SlideShare a Scribd company logo
1 of 36
Download to read offline
SIVATEJA
CHALLA
ANATOMY OF THE LACRIMAL
APPARATUS
1.Lacrimal gland
2.Lacrimal ducts
3.Conjunctival sac
4.Lacrimal puncta
5.Lacrimal canaliculi
6.Lacrimal sac and
7.Naso lacrimal duct
Embryology
Osteology
Secretory system
Excretory system
EMBRYOLOGY
DEVELOPMENT-LACRIMAL GLAND
 surface ectoderm
 Initially solid cords formed from supero lateral
conjunctiva,but by 3months central cells vacuolte and
lumina appear
 Full differentiation by 3-4 yrs postnatally
 Composed of ectodermal glandular units and
mesodermal myoepidermal cells and fibrous
tissue.
 Functions 6wks after birth.so no tears in new born
when crying.
DEVELOPMENT- LACRIMAL SAC & NASO LACRIMAL
DUCT
At junction of maxillary process and lateral nasal process a
mass of ectodermal cells submerge gets canalised to form
lacrimal sac and NLD. The lacrimal canaliculi
are extensions from the
lacrimal sac in to the
eyelid
 Non fusion of maxillary
and lateral processes
resuts in oblique facial
cleft and in such cases
NLD not formed
Fig. 6. Lacrimal drainage system embryology. A. At 5.5 weeks' gestation, an
ectodermal invagination forms between the lateral nasal process and
maxillary process,
which becomes pinched off from the surface. B. At 6 weeks' gestation, a solid
cord of ectoderm is located between the primitive medial canthus and nose.
C. At 12 weeks' gestation, proliferation of the cord occurs laterally toward the
eyelid and inferiorly toward the
inferior turbinate. The isolated cavities shown appear at3 to 4 months. D. At 7
months, canalization is nearly complete, with only the puncta and valve of
OSTEOLOGY
 The lacrimal sac fossa is a depression in the
inferomedial orbital rim,
 Maxillary and lacrimal bones.
 Bordered by the anterior lacrimal crest (maxillary
bone) & posterior lacrimal crest (lacrimal bone).
 The fossa is approximately 16-mm high, 4- to 9-
mm wide, and 2-mm deep.
Anatomy of the lacrimal apparatus sivateja
 The medial orbital wall : Frontal process of
maxilla, lacrimal ,ethmoid , lesser wing of
sphenoid bone.
 The frontoethmoidal suture is important in
lacrimal surgery
 It marks the roof of the ethmoid sinus. Bony
dissection superior to this suture may expose the
dura of the cranial cavity.
 The nasolacrimal canal originates at base of
lacrimal fossa.
 Formed by the maxillary bone laterally and the
lacrimal and inferior turbinate bones medially.
 The width of superior opening is 4–6 mm.
 The duct courses posteriorly and laterally in the
bone for 12 mm to drain into the inferior meatus
of the nasal cavity.
SECRETORY SYSTEM
 It includes lacrimal gland, accessory glands
 Lacrimal gland is above & anterolateral to globe.
 Secretes tears into superior fornix.
 Tears moisten & lubricates the : cornea ,
conjunctiva.
LACRIMAL GLAND
DEVELOPMENT
 Develops from surface ectoderm
 Develops as epithelial bud evaginating from basal
cells of conjunctiva in supratemporal portion of
embryonic fornix
 Initially solid cords formed,but by 3months central cells
vacuolte and lumina appear
 Full differentiation by 3-4 yrs postnatally
 Composed of ectodermal glandular units and
mesodermal myoepidermal cells and fibrous
tissue.
 Functions 6wks after birth.so no tears in new born
when crying.
ANATOMY
 Located in anterolateral
part of the roof of orbit
in fossa for lacrimal
gland
 Divided in to large
superficial orbital part
and small deep
palpebral part which
are continuous with
each other around
aponeurosis of LPS
ORBITAL PART
Almond shaped
Two surfaces (superior and inferior) two borders
(anterior and posterior and two extremities (medial
and lateral)
superior surface convex and related to orbit roof
Inferior surface concave and related to LPS
Anterior border limited by orbital septum
Posterior border related to orbital pad of fat
Medial extremity related to LPS
Lateral extremity rests on lateral rectus
PALPEBRAL PART
1/3RD size of orbital part
Superiorly related to
LPS and inferiorly to
superior fornix
When lid is everted the
gland can be seen in
superior fornix of
conjunctiva
ANCHORS
1.Above by suspensory ligament
2.Below by fibrous attachment to the zygomatic bone
3.Behind by fascial condensation around lacrimal
nerves and vessels
4.Internally by fascial expansion of ocular muscles
LACRIMAL DUCTS
 10-12 ducts
 Ducts arising from the orbital part passes through
palpebral part and opens in to superior fornix of
conjunctiva
 Additional ducts from palpebral part open directly in
to conjunctiva
 Removal or damage to palpebral part of the gland
will stop secrections reaching the fornix
 So biopsy of gland always done in orbital part of
lobe
STRUCTURE OF LACRIMAL GLAND
