extending downward from the temporal bone on each side of the skull

skull sutures

coronal, sagittal, squamous, lambdoid

sagittal suture of the skull

between parietal bones

squamous skull suture

between the parietal and temporal

supraorbital ridge

bony projection in the eyebrow area of the frontal bone

glabella of frontal bone

Smooth area between the eyes

palpebral fissures

spaces between the eyelids, should be equal in size

- indicates down syndrome

nasolabial fold

skin crevice between the nose and the corner of the mouth

The frontalis and occipitalis muscles together are called the

epicranius

Temporalis

elevates and retracts mandible

Masseter

elevates mandible and closes jaw

Sternocliedomastoid

flex neck, rotates neck

orbicularis oculi

Closes eyelids; used in blinking, winking, and squinting

Zygomatic muscle (Zygomaticus)

smiling muscle, pulls corners of the mouth upward

buccinator muscle

Thin, flat muscle of the cheek between the upper and lower jaw that compresses the cheeks and expels air between the lips.

orbicularis oris

closes and protrudes lips

Platysma

tenses skin of neck, depresses mandible

Parotid (Stensen's) duct drains where?

drains to top of mouth

Where does the submandibular (wharton) duct open?

drains into bottom of the mouth under the tongue

superficial temporal artery

A continuation of the external carotid nerve artery; supplies blood to the muscles of the front, side, and top of the head.

pathological facies

facial expressions that are indicative of an underlying pathology such as cushing's or down syndrome

hirsutism

excessive hair growth over the body

Parkinson's Facies

decreased facial mobility blunts expression.

decreased blinking and a characteristic stare present.

patient seems to peer upward towards observer.

facial skin becomes oily and drooling may occur.

Acromegaly Facies

enlargement of both bone and soft tissues. head is elongated with bony prominence over forehead, nose, and lower jaw. nose, lips, and ears also enlarge.

Cushing's syndrome facies

moon face

red cheeks

hirsutism

nephrotic syndrome facies

group of clinical signs and symptoms caused by excessive protein loss in urine

- periorbital edema

- puffy pale face

- lips was swell

Myxedema facies

hair dry, sparse

lateral eyebrows thin

periorbital edema

puffy dull face

medial and lateral canthus

corners of the eye

limbus

border between cornea and sclera

Iris

Colored part of the eye

pupil

the adjustable opening in the center of the eye through which light enters

The tarsal plate of the eyelid ________.

is connected to the levator palpebrae

meibomian glands

oil glands found in the upper and lower edges of the eyelids that help lubricate the eye

conjunctiva

Delicate membrane lining the eyelids and covering the eyeball

palpebral conjunctiva

membrane that lines underside of eyelids (vascular and red)

bulbar conjunctiva

overlays the eyeball, with the white sclera showing through (clear)

lacrimal gland

gland located in the upper outer region above the eyeball that secretes tears

nasolacrimal duct

passageway for tears from the lacrimal sac into the nose

Canaliculi eye

portion of the lacrimal sac

puncta

Tiny openings of the tear ducts.

what are the 3 layers of the eye?

external - sclera and cornea

middle or vascular layer - iris, ciliary body and choroid = uveal tract

internal layer - retina

ciliary body

ring of tissue behind the peripheral iris that is composed of ciliary muscle and ciliary processes - attached to the lens and moves it

lens

the transparent structure behind the pupil that changes shape to help focus images on the retina

Cornea

The clear tissue that covers the front of the eye

macula lutea

a yellowish central area of the retina that is rich in cones and that mediates clear detailed vision

choroid

middle, vascular layer of the eye, between the retina and the sclera

Retina

the light-sensitive inner surface of the eye, containing the receptor rods and cones plus layers of neurons that begin the processing of visual information

optic nerve

the nerve that carries neural impulses from the eye to the brain

aqueous humor

fluid in the eye, found between the cornea and the lens (anterior chamber)

Canal of Schlemm

duct in the anterior chamber that carries filtered aqueous humor to the veins and bloodstream

posterior chamber of eye

between iris and lens, filled with aqueous humor

What is the blind spot?

the point at which the optic nerve leaves the eye, creating a "blind" spot because no receptor cells are located there

Is the sclera vascular or avascular?

avascular

Scleral icterus

yellowing of the sclera due to jaundice

Is the cornea vascular or avascular?

avascular (has no blood vessels) - continuous with sclera

Bowman's membrane of cornea

tough, thin membrane of tightly woven collagen - prevents corneal scarring

what structure preforms the most refraction of incoming light?

cornea

uveal tract

the pigmented, vascular layer of the eye (iris, choroid), ciliary muscle, lens

What does the choroid do?

provides blood supply to retina and absorbs scattered light

iris controls

amount of light passing through the lens

circulation of aqueous humor

posterior chamber, anterior chamber, exits canal of schlemm, entering venous circulation

is the retina nervous tissue?

yes

optic disc

is the origin of the optic nerve

optic cup

the depression in the center of the optic disc; ratio should be 1:2

Fovea

the central focal point in the retina, around which the eye's cones cluster (best spot of sight)

are arteries or veins more prevalent in the eye

A:V ratio should be 2:3

Snellen chart

used to measure visual acuity - should be 20 ft away

Myopia (nearsightedness)

occurs when the image is focused in front of the retina

Hyperopia (farsightedness)

occurs when the image is focused behind the retina

OD, OS, OU

right eye,

left eye,

both eyes

what line should you read on snellen chart?

smallest line of print where the patient can read at least half

presbyopia

farsightedness caused by loss of elasticity of the lens of the eye, occurring typically in middle and old age.

astigmatism

defective curvature of the cornea or lens of the eye - causes distortion

visual field

the whole area that you can see without moving your head or eyes

testing visual fields by confrontation

- take fingers from behind patient's shoulders, should see fingers at 90 degree

- take fingers from behind head, should see fingers at 50 degrees just after eye brows

- take fingers from behind torso, should see fingers at 70 degrees

LR6 SO4 all the rest are 3

lateral rectus (6 - abducens)

superior rectus ( 4 - trochlear)

superior oblique (4 - trochlear)

inferior oblique (3 - oculomotor)

medial rectus (3 - oculomotor)

inferior rectus (3 - oculomotor)

action of superior rectus

elevates eye

action of inferior rectus

depresses eye

medial rectus

Turns the eyes inward towards the nose (add)

lateral rectus

moves eye laterally (VI abducens)

medial rectus innervation

Oculomotor nerve (CN III)

inferior rectus innervation

Oculomotor nerve (CN III)

superior rectus innervation

Oculomotor nerve (CN III)

superior oblique action

rotates eye towards nose and depresses eye

inferior oblique action

elevates eye and turns it laterally

superior oblique innervation

Trochlear nerve (CN IV)

inferior oblique innervation

Oculomotor nerve (CN III)

nystagmus

Involuntary rapid eye movements

convergence of eyes

eyes orient their visual axis toward object

what do pupils do during convergence?

pupils constrict to focus on a single point

accomodation of lens

lenses change shape to focus on objects near or far caused by contraction of the ciliary muscles

PERRLA stands for

pupils equal, round, reactive to light and accomodation

What does LLL mean?

Lids

Lashes

Lacrimals