Final Back of Book Questions: Astha (258-268), Ashley (269-279), Aarti (280-290)

Based on clinical studies select the correct effects (3) sleep deprivation has on the ocular surface a) increased osmolarity b) decreased osmolarity c) reduced TBUT d) increased TBUT e) reduced tear production

A,C,E increased osmolarity reduced TBUT reduced tear production

34. The normal tear volume is: A. 8.5 ul B. 10.8 ul C. 12.2 ul D. 14.6 ul E 15.5 ul

A. 8.5 ul

127. The superior ophthalmic vein receives blood directly from the following veins except: A. Facial vein B. Supraorbital vein C. Angular vein D. Vortex vein E. Posterior ethmoidal vein

A. Facial vein

99. Which of the following nerves and BVs is NOT passing through the annulus of Zinn? A. Frontal n B. Ophthalmic a C. Optic n D. Superior division of the third nerve

A. Frontal nerve

113. Which extraocular muscle exerts depression, extorsion, and adduction? A. Inferior rectus B. Superior rectus C. Inferior oblique D. Superior oblique

A. Inferior rectus

107. The sensory nerve ending NOT associated with extraocular muscles is: A. Pacinian corpuscle B. Palisade ending C. Spiral ending D. Muscle spindle E. Golgi tendon organ

A. Pacinian corpuscle

100. Venous blood leaving the orbit through the inferior orbital fissure will join: A. Pterygoid venous plexus B. Cavernous sinus C. Inferior ophthalmic v D. Angular v E. Facial v

A. Pterygoid venous plexus

41. The most peripheral structure seen in a wide open filtration angle is: A. ciliary body B. choroid C. scleral spur D. trabeculum E. cornea

A. ciliary body

30. The surface ectoderm serves as the germinal layer of origin for the: A. corneal epithelium and its basement membrane B. corneal endothelium and its basement membrane C. anterior and posterior limiting lamina of the cornea D. basement membranes of the epithelium and endothelium of the cornea

A. corneal epithelium and its basement membrane

28. Looking straight ahead, the action of the superior oblique extraocular muscle is A. depression, intorsion, and abduction B. depression, extorsion, and adduction C. depression, intorsion, and adduction D. depression, extorsion, and abduction

A. depression, intorsion, and adduction

46. In the trabecular meshwork, one would NOT normally find: A. epithelial cells B. endothelial cells C. collagen fibers D. elastic fibers E. basement membrane

A. epithelial cells

36. Which of the following elements does NOT contribute to the nutritious value of tears? A. glucose B. oxygen C. potassium D. magnesium E. calcium

A. glucose

10. Corneal epithelial function does NOT include: A. glucose uptake from tears B. protection of other corneal structures C. transparency D. microorganism barrier E. fluid barrier

A. glucose uptake from tears

42. Which vessel is NOT part of the orbital arterial supply to the eye lid? A. infraorbital A. B. supraorbital A. C. lacrimal A. D. frontal A. E. dorsal nasal A.

A. infraorbital A.

13. Which is true for the lacrimal gland? A. it is housed in a depression in the frontal bone B. the myoepithelial cell in the acinus is innervated C. it reached full development during the eighth month of pregnancy D. its palpebral lobe is located superior to the orbital lobe E. it is an apocrine gland

A. it is housed in a depression in the frontal bone

21. With the palpebral aperture open, in which orientation is the conjunctival sac deepest? A. superiorly B. inferiorly C. laterally D. medially E. between 8 and 9 o'clock

A. superiorly

45. Compared to the central cornea, which of the following epithelial modifications is NOT true at the limbus? A. the basement membrane is lost B. pigment granules may occur in cells C. the number of wing cells increases D. it becomes less regular along its internal border E. epithelial stem cells are present

A. the basement membrane is lost

31. The largest dimension of the globe is: A. 24 mm vertically B. 24 mm horizontally C. 25 mm vertically D. 25 mm horizontally E. 25 mm all meridians