Lobulated tubulo acinar gland
Microscopically has Glandular tissue,Stroma and
Septa
-Glandular tissue consists of
acini and ducts arranged in
lobes and lobules seperated by
Septa
-acini has pyramidal cells which
secrete the tears expelled by the
contraction of myofibrils
-Stroma formed by mesodermal
tissue which has connective
tissue,lymphoid cells,plasma
cells,rich nerve terminals and
BLOOD SUPPLY-
Internal carotid artery Angular vein
Ophthalmic artery Superior
ophthalmic vein
Lacrimal artery Lacrimal vein
Some times by infraorbital artery(Br of maxillary artery)
LYMPHATIC DRAINAGE-
Pre auricular group
NERVE SUPPLY
 Parasympathetic secretomotor fibres(efferent) from
superior salivatory nucleus
 Sympathetic nerve supply from carotid plexus
 Sensory supply(afferent) from lacrimal nerve Br of
ophthalmic division of fifth nerve
EXCRETORY SYSTEM
CONJUNCTIVAL SAC
 Conjunctiva stretches from lid margin to limbus
and encloses a potential space conjunctival sac
which opens at palpebral fissure
 Sac is closed only when lids are approximated
LACRIMAL PUNCTA
 Two puncta situated in
each lid margin at the
junction of ciliary and
lacrimal parts on
elevtion called lacrimal
papilla
 Upper punctum 6mm
and lower 6.5 mm from
medium canthus
 Surrounded by fibrous
tissue which keeps them
patent
LACRIMAL CANALICULI
 2 in number,Joins puncta to lacrimal sac
 Two parts vertical(2mm) and horizontal(8mm) at
junction dilated to form ampulla
 Pierce lacrimal fascia and unite to form common
canaliculi opens in to lacrimal sinus of maier
 At opening in to sac protected by valve of
rosenmuller
 Surrounded by fibres of pars lacrimalis of orbicularis
oculi muscle
 During blink canaliculi pulled medially,shortened and
compressed by pars lacrimalis.also helps in dilatation
of lacrimal sac
LACRIMAL SAC
 Upper expanded portion of
NLD
 Lodged in lacrimal fossa(medial
wall is lamina
papyracea,formed by lacrimal
bone and frontal process of
maxilla)
 Surrounded by lacrimal fascia
which results from splitting of
periorbita
 Between sac and fascia are
venous plexus
 Part of sac above MPL is
fundus.At junction of fundus
 RELATIONS
Anteriorly to medial palpebral ligament
Posteriorly to posterior lacrimal crest and orbicularis
oculi
Medially to middle meatus and ant ethmoidal sinus
Laterally to skin,fascia and orbicularis oculi(lacrimal
part)
ANGULAR VEIN and ANGULAR ARETRY crosses
MPL about 8mm from the medial canthus.many times
a tributary runs 3mm from medial canthus.so to avoid
profuse bleeding during sac surgery incison should
be made within 3mm medial to medial canthus
Anatomy of the lacrimal apparatus sivateja
 Extends from lacrimal
sac to inferior meatus of
nose
 18 mm in length and
3mm diameter
 Upper end is the
narrowest
 Runs
downward,backward
and laterally
 Lined by two layers of
coloumnar epithelium
 Has intraosseus and
intra mural part
NASO LACRIMAL DUCT
 Intraosseus part lodged in naso lacrimal Canal
formed by maxilla anterolaterally,lacrimal bone
and inferior nasal concha postero medially
 Intramural part variable in length and lies in inferior
meatus.
 NLD opens below in to anterior part of inferior
meatus.
 opening guarded by a fold of mucosa-valve of
hasner.prevents air from entering the sac when air
blown out of closed nose
 In infants some times canalisation is delayed or do
not occur causing epiphora and cong dacrocystitis
 Duct is surrounded by rich plexus of veins,forming a
erectile tissue .engorgement leads to obstruction of
NLD and epiphora
BLOOD SUPPLY
ARTERIAL SUPPLY
Superior and inferior palpebral
A.
Angular A.
Infraorbital A.
Nasal br. Of sphenopalatine A.
VENOUS DRIANAGE
Angular vein
Infraorbital vein
Nasal vein
LYMPHATICS
Sub mandibular group
Deep cervical group
NERVE SUPPLY
Infra trochlear nerve
Anterior superior alveolar N.
ELIMINATION OF TEARS
 Lacrimal fluid over the preocular surfacemarginal
tear stripLacus lacrimalisinner canthus lacrimal
passages  nasal cavity
 Lacrimal pump mechanism:- fibres of the pretarsal &
preseptal portion of the Orbicularis which arise from
the lacrimal fascia & posterior lacrimal crest.
 This LPM operates with the blinking movements of
the eyelids as follows:-
Anatomy of the lacrimal apparatus sivateja
Anatomy of the lacrimal apparatus sivateja
Anatomy of the lacrimal apparatus sivateja
DRAINAGE OF LACRIMAL FLUID FROM NLD INTO
NASAL CAVITY
 Gravity helps downward flow.
 Air currents in nose induce negative pressure within
NLD draw the fluid down the potential lumen of the
duct into the nose.
 Hasner’s valve present at lower end of NLD, remains
open as long as the pressure within nose is less than
the NLD, allows the tears to flow from NLD to nose
THANK YOU

