The Orbital Cavity and its Contents.

Learning Objectives

At the end of lecture, student should be able to: enlist the contents of orbital cavity Know the foramina of orbital cavity with their contents. Know the structures supplied by nerves of orbital cavity. Know the blood vessels of orbit. Introduction to orbit. The orbits are conical or four-sided pyramidal cavities, which open into the midline of the face and point back into the head. Each consists of a base, an apex and four walls. They are intended to protect the eye from mechanical injury Contains eye and its appendages which are thus protected from mechanical injury The Orbit.

Cone shaped cavity made up of Cranial And Facial Bones

Frontal bone Ethmoid bone Maxillary bone Lacrimal bone Zygomatic bone Palatine bone Sphenoid bone Foramina and openings CONTENTS Eyeball Fascias: Orbital, Bulbar Extraocular muscles: (Levator Palpebrae Superioris, Superior, Inferior, Lateral and Medial Rectus muscles, Superior and Inferior ) Nerves: cranial nerves II, III, IV, V, and VI Blood vessels. Extraocular Fat. Lacrimal gland, Lacrimal sac, Nasolacrimal duct Ciliar ganglion. Facial sheath of eye, tenons capsule Closely surrounds eyeball Attatchment:

 Ant :sclera behind coreoscleral junction Post: fuses with sclera & dura around optic nerve attachment to eyeball
Facial sheath of eye, tenons capsule Sheath pierced by tendons of 4 recti and 2 obliques Reflected as sleeve around each tendon Triangular expansions from sleeves of medial & lateral recti form medial and lateral check ligaments The sleeve of inf rectus blending with inf oblique forms suspensory ligament Prevents sagging of eyeball in fractures of maxilla Superior Orbital Fissure.

The superior orbital fissure is a foramen in the skull, although strictly it is more of a cleft, lying between the lesser and greater wings of the sphenoid bone. A number of important anatomical structures pass through the fissure, and these can be damaged in orbital trauma, particularly blowout fractures through the floor of the orbit into the maxillary sinus.

Structures passing through superior orbital fissure. Optic nerve(II). Occulomotor Nerve(III). The oculomotor nerve arises from the anterior aspect of mesencephalon (midbrain). There are two nuclei for the oculomotor nerve

Occulomotor Nerve. The oculomotor nucleus originates at the level of the superior colliculus. The muscles it controls are the striated muscle in levator palpebrae superioris and all extraocular muscles except for the superior oblique muscle and the lateral rectus muscle. The Edinger-Westphal nucleus supplies Parasympathetic fibres to the eye via the ciliary ganglion controls the sphincter pupillae muscle (affecting pupil constriction) and the ciliary muscle(affecting accommodation) to the smooth muscle of levator palpebrae superioris. It then divides into two branches, which enter the orbit through the superior orbital fissure, between the two heads of the lateral rectus. superior branch of oculomotor nerve inferior branch of oculomotor nerve

The superior branch of the oculomotor nerve or the superior division, the smaller, passes medialward over the optic nerve. It supplies the Superior rectus and Levator palpebrae superioris.

The inferior branch of the oculomotor nerve or the inferior division, the larger, divides into three branches. medial rectus. inferior rectus. inferior oblique. From this a branch is given to the ciliary ganglion, and forms its short root. . Trochlear nerve(IV). The trochlear nerve emerges from the dorsal aspect of the brainstem at the level of the caudal mesencephalon, just below the inferior colliculus. It circles anteriorly around the brainstem and runs forward toward the eye in thesubarachnoid space. it pierces the dura just under free margin of the tentorium cerebelli. It enters the cavernous sinus, where it is joined by the other two extraocular nerves (III and VI)

it enters the orbit through the superior orbital fissure and innervates the superior oblique muscle. Trochlear nerve.

Ophthalmic Nerve(V). The ophthalmic nerve (V1) is one of the three branches of the trigeminal nerve, the fifth cranial nerve. The ophthalmic nerve carries only sensory fibers Ophthalmic Nerve. The ophthalmic nerve supplies branches to the: cornea ciliary body and iris lacrimal gland and conjunctiva part of the mucous membrane of the nasal cavity skin of the eyelids Eyebrow Forehead Nose. BRANCHES. Nasociliary nerve: Sensory root of ciliary ganglion Posterior ethmoidal nerve Long ciliary nerve Infratochlear nerve Anterior ethmoidal nerve Lacrimal nerve. Frontal nerve: Supratrohlear nerve Supraorbital nerve

Sensory Supply of Ophthalmic Nerve. The ophthalmic nerve supplies branches to the: cornea ciliary body and iris lacrimal gland and conjunctiva part of the mucous membrane of the nasal cavity skin of the eyelids Eyebrow Forehead Nose.

Abducent Nerve (VI) Abducent nerve Blood Vessels.

Artery:

Opthalmic Artery Central artery of the retina Ciliary arteries (anterior and posterior) Lacrimal artery Supratrochlear and supraorbital arteries

No lymphatic vessels in eyeball. Lymphatics of eyelids drain with those of the face. Veins: Superior opthalmic vein Drains to cavernous siunus Inferior opthalmic vein Drains to pterygoid plexus May also drain to cav. Sinus Vorticose veins Through superior orbital fissure and drains to cav. sinus Arteries Of Orbit.

Ophthalmic Artery:

Branch of Internal Carotid Artery Passes through optic canal,inferolateral to the optic nerve and within its dural sheath. It Supplies: ethmoid air cells nasal cavity external nose Eyelids forehead

Ophthalmic Artery(cont) Ophthalmic Artery supplies : all the extraocular muscles the lacrimal gland and the eye. Ophthalmic Artery.

Central Retinal Artery Central retinal artery is an end artery. Central retinal artery supplies: Optic nerve Retina.

Posterior Ciliary Artery Pierce the sclera to enter the choroidal coat of the eye. Anterior Ciliary Artery. Anterior ciliary artery supplies from the muscular branches to: Recti, pierce the anterior part of the eye. Venous Drainage Superior Opthalmic Vein: With connection with the Cavernous sinus and Inf. Opthalmic Vein (inferiorly) Prone to infection that may infect cavernous sinus Inferior Opthalmic Vein With connection with the submandibular regiona and pterygoid plexus Also connected to the superior opthalmic vein and the cavernous sinus Angular Vein: Continuation of the Facial Vein Superior Ophthalmic Vein Commences above the medial palpebral ligament. It passes back above the optic nerve. it drains into cavernous sinus through superior orbital fissure. Inferior Ophthalmic Vein. It commences at the front of orbital floor It drains through inferior orbital fissure into pterygoid plexus Self Assessment. 1.list the foramina of orbital cavity with their contents?

2.Name the vessels seen in the diagram? THANKS