B. 24 mm horizontally

18. Approximately how large a proportion of the tears evaporate before being drained? A. 10% B. 25% C. 40% D. 55% E. 75%

B. 25%

40. How man cells/ mm^2 of endothelium will a 20-10 year old person have on average? A. 2,500-2,900 B. 3,000-3,500 C. 3,600-3,900 D. 4,000-4,500 E. 4,600-5,000

B. 3,000-3,500

97. To what extend is aqueous humor an active transport kind of secretion? A. 100% B. 70% C. 50% D. 30% E. 0%

B. 70%

15. What is considered the lower end of the normal range regarding tear break-up time (TBUT)? A. 4 sec B. 8 sec C. 16 sec D. 30 sec E. 1 min

B. 8 sec

120. The central element in the triad synapse in the cone pedicle is: A. A horizontal cell process B. An On-bipolar C. An Off-bipolar D. An amacrine cell process E. A Muller cell process

B. An On-bipolar

141. The palatine bone provides a surface for which wall of the orbit: A. Medial B. Floor C. Roof D. Lateral

B. Floor

143. Which cranial nerve does NOT carry autonomic nerve fibers? A. III B. IV C. V D. VII

B. IV

88. Retinal arterioles lack: A. Tunica intima B. Internal elastic lamina C. Pericytes D. Basement membrane

B. Internal elastic lamina

165. The location of the preganglionic sensory nucleus of the CN VII parasympathetic nerve fibers is located in the: A. Mid-brain B. Medulla oblongata C. Ciliary ganglion D. Geniculate ganglion E. Pterygopalatine ganglion

B. Medulla oblongata

158. Which of the following is NOT true of the retinal nerve fibers? A. The highest density near the disc is approximately at 3 o'clock in the right eye B. Papillo-macular fibers are medullated C. Nasal visual field is conveyed by temporal fibers D. The ganglion cell axon forms the nerve fiber

B. Papillo- macular fibers are medullated

142. Which of the following is true regarding the muscular branches off the ophthalmic artery? A. There are typically 4 in number B. They have terminal branches known as anterior ciliary arteries C. They supply blood to the orbicularis oculi and the levator palpebrae superioris D. They typically branch off the ophthalmic artery after the anterior and posterior ethmoidal arteries

B. They have terminal branches known as anterior ciliary arteries

87. What do bipolar cell dendrites have in common with ganglion cell dendrites? A. They both contain dynastic ribbons B. They never make presynaptic contact C. They both contain small granular vesicles D. They both make synaptic contact with amacrine cells E. They are both enclosed by the oligodendrocytes

B. They never make presynaptic contact

27. The neural ectoderm is the germinal layer of origin for: A. sphincter muscle but not dilator muscle of iris B. dilator and sphincter muscle of iris C. dilator muscle but not sphincter muscle of iris D. ciliary muscle of ciliary body

B. dilator and sphincter muscle of iris

7. Which neural feature does not exist in the cornea? A. free nerve endings B. encapsulated end organs C. myelinated nerve fibers D. unmyelinated nerve fibers E. naked nerve fibers

B. encapsulated end organs

5. Which is NOT true for the limbal epithelium? A. it receives nerve fibers from the conjunctiva B. it is thicker than the corneal epithelium due to a larger number of basal cells C. it may contain pigment granules D. surface cells have small cytoplasmic projections E. its internal surface is less flat and regular than in the central cornea

B. it is thicker than the corneal epithelium due to a larger number of basal cells

33. The optic nerve emerges from the eye: A. nasal and inferior to the posterior pole B. nasal and superior to the posterior pole C. temporal and inferior to the posterior pole D. temporal and inferior to the posterior pole E. at the posterior pole

B. nasal and superior to the posterior pole

11. Which is NOT true regarding corneal innervation? A. most corneal axons are located among the basal epithelial cells B. occasionally axons are myelinated in the central cornea C. only axons of CN V origin innervate the primate cornea D. all nerve terminals are classified as free nerve endings E. more than one sensory modality is conveyed by the corneal nerve fibers

