A&P Eye Adnexa and Eyelids

inferior lateral palpebral artery

What eyelid blood supply vessel is indicated by number 6?

ectropion

Eyelid turns out and loses contact between the globe and the eye lid; may cause watery eye; often in older people due to loss of muscle tone

Non-keratinized stratified columnar epithelium

Classify the type of epithelium the palpebral conjunctiva has.

orbicularis oculi

What part of the anterior eyelid margin is located below the skin and is a muscle?

eyebrows

Thick skin covered by short, prominent hairs; first body hairs produced during development; important for facial expression; diverts sweat from entering the eyes

1. Divert sweat from entering the eyes
2. Facial expression

What are the 2 purposes of eyebrows?

1. Frontalis
2. Corrugator superciliaris
3. Procerus
4. Orbicularis oculi

What are the four muscles involved in producing facial expression with your eye brows?

scalp

Where is the origin of the frontalis muscle?

Into connective tissues near superior orbital rim

Where does the frontalis muscle insert?

vertically

How are frontalis muscles oriented?

Raise the eyebrow

What is the main function of the frontalis muscle?

frontalis

What muscle is known as the surprise muscle?

frontal bone

Where is the origin of the corrugator superciliaris?

Into the skin (superior to the medial portion of the eyebrow)

Where does the corrugator superciliaris insert?

obliquely

How are the fibers oriented in the corrugator superciliaris muscle?

corrugator superciliaris

What eyebrow muscle moves the brow medially and makes the expression of “trouble” and “concentration”?

nasal bone

Where is the origin of the procerus muscle?

Medial side of the frontalis

Where does the procerus insert?

procerus

What eyebrow muscle pulls the medial eyebrow down (creates horizontal furrow over bridge of nose) in expressions of aggression or menance?

procerus

What eye brow muscle is responsible for “aggression” or “menance”?

orbicularis oculi

What eye brow muscle lowers the entire brow?

Facial nerve (CN VII)

All eye brow muscles are innervated by what nerve?

1. Depressor muscles
2. Elevator muscles

The position of the eyebrows are dependent on what 2 muscle types?

frontalis muscle

During up gaze, elevation of the eyebrows occur via what eyebrow muscle?

procerus

What eyebrow muscle is indicated by the green arrow?

corrugator supercilli

What eyebrow muscle is indicated by the red muscle?

orbicularis oculi

What eyebrow muscle is indicated by the purple arrows?

frontalis muscle

What eyebrow muscle is indicated by the blue arrow?

1. Frontalis
2. Procerus
3. Orbiularis oculi

Which eyebrow muscles are more superficial?

Depressor supercilli

Which eyebrow muscles are in intermediate muscle layers?

corrugator supercilli

Which eyebrow muscle lies in the deep muscle layer?

Relaxed skin tension lines

What is shown in the image?

Relaxed skin tension lines

Lines of the face similar to wrinkle lines of the skin; generally run perpendicular to the direction of the facial muscle fibers

relaxed skin tension lines

If ever making incisions on the face, they should correspond with what features of the face?

1. Less wound healing
2. Faster healing
3. Less chance of scar formation

Using skin tension lines as a reference for where to make incisions on a patient’s face results in what 3 things?

palpebrae

latin word for eyelids

blephara

Greek word for eyelids

1. Cover and protect anterior globe
2. Produce components of the tear film
3. Spread tears over the eye
4. Move tears toward the drainage canal

What are the 4 main functions of the eyelid?

palpebral fissure

The space between the eyelid margins that is not exposed (upper lid below superior limbus & lower lid near inferior limbus)

canthi

Ends of the palpebral fissure where superior and inferior lids meet

lateral canthus

Which canthus is 5-7mm medial to the orbital margin & has direct contact with the globe?

medial canthus

Which canthus lies at the medial orbital margin & is separated from the globe?

medial canthus

What structure is indicated by the green arrow?

lateral canthus

What structure is indicated by the red arrow?

1. Plica semilunaris
2. Caruncle

What are 2 other structures in the medial canthus?

plica semilunaris

narrow, crescent shaped fold of conjunctiva that allows for lateral movement without stretching

caruncle

Small pink mass of modified skin covered with epithelium & contains goblet cells and fine hairs, sweat & sebaceous glands

caruncle

What structure is indicated by the red arrow?

plica semilunaris

What structure is indicated by the green arrow?

epicanthal fold

What is the vertical fold of skin at the nasal canthus that can give the appearance of an eyeturn when none is present (pseudoesotropia); common in newborns and people of Eastern Asian descent?

pseudostrabismus

Gives an appearance of an eyeturn when the eyes are actually perfectly aligned

Eyelid margin to the eyebrow

What are the extents of the upper eyelid?

