Diabetic Retinopathy
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Questions and Answers

What percentage of patients with type 2 diabetes mellitus of 20 years' duration or more develop diabetic retinopathy?

  • 20% to 50%
  • 80% to 90%
  • 90% to 100%
  • 50% to 80% (correct)

What is the leading cause of blindness in middle-aged individuals in the United States?

  • Diabetic retinopathy (correct)
  • Cataracts
  • Macular degeneration
  • Glaucoma

What is a complication of diabetic retinopathy that can cause blindness?

  • Retinal detachment (correct)
  • Glaucoma
  • Cataracts
  • Macular edema

What is a factor that can accelerate the progression of diabetic retinopathy?

<p>Pregnancy (A)</p> Signup and view all the answers

What is the term for the abnormal growth of blood vessels and fibrous tissue in diabetic retinopathy?

<p>Fibrovascular proliferation (C)</p> Signup and view all the answers

What is the ophthalmoscopic examination used to detect?

<p>Edema of the optic disc (D)</p> Signup and view all the answers

Which muscle originates from the lesser wing of the sphenoid bone?

<p>Levator palpebrae superioris (A)</p> Signup and view all the answers

Which nerve innervates the inferior oblique muscle?

<p>Oculomotor nerve (B)</p> Signup and view all the answers

What is the primary action of the superior rectus muscle?

<p>Elevates, adducts, and rotates the eyeball medially (D)</p> Signup and view all the answers

Which muscle inserts into the sclera deep to the lateral rectus muscle?

<p>Inferior oblique (C)</p> Signup and view all the answers

What is the common origin of the superior rectus, inferior rectus, medial rectus, and lateral rectus muscles?

<p>Common tendinous ring (C)</p> Signup and view all the answers

Which muscle is innervated by the trochlear nerve?

<p>Superior oblique (D)</p> Signup and view all the answers

What is the primary action of the lateral rectus muscle?

<p>Abducts the eyeball (D)</p> Signup and view all the answers

Which muscle inserts into the tarsal plate and skin of the upper eyelid?

<p>Levator palpebrae superioris (C)</p> Signup and view all the answers

Which bone contributes to the orbit and has an orbital surface that forms part of the inferior orbital fissure?

<p>Maxillary bone (D)</p> Signup and view all the answers

Which nerve passes through the superior orbital fissure and is responsible for_eye movement?

<p>Abducens nerve (CN VI) (C)</p> Signup and view all the answers

Which structure separates the orbit from the cranial cavity?

<p>Pericranium (D)</p> Signup and view all the answers

Which bone forms the posterior aspect of the orbit?

<p>Greater wing of sphenoid bone (C)</p> Signup and view all the answers

Which nerve supplies the lacrimal gland?

<p>Lacrimal nerve (CN V1) (B)</p> Signup and view all the answers

What is the purpose of the superior orbital fissure?

<p>Allows passage of nerves and vessels to the orbit (D)</p> Signup and view all the answers

Which vessel passes through the optic canal?

<p>Ophthalmic artery (A)</p> Signup and view all the answers

What is the name of the bony structure that borders the superior orbital fissure?

<p>Lesser wing of sphenoid bone (B)</p> Signup and view all the answers

Which muscle attaches to the inferior orbital fissure?

<p>Inferior rectus muscle (D)</p> Signup and view all the answers

Which nerve is responsible for sensation in the forehead region?

<p>Frontal nerve (CN V1) (B)</p> Signup and view all the answers

Which artery supplies the lateral nose and lacrimal sac?

<p>Dorsal nasal artery (B)</p> Signup and view all the answers

Through which notch does the Supraorbital artery pass?

<p>Supraorbital notch (C)</p> Signup and view all the answers

Which part of the ear contains the three middle ear ossicles?

<p>Tympanic cavity (C)</p> Signup and view all the answers

What is the function of the stapedius muscle?

<p>To dampen sound vibrations (C)</p> Signup and view all the answers

What is the name of the tube that connects the middle ear to the pharynx?

