Lecture 7: Ciliary Body

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a

positive accommodation a) parasympathetic b) sympathetic

b

relaxation of accommodation a) parasympathetic b) sympathetic

Ciliary Body

responsible for: • Secretion - Aqueous humour - Zonular fibres - Vitreous hyaluronic acid • Accommodation • Anchors the zonular fibres

Ciliary Body Melanoma

- 4-8 cases per 1 million people. - Represent about 10% of intraocular melanomas Risk Factors: -sunlight exposure -age -race -iris colour.

posterior ciliary body, outer ciliary body

Blood Supply: The intramuscular circle primarily supplies what?

ciliary processes

Blood Supply: The major arterial circle of the iris primarily supplies what?

Major arterial circle of iris

Blood Supply: What primarily supplies the ciliary processes?

Intramuscular circle

Blood Supply: What primarily supplies the posterior and outer ciliary body?

b

Dentate processes/retinal teeth are located where? a) pars plicata b) pars plana

Neuroectoderm

Development/Embyology: Ciliary epithelial lining (NPE/PE) form from what? Represent the two layers of the optic cup.

Mesenchyme (mesoderm + neural crest cells)

Development/Embyology: Ciliary stroma and muscle form from what? At edge of optic cup, anterior continuation of the choroid.

b

Edinger-Westphal nucleus (in brain stem), oculomotor nerve, ciliary ganglion, short posterior ciliary nerves This is the neural pathway of what innervation? a) sympathetic b) parasympathetic c) sensory

Leaky

Fenestrated Capillaries in the Ciliary Processes are what?

16

Giant senate processes are not present in all eyes, what percentage of eyes have giant senate processes? in %

Parasympathetic

Innervation: Carried along oculomotor nerve, ciliary ganglion, short posterior ciliary nerves Results in positive accommodation

Sympathetic

Innervation: From Cervical sympathetic trunk (spine), superior cervical ganglion, via long ciliary nerves. relaxation of accommodation

Sensory fibres

Innervation: Nasociliary branch of ophthalmic division of trigeminal, long ciliary nerves

b

Insertion of ciliary muscle tendons, elastic attachment to anterior choroid & Bruch's membrane a) anterior insertion b) posterior insertion

long ciliary nerves

Name the nerve of the sensory pathway that enters the ciliary muscle.

long ciliary nerve

Name the nerve of the sympathetic pathway that enters the ciliary muscle.

b

Origin of zonules a) pars plicata b) pars plana

b

Origin of zonules is the a) Pars Plicata (corona ciliaris) b) Pars Plana (orbicularis ciliaris)

a

The non-pigmented epithelium of the ciliary body is in the... a) inner layer (towards the centre of the eye) b) outer layer (towards the surface of the eye)

Melanosomes

The outer pigmented epithelium of the ciliary body contain what?

Edinger-Westphal nucleus

The parasympathetic innervation of the ciliary muscle is carried along the oculormotor nerve which originated from?

oculomotor nerve

The parasympathetic innervation of the ciliary muscle originates at what nerve?

a

Valleys between ciliary processes are present at? a) pars plicata b) pars plana

a

Very vascular a) pars plicata b) pars plana

Major arterial circle of iris

What structure is C? Primarily supplies ciliary processes.

Canal of Schlemm (scleral venous sinus)

What structure is D?

Desmosome

What structure is D?

Iris

What structure is D?

anterior chamber

What structure is D?

basement membrane

What structure is D?

ciliary muscle

What structure is D?

long posterior ciliary artery

What structure is D?

pupil

What structure is D?

trabecular meshwork

What structure is D?

Canal of Schlemm

What structure is E?

Ciliary stroma

What structure is E?

ciliary process

What structure is E?

conjunctiva

What structure is E?

edge of pupil

What structure is E?

iris

What structure is E?

storm of ciliary body

What structure is E?

Pars plicata

What structure is F?

cornea

What structure is F?

corneal epithelium

What structure is F?

fenestrated capillary epithelium

What structure is F?

iris

What structure is F?

pupil

What structure is F?

Epithelium

What structure is G?

