眼科重点.docx

眼科重点.docx

《眼科重点.docx》由会员分享，可在线阅读，更多相关《眼科重点.docx（16页珍藏版）》请在冰豆网上搜索。

眼科重点

眼科重点（主观51分，客观49分，无平时分，黄色加双横线为重点中重点，你们懂的）

一、CorneaDiameter

•Horizon,11-12mm

•Vertical,10-11mm

二、角膜由前向后分为5层：

1）Epithelium,canberegenerated

2）Bowman’slayer

3）Stroma,themostthick

4）Descemet’smembrane，canberegenerated

5）Endothelium

三、Uvea葡萄膜由向后分iris,ciliarybody,choroid三个连续部分

四、眼内腔包括anteriorchamber,posteriorchamber,vitrouscavity

五、房水循环：

Aqueous（wateryfluid）ismadefromtheglandslocatedintheciliarybody.Itthencirculatesintheposteriorchamber,flowthroughthepupilandintotheanteriorchamberwhereitnourishesthecornea,andfinallyemptiesbackintothebloodstreamafterpassingthroughthetrabecularmeshworkandintoSchemm'sCanal.

六、Visualpathway包括6部分：

1）Opticnerve

2）Opticchiasm

3）Optictract

4）Lateralgeniculatebody

5）Opticradiation

6）Visualcortex

七、眼外肌的神经支配：

1.Oculomotornerve（III）:

1）Medialrectusmuscle

2）Inferiorrectusmuscle

3）Superiorrectusmuscle

4）Inferiorobliquemuscle

2.Trochlearnerve（Ⅳ）:

1）Superiorobliquemuscle

3.Abducensnerve（Ⅵ）:

1）Lateralrectusmuscle

八、直接对光反射：

whenthelightshinesononesideofthepupil,itcausesthepupiltobenarrowed

Pupillightreflex

Light→pupil→retina（macular）→opticnerve→chaism→optictract→brachiumofsuperiorcolliculus→epithalamus，pretectalarea→parasympatheticnerve（viacranialnerveⅢ）→ciliaryganglion→pupilsphinctermuscle

九、眼眶orbit的7块骨头：

1）Frontalbone

2）Sphenoidbone

3）Ethmoidbone

4）Palatinebone

5）Lacrimalbone

6）Maxilla

7）Zygomaticbone（malar）

十、Hordeolum睑腺炎：

Anacute,painful,purulent,nodularinflammatorylesionoftheeyelidglandtissue,oftenreferredtoassty.

•内睑腺炎Internalhordeolum–meibomianglands

•外睑腺炎Externalhordeolum–Zeis’sorMoll’sglands

十一、外睑腺炎：

.Theeyelashfollicleanditsassociatedsebaceousglandsandsweatglandsorabnormal[Moll（orZeis）glandinfection,calledexternalhordeolum（hordeolumexternal）orexternalhordeolum;

十二、内睑腺炎theDepartmentofmeibomianglandisinvolved,formingabigswellingarea,itiscalledinternalhordeolujnamelyinnersty.

十三、Trichiasis（trichiasis）倒睫aberrantlashes乱睫

Itisaabnormalsituationthatreferstotherearoftheeyelashesorirregulargrowth,sothattouchingtheeyeball

十四、睑外翻Ectropion（ectropionofeyelid）：

eyelidleaveseyeball,turnoutward,differentdegreesofpalpebralconjunctivaexposed,oftenassociatedwithlagophthalmos

十五、近视myopia：

theimageofdistantobjectsfocusesinfrontoftheretinaintheunaccommodatedeye

十六、远视Hyperopia：

unaccommodatedeyefocustheimagebehindtheretina.

十七、散光Astigmatism：

Theeyeproducesanimagewithmultiplefocalpointsorlines.

•Inregularastigmatism,therearetwoprincipalmeridians,withconstantpowerandorientationacrossthepapillaryaperture,resultingintwofocallines.

十八、弱视Amblyopia：

prolongedabnormalvisualexperienceinachildundertheageof7yearsmayleadtoamblyopia（reducedvisualacuityintheabsenceofdetectableorganicdiseaseinoneeye）.