B. occasionally axons are myelinated in the central cornea

6. Regarding accommodation, when no tension is present in the zonules of zinn: A. the ciliary muscle is relaxed and the axial length of the lens is increased B. the ciliary muscle is contracted and the axial length of the lens is increased C. the ciliary muscle is relaxed and the axial length of the lens is decreased D. the ciliary muscle is contracted and the axial length of the lens is decreased

B. the ciliary muscle is contracted and the axial length of the lens is increased

12. The function of the sebaceous component in tears is: A. to act as a wetting agent B. to reduce evaporation C. to help spread the tears D. to give tears a bacteriolytic action E. there is no sebaceous component of tears

B. to reduce evaporation

167. Which is NOT true for rod receptor cells? A. They are found in greatest numbers 20 degrees outside the fovea B. Discs are formed continuously at the base of the outer segment C. The myoid contains a great number of longitudinally oriented mitochondria D. They are found within 4 retinal layers E. The terminal swelling is often termed the spherule

C, D

139. How many separate bones contribute to the left and right orbit? A. 7 B. 9 C. 11 D. 12 E. 14

C. 11

1. How many basement membranes are there in the cornea? A. none B. 1 C. 2 D. 3 E. 4

C. 2

49. The sclera is normally penetrated by more than: A. 4 vortex veins B. 2 long ciliary nerves C. 4 short ciliary nerves D. 2 long posterior ciliary arteries E. 7 anterior ciliary arteries

C. 4 short ciliary nerves

32. According to Duke-Elder, the volume of the eye is: A. 2.4 cc B. 4.5 cc C. 6.6 cc D. 7.8 cc E. 8.8 cc

C. 6.6 cc

101. How many muscular aa are there in the orbit? A. 5 B. 6 C. 7 D. 8 E.9

C. 7

39. How much water does the cornea contain? A. 44% B. 56% C. 78% D. 86% E. 97%

C. 78%

121. Hiatus semilunaris is: A. Associated with the orbital floor B. Another name for the lamina fusca C. Associated with the nose D. A kind of junction between cells E. Latin for the word "bookworm"

C. Associated with the nose

122. The orbital floor is made up of: A. Maxilla, sphenoid, and zygomatic bones B. Maxilla, sphenoid, and lacrimal bones C. Maxilla, zygomatic, and palatine bones D. Maxilla, zygomatic and nasal bones E. Zygomatic, palatine and lacrimal bones

C. Maxilla, zygomatic, and palatine bones

153. The sclera, ciliary m and striated muscles of the eye are products of which germ layer? A. Surface ectoderm B. Neural ectoderm C. Mesoderm D. Endoderm E. Rectoderm

C. Mesoderm

149. The foveola (foveal pit) in a normal human adult contains which of the following cell types? A. Blue cone photoreceptors B. Rod photoreceptors C. Muller cells D. Retinal ganglion cells E. Amacrine cells

C. Muller cells

128. The oculomotor nerve does NOT contain: A. Somatic motor fibers B. Proprioceptive fibers C. Postganglionic parasympathetic fibers D. Schwann cells E. Neural sheaths

C. Postganglionic parasympathetic fibers

3. Which of the corneal layers is continuous into the sclera? A. Epithelium B. Anterior limiting lamina C. Stroma D. Posterior limiting lamina E. Endothelium

C. Stroma

24. Using a gonioscope to view the angle, the appearance of the normal filtration angle from anterior to posterior is: A. angle recess, Schwalbe's line, trabecular meshwork, scleral spur, canal of schlemm, cornea B. cornea, angle recess, scleral spur, trabecular meshwork, schwalbe's line, angle recess, canal of schlemm C. cornea, schwalbe's line, trabecular meshwork, canal of schlemm, scleral spur, angle recess D. schwalbe's line, cornea, trabecular meshwork, canal of schlemm, scleral spur, angle recess

C. cornea, schwalbe's line, trabecular meshwork, canal of schlemm, scleral spur, angle recess

23. What ocular structure most efficiently block electromagnetic radiation of a 320 nm wavelength? A. cornea B. aqueous C. crystalline lens D. vitreous E. retina

C. crystalline lens

29. Eye movements that result in the eyes moving in opposite directions are termed: A. conjugate eye movements B. yoked eye movements C. divergent eye movements D. disjunctive eye movements

