Scribd
Upload
86 views40 pages

Orbit and Its Contents

Uploaded by

naraw720
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
86 views40 pages

Orbit and Its Contents

Uploaded by

naraw720
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 40

Orbit and its Contents

Learning objectives

• Boundaries, Relations, Contents of orbit

• Related applied aspects


Body of sphenoid
Lesser wing
Greater wing sphenoid sphenoid

Optic canal
Introduction
• Pyramidal-shaped bony
cavities, located one on
either side of the nose
• Four-sided pyramid with
apex directed behind at the
optic canal and base
forward represented by the
orbital margin
• Boundaries – Roof, Floor,
Medial & Lateral wall
Boundaries
Features in the orbit
Apex – lies at the posterior
end of orbit, formed by
sphenoid
Base – Open, quadrangular
Roof – Fossa for lacrimal
gland medially & Trochlear
notch laterally
Floor – Inferior orbital fissure,
groove & foramen
Features in the orbit

Medial wall – Lacrimal fossa


and anterior & posterior
ethmoidal foramen

Lateral wall – Whitnall’s


tubercle & Zygomatic
foramen
Relations of Orbit
• Above – Anterior cranial
fossa & frontal sinus

• Below – Maxillary sinus

• Medial – Ethmoidal sinus

• Lateral – Temporal fossa


Periorbita
• Periosteum of the bony
orbit, which lines the bony
boundaries of the orbit

• Funnel-shaped fascial
sheath that encloses the
orbital contents
Contents
• Eyeball
• Extra-ocular muscles
• Fascia bulbi
• Nerves – 2nd, 3rd, 4th, 6th,
Ophthalmic nerve & Ciliary
ganglia
• Vessels – Ophthalmic artery &
veins
• Lacrimal gland
• Orbital fat
Eyeball
• Organ of sight
• Location – anterior one-
third of the orbital cavity
• 3 layers
 Outer fibrous – Sclera,
Cornea
 Middle vascular – Uveal
tract
 Inner neural - Retina
Retina
• Innermost layer of eyeball • Blood supply:
• 2 layers:  Superficial part – Diffusion
 Outer pigment – process
Pigmented epithelium  Deep part – Central artery
 Inner sensory layer – Rods of retina
& cones
• Venous drainage – Central
 Histologically, 10 layers are
vein of retina
present
Ophthalmoscopy
• AKA Fundoscopy
• To visualize fundus of eye
• Macula – yellowish area near the posterior pole
• Fovea centralis – Small pit in the centre of macula
• Optic disc – white spot medial to macula
• Physiological cup – depressed area in the centre
of it
• Optic nerve exits and central retinal artery & vein
enter the eye
Clinical aspects
• Retinal detachment –
separation of 2 layers of
retina

• Papilledema – Congestion
of optic disc due to raised
intracranial pressure
Middle vascular layer
• AKS Uveal tract
• Choroid, Ciliary body & Iris
• CHOROID:
 Brown, thin, highly vascular
 Anteriorly – Connected with
iris & ciliary body
 Posteriorly – Pierced by
Optic nerve
 Blood supply – Ophthalmic
vessels
Ciliary body Iris
• Continuous with the
choroid behind and the • Act as diaphragm
iris in front
• B/w Cornea & lens
• 3 parts:
 Ciliary ring – fibrous • Opening in its centre – Pupil
ring • 2 muscles – Constrictor &
 Ciliary process –
Dilator pupillae
made of capillaries &
epithelium that secretes
aqueous humor.
Resemble choroid
plexus of brain ventricle
Outer fibrous layer
Sclera Cornea
• White of the eye • Transparent
• Continuous anteriorly with • Avascular
cornea • Histologically, 5 layers present
• Junction b/w cornea & sclera –
Corneoscleral junction/Limbus
• Function – Maintain shape of
the eyeball, protect internal
structures and provides
attachment to muscles
Extraocular muscles

Voluntary (7) Involuntary (3)

4 Recti – Superior, Inferior, Superior Tarsal


Medial, Lateral Moves Inferior Tarsal
2 Oblique – Superior & eyeball Orbitalis
Inferior oblique
1 LPS – Levator palpebrae Elevates
superioris eyelid
Recti muscles
• Origin – Common tendinous
ring (Apex of orbit & tubercle
of zinn)
• Insertion – limbus in front of
equator
Oblique muscles
• Origin – SO from body of
sphenoid & IO from floor of
orbit
• Insertion – sclera behind the
equator
Action & Nerve supply
Muscle Movements
Superior rectus Elevation, Adduction, Intorsion
Inferior rectus Depression, adduction, Extorsion
Medial rectus Adduction
Lateral rectus Abduction
Superior oblique Depression, Abduction, Intorsion
Inferior oblique Elevation, Abduction, Extorsion

