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Anatomy - NEETMDS- courses
NEET MDS Lessons
Anatomy

The Eye and Orbit

  • The orbit (eye socket) appears as a bony recess in the skull when it is viewed from anteriorly.
  • It almost surrounds the eye and their associated muscles, nerves and vessels, together with the lacrimal apparatus.
  • The orbit is shaped somewhat like a four-side pyramid lying on its side, with its apex pointing posteriorly and its base anteriorly.

 

First pouch

Auditory tube, which comes in contact

    with epithelial line of first pharyngeal

    cleft, where future external acoustic

    meatus will form.

Distal portion will form tympanic   

    cavity (lining will become eardrum)

Proximal portion will become auditory tube

Second pouch

Forms buds that penetrate surrounding

    mesenchyme, which together form the 

    palatine tonsils

Third pouch

Forms thymus and inferior parathyroid

    glands

Fourth pouch

Forms superior parathyroid glands

Fifth pouch

Forms utlimobranchial body

Eye 

At week 4, two depressions are evident on each of the forebrain hemispheres.  As the anterior neural fold closes, the optic pits elongate to form the optic vesicles.  The optic vesicles remain connected to the forebrain by optic stalks. 
The invagination of the optic vesicles forms a bilayered optic cup.  The bilayered cup becomes the dual layered retina (neural and pigmented layer)
Surface ectoderm forms the lens placode, which invaginates with the optic cup.
The optic stalk is deficient ventrally to contain choroids fissure to allow blood vessels into the eye (hyaloid artery).  The artery feeds the growing lens, but will its distal portion will eventually degenerate such that the adult lens receives no hyaloid vasculature.
At the 7th week, the choroids fissure closes and walls fuse as the retinal nerve get bigger.
The anterior rim of the optic vesicles forms the retina and iris.  The iris is an outgrowth of the distal edge of the retina.
Optic vesicles induces/maintains the development of the lens vesicle, which forms the definitive lens.  Following separation of the lens vesicle from the surface ectoderm, the cornea develops in the anterior 1/5th of the eye.
The lens and retina are surrounded by mesenchyme which forms a tough connective tissue, the sclera, that is continuous with the dura mater around the optic nerve.  
Iridopupillary membrane forms to separate the anterior and posterior chambers of the eye.  The membrane breaks down to allow for the pupil
Mesenchyme surrounding the forming eye forms musculature (ciliary muscles and pupillary muscles – from somitomeres 1 and 2; innervated by CN III), supportive connective tissue elements and vasculature.


Eyelids

Formed by an outgrowth of ectoderm that is fused at its midline in the 2nd trimester, but later reopen.

Geniohyoid Muscle

  • Origin: Inferior genial tubercles of the mandible.
  • Insertion: Anterior surface of the body of the hyoid bone.
  • Nerve Supply: Branch of C1 through the hypoglossal nerve (CN XII).
  • Arterial Supply: Sublingual branch of the lingual artery.
  • Action: Elevates the hyoid bone and depresses the mandible.

  • The six muscles rotate the eyeball in the orbit around three axes (sagittal, horizontal and vertical).
  • The action of the muscles can be deduced by their site of insertion on the eyeball.
Muscle Action(s) on the Eyeball Nerve Supply
Medial Rectus Adducts CN III
Lateral Rectus Abducts CN VI
Superior Rectus Elevates, adducts, and medially rotates CN III
Inferior Rectus Depresses, adducts, and laterally rotates CN III
Superior Oblique Depresses, abducts, and medially rotates CN IV
Inferior Oblique Elevates, abducts, and laterally rotates CN III

Connective Tissue

Functions of Connective tissue:

→ joins together other tissues

→ supporting framework for the body (bone)

→ fat stores energy

→ blood transports substances

 

Connective tissue is usually characterized by large amounts of extracellular materials that separate cells from each other, whereas epithelial tissue is mostly cells with very little extracellular material. The extracellular substance of connective tissue consists of protein fibers which are embedded in ground substance containing tissue fluid.

Fibers in connective tissue can be divided into three types:

→ Collagen fibers are the most abundant protein fibers in the body.

→ Elastic fibers are made of elastin and have the ability to recoil to original shape.

→ Reticular fibers are very fine collagen fibers that join connective tissues to other tissues.

Connective tissue cells are named according to their functions:

 → Blast cells produce the matrix of connective tissues

→ Cyte cells maintains the matrix of connective tissues

→ Clast cells breaks down the matrix for remodeling (found in bone)

The Orbital Vessels

  • The orbital contents are supplied chiefly by the ophthalmic artery.
  • The infraorbital artery, the continuation of the maxillary, also contributes blood to this region.
  • Venous drainage is through the superior orbital fissure to enter the cavernous sinus.

The Ophthalmic Artery

  • This artery arises from the internal carotid artery as it emerges from the cavernous sinus.
  • It passes through the optic foramen within the dural sheath of the optic nerve and runs anteriorly, close to the superomedial wall of the orbit.

 

The Central Artery of the Retina

  • This is the one of the smallest but most important branches of the ophthalmic artery.
  • It arises inferior to the optic nerve until it approaches the eyeball.
  • It then pierces the optic nerve and runs within it to emerge through the optic disc.
  • The central artery of the retina spreads over the internal surface of the retina and supplies it.

 

The Ophthalmic Veins

The Superior Ophthalmic Vein

  • The superior ophthalmic vein anastomoses with the facial vein.
  • It has no valves and blood can flow in either direction.
  • It crosses superior to the optic nerve, passes through the superior orbital fissure and ends in the cavernous sinus.

The Inferior Ophthalmic Vein

  • This begins as a plexus on the floor of the orbit.
  • It communicates with the inferior orbital fissure with the pterygoid plexus, crosses inferior to the optic nerve, and ends in either the superior ophthalmic vein or the cavernous sinus.

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