More Related Content

What's hot (20)

Anatomy of macula
Anatomy of maculaAnatomy of macula
Anatomy of macula
 
Anatomy Of Sclera
Anatomy Of ScleraAnatomy Of Sclera
Anatomy Of Sclera
 
Anatomy and Physiology of Lacrimal system
Anatomy and Physiology of Lacrimal system Anatomy and Physiology of Lacrimal system
Anatomy and Physiology of Lacrimal system
 
Anatomy of Cornea
Anatomy of CorneaAnatomy of Cornea
Anatomy of Cornea
 
Ocular circulation
Ocular circulationOcular circulation
Ocular circulation
 
anatomy And Physiology of tear film
anatomy And Physiology of tear film anatomy And Physiology of tear film
anatomy And Physiology of tear film
 
Orbital blood supply
Orbital blood supplyOrbital blood supply
Orbital blood supply
 
BLOOD SUPPLY OF VISUAL PATHWAY
BLOOD SUPPLY OF VISUAL PATHWAYBLOOD SUPPLY OF VISUAL PATHWAY
BLOOD SUPPLY OF VISUAL PATHWAY
 
Anatomy OF ORBIT
Anatomy OF ORBITAnatomy OF ORBIT
Anatomy OF ORBIT
 
Anatomy of lacrimal apparatus
Anatomy of lacrimal apparatusAnatomy of lacrimal apparatus
Anatomy of lacrimal apparatus
 
Orbital anatomy
Orbital anatomyOrbital anatomy
Orbital anatomy
 
Applied anatomy and physiology of cornea
Applied anatomy and physiology of corneaApplied anatomy and physiology of cornea
Applied anatomy and physiology of cornea
 
Aqueous Humour Dynamics
Aqueous Humour DynamicsAqueous Humour Dynamics
Aqueous Humour Dynamics
 
Aqueous humor dynamics
Aqueous humor dynamicsAqueous humor dynamics
Aqueous humor dynamics
 
Anatomy of eyelid
Anatomy of eyelidAnatomy of eyelid
Anatomy of eyelid
 
Anatomy of eyelids
Anatomy of eyelidsAnatomy of eyelids
Anatomy of eyelids
 
Eye lymphatics
Eye lymphaticsEye lymphatics
Eye lymphatics
 
Orbit anatomy
Orbit   anatomyOrbit   anatomy
Orbit anatomy
 
Lacrimal sac surgery
Lacrimal sac surgeryLacrimal sac surgery
Lacrimal sac surgery
 
Aqueous humor anatomy
Aqueous humor anatomyAqueous humor anatomy
Aqueous humor anatomy
 

Viewers also liked

Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...
Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...
Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...Mohammad Asif
 
Lacrimal apparatus anatomy by Dr sravani
Lacrimal apparatus anatomy by Dr sravaniLacrimal apparatus anatomy by Dr sravani
Lacrimal apparatus anatomy by Dr sravaniAkkala Sravani
 
lacrimal apparatus - diseases.
lacrimal apparatus - diseases.lacrimal apparatus - diseases.
lacrimal apparatus - diseases.Irine Jeba
 