Lens

What structure is G?

anterior limiting lamina

What structure is G?

blood vessel of ciliary body

What structure is G?

ciliary body

What structure is G?

limbus

What structure is G?

corneal stroma (substantia propria)

What structure is H?

neural part of the retina

What structure is H?

nonpigmented epithelium

What structure is H?

sclera

What structure is H?

vitreous chamber

What structure is H?

Outer longitudinal fibres/ meridional fibres/ Brücke's muscle

What structure is I?

ora serrata

What structure is I?

pigmented epithelium

What structure is I?

posterior limiting lamina

What structure is I?

crypt

What structure is J?

oblique fibres of ciliary muscle/ radial fibres of ciliary muscle

What structure is J?

pars plana

What structure is J?

Bruch's membrane

What structure is K?

ciliary processes

What structure is K?

pigment layer

What structure is K?

lens capsule

What structure is L?

lens nucleus

What structure is M?

zonule

What structure is N?

trabecular meshwork

What structure is O?

ciliary epithelium

What structure is P?

cysts at ora serrata

What structure is Q?

major ciliary processes

What structure is a?

intermediate processes

What structure is b?

pars plana

What structure is c?

scalloped bays

What structure is d?

dentate processes

What structure is e?

striate, linear markings

What structure is f?

valleys

Where are the minor ciliary processes located in?

a

Which ciliary muscle tendon assists aqueous drainage? a) anterior insertion b) posterior insertion

a

Which epithelial layer contains infoldings? a) Inner non-pigmented epithelium b) outer pigmented epithelium

b

Which epithelial layer contains melanosomes? a) Inner non-pigmented epithelium b) outer pigmented epithelium

a

Which epithelial layer contains secretory granules? a) Inner non-pigmented epithelium b) outer pigmented epithelium

b

Which epithelial layer is the extension of the retinal pigment epithelium? a) Inner non-pigmented epithelium b) outer pigmented epithelium

b

Which epithelial layer junctions? a) Inner non-pigmented epithelium b) outer pigmented epithelium

a

Which includes the ciliary muscle? a) pars plicata b) pars plana

a

Which is continuous with neural retina a) Inner non-pigmented epithelium b) outer pigmented epithelium

a

Which is true regarding the epithelial cells of the outer pigmented epithelium of the ciliary body? a) cells case base face out towards the surface of eye, apices face in b) cells case base face in towards the centre of eye, apices face out

lens

What structure is C?

nonpigmented epithelium

What structure is C?

pigmented epithelium

What structure is C?

tight junction

What structure is C?

trabecular meshwork

What structure is C?

unpigmented epithelium

What structure is C?

a

- Type 1 from outer longitudinal muscle into sclera or scleral spur. a) anterior insertion b) posterior insertion

b

Age changes to ciliary body: Amount of muscle fibers a) increases b) decreases

a

Age changes to ciliary body: connective tissue a) increases b) decreases

a

Age changes to ciliary body: extracellular material a) increases b) decreases

capillary plexus

Blood supply: what is present in each ciliary process that supplies blood?

Fenestrated Capillaries

Capillaries in the Ciliary Processes are Leaky, what type of capillaries are these?

a

Changes with Age: a) Ciliary body of a young eye b) Ciliary body of an older eye

b

Changes with Age: a) Ciliary body of a young eye b) Ciliary body of an older eye

cuboidal cells

Ciliary Epithelium is made of Double layered what cells?

b

Ciliary Muscle contracts to give a) outward movement b) inward movement

a

Ciliary Muscle is a ring of a) smooth muscle b) skeletal muscle

Supraciliaris (superciliary lamina)

Ciliary body attachment sites: Outermost layer of ciliary body (adjacent to sclera)

Scleral spur

Ciliary body attachment sites: region of circularly oriented collagen bundles that extends from inner aspect of sclera

Vitreous base

Ciliary body attachment sites: strong region of adhesion to basement membrane of Pars Plana epithelium, and inner limiting membrane of the retina BUT common spot for Peripheral retinal detachments

outer longitudinal portion /outer meridional portion (Brücke's muscle)

Ciliary muscle: what portion is A?

radial portion, middle oblique portion

Ciliary muscle: what portion is B?

inner circular portion

Ciliary muscle: what portion is C?