十九、弱视的治疗：

1）Achildcanbeexaminedatanyage,andtreatmentforamblyopiashouldbeinstitutedassoonasthediagnosisismade

2）Eliminationofcauses,

3）occlusiontherapy,

4）opticaldrugtherapy（suppressiontherapy）,

5）visualstimulationtherapy（CAM）,

6）combinedtherapy

二十、CorrectionofRefractiveErrors：

1）Spectaclelenses

2）Contactlenses

3）Keratorefractivesugery

4）Intraocularlenses

5）Clearlensextractionformyopia

二十一、结膜充血与睫状充血的鉴别

Conjunctivalcongestion

ciliarycongestion

Color

Freshred

Darkred

Site

Nearfornix

Nearcornealmargin,

vision

Normal

Decrease

Vascularbranches

Clear

Unclear

vascularmorphology,

Coarse,bent,

straightstraight

vascularorigin,

Posteriorconjunctivalartery,

anteriorciliaryartery

vascularlevels

Theocularsurface

thedeeplayerunderconjunctiva

secretions,

Yes

no

bloodvesselsmoving

yes

no

ciliarybodycompression,

no

yes

responsestoepinephrine

Congestiondisapearance

Nodisapearance

Commondisease

Conjunctivitis

Conjunctivitis,episcleritis,glaucoma,iridocyclitis

二十二、泪膜TearFilm（重要）

Definition:

Tearsformathinlayerapproximately7-10μmthickthatcoversthecornealandconjunctivalepithelium.

Table1CompositionofTearFilm

Title

Thickness

Source

Lipid layer

0.1μm

Meibomian glands

Aqueous layer

7μm

Major & minor lacrimal glands

Mucus layer

20 ~ 50nm

Conjunctival goblet cell

FunctionofTearFilm

1.Tomakethecorneaasmoothopticalsurfacebyabolishingminutesurfaceepithelialirregularities;

2.Towetandprotectthedelicatesurfaceofthecornealandconjunctivalepithelium;

Toinhibitthegrowthofmicroorganismsbymechanicalflushingandantimicrobialaction;

3.Toprovidethecorneawithnecessarynutrientsubstances.

二十三、慢性泪囊炎概念

PPT：

Dacryocystitis

Commonininfantandpostmenopausalwoman

Secondarytoobstructionoflacrimalduct

Clinicalfindings

Tearinganddischarge

Acuteform

imflammation,pain,swellingandtenderness

Purulentmaterial

Chronicform

Tearing

Mucoidmaterial

Riskofendophthalmitis

书：

慢性泪膜炎是一种较常见的眼病，在鼻泪管下端阻塞，泪囊内有分泌物滞留的基础上发生，常见致病菌为肺炎球菌、链球菌、葡萄球菌等。

ChronicDacryocystitisisarelativelycommoneyedisease,inthelowernasolacrimalductobstruction,strandedonthebasisofthelacrimalsacwithsecretion,commonpathogenicbacteriaforpneumococcalstaphylococcus,streptococcus,etc.

二十四、结膜炎临床表现

Signsofconjunctivitis

1.Hyperemia

2.Chemosis

3.Exudation

4.Subconjunctivalhemorrhage

5.Papillaryhypertrophy

6.Follicles

7.Pseudomembranesandmembranes

8.Scarformation

9.Granulomas

10.Phlyctenules

11.Preauricularlymphadenopathy

二十五、角膜炎：

keratitis

定义：

Definition:

Cornealdefencedecrease，Exogenous&endogenousetiologicalfactor，

Inflammationofcornealorganism

病理过程：

浸润期（cornealinfiltration）溃疡形成期（cornealulcer）

溃疡消退期（Exelcosisextinctionperiod）愈合期（Healingperiod）

临床表现：

ClinicalManifestation:

PainPhotophobiaTearingSpasmofeyelidVisualactivitydecrease

治疗原则：

controlinfection，relieveinflammatoryreaction，promoteulcerhealing，reducescarformation

二十六、Classificationofcataract:

Congenital

Age-related

Complicated

Metabolic

Toxic

Traumatic

Aftercataract

二十七、clinicalmanifestationsofcataract:

Progressivevision↓

Monocularvisionorpolyvision

contrastsensitivity↓

refractionchange

Glare

coloursensechange

defectvisionfield

二十八、Classificationofage-relatedcataract（senile）

Corticalcataract

Nuclearcataract

Posteriorsubcapsularcataract

二十九、Morgagni’scataract

thedensebrownnucleuswillsubsidewithinthecapsuleduetogravity.Thiscondition,referredtoasMorgagni’scataract

5.congenitalcataract

Cataractwhichishereditaryordevelopmentaldisorderexistsbeforeorafterbirth,orformsgraduallyafterbirth

6.aftercataract

AfterECCEorlenstrauma,theremainingcortexorlensepithelialcellsproliferate,formingturbidity.