DISORDERS OF THE LACRIMAL SYSTEM
DISORDERS OF THE LACRIMAL SYSTEMDISORDERS OF THE LACRIMAL SYSTEM
DISORDERS OF THE LACRIMAL SYSTEMHossein Mirzaie
 
Suraj ..lacrimal appartus ppt (2)
Suraj ..lacrimal appartus ppt (2)Suraj ..lacrimal appartus ppt (2)
Suraj ..lacrimal appartus ppt (2)Suraj Chhetri
 
Lacrimal apparatus
Lacrimal apparatusLacrimal apparatus
Lacrimal apparatusAmr Mehrez
 

Viewers also liked (13)

nasolacrimal system examination
nasolacrimal system examinationnasolacrimal system examination
nasolacrimal system examination
 
Watering eye
Watering eyeWatering eye
Watering eye
 
Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...
Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...
Eye presentation causes of a watering eye and evaluation,dr.mohammad ashraful...
 
Dry eye
Dry eyeDry eye
Dry eye
 
Lacrimal apparatus anatomy by Dr sravani
Lacrimal apparatus anatomy by Dr sravaniLacrimal apparatus anatomy by Dr sravani
Lacrimal apparatus anatomy by Dr sravani
 
lacrimal apparatus - diseases.
lacrimal apparatus - diseases.lacrimal apparatus - diseases.
lacrimal apparatus - diseases.
 
DISORDERS OF THE LACRIMAL SYSTEM
DISORDERS OF THE LACRIMAL SYSTEMDISORDERS OF THE LACRIMAL SYSTEM
DISORDERS OF THE LACRIMAL SYSTEM
 
Suraj ..lacrimal appartus ppt (2)
Suraj ..lacrimal appartus ppt (2)Suraj ..lacrimal appartus ppt (2)
Suraj ..lacrimal appartus ppt (2)
 
Dry eye
Dry eyeDry eye
Dry eye
 
Lacrimal apparatus
Lacrimal apparatusLacrimal apparatus
Lacrimal apparatus
 
The lacrimal appratus
The lacrimal appratusThe lacrimal appratus
The lacrimal appratus
 
Lacrimal sac syringing
Lacrimal sac syringingLacrimal sac syringing
Lacrimal sac syringing
 
Dry eye: An Overview
Dry eye: An OverviewDry eye: An Overview
Dry eye: An Overview
 

Similar to Anatomy of the lacrimal apparatus sivateja

Anatomyoflacrimalapparatus 160313074220
Anatomyoflacrimalapparatus 160313074220Anatomyoflacrimalapparatus 160313074220
Anatomyoflacrimalapparatus 160313074220Ankur gaur
 
Anatomy of Nose and PNS
Anatomy of Nose and PNSAnatomy of Nose and PNS
Anatomy of Nose and PNSVictoria2021
 
lacrimal app.pptx
lacrimal app.pptxlacrimal app.pptx
lacrimal app.pptxdrsaavi87
 
Anatomy -Lacrimal Apparatus.pptx
Anatomy -Lacrimal Apparatus.pptxAnatomy -Lacrimal Apparatus.pptx
Anatomy -Lacrimal Apparatus.pptxSHAYRI PILLAI
 
Surgical anatomy of eyelid
Surgical anatomy of eyelidSurgical anatomy of eyelid
Surgical anatomy of eyelidankita mahapatra
 
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGY
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGYLACRIMAL APPARATUS- ANATOMY & PHYSIOLOGY
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGYSAPHAL PANTHI
 
Eyelids & Lacrimal Apparatus
Eyelids & Lacrimal ApparatusEyelids & Lacrimal Apparatus
Eyelids & Lacrimal ApparatusGeethaHari3
 
ANATOMY OF CONJUNCTIVA.pptx
ANATOMY OF CONJUNCTIVA.pptxANATOMY OF CONJUNCTIVA.pptx
ANATOMY OF CONJUNCTIVA.pptxSabnaSasidharan3
 
2 The orbital region part 1.pdf
2 The orbital region  part 1.pdf2 The orbital region  part 1.pdf
2 The orbital region part 1.pdfDr Rafid Al-Temimi
 
Salivary gland and its importance in dentistry
Salivary gland and its importance in dentistrySalivary gland and its importance in dentistry
Salivary gland and its importance in dentistrylipiprakash01
 
Anatomy of maxilla and its development
Anatomy of maxilla and its developmentAnatomy of maxilla and its development
Anatomy of maxilla and its developmentDr.komal sharma
 