C. divergent eye movements

22. What type of glandular secretion is produced by goblet cells? A. merocrine B. apocrine C. holocrine D. serous E. sebaceous

C. holocrine

4. Which is true for corneal endothelium? A. the cells are mainly octagonal in flat sections B. the cells are thicker than they are wide C. in flat section the nucleus is kidney shaped D. it receives sensory innervation E. it lacks zonula occludens

C. in flat section the nucleus is kidney shaped

20. What is true for orbicularis oculi? A. muscle fibers from the upper and lower lid meet at the medial palpebral raphe B. it has a non-striated ciliary portion, known as the muscle of riolan C. it has an orbital and a palpebral portion D. it is innervated by CN III E. its action is supported by the tarsal muscles

C. it has an orbital and a palpebral portion

47. Which is true for the canal of schlemm? A. its external wall shows vacuoles B. the diameter of the lumen is under nervous control C. it may contain some blood D. muscle cells are present in the wall of the canal E. it is located peripheral to the scleral spur

C. it may contain some blood

35. Which of the following forces is NOT involved in the removal of tears? A. capillary attraction B. gravity C. osmosis D. blinking E. lateral lid movement

C. osmosis

16. Which of the following anatomical structures does not form a part of the tear drainage system? A. ampulla B. punctuma C. plica semilunaris D. canaliculus E. lacrimal sac

C. plica semilunaris

9. Which statement is not true for the corneal stroma? A. its nerves are found anteriorly B. the lamellae are parallel to the corneal surface C. the collagen fibers within the lamellae are equidistant from each other D. its collagen fibers are coarser than those in the anterior limiting lamina E. keratocytes contain few mitochondria

C. the collagen fibers within the lamellae are equidistant from each other

8. Which of the following statements on the macrostructure of the cornea is correct? A. the vertical diameter of the cornea is the greatest one B. the central thickness of the normal cornea is 1 mm C. the combination of the front and back surfaces of the cornea (in air) makes it a negative powered lens D. the radius of curvature of the back surface of the cornea is approximately 7.9 mm E. along its anterior surface the cornea is steeper peripherally than centrally

C. the combination of the front and back surfaces of the cornea (in air) makes it a negative powered lens

25. Where is sclera thickest? A. the equator B. the anterior pole C. the posterior pole D. the sclero-limbal junction E. the point just posterior to where the insertions of the extraocular muscles merge with the sclera

C. the posterior pole

146. Which of the following ganglia does NOT provide a synapse for the parasympathetic nervous system to the orbit? A. Pterygopalatine B. Ciliary C. Axenfeld (accessory) D. Superior cervical

D. Axenfeld (accessory)

155. The eye can be thought of as an extension of which of the following? A. Cardiovascular system B. Peripheral nervous system C. Autonomic nervous system D. Central nervous system E. None- it develops in complete isolation

D. Central nervous system

89. High concentrations of mitochondria are NOT found in: A. The ellipsoid of rods B. Corneal endothelium C. Ciliary muscle cells D. Cone outer segments E. Ciliary epithelium

D. Cone outer segments

38. Which type of collagen fibers do you associate with posterior limiting lamina? A. I B. II C. III D. IV E. VII

D. IV

166. Which of the following extra-ocular muscles does NOT originate from or near the annulus of Zinn? A. Medial rectus muscle B. Inferior rectus muscle C. Superior oblique muscle D. Inferior oblique muscle E. Levator

D. Inferior oblique muscle

126. The orbitociliary nerve is a branch off the: A. Lacrimal nerve B. Frontal nerve C. Nasociliary nerve D. Infraorbital nerve E. Zygomatic nerve

D. Infraorbital nerve

140. Which is true regarding CN IV: A. It passes through the optic canal B. It passes through the IOF C. It innervates the ipsilateral superior oblique D. It approaches the muscle from the external surface rather than the internal surface

D. It approaches the muscle from the external surface rather than the internal surface

129. The mesencephalic nucleus of the trigemincal nerve is concerned with: A. Pain B. Touch C. Temperature D. Proprioception E. Pressure

