review of clinical anatomy & physiology of the orbit dr. ayesha abdullah 19.08.2015
TRANSCRIPT
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REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF
THE ORBIT
Dr. Ayesha Abdullah 19.08.2015
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LEARNING OUTCOME
By the end of this lecture the students would be able to;
“correlate the structural organization of the orbit with its functions and clinical significance”
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ANATOMY OF THE ORBIT
• The orbital cavities are …………
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Adult orbital dimensions
Entrance height 35 mm
Entrance width 40 mm
Medial wall length / depth
45 mm
Volume 30 cc
Distance from the back of the globe to the optic foramen
18 mm
45mm
45mm
35mm
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SALIENT ANATOMICAL FEATURES
• 7 bones• 6 contents• 5 important relationships • 4 walls• 4 margins• 4 important openings
7-6-5-4
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v
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MZSFELP
Bones &
walls
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Which orbit ?
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IMPORTANT OPENINGS OF THE ORBIT Optic Foramen• Where?• size?• what passes through?• Clinical significance?Superior orbital fissure• Where? • What passes through? • What is annulus of Zinn?• Clinical significance?Inferior orbital fissure: • Where?• What passes through?• Clinical significance?
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Openings of the orbit
Nasolacrimal canal • Where? • What passes through? • Clinical significance
Inferior orbital foramen• Where?• What passes through• Clinical significance?
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Sensory Nerve Supply of the Face
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Orbital walls Roof• Frontal bone and sphenoid lesser wing• Lacrimal gland, trochlea • Superior orbital notch • BrainFloor• Zygomatic, maxilla and palatine bones. • weak part • Infraorbital groove & canal for the
infraorbital nerve • Maxillary sinus.
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Medial Wall• lacrimal, maxillary, ethmoid &
sphenoid• Thinnest wall• Lamina papyrecea• It separates the orbit from the nasal
cavity, the ethmoidal and the sphenoidal sinuses
Lateral Wall• Zygomatic & Sphenoid (greater wing) • Stronger wall• It separates the orbit from the
(temporal fossa) and the brain
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Roof
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Medial wall
Floor
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IMPORTANT RELATIONS OF THE ORBIT
1. Brain : Orbit is closely related to the brain in relation to its roof and lateral wall.
2. Para nasal sinuses: Orbit is intimately connected to the paranasal sinuses.
– Maxillaly sinus via the floor. – Ethmoidal and sphenoidal sinus via the medial
wall. – Frontal sinus at the roof. – Any infection can easily spread to the orbit from
the sinuses. 3. Nasal cavity: Nasal cavity is related to the
orbit at its medial or inner wall & through the nasolacrimal duct
4. Cavernous sinus via the veins of the orbit5. Pterygopalatine fossa via the inferior
orbital fissure
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Orbit as seen from above
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Relations of the orbit to the paranasal sinuses :FS, frontal sinus; ES, ethmoidal sinus; MS , maxillary sinus; SS, sphenoid sinus- American Academy of Ophthalmology
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CONTENTS OF THE ORBIT
1. Eyeball & the optic nerve2. Muscles – To move the eyeball. 3. Nerves –
– To move the muscles ( III, IV, VI). – To carry different sensations ( V)– parasympathetic innervation
( accommodation, pupillary constriction & lacrimal gland stimulation
– Sympathetic innervation ( pupillary dilatation, vasoconstriction, smooth muscles of the eye lids & hidrosis)
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CONTENTS OF THE ORBIT
4. Blood vessels ( branches of ophthalmic artery, superior & inferior ophthalmic veins)
5. Fat & orbital fascia – For padding purposes & for smooth movements
6. Most of the Lacrimal Apparatus (lacrimal gland & part of the tear drainage system)
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Lacrimal gland and the view of the orbit from
the roof
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Orbital fascia
• Periorbita• Orbital septum• Tenon’s capsule• Fascial spaces
intraconal extraconalsubtenon
subperiosteal
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Extraconal space
Intraconal space
Subperiosteal space
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Structure of the lids-AAO
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VIEWS : AXIAL VIEWS
RADIOGRAPHIC ANATOMY OF THE ORBIT
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CORONAL VIEW
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SAGITTAL VIEW
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AXIAL CT SCAN
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Summary
• Orbit is the protective casing for the delicate visual apparatus - the eyeball
• It is made up of 7 bones, has 4 margins, 4 walls/ boundaries, 4 important openings , 5 important relations & 6 contents
• Infection can spread to the brain from the orbit directly or through the haematogenous spread
• Trauma mostly damages the medial wall & the floor (the weakest parts give way)
• The symptomotology of orbital diseases is reflective of its clinical anatomy