Eye and Ear

Clinical Anatomy II –Spring

Rutland
 EYES
https://www.youtube.com/watch?v=4f0p5KqdU9U

• But the eyes of the LORD are on those who fear

him, on those whose hope is in his unfailing love.
Psalms 33:18
• You kept my eyes from closing; I was too troubled to
speak …… Psalms 77:4
• Allow no sleep to your eyes, no slumber to your
eyelids…. Proverbs 6:4
 EARS
• Ears that hear and eyes that see—the LORD
has made them both. Proverbs 20:12
• The eyes of the Lord are on the righteous, and
his ears are attentive to their cry. Psalm 34:15
• Apply your heart to instruction and your ears
to words of knowledge. Proverbs 23:12
WATCH these!
Which
nerves
affect the
nose?

Eyes?

Ear?
Bony Orbit
3 bones make the eye
orbit?
1. F_______ process of
maxilla
2. F________ bone
3. Zygomatic bone

What other bones make up

the full eye socket?
S________
E________
L___________
P__________

So how many bones?

MZLFESP

Gray’s Fig 8.73, p. 927

• Thin layer of Skin
connective tissue/
loose
arrangement---
leads to
accumulation of
fluid (blood)around
skin of eyelids

Do you have swelling

in your eyes after
crying?
 EYELIDS
• With which motion
of the eyes do pts
with Bell’s Palsy have
difficulty?
– difficulty with closing
eye or opening eye?
• Bell’s Palsy often
caused by Herpes
Simples or Herpes
Zoster virus
(shingles)
Which part of this muscle
Orbicularis Oculi M.
performs a tight squeeze
of the eyelid? ______
Light squeeze?palperbral

Gray’s Fig 8.75, p. 929

Attaches
to
sphenoid Eyelids
Note tendon of the
levator palpebrae
superioris ms. – open
eye

Gray’s Fig 8.76, p 929

 Levator Palpebrae Superioris Ms
• Innervated by Oculomotor(Cr n III)
• Elevates and retract the upper eye lid
• Ptosis(“Greek word for fall) can develop:
Droopy eyelid ( “student syndrome”)
 Loss of :
• Inability to close eyelids
• Facial n:
– Orbicularis Oculi
tightly and lower eyelid
droops away with
spillage of tears

• Oculomotor n: • Inability to open superior

– Levator palpebrae eyelid voluntarily, leads
superioris
to complete ptosis

• Superior tarsal muscle: • Constant partial ptosis

– Sympathetic fibers
 Glands
• Tarsal gland can be • Eyelid sebaceous gland
blocked and inflamed- and sweat glands: stye
Chalazion (benign,
painless nodule on inner
surface of eyelid
Tears: so important to God
• You have taken account
of my wanderings; Put
my tears in Your bottle.
Are they not in Your
book? Psalm 56:8

• Those who sow in tears

shall reap with joyful
shouting. Psalm 126:5
 Lacrimal Apparatus
Where does the
nasolacrimal
duct drain?
____________

Note location
of lacrimal
gland

Gilroy Fig 41.15, p. 575

Lacrimal Gland of eye
 Superior Orbital Fissure - Contents

Which cranial
nerves affect
the eye?

Gray’s Fig 8.86, p. 934

 Which cranial nerves affect the eye?
• Cr N ___
• Cr N ___
• Cr N ___
• Cr N V1-2-3
• Cr N ___
• Cr N ___
Extra-ocular Mm.
Superior
view

Gilroy Fig 41.2B, p. 568

Extra-ocular Mm.
How many
extraocular ms?
____

Gilroy Fig 41.2A, p. 568

 Cranial nn. III, IV, VI in Orbit
Look for these in
the cranium
today

Gilroy Fig 39.6A, p. 529

Cut window
into cranium
to see
muscles and
nerves

Try this
dissection on
one eye

Gilroy Fig 39.5C, p. 529

Extra-ocular Mm.