<p>Pharyngotympanic tube (B)</p> Signup and view all the answers

What is the name of the veins that drain the orbit?

<p>Superior and inferior ophthalmic veins (B)</p> Signup and view all the answers

What is the origin of preganglionic sympathetic fibers in the spinal cord?

<p>T1-T2 (A)</p> Signup and view all the answers

What type of photoreceptive cells are more sensitive to low light conditions?

<p>Rods (A)</p> Signup and view all the answers

What is the pathway of postganglionic sympathetic fibers to the eyeball?

<p>Internal carotid artery, ophthalmic artery, and ophthalmic nerve (A)</p> Signup and view all the answers

What is the function of the dilator muscle of the pupil?

<p>Dilation of the pupil (D)</p> Signup and view all the answers

What is the location of the photosensitive region of the neural retina?

<p>Adjacent to the vascular choroid (B)</p> Signup and view all the answers

What is the destination of the axons of ganglion cells?

<p>Optic disc (B)</p> Signup and view all the answers

What type of cells are interspersed between the photoreceptive cells in the neural retina?

<p>All of the above (D)</p> Signup and view all the answers

What is the location of the ciliary ganglion in relation to the eyeball?

<p>On the path of the ophthalmic nerve to the eyeball (A)</p> Signup and view all the answers

Study Notes

Diabetic Retinopathy

  • Develops in almost all patients with type 1 diabetes mellitus (DM) and in 50% to 80% of patients with type 2 DM of 20 years’ duration or more.
  • Number-one cause of blindness in middle-aged individuals and the fourth leading cause of blindness overall in the United States.
  • Complications include retinal detachment, vitreous contraction, and fibrovascular proliferation and hemorrhage.

Bony Orbit

  • Formed by seven bones: frontal, sphenoid, zygomatic, maxillary, lacrimal, palatine, and ethmoid bones.
  • Openings in the orbit include the superior orbital fissure, inferior orbital fissure, and optic canal.
  • Muscles attached to the orbit include the levator palpebrae superioris, superior rectus, inferior rectus, medial rectus, lateral rectus, and superior oblique.

Orbital Muscles

  • Levator palpebrae superioris: elevates the upper eyelid
  • Superior rectus: elevates, adducts, and rotates the eyeball medially
  • Inferior rectus: depresses, adducts, and rotates the eyeball laterally
  • Medial rectus: adducts the eyeball
  • Lateral rectus: abducts the eyeball
  • Superior oblique: medially rotates, depresses, and abducts the eyeball
  • Inferior oblique: laterally rotates and elevates the eyeball

Neural Retina

  • Composed of an outer retinal pigmented epithelium and a photosensitive region consisting of photoreceptive cells: rods and cones.
  • Rods are more sensitive to light and respond to low light conditions, while cones are less sensitive to low light but respond to red, green, and blue regions of the visual spectrum.

Sympathetic Innervation of the Eye

  • Postganglionic sympathetic fibers course along the internal carotid artery and ophthalmic nerve, and pass through the ciliary ganglion or along the long and short ciliary nerves to the eyeball.
  • Innervate the dilator muscle of the pupil and the eyeball.

Blood Supply of the Orbit

  • Ophthalmic artery supplies the orbit, including the eyeball, lacrimal gland, and eyelids.
  • Muscular arteries supply the skeletal muscles of the orbit and smooth muscles of the eyeball.
  • Supraorbital, dorsal nasal, and medial palpebrae arteries supply the forehead, nose, and eyelids.

Eye Structure

  • Consists of the cornea, iris, lens, zonular fibers, and retina.
  • The human ear consists of the external ear (auricle, external acoustic meatus, and tympanic membrane), middle ear (tympanic cavity, middle ear ossicles, and stapedius and tensor tympani muscles), and internal ear (labyrinthine wall and auditory tube).

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Diabetic retinopathy develops in almost all patients with type 1 diabetes mellitus and in 50% to 80% of patients with type 2 DM of 20 years’ duration.

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