a

Ciliary processes are present at? a) pars plicata b) pars plana

b

Ciliary/scalloped bays are located at? a) pars plicata b) pars plana

b

Comprises giant dentate processes which are only present in 16% of eyes. a) pars plicata b) pars plana

a

Insertion of ciliary muscle tendons: - Type 1 from outer longitudinal muscle into sclera or scleral spur - Type 2, elastic-like to trabecular meshwork - Type 3 collagenous to trabecular meshwork and corneal stroma a) anterior insertion b) posterior insertion

a

Insertion of ciliary muscle tendons: - Type 2, elastic-like to trabecular meshwork a) anterior insertion b) posterior insertion

a

Insertion of ciliary muscle tendons: - Type 3 collagenous to trabecular meshwork and corneal stroma a) anterior insertion b) posterior insertion

supreciliaris, ciliary epithelium, ciliary stroma, ciliary muscle

List the main structural components o the ciliary body.

fibroblasts

Muscle bundles of the ciliary muscles are surrounded by flattened what? Instead of collagen fibres.

short posterior ciliary nerve

Name the nerve of the parasympathetic pathway that enters the ciliary muscle.

anterior chamber angle

What structure is C?

b

Pars Plana (orbicularis ciliaris) is a) highly vascular b) relatively avascular

a

Pars Plicata (corona ciliaris) is a) highly vascular b) relatively avascular

b

Pars plana a) Very vascular b) relatively avascular

orbucularis ciliaris

Pars plana is also called/known as?

a

Pars plicata a) Very vascular b) relatively avascular

corona ciliaris

Pars plicata is also called/known as?

Pars plicata (corona ciliaris)

Pleated/ridged surface, 70-80 folds - ciliary processes • ~2mm anterior/posterior length • Ciliary processes (largest are ~2 mm long, 0.5 mm wide, 1.0 mm high) • Minor processes (in valleys) • Giant processes (nasal) • Valleys (between processes) • Very vascular • Site of aqueous production • Includes ciliary muscle

b

Relatively avascular a) pars plicata b) pars plana

secretory granules

The Inner non-pigmented epithelium of the ciliary body contain what?

Vortex veins

The Venous drainage of the ciliary body is through the choroid via?

c

The ciliary stroma has a) myelinated nerves b) non-myelinated nerves c) both

a

The ciliary stroma... a) has blood vessels, highly vascular b) has no blood vessels, avascular

neural retina

The inner non-pigmented epithelium is continuous with what?

2/3rds

The pars plana is what fraction of the ciliary body?

70-80

The pars plicata is a pleated/ridged surface that makes up the ciliary processes and is composed of how many folds?

b

The pigmented epithelium of the ciliary body is in the... a) inner layer (towards the centre of the eye) b) outer layer (towards the surface of the eye)

trigeminal nerve

The sensory innervation of the ciliary muscle originates at what nerve?

a

The site of aqueous production is? a) pars plicata b) pars plana

superior cervical ganglion, carotid plexus

The sympathetic innervation of the ciliary muscle originates where?

Supraciliaris

Thin, outermost layer of loose connective tissue of ciliary body.

c

Trigeminal nerve, Nasociliary branch of ophthalmic division, long ciliary nerves a) sympathetic b) parasympathetic c) sensory

outer longitudinal, middle oblique, inner circular

What are the 3 types of ciliary muscle?

Melanocytes, fibroblasts, collagen

What cells are the supraciliaris composed of?

melanocytes, fibroblasts, mast cells

What cells is the ciliary stroma composted of?

ciliary muscle

What forms the bulk of the ciliary body?

contraction of ciliary muscle

What increases the size of the pore in the trabecular meshwork, opening the trabecular meshwork and facilitates drainage of the aqueous humour?

Pars plicata (anterior)

What is A?

Pars plana (posterior)

What is B?

Supraciliaris

What is adjacent to the sclera and allows the movement of the ciliary body?

basement membrane

What is continuous around ciliary muscle fibres?

1.0mm

What is the approximate height of the largest ciliary processes? in mm

2mm

What is the approximate length of the largest ciliary processes? in mm

4-4.5mm

What is the approximate length of the pars plana? in mm

2mm

What is the approximate length of the pars plicata? in mm

0.5mm

What is the approximate width of the largest ciliary processes? in mm

valleys of the pars plicata

What is the arrow pointing to in the pars plicata?

valleys of the pars plicata

What is the arrow pointing to?

loose connective tissue

What is the ciliary stroma made up of?

