Anatomy Of The Eyelids
Click here to load reader
-
Upload
ankit-punjabi -
Category
Health & Medicine
-
view
20.832 -
download
20
description
Transcript of Anatomy Of The Eyelids
![Page 1: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/1.jpg)
Dr. Mrinmayee Ghatak (DOMS Final Year)Dr. Ankit Punjabi (DOMS Final Year)
Dept of Ophthalmology,KIMS Hospital, Bangalore, Karnataka, INDIA
Email: [email protected]
![Page 2: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/2.jpg)
![Page 3: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/3.jpg)
1)Extent
2)Lid folds
3)Position of eyelids
4)Canthi
5)Eyelid Margins
6)Eyelashes
7)Palpebral aperture or fissure
Gross Anatomy
![Page 4: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/4.jpg)
Upper eyelid From eyebrow downward to end in a free
margin Superior boundary of palpebral fissure
Lower eyelid Merge into skin of cheek
![Page 5: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/5.jpg)
Superior lid fold Orbital & tarsal portion Formed by fibrous slips, from tendon
of levator Inferior lid fold
On skin of lower eyelids Fibrous slips from fascia of inferior
rectus
![Page 6: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/6.jpg)
In primary position of gaze Upper eyelid covers 1/6th of cornea
Lower eyelid just touches the cornea
![Page 7: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/7.jpg)
![Page 8: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/8.jpg)
![Page 9: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/9.jpg)
2-3 rows
When lids close eyelashes do not interlace
Cilia 20 – 120 microns Taper & end in fine point Lifespan 3-4 months
Glands of Zeis & Moll- empty into infundibulum of each piliary gland
![Page 10: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/10.jpg)
Elliptical space b/w upper & lower lid margins
At Birth Horizontally– 18 to 21 mm Vertically -- 8mm
In Adults 28 to 3o mm (hor) 9 to 11 mm (ver)
Caucasians & the X- axis Mongoloid & antimongoloid slant
![Page 11: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/11.jpg)
From without inwards, each lid has following layers:1) Skin2) Layer of subcutaneous areolar
tissue3) Layer of striated muscles4) Sub muscular areolar tissue5) Fibrous layer6) Layer of non-striated muscle fibres7) Conjunctiva
![Page 12: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/12.jpg)
![Page 13: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/13.jpg)
Elastic , fine texture, thinnest in the body Epidermis
› 6-7 layers , stratified squamous epithhelium› Basal layer- unicellular sebaceous glands,
sweat glands Dermis
› Thin layer , dense connective tissue› Rich network : BV, elastic fibers, lymphatics,
nerve› Variable no. of melanocytes
![Page 14: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/14.jpg)
Beneath the skin No fat Readily distended by blood/ oedema Nonexistent
› Near ciliary margin› At lid folds› Medial & lateral angles
![Page 15: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/15.jpg)
Orbicularis muscle , thin oval sheet across eyelids
Upper eyelid- also has levator muscle
![Page 16: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/16.jpg)
![Page 17: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/17.jpg)
From anterior part of the medial palpebral ligament & adjacent bones
Cover orbital margins , large ellipse , meet at lateral palpebral raphe
Intermingle with frontalis
MUSCULUS SUPERCILIARIS MUSCULUS MALARIS
![Page 18: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/18.jpg)
Preseptal fibres
Pretarsal fibres
![Page 19: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/19.jpg)
› Deep head & superficial head› From lacrimal fascia, posterior
lacrimal crest, MPL› Pass superiorly & inf. In front of
orbital septum› Unite at lateral palpebral raphe
![Page 20: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/20.jpg)
Deep head› From lacrimal fascia & post. Lacrimal crest
Superficial head› From medial palpebral ligament
Overlying upper & lower tarsus Join laterally to form lateral canthal
tendon It is inserted over lateral orbital
tubercle of WHITNALL Pars lacrimalis (Horner’s muscle) Pars ciliaris (muscle of Riolan)
![Page 21: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/21.jpg)
Orbital part› Forced closure of eyelids› Thus pull eyebrows downwards
Palpebral part› Helps in gentle closure during blinking,
sleep, soft voluntary closure Entire muscle supplied by branches of
7th nerve
![Page 22: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/22.jpg)
Origin Course & attachments Superior transverse ligament of
Whitnall Nerve supply & action
![Page 23: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/23.jpg)
![Page 24: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/24.jpg)
At apex of orbit Under surface of lesser wing of
sphenoid Above Annulus of Zinn Short tendon Blended with origin of SR
![Page 25: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/25.jpg)
Ribbon like belly Axis slightly nasal Medial & lateral horns Aponeurosis passes through septum
orbitale LPS inserted – pretarsal skin of lid-
sup.lid fold Thickened posterior part- ant tarsal
surface Few fibrous slips – post.LPS- sup.conj.
