UHCO Eyelids

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Eyelids first appear as 2 circular folds around

2 months into fetal development

Folds fuse together

2 1/2 months into fetal development

Keratinization of surface epithelial cells initiates what when?

seperation of lids at 5 months

complete seperation of lids occurs when?

by the eighth month of gestation

do the lids of snakes seperate

no they remain clear as embryonic tissue

the hairless area between the two eyebrows is known as

the glabella

?Muscles of the eyebrow for Bergmanson

2 1/2 month gestation

Function of Frontalis muscle

Raises the brow in expression of surprise

Orientation of frontalis

radially over the forehead

3 portions of Orbicularis oculi

orbital, palpebral, ciliary(muscle of Riolan)

muscle fibers of Orb. ocul. are organized how?

concentrically

function of Orb. ocul.

close the eyelids by a sphincter action, spreading tears and flushing away waste

function of Corrugator supercilii

pulls eyebrows together (frown)

function of Pyramidalis (procerus)

creates transverse furrows above your nose (a bad smell expression)

4 functions of eyelids

protection, tear production, spread of tears across cornea, drainage of tears

is there a horizontal motion during blinking?

yes, it sweeps the tears towards the puncta

6 structures of the eyelids

1.skin 2. subcutaneous layer 3. muscles 4. submuscular areolar layer 5. fibrous layer 6. palpebral conjunctiva

describe the cutaneous portion of your eyelid

very thin, elastic and fat free

what is the skin composed of (3)

epidermis, dermis and subcutaneous tissue

the outermost layer is composed of

keratinized epithelial layer and many non-keratinized layers of epithelial cells

6 cell types in the epidermis

epithelial cells, keratinocytes, melanocytes, Langerhans & merkel cells, and neurons

Which cell type is most numerous

keratinocytes

location of dermis in relation to epidermis

internal and adjacent

dermis is composed of

dense irregular collagenous tissue

subcutaneous layer is found _____ to the dermis

deep

name 3 appendages on the surface of the eyelid

fine hairs, sweat glands and pigment cells

the appendages on the surface originate from

epithelial downgrowths

how many rows of lashes and glands along lid margin

2

where the skin meets the conjunctiva (along tarsal glands)

mucocutaneous junction

Keratinization of surface epithelium does or does not include epithelial lining of tarsal gland orifice

Does

malignant tumors are 4x more likely in which lid

lower

what type of cancer is related to UV radiation exposure

Basal cell carcinoma

What's the most common form of cancer in the Southern states?

Skin cancer

Are benign growths more prominant in one lid vs the other

no, they are evenly distributed

striated, voluntary muscle of eyelid

Orbicularis oculi or Levator palpebrae superiorus

Most prominent muscle of the lid

Orbicularis oculi

Palpebral portion of Orb. ocul. arises from

the medial palpebral ligament

at the lateral angle the fibers of Orbicularis oculi meet at the ____ _____ ___

Lateral palpebral raphe

function of ciliary portion

helpful in keeping the lid margin tight to the globe

Innervates Orbicularis Oculi

CN VII

Paralysis of CN VII leads to this

Lag ophthalmus, a dry eye condition due to inability to close the eyelids

origination of Levator palpebrae superioris

it originates from the inferior surface of the lesser wing of the sphenoid bone

levator palp. sup. origination location in relation to optic canal

above and anterior to the optic canal

which muscle is only found in the upper lid

Levator Palpebrae superiorus

Function of Levator Palpebrae superiorus

raising the eyelid

When the Levator palp. sup. becomes tendinous it is called

apaneurosis of the levator.

Where does the Levator become tendinous

as it enters the lid

Where is the aponeurosis of the levator found

between the bundles of the orbicularis oculi.

Innervation of Levator

CN III

Paralysis of levator causes

Ptosis

Smooth muscle in the lid

Tarsal muscles

Has primary sympathetic innervation and is found in upper and lower lids

Tarsal muscles

it lines the levator internally

SuperiorTarsal muscle

Function of Tarsal muscle

aids in laction of the levator

which muscle is important for the wide eyed expression of fear

Tarsal muscles

Damage to Sympathetic innervation of sup. tarsal muscle causes

droopy lid

Loose connective tissue btwn muscular tissue and the tarsal plate

Submuscular areolar tissue

What type of tissue makes of the fibrous layer

it consists of dense fibrous tissue

function of Fibrous layer

gives firmness and shape to the eyelids

AKA Tarsal plate

Fibrous layer of eyelid

what allows the upper lid to be everted

well developed tarsal plate collagen (not as much in the lower lid)

