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Anatomy of orbit презентация
Содержание
- 1. Anatomy of orbit
- 2. Development of orbit Develops from mesenchyme
- 3. Developmental Anomalies : Craniosynosotosis: Brachycephaly Oxycephaly Scophocephaly Trigonocephaly
- 4. Craniosfacial dysostois / Crouzon’ syndrome
- 5. Oxycephaly-syndactlye / Apert’ syndrome:
- 6. Bones of Orbit Frontal
- 7. Dimensions - orbit 30 ml –volume 35
- 8. Boundaries of Orbit Roof Floor Side walls Orbital apex
- 9. Roof of orbit Frontal
- 10. Orbital roof anomaly / fracture
- 11. Medial wall Body of sphenoid
- 12. Orbital cellulitis Extremely thin wall
- 13. Floor of orbit Maxilla Zygomatic
- 14. Blow out fractures Fragile barrier
- 15. Le fort’s fracture Type 2 - Pyramidal Type 3 - Craniofacial dissociation
- 16. Lateral wall Greater wing –sphenoid
- 17. Behind Zygomatic sphenoidal suture
- 18. At frontal sphenoidal
- 19. Orbital apex
- 20. Orbital apex syndrome /
- 21. Other causes:
- 22. Superior orbital fissure syndrome
- 23. Contents of orbit Eye ball Orbital fat Connective tissue system Blood vessels Nerves Extraocular muscles
- 24. Eyeball - Applied anatomy: Proptosis : Dystopia Enophthalmosis Ophthalmoplegia
- 25. Connective tissue system Periorbita Orbital septum Tenon’s capsule
- 26. Periorbita: Loosely attached to
- 27. Orbital septum:
- 28. Anterior fascial system
- 29. Tenon’s capsule
- 31. Surgical spaces in orbit : Sub periosteal
- 32. Extra ocular muscles 4 rectal muscles 2
- 33. Arterial supply
- 34. Venous drainage
- 35. Optic nerve Intra orbital part = 25
- 36. Oculomotor nerve Divides at anterior part of
- 37. Trochlear nerve Runs medially from lateral wall
- 38. Abducent nerve Running inferior lateral to 3
- 39. Trigeminal nerve Three terminal branches of
- 40. Nasociliary nerve: Communicating branch to
- 41. THANK YOU
Development of orbit Develops from mesenchyme by ossification 6 th to 7 th week laying down of bones starting with maxilla bone around the Optic vesicle
Слайд 2Development of orbit
Develops from mesenchyme by ossification
6 th to 7
th week laying down of bones
starting with maxilla bone around the
Optic vesicle
During this time optic vesicle 170 degree apart rotates anteriorly
starting with maxilla bone around the
Optic vesicle
During this time optic vesicle 170 degree apart rotates anteriorly
Слайд 3Developmental Anomalies :
Craniosynosotosis:
Brachycephaly
Oxycephaly
Scophocephaly
Trigonocephaly
Слайд 4
Craniosfacial dysostois / Crouzon’ syndrome
Proptosis – shallow orbits
Hypertelorim - wide separation
of orbits
V pattern exotropia
Слайд 5
Oxycephaly-syndactlye / Apert’ syndrome:
Flattened occiput , steep forehead ,
supra orbital
ridge
Midfacial hypoplasia ,
parrot beak nose
Midfacial hypoplasia ,
parrot beak nose
Слайд 7Dimensions - orbit
30 ml –volume
35 mm vertically ,
40 mm
horizontally
45 degree between lateral wall
and sagital plane
23 degree between visual
and orbital axis
45 degree between lateral wall
and sagital plane
23 degree between visual
and orbital axis
Слайд 9
Roof of orbit
Frontal bone [Orbital plate] & lesser wing
of sphenoid
Separated from frontal sinus and anterior
cranial fossa above
Lacrimal gland fossa and trochlear fossa
behind orbital rim
Separated from frontal sinus and anterior
cranial fossa above
Lacrimal gland fossa and trochlear fossa
behind orbital rim
Слайд 10
Orbital roof anomaly / fracture
CSF pulsation
pulsatile
exophthalmos
Orbital meningocele / encephalocele
exophthalmos
Orbital meningocele / encephalocele
Слайд 12
Orbital cellulitis
Extremely thin wall
Prone for damage & sinusitis
spread
Infection across Orbital cellulitis
Infection across Orbital cellulitis
Слайд 14
Blow out fractures
Fragile barrier to maxillary
sinus
Due to trauma eyeball collapse
into Maxillary sinus
Слайд 16
Lateral wall
Greater wing –sphenoid
Orbital surface –
Frontal process of zygomatic