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...TariqJamilFaridi
 

Similar to Anatomy of the lacrimal apparatus sivateja (20)

anatomy And Physiology of lacrimal secretions
anatomy And Physiology of lacrimal secretions anatomy And Physiology of lacrimal secretions
anatomy And Physiology of lacrimal secretions
 
LACRIMAL APPARATUS.pptx
LACRIMAL APPARATUS.pptxLACRIMAL APPARATUS.pptx
LACRIMAL APPARATUS.pptx
 
Anatomyoflacrimalapparatus 160313074220
Anatomyoflacrimalapparatus 160313074220Anatomyoflacrimalapparatus 160313074220
Anatomyoflacrimalapparatus 160313074220
 
Anatomy of Nose and PNS
Anatomy of Nose and PNSAnatomy of Nose and PNS
Anatomy of Nose and PNS
 
Lacrimal Apparatus.pptx
Lacrimal Apparatus.pptxLacrimal Apparatus.pptx
Lacrimal Apparatus.pptx
 
lacrimal app.pptx
lacrimal app.pptxlacrimal app.pptx
lacrimal app.pptx
 
Khalil seminar
Khalil seminarKhalil seminar
Khalil seminar
 
Anatomy -Lacrimal Apparatus.pptx
Anatomy -Lacrimal Apparatus.pptxAnatomy -Lacrimal Apparatus.pptx
Anatomy -Lacrimal Apparatus.pptx
 
Surgical anatomy of eyelid
Surgical anatomy of eyelidSurgical anatomy of eyelid
Surgical anatomy of eyelid
 
Lacrimal system ppt.
Lacrimal system ppt.Lacrimal system ppt.
Lacrimal system ppt.
 
lacrimal sys -1.pdf
lacrimal sys -1.pdflacrimal sys -1.pdf
lacrimal sys -1.pdf
 
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGY
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGYLACRIMAL APPARATUS- ANATOMY & PHYSIOLOGY
LACRIMAL APPARATUS- ANATOMY & PHYSIOLOGY
 
Eyelids & Lacrimal Apparatus
Eyelids & Lacrimal ApparatusEyelids & Lacrimal Apparatus
Eyelids & Lacrimal Apparatus
 
The Orbit
The OrbitThe Orbit
The Orbit
 
ANATOMY OF CONJUNCTIVA.pptx
ANATOMY OF CONJUNCTIVA.pptxANATOMY OF CONJUNCTIVA.pptx
ANATOMY OF CONJUNCTIVA.pptx
 
2 The orbital region part 1.pdf
2 The orbital region  part 1.pdf2 The orbital region  part 1.pdf
2 The orbital region part 1.pdf
 
Salivary gland and its importance in dentistry
Salivary gland and its importance in dentistrySalivary gland and its importance in dentistry
Salivary gland and its importance in dentistry
 
Anatomy of maxilla and its development
Anatomy of maxilla and its developmentAnatomy of maxilla and its development
Anatomy of maxilla and its development
 
Eyelid Anatomy.pptx
Eyelid Anatomy.pptxEyelid Anatomy.pptx
Eyelid Anatomy.pptx
 
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...
nose and paranasal sinuses EXCELLENT SLIDES TO CULL FROM NOSE SINUSES [Autosa...
 

More from Sivateja Challa

More from Sivateja Challa (20)

Agis ppt
Agis pptAgis ppt
Agis ppt
 
Ocular hypertension
Ocular hypertensionOcular hypertension
Ocular hypertension
 
Anophthalmic socket
Anophthalmic socketAnophthalmic socket
Anophthalmic socket
 
Choroidal melanoma
Choroidal melanomaChoroidal melanoma
Choroidal melanoma
 
ocular Sarcoidosis
ocular Sarcoidosisocular Sarcoidosis
ocular Sarcoidosis
 
keratoprosthesis
keratoprosthesiskeratoprosthesis
keratoprosthesis
 
Chemical injuries of the eye
Chemical injuries of the eyeChemical injuries of the eye
Chemical injuries of the eye
 
Binocular vision
Binocular visionBinocular vision
Binocular vision
 
Anisocoria
AnisocoriaAnisocoria
Anisocoria
 
CENTRAL SEROUS CHORIOETINOPATHY
CENTRAL SEROUS CHORIOETINOPATHYCENTRAL SEROUS CHORIOETINOPATHY
CENTRAL SEROUS CHORIOETINOPATHY
 