三十、Operationmethodofcataract

Couchingoflens

ICCE

ECCE

Phacoemulsification

Femtosecondlaser-assistedcataractsurgery

Intraocularlensimplantation

三十一、aftercataractsurgery,howtocorrectvisionactivity

Artificiallensimplantation

Wearcornealcontactlens

Wearhigh-degreeglassesforhypermetropia

三十二、Subluxation（partialdislocation）:

Thesuspensionofthelens（thezonulefibers）isslackened,andthelensisonlypartiallywithinthehyaloidfossa.瞳孔区仍可见部分晶状体，散瞳后可见到部分晶状体的赤道部

Luxation（completedislocation）:

Thelensistorncompletelyfreeandhasmigratedintotheintraocular（vitreousbodyor,lessfrequently,intotheanteriorchamber）

三十三、Posteriorvitreousdetachment:

Aconditionoftheeyeinwhichthevitreousmembraneseparatesfromtheretina.

三十四、Conceptofglaucoma:

itisagroupofdiseasescharacteredbyopticnerveatrophyandvisualfunctiondefectionandthemainpathogenicfactoristhepathologicalIOPincreasing.

三十五、Clinicalmanifestationofacuteangle-closureglaucoma

1）acuteACG:

（1）Itischaracteredbythesuddenincreasing

ofIOPandthusbringingaboutsymptomsand

anteriorsegmenttissueschanges.

（2）Clinicalfindings:

pre-clinicalstage,onsetstage,interstitialstage,chronicprogressivestage

<1>pre-clinicalstage:

①acuteonsetACGofoneeye,theother

entersthisstageevenithasnosymptom

②thereexistsanatomicalchangessuch

asshallowanteriorchamber,narrowanterior

chamberanglewithdefinitefamilyhistoryand

theIOPincreasesafterdarkroomtest.

<2>aurastage:

transientorrepeatedlittle

attackssuchasiridization,foggyvisionor

headache.Theseattackscanreliefsoon.If

tested,theIOPmaybe30-50mmHg.

<3>acuteonset:

symptomsaresevereheadache,eyeballpain,blurredvisionandnausea,vomiting.

signs:

①mixhyperemia

②cornealedema

③highIOP

④dilatedpupil

⑤shallowanteriorchamber

⑥turbidaqueoushumor

⑦glaucomatousfleckorVogtspot

<4>interstitialstage:

referstothereliefafterlittleattacks,thetrabecularmeshworkhasnotbeendamaged.

①definitelittleattackhistory

②ant.chm.angleislargelyorcompletelyopen

③theIOPcankeepinanormalrangewithlittleornodrugagents.

<5>chronicstage:

referstothereliefafterrepeatedlittleattacksoracuteonset,thetrabecularmeshworkhasbeenseverelydamaged,thereareanteriorchamberanglelargelyadhesion,opticnerveatrophyandvisualfielddefection.

<6>absolutestage:

referstothecaseswithnolightsense.

三十六、青光眼治疗中视神经保护性治疗：

1）Neurotrophicfactors

2）Antioxidant

3）Glutamateantagonists

4）Calciumchannelblocker

5）genetherapy

6）Nerveregenerationortransplantation

三十七、majorcausesofbloodvesseldiseasesrelatedglaucoma新生血管性青光眼areretinalveinobstruction视网膜静脉阻塞、diabeticretinopathy糖尿病性视网膜病变andotherdiseases.

三十八、Uveitis葡萄膜炎iscausedof4kindsofhypersensitivity,typeⅠ~Ⅳhypersensitivity

三十九、AnteriorUveit