Autonomic Innervation of the Orbit - Laboratory Identifications

Orbit - Anterior View

1. Supraorbital foramen -- supraorbital nerve, artery and vein
2. Infraorbital foramen -- infraorbital nerve, artery and vein
3. Supratrochlear nerve, artery, and vein -- anastomosis with angular vein from facial vein
4. Infratrochlear nerve, artery, and vein -- anastomosis with angular vein from facial vein
5. Lacrimal nerve -- along superior aspect of lateral rectus
6. Orbital septum -- divides the face from the orbit
7. Superior conjunctival fornix -- lateral portions receives lacrimal secretions (tears)
8. Inferior conjunctival fornix -- between inferior tarsal plate and cornea
9. Lacrimal ducts -- empty into lateral superior conjunctival fornix
10. Caruncle -- near medial palpebral ligament between superior and inferior lacrimal puncta
11. Superior lacrimal punctum -- drains into superior canaliculus
12. Inferior lacrimal punctum -- drains into inferior canaliculus
13. Superior lacrimal canaliculus -- combines with inferior canaliculus to form common canaliculus
14. Inferior lacrimal canaliculus -- combines with superior canaliculus to form common canaliculus
15. Common lacrimal canaliculus -- drains into nasolacrimal sac at level of medial palpebral ligament
16. Nasolacrimal sac -- posterior to medial palpebral ligament
17. Nasolacrimal duct -- inferior continuation of nasolacrimal sac, drains into inferior nasal meatus
18. Lateral palpebral ligament -- secures superior and inferior tarsal plates to the lateral orbital rim
19. Medial palpebral ligament -- secures superior and inferior tarsal plates to the medial orbital rim, spine
20. Superior tarsal plate -- receives insertion of levator palpebral superioris
21. Inferior tarsal plate --
22. Trochlea for superior oblique muscle - pulley, relation for supratrochlear and infratrochlear nerves
23. Superior oblique muscle -- depresses, abducts, medial rotates
24. Inferior oblique muscle -- elevates, abducts, lateral rotates
25. Anterior ethmoidal artery and nerve -- accessible through orbital septum for ligation

Orbit - Superior View (frontal bone removed)

1. Periorbital fascia -- lining of the orbit
2. Bulbar fat -- cushions the highly mobile globe and optic nerve
3. Optic canal -- within lesser wing of sphenoid bone
4. Superior orbital fissure -- between greater and lesser wings of sphenoid bone
5. Ophthalmic artery -- passing through optic canal and within annulus tendineus
6. Ophthalmic vein -- anterior continuation of cavernous sinus, divides into superior and inferior ophthalmic veins
7. Lacrimal nerve (GSA) -- passes along superior border of lateral rectus toward lacrimal gland, transmits GVE postganglionic fibers from pterygopalatine ganglion (facial nerve).
8. Frontal nerve (GSA) -- terminates as the supraorbital (lateral) and supratrochlear (medial) nerves
9. Supratrochlear nerve (GSA) -- passes superior to the trochlea for the superior oblique
10. Lateral rectus muscle -- abduction
11. Abducens nerve (GSE) -- passes through annulus tendineus, applied to medial (inner) proximal surface of lateral rectus
12. Levator palpebrae superioris muscle --
13. Superior rectus muscle -- elevation
14. Superior division of oculomotor nerve (GSE) --
15. Superior oblique muscle -- depression, abduction, medial rotation
16. Trochlear nerve (GSE) -- applied to proximal superior border of superior oblique
17. Lacrimal gland and ducts -- drain into superior conjunctival fornix
18. Ciliary ganglion -- one of the "cops", postganglionic parasympathetic cell bodies, pupil constriction, accommodation
19. Inferior division oculomotor nerve (GSE GVE) --
20. Motor (short) root ciliary ganglion -- GVE branch from inferior division of oculomotor nerve
21. Sensory (long) root ciliary ganglion -- GSA branch from nasociliary nerve
22. Sympathetic root of the ciliary ganglion (GVE sympathetic) -- derived from internal carotid plexus within the cavernous sinus
23. Short ciliary nerves (GSA) -- derived from ophthalmic division of trigeminal nerve, continuation of fibers from sensory root. hitchhikers on board
24. Zygomatic nerve (GSA V2) - lateral orbital floor, terminates as zygomaticofacial and zygomaticotemporal nerves, transmit GVE postganglionic from facial
25. Zygomaticotemporal nerve -- transmits postganglionic GVE fibers from facial nerve
26. Zygomaticotemporal canal -- high-lateral orbital wall, close proximity to lacrimal nerve
27. Zygomaticofacial canal -- mid-lateral orbital wall
28. Nasociliary nerve (GSA V1) -- passes through the annulus tendinous
29. Infratrochlear nerve (GSA V1) -- passes inferior to the trochlea for the superior oblique muscle
30. Posterior ethmoidal nerve (GSA V1) and artery -- to posterior ethmoidal air cells and sphenoid sinus
31. Anterior ethmoidal nerve (GSA V1) and artery -- entering the anterior ethmoidal canal, site of ligation to treat epistaxis
32. Superior head of lateral rectus muscle -- bridges the superior orbital fissure and closes the annulus tendineus
33. Annulus tendineus -- CNII, CNIII, CNVI, nasociliary nerve, sympathetic root ciliary ganglion, ophthalmic artery (sometimes vein)
34. Medial rectus -- adduction