D. Proprioception

17. The sympathetic distribution within the lacrimal gland includes: A. acini B. secreting ducts C. serous cells D. blood vessels E. lacrimal gland lacks a sympathetic innervation

D. blood vessels

37. Mast cells are NOT: A. present in the conjunctiva B. inflammatory cells C. Involved in allergic responses D. fixed (stationary) cells E. activated by neurogenic stimulation

D. fixed (stationary) cells

48. Where is the sclera thinnest: A. anterior pole B. posterior pole C. equator D. immediately posterior to the tendonous insertion of the recti muscles E. 3 mm posterior to the equator

D. immediately posterior to the tendonous insertion of the recti muscles

50. Which of the following statements is true for the lamina fusca of the sclera? A. it is made up of a layer of epithelial cells B. it is made up of a layer of endothelial cells C. it is only found where the optic nerve leaves the eye D. it contains uveal melanocytes E. it is mainly made up of fibrocytes and their long slender processes

D. it contains uveal melanocytes

14. Tear production is mainly supported by the A. goblet cells B. gland of wolfring C. gland of Krause D. lacrimal gland E. tarsal gland

D. lacrimal gland

2. Which statement is true regarding the parasympathetic innervation of the lacrimal gland? A. at some point the secreto-motor fibers link up with the lacrimal nerve B. the post-ganglionic cell station is the geniculate ganglion C. secreto-motor fibers are found in the rami oculares D. secreto-motor fibers enter the orbit through the inferior orbital fissure E. the anastomosing branch between the zygomatic and lacrimal nerves contains postganglionic secreto-motor fibers

D. secreto-motor fibers enter the orbit through the inferior orbital fissure

44. The corneal epithelium does NOT harbor: A. squamous cells B. basal cells C. neurons D. white blood cells E. Langerhans cells

D. white blood cells

148. Which of these cells would you never find in the retina? A. Astrocytes B. Perivascularglia C. Microcglia D. Oligodendrocyte E. Schwann cell

E. Schwann cell

26. Why is the canal of schlemm not a vein? A. because it is innervated B. because it has some associated smooth muscle cells C. because it has a fundamentally different structure D. because it never contains blood E. because it does not function as a vein

E. because it does not function as a vein

19. The lower lid is supplied by: A. infratrochlear nerve B. anterior ethmoidal nerve C. inferior alveolar nerve D. external nasal nerve E. infraorbital nerve

E. infraorbital nerve

43. Where are lymphatics NOT present? A. lacrimal gland B. eye lid C. conjunctiva D. limbus E. sclera

E. sclera

Experimental data from a variety of research models coupled with recent clinical studies strongly point to an important role of NO nitric oxide in modulating IOP by? a) increasing uveal scleral outflow b) increasing conventional outflow c) decreasing aqueous production d) increasing aqueous production

Increasing conventional outflow (B)

Vascular endothelial growth factor VEGF has been implicated as a primary player in select 3 a) angiogensis b) promoting vascular permeability c) wound healing d) apoptosis

a) angiogenesis b) promoting vascular permeability c) wound healing

Which of the following three are true regarding dry eyes? a) patients often report symptoms before ocular signs are present b) post-menopasual women are the most likely to complain of dry eye c) an increased blink rate can often lead to dry eye d) dry eye can have a significant effect on a person's activities of daily living

a) patients often report symptoms before ocular signs are present b) post-menopausal women are most likely to complain of dry eye d) dry eye can have significant effect on a person's activities of daily living