Epiphora
EpiphoraEpiphora
Epiphora
 
Ocular viscoelastic devices(OVD)
Ocular viscoelastic devices(OVD)Ocular viscoelastic devices(OVD)
Ocular viscoelastic devices(OVD)
 
Presbyopia
PresbyopiaPresbyopia
Presbyopia
 
AMBLYOPIA TREATMENT STUDIES PEDIG
AMBLYOPIA TREATMENT STUDIES PEDIGAMBLYOPIA TREATMENT STUDIES PEDIG
AMBLYOPIA TREATMENT STUDIES PEDIG
 
Amblyopia & its management by sivateja challa
Amblyopia & its management by sivateja challaAmblyopia & its management by sivateja challa
Amblyopia & its management by sivateja challa
 
Vernal kerato conjunctivitis
Vernal kerato conjunctivitisVernal kerato conjunctivitis
Vernal kerato conjunctivitis
 
visual pathways sivateja
visual pathways sivatejavisual pathways sivateja
visual pathways sivateja
 
Pachymetry sivateja
Pachymetry sivatejaPachymetry sivateja
Pachymetry sivateja
 
Aqueous humor dynamics sivateja
Aqueous humor dynamics sivatejaAqueous humor dynamics sivateja
Aqueous humor dynamics sivateja
 
Physiology of lens and cataractogenesis sivateja
Physiology of lens and cataractogenesis sivatejaPhysiology of lens and cataractogenesis sivateja
Physiology of lens and cataractogenesis sivateja
 

Recently uploaded

Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyMedicoseAcademics
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxMAsifAhmad
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE Mamatha Lakka
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionkrishnareddy157915
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communicationskatiequigley33
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptxNIKITA BHUTE
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Peter Embi
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfMedicoseAcademics
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologyDeepakDaniel9
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...Sujoy Dasgupta
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.pptRamDBawankar1
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfHongBiThi1
 

Recently uploaded (20)

Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before Pregnancy
 
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptxDNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
DNA nucleotides Blast in NCBI and Phylogeny using MEGA Xi.pptx
 
BENIGN BREAST DISEASE
BENIGN BREAST DISEASE BENIGN BREAST DISEASE
BENIGN BREAST DISEASE
 
American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...American College of physicians ACP high value care recommendations in rheumat...
American College of physicians ACP high value care recommendations in rheumat...
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
Immune labs basics part 1 acute phase reactants ESR, CRP Ahmed Yehia Ismaeel,...
 
AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
EXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung functionEXERCISE PERFORMANCE.pptx, Lung function
EXERCISE PERFORMANCE.pptx, Lung function
 
Using Data Visualization in Public Health Communications
Using Data Visualization in Public Health CommunicationsUsing Data Visualization in Public Health Communications
Using Data Visualization in Public Health Communications
 
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptxORAL HYPOGLYCAEMIC AGENTS  - PART 2.pptx
ORAL HYPOGLYCAEMIC AGENTS - PART 2.pptx
 
Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024Clinical Research Informatics Year-in-Review 2024
Clinical Research Informatics Year-in-Review 2024
 
Red Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdfRed Blood Cells_anemia & polycythemia.pdf
Red Blood Cells_anemia & polycythemia.pdf
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
pA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacologypA2 value, Schild plot and pD2 values- applications in pharmacology
pA2 value, Schild plot and pD2 values- applications in pharmacology
 
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio..."Radical excision of DIE in subferile women with deep infiltrating endometrio...
"Radical excision of DIE in subferile women with deep infiltrating endometrio...
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D.  Bawankar.pptPharmacokinetic Models by Dr. Ram D.  Bawankar.ppt
Pharmacokinetic Models by Dr. Ram D. Bawankar.ppt
 
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdfSGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
SGK RỐI LOẠN TOAN KIỀM ĐHYHN RẤT HAY VÀ ĐẶC SẮC.pdf
 

