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REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT

REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT. Dr. Ayesha Abdullah 12.09.2012. 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”. ANATOMY OF THE ORBIT .

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REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT

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  1. REVIEW OF CLINICAL ANATOMY & PHYSIOLOGY OF THE ORBIT Dr. Ayesha Abdullah 12.09.2012

  2. 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”

  3. ANATOMY OF THE ORBIT • The orbital cavities are …………

  4. 35mm 45mm 45mm Adult orbital dimensions

  5. SALIENT ANATOMICAL FEATURES • 7 bones • 4 walls • 4 margins • 4 important openings • 6 contents • 5 important relationships

  6. v

  7. Bones & walls MZSF ELP

  8. IMPORTANT OPENINGS OF THE ORBIT

  9. Which orbit ?

  10. 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?

  11. Openings of the orbit Nasolacrimal canal • Where? • What passes through? • Clinical significance Inferior orbital foramen • Where? • What passes through • Clinical significance?

  12. Orbital walls Roof • Frontal bone and sphenoid lesser wing • Lacrimal gland, trochlea • Superior orbital notch • Brain Floor • Zygomatic, maxilla and palatine bones. • weak part • Infraorbital groove & canal for the infraorbital nerve • Maxillary sinus.

  13. 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

  14. Roof

  15. Medial wall Floor

  16. IMPORTANT RELATIONS OF THE ORBIT • Brain : Orbit is closely related to the brain in relation to its roof and lateral wall. • 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. • Nasal cavity: Nasal cavity is related to the orbit at its medial or inner wall & through the nasolacrimal duct • Cavernous sinus via the veins of the orbit • Pterygopalatine fossa via the inferior orbital fissure

  17. Orbit as seen from above

  18. CONTENTS OF THE ORBIT • Eyeball & the optic nerve • Muscles – To move the eyeball. • 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) • Blood vessels ( branches of ophthalmic artery, superior & inferior ophthalmic veins) • Fat & orbital fascia – For padding purposes &for smooth movements • Most of the Lacrimal Apparatus ( lacrimal gland & part of the tear drainage system)

  19. Lacrimal gland and the view of the orbit from the roof

  20. Orbital fascia • Periorbita • Orbital septum • Tenon’s capsule • Fascial spaces intraconal extraconal subtenon • subperiosteal

  21. extraconal Intraconal subtenon subperiosteal

  22. Subperiosteal space Extraconal space Intraconal space

  23. VIEWS : AXIAL VIEWS RADIOGRAPHIC ANATOMY OF THE ORBIT

  24. CORONAL VIEW

  25. SAGITTAL VIEW

  26. AXIAL CT SCAN

  27. 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 venous drainage • Trauma mostly damages the medial wall & the floor ( the weakest parts give way) • The symptomotology of orbital diseases is reflective of its clinical anatomy

  28. References • American Academy of Ophthalmology.Orbit, eyelids & lacrimal system. American Academy of Ophthalmology; 1997-98 • Jack J Kanski. Clinical ophthalmology a systematic approach. 5th ed;2003:557-89 • Parsons’ diseases of the eye. Diseases of the adnexa-diseases of the orbit. 19th ed. 2004; 505-524 • Remington LA. Clinical Anatomy of the visual system. Bones of the skull & orbit. 1998; 123-35

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