Where are the tarsal glands located

within the tarsal plate

A sero-mucous membrane containing goblet cells

Palpebral conjunctiva

Goblet cells

Mucin (MUC 5AC) producing, unicellular holocrine glands that make up the inner layer of the tears.

when do tarsal glands develope

2 1/2 months gestation

it has little saccules leading to a central canal, which opens at the lid margin

Tarsal gland(s)

Modified sebaceous gland

Tarsal gland

Function of sebum

forms the surface of the tears and slows their evaporation

organized in a single row running vertically throught eyelid

Tarsal glands

How many tarsal glands in the upper and lower lids

30-40 in upper and 20-30 in lower

rich innervation of tarsal gland

majority parasympathetic with sympathetic and sensory sources contributing to a lesser extent

Derived from pterygopalatine ganglion

CN VII Parasympathetic fibers

Infection of the tarsal gland

internal hordeolum

sterile lesion caused by chronic inflammation of tarsal gland

Chalazion (sometimes independent of chronic inflammation= de novo)

Glands associated with cilia

Ciliary glands(Moll) & Seabaceous glands (Zeis)

Ciliary and sebaceous glands are located ____to the tarsal plate

anterior

primitive sweat glands observed around the eyelash follicle

Ciliary glands

look like circles on histological slides but are actually spirals

ciliary glands

infection of ciliary gland

external hordeolum (Sty)

Which hordeolum is painful as a general rule

external hordeolums

they are self-limiting and easily treatable

External hordeoulums

chalazions can occur in _____ ______ as well as tarsal glands

sebaceous glands

mucin combines with water to form

mucous

function of mucous from goblet cells

acts as a wetting agent and helps spread tears across the cornea.

where is palpebral accessory lacrimal gland found

in the peripheral aspect of the tarsal plate

structurally and functionally similar to the lacrimal gland

palpebral accessory lacrimal gland

produces a serous secretion

palpebral accessory lacrimal gland

complex ductal system

connects palpebral accessory lacrimal gland to the palpebral conjunctival surface

palpebral accessory lacrimal gland ducts are lined by

secretory cells

how many openings are there on the middle portion of the lid

more than 100 openings per mm^2

reported in older literature to occur along the palpebral surface

Crypts of Henle

May have been mistaken for openings of the palpebral accessory lacrimal gland

Crypts of Henle

possibly artificial wrinklings of the tissue resulting from fixation induced shrinkage of the specimen

Crypts of Henle

2 transverse arcades in eyelid

marginal and peripheral arterial arcades

which arcade is found near the lid margin

marginal arterial arcade

the peripheral arcades are ____in location to the marginal

superior

name 2 arterial supply systems of eyelid

Facial and orbital

arteries of Facial system

Facial, superficial temporal, and infraorbital Arteries

Arteries of Orbital system

Dorsal nasal, frontal, supraorbital, lacrimal

Facial system branches off of

external carotid artery

Orbital system branches of of

internal carotid artery

name 2 venous drainage systems of eyelid

superficial (pre-tarsal) and deep (post-tarsal)

name veins of superficial system and where they drain

Anterior facial V drains to internal jugular V and Superficial temporal V drains to external jugular V

Name Veins of Deep system and where they drain

Ophthalmic V drains to cavernous sinus and Deep facial V to pterygoid plexus then cavernous sinus.

Eye itself has no lymph but eyelid has 2 systems name them

Superficial (pre-tarsal) and Deep (post-tarsal)

Superficial lymph. system drains

skin and orbicularis

Deep Lymph system drains

regions of the tarsal plate and the conjunctiva

which way does lymp flow

inward towards the conjunctiva (opposite blood flow)

lymphatic vessels drain into ____ ____ laterally

Parotid nodes

Lymphatic vessels drain into the ____ ____ medially

Submandibular nodes

Motor innervation of Eyelids

CN VII (voluntary) and CN III

CN VII innervates

all striated facial muscles except for levator

superior division of CN III innervates

levator

provides excitatory innervation of smooth tarsal muscles and gland

Sympathetic NS

Pre-ganglionic fibers of symp. NS are found

Lateral horn, Spine

Post-ganglionic fibers of symp. NS are found

superior cervical ganglion

provides inhibitory innervation to tarsal muscles and primary innervation to tarsal gland

Parasympathetic NS

Location of parasym. preganglionic neurons

superior salivatory nucleus of CN VII motor nucleus

location of parasymp. postganglionic neurons

pterygopalatine ganglion

Sensory innervation of lid is from

CN V

V1 innervates

upper lid (supraorbital N)

V2 innervates

lower lid (Infraorbital N)

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