Circle the
nerves

Gilroy Fig 39.6B, p. 529

https://www.youtube.com/watch?
v=3J2UZiLVZKA

https://www.youtube.com/watch?v=3J2UZiLVZKA
Moore’s eye chart*****
 MUSCLE /NERVE MOVEMENT
Medial rectus Oculomotor (III) IN (ADDUCTION)
Lateral rectus Abducens (VI) OUT (ABDUCTION)
Inferior rectus Oculomotor (III) DOWN and IN
Superior rectus Oculomotor (III) UP and IN
Inferior oblique Oculomotor (III) UP and OUT
Superior oblique Trochlear (IV) DOWN and OUT

http://www.youtube.com/watch?v=vd7OOJ7c1q4
Cr N III: Oculomotor PALSY
“Down and Out”
• NOT WORKING:
– Superior rectus
– Inferior rectus
– Medial rectus
– Inferior oblique

– Causes: DM, HTN,

Aneurysms
Cr N IV:Trochlear nerve palsy
• Superior oblique not
PALSY
working
– S.O. ms. moves eye DOWN
and OUT
– So with palsy: up and in
• Only ms it innervates
• Causes: DM, HTN, Trauma,
congenital, tumor
• Tend to tilt head away
from lesion
 Cr N. VI: Abducens nerve palsy:
• Lateral rectus not working
on L
– Not able to abduct eye(L)
(paralysis of lateral rectus)
– COMPLETE LESION OF VI: eye
will rest medially due to
unopposed medial rectus
• Can be caused by Diabetes,
HTN, high intracranial
pressure affects 6th n.
• Follow pencil in circle
 Six Abducts Laterally, Trochlear acts Medially Down,
Oculomotor is everything else

http://www.firstaidteam.com/2978/mnemonic-monday-major-actions-of-extraocular-
muscles
 (LR SO )3
6 4

LAST
Ophthalmic Division of Trigeminal
Supplies sensory nerve
N.
(V1) supply to cornea, ciliary
body, iris, lacrimal gland,
conjunctiva, mucous
membrane of nasal cavity
and skin to eyelids,
eyebrow, forehead, and
nose

Gilroy Fig 39.9D, p. 531

Trigeminal nerve
 Trigeminal N. in Orbit (branch of V₁)
Frontal n=V1 Ophthalmic n.-
sensation to eyelid

Gilroy Fig 41.12A, p. 573

Internal
Carotid A.
-ophthalmic
a.
Parent of the
ophthalmic a.
_______________
Grandparent?
_____________

Gilroy Fig 41.7, p. 570

Eye - Sagittal

Gilroy Fig 41.13, p. 574

 Eyeball

Gilroy , 41.16, p. 576

Cornea, Iris, Lens

Gilroy Fig 40.18, p. 578

Where would you dissect to find
the bones of the ear?
Ear
Which CR nerve
affects the ear? ___

Gilroy Fig 43.3, p. 588

 Do ears grow as you age?
– Earlobes elongate due to gravity
– Bones do not grow

• The facial nerve travels through the internal

acoustic meatus. In which bone of the skull is
this located?
a. Temporal
b. Parietal
c. Occipital
d. Sphenoid
 External Ear

Gilroy Fig 43.4, p. 588

 Does the facial n supply
Middle Ear anything to the ear?
Supplies motor function to stapedius ms in
middle ear
If someone has facial n. disorder, they may
have pain in ear and sensitivity to loud
sounds.

“The
“Drum”

Gilroy Fig 43.10, p. 591

Facial nerve

By Patrick J. Lynch, medical illustrator - Patrick J. Lynch, medical illustrator, CC BY 2.5,

https://commons.wikimedia.org/w/index.php?curid=1498075
Hair cells in
inner ear
http://www.nidcd.nih.gov/health/hearing/pages/otosclerosis.aspx
Middle Ear Ossicles
 Barotrauma • Increased pressure or fluid on ear from air
travel/ scuba diving / weather frontal
systems
• Pressure builds causing eardrum to be pulled
inward.
Common symptoms of ear barotrauma include:
• Ear pain
• A sensation that the ears are stuffed
• A need to "pop" your ears by swallowing,
yawning or chewing gum
• More severe signs include:
Extreme pain in the ear
• Dizziness (vertigo)
• Bleeding or fluid coming from the ear, which
can mean you have a ruptured eardrum
• Hearing loss

https://www.health.harvard.edu/a_to_z/barotrauma-a-to-z
 Which cranial nerves?
• do not affect the eye? • do not affect the ear?
Which ms / nerve is affected?
Follow lab manual for dissection of eye
• Bring your lab manual
and anatomy book to
lab