تقرير محدثي التقرير اليومي في يوليو، أغسطس، سبتمبر لعام 2012
Ocular AnatomyS.Khairallah, M.D.1 مقرر طب وجراحة العيون الفصل الثاني...
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Transcript of Ocular AnatomyS.Khairallah, M.D.1 مقرر طب وجراحة العيون الفصل الثاني...
Ocular Anatomy S.Khairallah, M.D. 1
العيون وجراحة طب مقررلعام – الثاني هـ1428/1429الفصل
Ocular Anatomy S.Khairallah, M.D. 2
OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
Ocular Anatomy S.Khairallah, M.D. 3
Ocular Anatomy S.Khairallah, M.D. 4
THE GLOBE(EYEBALL):THE GLOBE(EYEBALL):
• TOPOGRAPHY & OPTICAL SYSTEM• LAYERS(COATES)• CHAMBERS• LENS & ZONULES
Ocular Anatomy S.Khairallah, M.D. 5
THE EYEBALL,cont’d:
• TOPOGRAPHY & OPTICAL SYSTEM:Axial length ..24 mm.Equator ..16 mm.posterior to limbusDiopteric power:
cornea … 40 Dlens … 20 D
Ocular Anatomy S.Khairallah, M.D. 6
Ocular Anatomy S.Khairallah, M.D. 7
THE GLOBE(EYEBALL):THE GLOBE(EYEBALL):
• TOPOGRAPHY & OPTICAL SYSTEM• LAYERS(COATES)• CHAMBERS• LENS & ZONULES
Ocular Anatomy S.Khairallah, M.D. 8
COATES OF EYECOATES OF EYE
OUTEROUTER MIDDLEMIDDLE
“Uveal tract”
INNERINNER
CORNEA IRIS RETINA
LIMBUS CILIARY BODY
_____
SCLERA CHOROID _____
Ocular Anatomy S.Khairallah, M.D. 9
OUTER COATE (LAYER):OUTER COATE (LAYER):
• PRECORNEAL TEAR FILM• CORNEA• SCLERA• LIMBUS
Ocular Anatomy S.Khairallah, M.D. 10
PRECORNEAL TEAR FILM:PRECORNEAL TEAR FILM:
• THREE LAYERS:– Outer most : lipids …Meibomian ,
Zeiss and Moll glands – Middle : aqueous(watery) …Lacrimal
and accessory lacrimal glands– Inner most : mucinous(mucoid) …
Goblet cells
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PRECORNEAL TEAR FILM:PRECORNEAL TEAR FILM:
• FUNCTIONS:– Optical clarity– Nutrition– Defense mechanism
Ocular Anatomy S.Khairallah, M.D. 12
Ocular Anatomy S.Khairallah, M.D. 13
OUTER COATE (LAYER):OUTER COATE (LAYER):
• PRECORNEAL TEAR FILM• CORNEA• SCLERA• LIMBUS
Ocular Anatomy S.Khairallah, M.D. 14
Ocular Anatomy S.Khairallah, M.D. 15
CORNEA :CORNEA :
• THREE LAYERS:– Epithelium / Bowman’s membrane– Stroma– Endothelium / Descemete’s membrane
• DIAMETER : 12 mm.Horiz. / 11 mm.Vertic.
• NERVE : Trigeminal,nonmylinated• BLOOD SUPPLY: NONE “AVASCULAR”
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OUTER COATE (LAYER):OUTER COATE (LAYER):
• PRECORNEAL TEAR FILM• CORNEA• SCLERA• LIMBUS
Ocular Anatomy S.Khairallah, M.D. 20
Ocular Anatomy S.Khairallah, M.D. 21
Ocular Anatomy S.Khairallah, M.D. 22
SCLERA :SCLERA :
• THREE LAYERS : – Episclera– Stroma– Lamina fusca
• TWO OPPENINGS : anterior & posterior
• THICKEST ..1 mm. , THINNEST..0.3mm
• NERVES : anterior;long ciliary n. posterior;short ciliary n.
both:sensory from trigeminal n.:EXTREMELY PAINFULL WHEN INFLAMMEDEXTREMELY PAINFULL WHEN INFLAMMED
Ocular Anatomy S.Khairallah, M.D. 23
SCLERA,cont’d:
• BLOOD SUPPLY:– Episclera & choroidal vesseles.– Anterior to recti muscle’s insertion:-
• Anterior ciliary arteries ciliary injection
– Posterior to recti muscle’s insertion:-• Posterior ciliary arteries
• LYMPHATICS :• None
Ocular Anatomy S.Khairallah, M.D. 24
OUTER COATE (LAYER):OUTER COATE (LAYER):
• PRECORNEAL TEAR FILM• CORNEA• SCLERA• LIMBUS
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LIMBUS:LIMBUS:
• It is corneo-scleral junction• Covered by conj./Tenon’s capsule• Aqueous humor drainage system• Nerves:autonomic n.& sensory
from trigeminal n.• Blood:ant.ciliary
arteries&episcleral vesseles
Ocular Anatomy S.Khairallah, M.D. 28
COATES OF EYECOATES OF EYE
OUTEROUTER MIDDLEMIDDLE
“Uveal tract”
INNERINNER
CORNEA IRIS RETINA
LIMBUS CILIARY BODY
_____
SCLERA CHOROID _____
Ocular Anatomy S.Khairallah, M.D. 29
MIDDLE COATE:MIDDLE COATE:
• =Uveal tract (uvea = grape (عنب
• 3 parts :
ANTERIOR INTER-MEDIATE
POSTERIOR
IRIRS CILIARYBODY
CHOROID
Ocular Anatomy S.Khairallah, M.D. 30
Ocular Anatomy S.Khairallah, M.D. 31
Ocular Anatomy S.Khairallah, M.D. 32
IRIS (IRIS (:(:(القزحيةالقزحية
• It has a central hole (pupil) to control light entering the eye ( ↓ glare)
• It’s thinnest at its insertion to Ciliary Body! (traumatic iris dialysis)
• Two layers: anterior stroma posterior epithelium• Two muscles: sphincter pupillae m.
