Head and Neck —— 5, Organs and Their Neurovascular Structures Zz quater Aenscapeie ole Bok * a € Reference lines and dynamics ofthe lens 1 Pricipal reference nes of the lent: The ln has an anterior and posterior poke, an axk passing betwees the poles, and an equator The ns has a bconvex shape witha greatce radius of curvature poste= ‘orly (16 mm) than antevoey (10 mm). funetion isto tense Haht rays and make fine adjustments in retiaction. Bs refractive po= weeranges fiom 10 0 20 diopters, depending on the state of accom rmodatson. The comea hes a considerably higher refiactine power of 43 diopters. Fetalmckus fas epaule Fpithebom Inti Ade 2 neue stcets » D Growth of the tens and zones of discontinuity (alle Lang) Anterior view, blateal view, ‘The lens contiaucsto gcow thoughout Bf, doing so m ¢ meaner oppo- ste to that of ether epithelal structures, ce. the youngest eel re a the surfice ofthe lens while the oldest cel are deeper. Due tothe con- stant proliératon of epielal eels, which are all firmly incorporated in the lens capsule, the tmsue ofthe lens becomes increasingly dense with, age. Aslitshmp examination willdemonstrate zones of varying cell den- shy (anes of dscontinity). The mone of highest cell density. the emb- Fyonic nuckus isa the center ofthe lens. With further growth, it beco= res surrounded by the tal icles, The infil nuckus develops ater birth and finaly the adult nucleus begins to form during the third de- cade of ie, These snes are the bass forthe morpholo gia chssfca- tion ofcataact,aseuctual alteration in the lens causing opacity, thal ismore or ess normal in old age (present in 10%0F 80-year-old), Ligh ap instant Scovemotatbe lem ihe sme ‘icommodation acy muscle contre, » Seeman owndet bight refraction and dymamies of the lens + Upper half of diagram; fine adjstaient of the eye for Gr vision. Pa- ralll ight ays ave fom a distant souree, and the tens i flat- teed + Iowerhalfordagram: For nea vision (accommodation objets less than $m fom the eye), the lens assumes a more rounded shape (ce This fected by contraction ofthe ciliary muscle (parasyenpat~ heti innervation from the oculomotor nerve), causing the zonular fibers to relaxand allowing the kns to assume 2 mote rounded shape beeause of ts intrinsic resience Donker seid REErSeoee sone a roma Descemet wo mene E Structure ofthe come ‘The cornea s covered externally by nonkeratnizd stratified squamous cpithelum whose basil membrane borders om the anterior iting l= fina (lnwman membrane) The stroma (cubetania pepe) makes up ‘pproximatcly 90%of the coracal thickness and is bounded on ts deep surface by the posterior limiting lamina (Deseemet membrane). Be- neath isa single ier of corneal endothelum. The cornea does have nerve supply (for comeal reflexes) but it snot vaseularied and there- {ore has animmunologieally privileged status: normally,» comealtrans- plant ean be performed without fer of host rejection response. 159