Fornix Check lig. Of LPS
![Page 26: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/26.jpg)
Thickened band of orbital fascia From trochlear pulley to the
capsule of orbital lobe of lacrimal gland
How is it formed?? Importance in ptosis surgery…
![Page 27: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/27.jpg)
Branch of superior division of 3rd nerve
Elevator of upper lid
![Page 28: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/28.jpg)
Layer of loose connective tissue
b/w orbicularis muscle & fibrous layer
Nerves & vessels lie in this layer
Splits lid into anterior & posterior lamina
Superiorly communicates with subaponeurotic layer of scalp
![Page 29: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/29.jpg)
![Page 30: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/30.jpg)
Framework of the lids
Central thick part- tarsal plate
Peripheral thin part- septum orbitale/ palpebral fascia
Framework of the lids
Central thick part- tarsal plate
Peripheral thin part- septum orbitale/ palpebral fascia
![Page 31: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/31.jpg)
![Page 32: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/32.jpg)
Dense fibrous tissue, skeleton of lids 29mm long, 1mm thick Dimensions of upper & lower tarsus Borders – septum orbitale, muller’s
muscle Surfaces Extremities Tarsal glands embedded in
substance of tarsal plates
![Page 33: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/33.jpg)
![Page 34: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/34.jpg)
Thin , floating membrane of connective tissue
Takes part in all movements of lids
Thin , floating membrane of connective tissue
Takes part in all movements of lids
![Page 35: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/35.jpg)
![Page 36: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/36.jpg)
Lacrimal vessels & nerves Supraorbital vessels & nerves Supratrochlear artery & nerve Infratrochlear nerve Anastomosing vein b/w angular &
ophthalmic Superior & inferior palpebral arteries Aponeurosis of levator muscle in
upperlid Expansion of inferior rectus in lower
lid
Lacrimal vessels & nerves Supraorbital vessels & nerves Supratrochlear artery & nerve Infratrochlear nerve Anastomosing vein b/w angular &
ophthalmic Superior & inferior palpebral arteries Aponeurosis of levator muscle in
upperlid Expansion of inferior rectus in lower
lid
![Page 37: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/37.jpg)
Triangular band of connective tissue Attached to frontal process of
maxilla From ant. Lacrimal crest To suture line of frontal process with
nasal bone Divided into 2 parts
› Ant. part of MPL› Post. part of MPL
Triangular band of connective tissue Attached to frontal process of
maxilla From ant. Lacrimal crest To suture line of frontal process with
nasal bone Divided into 2 parts
› Ant. part of MPL› Post. part of MPL
![Page 38: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/38.jpg)
![Page 39: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/39.jpg)
Thin band Lateral- whitnall’s tubercle Anterior surface- lat.palpebral raphe Posterior surface- check ligament of LR Upper border- aponeurosis of levator
muscle Lower border- IO ,IR
![Page 40: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/40.jpg)
![Page 41: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/41.jpg)
![Page 42: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/42.jpg)
![Page 43: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/43.jpg)
![Page 44: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/44.jpg)
![Page 45: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/45.jpg)
Modified sebaceous glands Structure Microscopy
epithelium on basement membrane Cuboidal cells actively dividing
Secretion Sebum, prevents lashes becoming dry Oily layer of tear film
![Page 46: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/46.jpg)
Modified sweat gland
Gross structure Unbranched spiral shape Fundus, body, ampullary portion & neck
Microscopic structure Secretory part- cylindrical cell b/w cells & bm – myoepithelial cells Ducts lined by one/two layers of cells
![Page 47: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/47.jpg)
![Page 48: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/48.jpg)
Mainly by medial & lateral palpebral arteries
Marginal Arterial arcades Medial palpebral + lateral palpebral
Superior or peripheral arterial arcade Superior branches of medial palpebral artery
Tarsal arcades Superficial temporal artery Transverse facial artery Infraorbital artery
![Page 49: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/49.jpg)
![Page 50: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/50.jpg)
Pretarsal Venous Plexus Superficial to the tarsus Angular vein– Internal jugular vein , sup.
temporal, lacrimal vein External jugular vein
Post-tarsal venous plexus Structures posterior to tarsal plate Ophthalmic veins
![Page 51: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/51.jpg)
![Page 52: Anatomy Of The Eyelids](https://reader038.fdocuments.net/reader038/viewer/2022102407/554b11f9b4c9056f098b4a88/html5/thumbnails/52.jpg)
Sympathetic nerves Supply Muller’s muscle Vessels & glands of skin
Arrangement of Nerves Submuscular plane Forward branches for orbicularis & skin Backward to tarsal structures & conjunctiva