(para.n.) dilator pupillae m.(sym.n.)
Ocular Anatomy S.Khairallah, M.D. 33
IRIS,IRIS,cont’d:
• Blood : major arterial circle of iris• Nerve : sensory,nasociliary n.(5th
C.N.)
Ocular Anatomy S.Khairallah, M.D. 34
CILIARY BODY:CILIARY BODY:
• It’s a triangular organ,base forward• Two portions: uveal & epithelial
– Uveal portion:3 muscles;longitudinal,radial and circular
– Epithelial portion:pars plicata & pars plana
• Blood:majot arterial circle of iris• Nerve:short ciliary nerves
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Ocular Anatomy S.Khairallah, M.D. 36
Ocular Anatomy S.Khairallah, M.D. 37
CHOROID:CHOROID:
• It’s posterior part of uveal tract
• It’s 3 vascular layers , inner most :
choriocapillaris
• Blood: anterior & post. Ciliary arteries , drainage via vortex veins
• Nerve : short ciliary nerves
Ocular Anatomy S.Khairallah, M.D. 38
COATES OF EYECOATES OF EYE
OUTEROUTER MIDDLEMIDDLE
“Uveal tract”
INNERINNER
CORNEA IRIS RETINA
LIMBUS CILIARY BODY
_____
SCLERA CHOROID _____
Ocular Anatomy S.Khairallah, M.D. 39
Ocular Anatomy S.Khairallah, M.D. 40
Eyeball,INNER COATE:INNER COATE:
• RETINA :– Two major layers:
• Retinal pigment epithelium ( RPE) .. Outermost• Neuro-sensory retina .. Innermost :
– Subdivided into 10 layers :» Photoreceptors (rods,cones) … outermost » Nerve fiber layer … innermost
– Centrally : Macula , fovea , foveola
– Blood : choriocapillaris & central retinal artery
– Functions :
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Ocular Anatomy S.Khairallah, M.D. 43
Ocular Anatomy S.Khairallah, M.D. 44
THE GLOBE(EYEBALL):THE GLOBE(EYEBALL):
• TOPOGRAPHY & OPTICAL SYSTEM• LAYERS(COATES)• CHAMBERS• LENS & ZONULES
Ocular Anatomy S.Khairallah, M.D. 45
Eye,CHAMBERS:CHAMBERS:
ANT.CHM.
POS.CHM
VIT.CAVIT
Anteriorly Cornea Iris L.,zon.,CB
posteriorly
Iris,lens Ant vit face Ret.,opt.n.
Laterally A/c angle Cil process Retina
medially --- Lens equato
---
volume 0.20 ml 0.06 ml 4.50 ml
Filled by Aqueous h. Aqueous h. Vitreous h.
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Ocular Anatomy S.Khairallah, M.D. 47
Anterior chamber ANGLE:Anterior chamber ANGLE:
• Between peripheral cornea & iris root• ANGLE STRUCTURES: anterior to posterior
– Schwalbe’s line– Trabecular meshwork Schlemm’s canal– Scleral spur
• FUNCTION : Drainage of aqueous humor
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Ocular Anatomy S.Khairallah, M.D. 49
Ocular Anatomy S.Khairallah, M.D. 50
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Ocular Anatomy S.Khairallah, M.D. 53
THE GLOBE(EYEBALL):THE GLOBE(EYEBALL):
• TOPOGRAPHY & OPTICAL SYSTEM• LAYERS(COATES)• CHAMBERS• LENS & ZONULES
Ocular Anatomy S.Khairallah, M.D. 54
Ocular Anatomy S.Khairallah, M.D. 55
Eyeball , LENS:LENS:
• Biconvex,transparent,colorless• No vesseles,no nerves• Held in position by zonules• 10 mm.in diameter,4 mm.thick• Consist of :
– Lens capsule– Anterior lens epithelium– Lens substances: cortex(new
f.)&nucleus(old f.)
Ocular Anatomy S.Khairallah, M.D. 56
LENS ..cont’d:LENS ..cont’d:
• Lens suture lines:ant.”y”,post.inverted”y”
• Contains 65% water , 35% proteins , trace minerals ,↑ K+ ,ascorbic acid and glutathione.
• AGING:– Larger– Harder(less elastic)– Coloring: yellow deep brown.why?
Ocular Anatomy S.Khairallah, M.D. 57
ZONULE :ZONULE :
• = Zonule of Zinn , suspensory ligament
• Collagen fibrils• Attach to nonpigmented
epithelium of ciliary body and either sides of lens equator
Ocular Anatomy S.Khairallah, M.D. 58
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OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
Ocular Anatomy S.Khairallah, M.D. 65
Ocular Anatomy S.Khairallah, M.D. 66
Ocular Anatomy S.Khairallah, M.D. 67
OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
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OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
Ocular Anatomy S.Khairallah, M.D. 71
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OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
Ocular Anatomy S.Khairallah, M.D. 77
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Ocular Anatomy S.Khairallah, M.D. 79
OCULAR ANATOMYOCULAR ANATOMY
• GLOBE (EYE BALL)• CONJUNCTIVA & EYELIDS• LACRIMAL SYSTEM• EXTRAOCULAR MUSCLES• NERVES• ORBIT
Ocular Anatomy S.Khairallah, M.D. 80
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اليك .. أتوب و اللهم استغفرك وبحمدك اللهم سبحانك