Inferiorly – inf
orbital fissure
Medially – sup orbital fissure
Medially – sup orbital fissure
Слайд 17
Behind Zygomatic sphenoidal suture
lateral orbitotomy of greater wing
( thin wall ) cancellous bone
middle cranial fossa
dura matter
Слайд 18
At frontal sphenoidal suture
-- meningeal foramen
Site of anastomosis of Lacrimal artery and
meningeal artery collaterals
Periosteal elevation at this site Brisk bleeding
Слайд 20
Orbital apex syndrome
/ Tolosa - hunt syndrome :
Damage to
structures at apex 2 nd, 3 rd, 4 th ,6 th nerves
Symptoms : visual loss, ophthalmoplegia
periorbital & facial pain
Symptoms : visual loss, ophthalmoplegia
periorbital & facial pain
Слайд 22
Superior orbital fissure syndrome
/ Rochon – Duvigneaud
syndrome :
Lesion anterior to orbital apex excluding optic nerve pathology
Lesion anterior to orbital apex excluding optic nerve pathology
Слайд 23Contents of orbit
Eye ball
Orbital fat
Connective tissue system
Blood vessels
Nerves
Extraocular muscles
Слайд 26
Periorbita:
Loosely attached to orbital bone
Attached firmly to
Arcus marginalis
Trochlea
Lateral orbital
tubercle
Optic foramen
Orbital fissures
Dura and optic canal margins
Optic foramen
Orbital fissures
Dura and optic canal margins
Слайд 27
Orbital septum:
Interconnecting / circumferential radial webs of
fascial system
support and transmit forces in trauma
Compressive optic neuropathy following trauma
support and transmit forces in trauma
Compressive optic neuropathy following trauma
Слайд 28
Anterior fascial system
Formed by condensation of fibrous septa
Lockwood lig,
whitnall sup susp lig
Lacrimal lig
Intermuscular septum
Posterior Fascial system Incompletely
formed
whitnall sup susp lig
Lacrimal lig
Intermuscular septum
Posterior Fascial system Incompletely
formed
Слайд 29
Tenon’s capsule
Dense elastic , vascular
Extent : from perilimbal sclera to optic
nerve meninges with bursa within
Sleeve like extensions for
extra ocular muscles continues as
fibrous capsule along its length
nerve meninges with bursa within
Sleeve like extensions for
extra ocular muscles continues as
fibrous capsule along its length
Слайд 32Extra ocular muscles
4 rectal muscles
2 oblique muscles
Two lid retractors
To
serve in eyeball movements in the orbital cavity
Слайд 35Optic nerve
Intra orbital part = 25 mm out
of 4 cm
Enclosed in three meningeal sheaths
At apex surrounded by recti muscles ,
Central retinal artery and vein pierces optic nerve 1.25 cm behind optic nerve
Relations: superiorly ophthalmic artery
sup ophthal vein
nasociliary nerve
inferiorly nerve to medial rectus
Слайд 36Oculomotor nerve
Divides at anterior part of cavernous
sinus before
Entering sup orbital fissure
Sup division Sup rectus
LPS
Inf division Medial rectus
Inf rectus
Inf oblique
And motor root relay at ciliary ganglion
sphincter pupillae , ciliary muscle
Entering sup orbital fissure
Sup division Sup rectus
LPS
Inf division Medial rectus
Inf rectus
Inf oblique
And motor root relay at ciliary ganglion
sphincter pupillae , ciliary muscle
Слайд 37Trochlear nerve
Runs medially from lateral wall
of cavernous sinus
Above Levator
palpebral sup
Then supplies orbital surface of
Superior oblique
Then supplies orbital surface of
Superior oblique
Слайд 38Abducent nerve
Running inferior lateral to 3 rd
nerve then supplies ocular
surface of lateral Rectus
Слайд 39Trigeminal nerve
Three terminal branches of ophthalmic division:
Frontal nerve
supratrochlear
supraorbital
Lacrimal nerve Sensory and secretomotor
fibres to lacrimal gland tru
zygomaticotemporal nerve
supraorbital
Lacrimal nerve Sensory and secretomotor
fibres to lacrimal gland tru
zygomaticotemporal nerve
Слайд 40
Nasociliary nerve:
Communicating branch to sensory root of ciliary ganglion
Long ciliary nerves
- dilator pupillae
Posterior and anterior ethmoidal branches
Infratrochlear nerve
Posterior and anterior ethmoidal branches
Infratrochlear nerve