In the eye under hyperglycemic conditions which ocular cells produce vascular endothelial growth factor (VEGF) a) retinal Muller cells b) corneal epithelium c) lens fibers d) conjunctiva

a) retinal Muller cells

180. The maxillary nerve passes through which passage a. formen rotundum b. foramen ovale c. superior orbital fissure d. inferior orbital fissure e. meningeal foramen

a. formen rotundum

205. Select the incorrect statement about autoregulation of retinal vessels a. it is under parasympathetic control b. under physiological conditions the diameter of retinal arterioles is auto regulated in response to changes in the blood pressure so that the retinal blood perfusion is kept at the balanced level c. changes in ocular perfusion pressure occur routinely in daily life, stress and exercise induce elevation sin mean arterial pressure while there is a nocturnal reduction in arterial pressure, all which lead to a diurnal variation in IOP d. when changes in perfusion pressure occur, local vascular constriction or dilation maintain a constant nutrient supply

a. it is under parasympathetic control

195. how many degrees of visual angle correspond to each millimeter in the lateral organization of the adult human retina? a.3 b.6 c.10 d.100 e.300

a.3

The Rho GTPase inhibitor can increase? a) aqueous humor drainage through the trabecular meshwork b) corneal edema c) retinal edema d) lens swelling

aqueous humor drainage through the trabecular meshwork

203. Select the TWO correct statements about occlusion of blood flow a. chorodial arteriole emboli destroy the inner retina b. Retinal arteries are the end arteries c. terminal choroidal arteriole emboli cannot be compensated for since adjacent vessels pressure is too low d. non repairable damage will occur after 5 minutes of occlusion

b. Retinal arteries are the end arteries c. terminal choroidal arteriole emboli cannot be compensated for since adjacent vessels pressure is too low

199. Which of the waves of the dark-adapted electroretinogram ERG is generated primarily by the rod bipolar cells? a. the a wave b. the b wave c. the c wave d. the d wave

b. the b wave

The RHO GTPase mediated signaling pathways plays an important role in the regulation of a) accommodation b) phototransduction c) aqueous outflow d) deturgescense

c) aqueous outflow

200. What is the most important neurotransmitter receptor type for the transmission of visual signals from either rod or cone photoreceptors to OFF type cone bipolar cells? a. iontropic glycine receptor b. ionotropic GABA-A receptor c. ionotropic glutamate receptor d. metabotropic glutamate receptor e. metabotropic acetylcholine receptor

c. ionotropic glutamate receptor

178. What happens to the nonpigmented ciliary epithelium as you follow it across the ora serrate a. it continues into the choroids b. it becomes pigmented c. it becomes the neural part of the retina d. it terminates e. it remains unchanged

c. it becomes the neural part of the retina

179. Which of the following nerves or blood vessels is not passing through the superior orbital fissure? a. inferior division of CNIII b. CN IV c. ophthalmic A. d. Ophthalmic V e. frontal nerve

c. ophthalmic A.

Recent studies show a dose response relationship this nutrient intake and cortical cataract formation a) fat b) carbohydrate c) protein d) minerals

carbohydrate

197. Which of the following is not a function of the retinal pigment epithelium RPE? a. Along the Bruch's membrane it forms the blood retina barrier b. it regulates the extracellular environment of the outer segments of the photoreceptors c. it is essential for the regeneration of visual pigments d. it synthesizes new photoreceptor disc outer segments e. it controls retinal hydration via the transport of fluids

d. it synthesizes new photoreceptor disc outer segments

196. Which of the following statements is TRUE of the fovea? a. the central fovea (the foveola) is the most highly vascularized region of the retina b. the fovea contains only rods and blue (S-) cone outer segments c. the fovea is fully developed at birth d. the foveola contains only photoreceptors and Muller cells e. the foveola is about 5 degrees nasal to the optic disc

d. the foveola contains only photoreceptors and Muller cells

198. Which is the correct statement about the retinal ganglion cells that project to the parvocelluar layers of the lateral geniculate nucleus LGN a. they comprise 10% of retinal ganglion cells b. their major input comes from diffuse cone bipolar cells c. their cell density is lowest in the fovea and increases with eccentricity d. they are morphologically classified as midget type retinal ganglion cells e. their receptive fields show a broadband center surround organization with no color opponency

d. they are morphologically classified as midget type retinal ganglion cell

Why are corticosteroid useful in dry eye treatment? a) they replace lost fluid in the tear film b) they reduce inflammation of the ocular surface c) they stimulate production of tears from the lacrimal glands d) they soften the meibum to improve the stability of the tear film

they reduce inflammation of ocular surface