14 OPTM4102_Vasculature of the orbit and contents.pdf

O PTM4102 V ascular sup ply to the orbit and c ontents Dr. Jason Charng [email protected] A cknowle d g e m ent of country Th e Univ ersity o f W est ern A ustr a li a a c kn o wl e d g es th a t its c a m p us is situ a t e...

O PTM4102 V ascular sup ply to the orbit and c ontents Dr. Jason Charng [email protected] A cknowle d g e m ent of country Th e Univ ersity o f W est ern A ustr a li a a c kn o wl e d g es th a t its c a m p us is situ a t e d o n N o o n g a r l a n d , a n d th a t N o o n g a r p e o p l e r e m a in th e sp iritu a l a n d c ultur a l c ust o di a ns o f th e ir l a n d , a n d c o ntin u e t o pr a c tis e th e ir v a lu es, l a n g u a g es, b e li e fs a n d kn o wl e d g e. Artist: Dr Richard Barry Walley O AM Objectives Blood vessel to/from the globe Blood vessels Marieb & Hoehn, Human Anatomy and Physiology, 7th ed  Blood to the eye Right eye Left eye Right internal Left internal carotid carotid Oxygenated blood enters : Right atrium → right ventricle → pulmonary artery → gas exchange occurs) lung → C lung in the pulmonary vein → left atrium → left ventricle → aorta (existing heart the via cortal. https://www.ncbi.nlm.nih.gov/books/NBK499911/figure/article-17736.image.f1/ Internal carotid Runs through neck, enters the cranial vault via the carotid canal then into the cavernous sinus Carotid Canal cranial Vault > - > - Cavernous Sinus Bifurcates into ophthalmic artery as it exits the cavernous sinus https://pubmed.ncbi.nlm.nih.gov/32804680/ Ophthalmic artery Enters orbit via optic canal (along with optic nerve), bifurcates into multiple arteries https://pubmed.ncbi.nlm.nih.gov/32804680/  Blood supply to the globe optic< nerve) Inner retina Short – posterior choroid, anterior ON Long – anterior choroid, ciliary body, conjunctiva, iris episclera, iris Central retinal artery 1st branch of the ophthalmic artery Pierces the dura ~ 1 cm from globe and enters the optic nerve Many collateral branches serve the ON fibres prior to ONH Exits optic nerve, visible when viewing fundus ~ Temporal arcades encircle https://clinicalgate.com/orbital-blood-supply/ macula ~ Nasal arcades run radially O - supply optical it before nerve the - reaches n optic  Cilioretinal artery short posterior ciliary artery. Arise from SPCA me Makes a characteristic bend as leaves disk margin Present in ~30 % of https://pubmed.ncbi.nlm.nih.gov/26597555/ population C Supplies fovea Cresponsible for central O Vision)- to provide alternative blood supply the forea E. https://www.ophthalmologyretina.org/article/s2468-6530(17)30299-3/fulltext Inner retinal supply 4 retinal vascular nerve Works. * Directly supply by the central artery Superficial vascular complex Superficial vascular complex supply by verticle Vessles running from the superficial Vascular complex. radial peripapillary capillary plexus superficial vascular plexus intermediate capillary plexus deep capillary plexus https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301488/  Inner retina venous return Post capillary venules → branched retinal veins → central retinal vein CRV empties into https://link.springer.com/chapter/10.1007/978-1-4614-3439-9_1 superior ophthalmic vein or cavernous sinus (differ between people) The orygenated blood will converge into the central retina vein before exitting optic nerve. via the the eye before nerve the optic Then travel along Then vein. joining the supperior ophthalmic. since the cavernous travel to  Short posterior ciliary arteries Pierce sclera in an annulus around the ONH, supply choroid => supply > - outer retina where Other branches form photorecepters circle of Zinn Haller to are supply optic nerve will also form Short posterior ciliary artery caller the circule of zinn. a circular region https://clinicalgate.com/orbital-blood-supply/ Long posterior ciliary arteries Pierce posterior sclera - to supply choroid m Then join major circle - of the iris to supply - ciliary body and iris - - Muscular arteries From ophthalmic artery, 2 branches O ~ Superior, runs laterally, supplies levator, superior rectus, superior oblique and partially lateral rectus ~ Inferior, runs ⑥ medially, supplies inferior rectus, inferior oblique and anterior ciliary arteries Anterior ciliary arteries Branch from muscular arteries & anterior choriod. ~ One branch joins the major circle of iris => to supply the iris , ciliary body ~ One branch supplies episclera and conj https://www.dartmouth.edu/~humananatomy/figures/chapter_46/46-10.HTM Lateral branches  Lacrimal artery 2nd branch off ophthalmic - artery Runs along orbital wall with lateral rectus ① ~Muscular branch supplies lateral and superior rectus muscle ② ~Glandular branch supplies lacrimal gland ③~Recurrent branch anastomoses with meninges 5 branches Have. https://www.earthslab.com/anatomy/ophthalmic-artery/ Zygomatic artery Branch off the lacrimal artery before lacrimal gland Supply orbicularis and other facial muscles  Lateral palpebral artery Terminal branch of the lacrimal artery Supply lower and upper lids Anastomose with the medial palpebral artery medial will join up with the palpebral artery. https://www.ophthalmologyreview.org/bcsc-fundamentals/eyelid-anatomy Medial branches nasal Supraorbital artery Arises from ophthalmic artery (branch of Ophthalmic artery ( Supplies periosteum of the frontal bone, skin of forehead, superior rectus, palpebrae superioris upper eyelid https://www.earthslab.com/anatomy/supratrochlear-artery/ Supratrochlear artery Arises from ophthalmic artery (branch of Ophthalmic artery ( Supplies forehead, scalp https://www.earthslab.com/anatomy/supratrochlear-artery/ Dorsal nasal artery At the terminal branch of the lacrimal artery - - Supplies lacrimal sac, nose https://www.earthslab.com/anatomy/supratrochlear-artery/  return to the circulation de-oxygenated blood the How from eye for exchange. Conjunctival/Episcleral return Drain to the anterior ciliary - ( veins, which drains into - ophthalmic veins - Aqueous - humour also drains via this route & blood. Aqueon humour https://link.springer.com/chapter/10.1007/978-3-319-42781-2_3 Vortex/vorticose veins choroid will drain into the Vortex , then drain into surperior inferior ophthalmic Drains the choroid or Vein , Some vortex veins drain into superior ophthalmic vein, some into inferior ophthalmic vein ~C Superior ophthalmic vein, exits via the superior orbital fissure and drains to the cavernous sinus - ~G - - ° Inferior ophthalmic vein, exits via the inferior orbital fissure, drains to the pterygoid plexus - - Superior => cavernous sirs - An normal eye has 4 to 8 Inferior > = pterygoid plexus. vortex veins, at least 1 vein in each quadrant Vortex veins https://www.sonorandeserteye.com/vortex-veins/ Summary Summary Retinal drainage: central retinal vein → ophthalmic vein → cavernous sinus Conj/episcleral drainage: anterior ciliary vein → ophthalmic vein → cavernous sinus Uveal drainage: vortex vein → superior ophthalmic vein → cavernous sinus vortex vein → inferior ophthalmic vein → pterygoid plexus