Nerve supply – SO4, LR6, Rest all muscles supplied by


Oculomotor nerve
LVP (Levator palpebrae superioris)
• Origin – Lesser wing sphenoid
• Insertion – 3 lamellae
 Upper lamellae – skin of upper
eyelid
 Middle – Superior tarsal plate
 Lower – Superior fornix of
conjunctiva
• Nerve supply – Oculomotor nerve
& Superior cervical ganglion
• Action – Elevated the upper eyelid
Applied aspects
• Strabismus/Squint – Paralysis of
individual muscle due to
involvement of nerve
• Double vision (Diplopia)
• Ptosis – Paralysis of LVP due to
involvement of nerve
• Involvement of oculomotor
nerve – Complete ptosis
• Involvement of Cervical
sympathetic chain – Partial
ptosis
Fascia bulbi (Tenon’s capsule)

• Membranous sheath that extend from optic nerve to sclero-

corneal junction and envelops eyeball

• Act as socket to facilitate eyeball movements

• Pierced by 4 recti & oblique muscles, ciliary nerves & vessels


Suspensory & Check ligament of the eye
• Lateral check ligament
• Medial check ligament
• Suspensory ligament of
lockwood
• Posteriorly – continuous with
sheath of optic nerve
• Function – Support to eyeball
 C/I – Any fracture to floor of
orbit or maxilla – eyeball does
not sag down
Nerves of Orbit
Oculomotor nerve (3RD Cranial nerve)
• 2 divisions (superior & Inferior)
enter the orbit by passing
through superior orbital fissure
• b/w 2 divisions, Nasociliary
nerve lies
• Superior division – passes above
the optic nerve & supplies SR,
LVP
• Inferior division – passes below
the optic nerve & supplies MR,
IR, IO
Trochlear nerve (4 cranial nerve)
th

• Enter the orbit by passing


through superior orbital fissure

• Passes above & medial to LVP

• Supplies superior oblique


muscle
Abducent nerve (6 cranial nerve)th

• Enter the orbit by passing


through superior orbital fissure

• Passes lateral to oculomotor


nerve

• Supplies lateral rectus muscle


Ophthalmic nerve
• First & smallest branch of
trigeminal nerve (5th CN)
• Arise from trigeminal ganglion
(trigeminal cave) enter
lateral wall of cavernous sinus
enter the orbit by passing
through superior orbital fissure
• Divides into 3 branches
 Lacrimal, Frontal & Nasociliary
Ophthalmic nerve

Lacrimal nerve Frontal nerve Nasociliary nerve

Runs along lateral Runs above LVP, Runs above the


wall of orbit and divides into optic nerve, then
supplies lacrimal Supraorbital & passes medial to it,
gland & Conjunctiva Supratrochlear gives off anterior &
nerve posterior ethmoidal
nerves, Inferior
Sensory root to ciliary ganglion trochlear nerve
and 2 or 3 Long ciliary nerves
Ciliary ganglion (b/w optic nerve & LR)
Optic nerve
 2nd cranial nerve

 Covered by 3 meningeal layers

 Devoid of neurilemmal sheath

 Emerge from posterior pole of the eyeball, run backwards,


enter cranial cavity, joins with opp side optic nerve to form
Optic chiasma
Relations
• Posteriorly – four recti muscles

• Anteriorly – separated from muscles by fat

• Laterally – Ciliary ganglion

• Infero-medially – CRA & V

• Above – Nasociliary nerve, Ophthalmic artery, Superior


ophthalmic vein, Superior division of 3rd nerve

• Below – Inferior division of oculomotor nerve


Ophthalmic artery

• Branch of internal carotid artery

• Enter the orbit by piercing dural


sheath

• First it passes above the optic


nerve, then it crosses to medial
side along with nasociliary nerve
Branches
• Supraorbital artery

• Supratrochlear artery

• Dorsal nasal artery

• Anterior & Posterior ethmoidal arteries

• Ciliary arteries

• Lacrimal artery
Ophthalmic veins
• Superior ophthalmic vein –
accompanies ophthalmic artery

• Inferior ophthalmic vein – runs


below optic nerve, then joins
with superior oph vein

• Both drains into cavernous sinus


Lymphatic drainage
• No lymphatic nodes involved
Summary
• Boundaries
• Contents
 Eyeball
 Extra-ocular muscles
 Nerves
 Artery
 Veins
Thank you

You might also like