1. Tarsal portion
2. Orbital portion

What are the 2 sections of the upper eyelid?

superior palpebral sulcus

What divides the 2 sections of the upper eyelid?

inferior palpebral sulcus

What separates the tarsal portion of the eyelid from the orbital portion of the eyelid?

Lower border of the tarsus to the nasojugal and malar sulci

What are the limits of the orbital portion of the eyelid?

tarsal portion

What portion of the eyelid is thin skin that is closer to the lid margin, rests on the globe, contains the tarsal plate, & has a tight adherence of skin to fibrous tissue?

loose connective tissue

What type of connective tissue lies underneath the tarsal portion of the eyelid and has no adipose tissue?

orbital portion

What portion of the eyelid extends from the tarsus to the eyebrow, overlies an adipose tissue cushion, and is bound less tightly to underlying connective tissue?

orbital portion

Which portion of the eyelid overlies an adipose tissue cushion?

1. Anterior lamella
2. Posterior lamella

What two lamella can the eyelid margin be divided into?

1. Skin
2. Muscle
3. Glands

What features of the eyelid are included in the anterior lamella?

1. Tarsal plate
2. Conjunctiva
3. Glands

What features of the eyelid are included in the posterior lamella?

Grey line

What separates the anterior and posterior lamellae of the eyelid?a

1. Lashes
2. Meibomian glands

The grey line of the eyelid is found between what two structures?

muscle of Riolan

What muscle helps with holding the eyelid to the globe and expelling glandular contents?

Lack of direct vascularization

Why is the grey line “grey”?

grey line

What part of the eyelid margin is used as a surgical landmark?

Skin eyelid margin (anterior)

What skin is the thinnest skin in the body, has a thin dermis, and has no fat layer?

sebaceous glands

What type of glands are the glands of Zeis (aka what do they secrete?)?

cilliary follicles

Glands of Zeis empty into what?

Tubular apocrine sweat glands

How would you classify glands of moll?

Between lash follicles

Where are the glands of Moll located on the anterior eyelid margin?

upper lid

Do more lashes exist in the upper or lower lid?

10 weeks

How long does it take for eyelashes to grow to full length?

Every 5 months

How often are eyelashes replaced?

Type I & III

What types of collagen composes the tarsal plate?

orbital septum; lid margin

What is the tarsal plate attached to? Where does it terminate?

canthal tendons (palpebral ligaments)

Medially and laterally, both tarsal plates taper to become the medial and lateral _______________.

superior tarsal plate

What structure is indicated by the orange arrow in the image?

lateral palpebral ligament

What structure is indicated by the green arrow in the image?

medial palpebral ligament

What structure is indicated by the purple arrow in the image?

inferior tarsal plate

What structure is indicated by the red arrow in the image?

True

True/False: The medial and lateral canthal tendons attach to the orbit.

Whitnall’s lateral tubercle

Where does the lateral palpebral ligament insert?

Meibomian glands

What glands secrete the lipid layer of the tears?

posterior side of tarsal plate

The palpebral conjunctiva is tightly bound to what?

mucocutaneous junction

What is the name of the transition zone between thin skin and conjunctiva?

1. basal germinal layer
2. granular layer
3. superficial cornified layer

What layers of the skin of the eyelid are contained within the epidermal layer?

1. Epidermal layer
2. Dermis
3. Subcutaneous layer

What are the 3 primary layers of the skin of the eyelid?

dermis

What layer of the skin of the eyelid contains many elastic fibers?

subcutaneous layer

What layer of the skin of the eyelid contains sparse areolar connective tissue, has no adipose tissue in the tarsal section, and is often a pad of fat in the orbital?

subcutaneous layer

What layer of the skin separates the orbicularis from the skin?

tarsal plate

In the slide image of the eyelid, what structure is indicated by the black arrow?

cornea

In the slide image of the eyelid, what structure is indicated by the red arrow?

mucocutaneous junction

In the slide image of the eyelid, what structure is indicated by the purple arrow?

orbicularis muscle

In the slide image of the eyelid, what structure is indicated by the orange arrow?

meibomian glands

In the slide image of the eyelid, what structure is indicated by the green arrow?

orbicularis oculi muscle

In the image of the eyelid, what structure is indicated by #1?

epidermis of skin

In the image of the eyelid, what structure is indicated by #3?