Edinger-Westphal nucleus (in brain stem), oculomotor nerve, ciliary ganglion, short posterior ciliary nerves

What is the parasympathetic nerve innervation pathway of the ciliary muscle? please write in order.

Trigeminal nerve, ophthalmic division, Nasociliary branch, long ciliary nerves

What is the sensory nerve innervation pathway of the ciliary muscle? please write in order.

loose connective tissue

What is the supraciliaris made of?

superior cervical ganglion, carotid plexus, long ciliary nerves

What is the sympathetic nerve innervation pathway of the ciliary muscle? please write in order.

b

What makes up 2/3rds of the ciliary body? a) pars plicata b) pars plana

Long posterior ciliary artery

What structure is A?

Punctum adherens

What structure is A?

basement membrane

What structure is A?

ciliary body

What structure is A?

ciliary muscle

What structure is A?

ciliary processes

What structure is A?

circular fibres of ciliary muscle

What structure is A?

maxillary capillary

What structure is A?

nonpigmented epithelium

What structure is A?

pigmented epithelium

What structure is A?

rectus muscle

What structure is A?

Major arterial circle of iris

What structure is A? Primarily supplies ciliary processes

Episcleral vessels

What structure is B?

Scleral spur

What structure is B?

Stroma

What structure is B?

anterior ciliary artery

What structure is B?

canal of schlemm

What structure is B?

fibres of suspensory liagements

What structure is B?

gap junction

What structure is B?

iris

What structure is B?

middle oblique fibres of ciliary muscle/ radial fibres of ciliary muscle

What structure is B?

nonpigmented epithelium

What structure is B?

pigmented epithelium

What structure is B?

Intramuscular circle

What structure is B? Supplies the posterior and outer ciliary body

Anterior ciliary arteries

What structure is C?

Collector channels

What structure is C?

Outer longitudinal fibres/ meridional fibres/ Brücke's muscle

What structure is C?

Supraciliaris (superciliary lamina)

What structure is C?

anterior chamber

What structure is C?

uveal tract

iris, ciliary body, choroid

a

superior cervical ganglion, carotid plexus, long ciliary nerves. This is the neural pathway of what innervation? a) sympathetic b) parasympathetic c) sensory

Infoldings of basal non-pigmented epithelium

what is this? provides the ciliary body with an enormous surface area available for fluid secretion

Pars Plana (orbicularis ciliaris)

what structure makes up 2/3rds of the ciliary body?

Pars Plana (orbicularis ciliaris)

• 4-4.5mm anterior posterior length (2/3rd of ciliary body) • Smooth flat surface • Scalloped posterior margin • Relatively avascular • Origin of zonules • Ciliary bays • Dentate processes/ retinal teeth • Giant dentate processes (16% of eyes)

Ciliary Epithelium

• Double layered, cuboidal cells • Outer pigmented (PE) - Extension of RPE - Melanosomes - Infoldings of BM •Inner non-pigmented (NPE) - Secretory organelles - Continuous with neural retina - Infoldings • Base out, apices in • Junctions

Ciliary Muscle Tendons

• Insert into surrounding structures • Posterior insertion: - Elastic attachment to anterior choroid & Bruch's membrane • Anterior insertions: - Type 1 from outer longitudinal muscle into sclera or scleral spur - Type 2, elastic-like to trabecular meshwork - Type 3 collagenous to trabecular meshwork and corneal stroma - Assists aqueous drainage

Ciliary stroma

• Loose connective tissue • Collagen/elastic network • Cells: melanocytes, fibroblasts, mast cells • Myelinated and non-myelinated nerves • Blood vessels, highly vascular

Supraciliaris (superciliary lamina)

• Thin, outermost layer of loose connective tissue • Adjacent to sclera, allows movement of Ciliary body • Melanocytes, fibroblasts and collagen

Ciliary Muscle

•Ring of smooth muscle •Located against inner surface of anterior sclera •Forms bulk of ciliary body •Fast action, multi-unit 3 parts: -Outer longitudinal/meridional (Brücke's muscle) -Middle oblique/radial -Inner circular (termed Muller's muscle) contract to give complete 3D inward movement


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