Anatomy of the lacrimal apparatus sivateja

  • 1. SIVATEJA CHALLA ANATOMY OF THE LACRIMAL APPARATUS
  • 2. 1.Lacrimal gland 2.Lacrimal ducts 3.Conjunctival sac 4.Lacrimal puncta 5.Lacrimal canaliculi 6.Lacrimal sac and 7.Naso lacrimal duct
  • 4. EMBRYOLOGY DEVELOPMENT-LACRIMAL GLAND  surface ectoderm  Initially solid cords formed from supero lateral conjunctiva,but by 3months central cells vacuolte and lumina appear  Full differentiation by 3-4 yrs postnatally  Composed of ectodermal glandular units and mesodermal myoepidermal cells and fibrous tissue.  Functions 6wks after birth.so no tears in new born when crying.
  • 5. DEVELOPMENT- LACRIMAL SAC & NASO LACRIMAL DUCT At junction of maxillary process and lateral nasal process a mass of ectodermal cells submerge gets canalised to form lacrimal sac and NLD. The lacrimal canaliculi are extensions from the lacrimal sac in to the eyelid  Non fusion of maxillary and lateral processes resuts in oblique facial cleft and in such cases NLD not formed
  • 6. Fig. 6. Lacrimal drainage system embryology. A. At 5.5 weeks' gestation, an ectodermal invagination forms between the lateral nasal process and maxillary process, which becomes pinched off from the surface. B. At 6 weeks' gestation, a solid cord of ectoderm is located between the primitive medial canthus and nose. C. At 12 weeks' gestation, proliferation of the cord occurs laterally toward the eyelid and inferiorly toward the inferior turbinate. The isolated cavities shown appear at3 to 4 months. D. At 7 months, canalization is nearly complete, with only the puncta and valve of
  • 7. OSTEOLOGY  The lacrimal sac fossa is a depression in the inferomedial orbital rim,  Maxillary and lacrimal bones.  Bordered by the anterior lacrimal crest (maxillary bone) & posterior lacrimal crest (lacrimal bone).  The fossa is approximately 16-mm high, 4- to 9- mm wide, and 2-mm deep.
  • 9.  The medial orbital wall : Frontal process of maxilla, lacrimal ,ethmoid , lesser wing of sphenoid bone.  The frontoethmoidal suture is important in lacrimal surgery  It marks the roof of the ethmoid sinus. Bony dissection superior to this suture may expose the dura of the cranial cavity.
  • 10.  The nasolacrimal canal originates at base of lacrimal fossa.  Formed by the maxillary bone laterally and the lacrimal and inferior turbinate bones medially.  The width of superior opening is 4–6 mm.  The duct courses posteriorly and laterally in the bone for 12 mm to drain into the inferior meatus of the nasal cavity.
  • 11. SECRETORY SYSTEM  It includes lacrimal gland, accessory glands  Lacrimal gland is above & anterolateral to globe.  Secretes tears into superior fornix.  Tears moisten & lubricates the : cornea , conjunctiva.
  • 12. LACRIMAL GLAND DEVELOPMENT  Develops from surface ectoderm  Develops as epithelial bud evaginating from basal cells of conjunctiva in supratemporal portion of embryonic fornix  Initially solid cords formed,but by 3months central cells vacuolte and lumina appear  Full differentiation by 3-4 yrs postnatally  Composed of ectodermal glandular units and mesodermal myoepidermal cells and fibrous tissue.  Functions 6wks after birth.so no tears in new born when crying.
  • 13. ANATOMY  Located in anterolateral part of the roof of orbit in fossa for lacrimal gland  Divided in to large superficial orbital part and small deep palpebral part which are continuous with each other around aponeurosis of LPS
  • 14. ORBITAL PART Almond shaped Two surfaces (superior and inferior) two borders (anterior and posterior and two extremities (medial and lateral) superior surface convex and related to orbit roof Inferior surface concave and related to LPS Anterior border limited by orbital septum Posterior border related to orbital pad of fat Medial extremity related to LPS Lateral extremity rests on lateral rectus
  • 15. PALPEBRAL PART 1/3RD size of orbital part Superiorly related to LPS and inferiorly to superior fornix When lid is everted the gland can be seen in superior fornix of conjunctiva
  • 16. ANCHORS 1.Above by suspensory ligament 2.Below by fibrous attachment to the zygomatic bone 3.Behind by fascial condensation around lacrimal nerves and vessels 4.Internally by fascial expansion of ocular muscles
  • 17. LACRIMAL DUCTS  10-12 ducts  Ducts arising from the orbital part passes through palpebral part and opens in to superior fornix of conjunctiva  Additional ducts from palpebral part open directly in to conjunctiva  Removal or damage to palpebral part of the gland will stop secrections reaching the fornix  So biopsy of gland always done in orbital part of lobe
  • 18. STRUCTURE OF LACRIMAL GLAND Lobulated tubulo acinar gland Microscopically has Glandular tissue,Stroma and Septa -Glandular tissue consists of acini and ducts arranged in lobes and lobules seperated by Septa -acini has pyramidal cells which secrete the tears expelled by the contraction of myofibrils -Stroma formed by mesodermal tissue which has connective tissue,lymphoid cells,plasma cells,rich nerve terminals and
  • 19. BLOOD SUPPLY- Internal carotid artery Angular vein Ophthalmic artery Superior ophthalmic vein Lacrimal artery Lacrimal vein Some times by infraorbital artery(Br of maxillary artery) LYMPHATIC DRAINAGE- Pre auricular group
  • 20. NERVE SUPPLY  Parasympathetic secretomotor fibres(efferent) from superior salivatory nucleus  Sympathetic nerve supply from carotid plexus  Sensory supply(afferent) from lacrimal nerve Br of ophthalmic division of fifth nerve
  • 22. CONJUNCTIVAL SAC  Conjunctiva stretches from lid margin to limbus and encloses a potential space conjunctival sac which opens at palpebral fissure  Sac is closed only when lids are approximated
  • 23. LACRIMAL PUNCTA  Two puncta situated in each lid margin at the junction of ciliary and lacrimal parts on elevtion called lacrimal papilla  Upper punctum 6mm and lower 6.5 mm from medium canthus  Surrounded by fibrous tissue which keeps them patent
  • 24. LACRIMAL CANALICULI  2 in number,Joins puncta to lacrimal sac  Two parts vertical(2mm) and horizontal(8mm) at junction dilated to form ampulla  Pierce lacrimal fascia and unite to form common canaliculi opens in to lacrimal sinus of maier  At opening in to sac protected by valve of rosenmuller  Surrounded by fibres of pars lacrimalis of orbicularis oculi muscle  During blink canaliculi pulled medially,shortened and compressed by pars lacrimalis.also helps in dilatation of lacrimal sac
  • 25. LACRIMAL SAC  Upper expanded portion of NLD  Lodged in lacrimal fossa(medial wall is lamina papyracea,formed by lacrimal bone and frontal process of maxilla)  Surrounded by lacrimal fascia which results from splitting of periorbita  Between sac and fascia are venous plexus  Part of sac above MPL is fundus.At junction of fundus
  • 26.  RELATIONS Anteriorly to medial palpebral ligament Posteriorly to posterior lacrimal crest and orbicularis oculi Medially to middle meatus and ant ethmoidal sinus Laterally to skin,fascia and orbicularis oculi(lacrimal part) ANGULAR VEIN and ANGULAR ARETRY crosses MPL about 8mm from the medial canthus.many times a tributary runs 3mm from medial canthus.so to avoid profuse bleeding during sac surgery incison should be made within 3mm medial to medial canthus
  • 28.  Extends from lacrimal sac to inferior meatus of nose  18 mm in length and 3mm diameter  Upper end is the narrowest  Runs downward,backward and laterally  Lined by two layers of coloumnar epithelium  Has intraosseus and intra mural part NASO LACRIMAL DUCT
  • 29.  Intraosseus part lodged in naso lacrimal Canal formed by maxilla anterolaterally,lacrimal bone and inferior nasal concha postero medially  Intramural part variable in length and lies in inferior meatus.  NLD opens below in to anterior part of inferior meatus.  opening guarded by a fold of mucosa-valve of hasner.prevents air from entering the sac when air blown out of closed nose  In infants some times canalisation is delayed or do not occur causing epiphora and cong dacrocystitis  Duct is surrounded by rich plexus of veins,forming a erectile tissue .engorgement leads to obstruction of NLD and epiphora
  • 30. BLOOD SUPPLY ARTERIAL SUPPLY Superior and inferior palpebral A. Angular A. Infraorbital A. Nasal br. Of sphenopalatine A. VENOUS DRIANAGE Angular vein Infraorbital vein Nasal vein LYMPHATICS Sub mandibular group Deep cervical group NERVE SUPPLY Infra trochlear nerve Anterior superior alveolar N.
  • 31. ELIMINATION OF TEARS  Lacrimal fluid over the preocular surfacemarginal tear stripLacus lacrimalisinner canthus lacrimal passages  nasal cavity  Lacrimal pump mechanism:- fibres of the pretarsal & preseptal portion of the Orbicularis which arise from the lacrimal fascia & posterior lacrimal crest.  This LPM operates with the blinking movements of the eyelids as follows:-
  • 35. DRAINAGE OF LACRIMAL FLUID FROM NLD INTO NASAL CAVITY  Gravity helps downward flow.  Air currents in nose induce negative pressure within NLD draw the fluid down the potential lumen of the duct into the nose.  Hasner’s valve present at lower end of NLD, remains open as long as the pressure within nose is less than the NLD, allows the tears to flow from NLD to nose