Term
| The lacrimal gland secretes what three things? |
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Definition
| Water, electrolytes, and proteins |
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Term
| The lacrimal gland is part of a functional unit that includes the cornea and conj, accessory lacrimal glands, and meibomian glands that serves to do what? |
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Definition
| Maintain the tear film homeostasis and meet tear fluid demand via neural and hormonal feedback loops |
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Term
| Which lacrimal gland is primarily responsible for normal or basal aqueous secretions? Which is responsible for reflex secretion? |
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Definition
Primary lacrimal gland
The accessory lacrimal glands |
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Term
| Normal aqueous secretion is about 1.2 microliters/min. What happens to the secretion rate with reflex stimulation? |
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Definition
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Term
| The aqueous layer of the tear film is renewed how often? |
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Definition
Every 6-7 mins
All production is probably neurogenic/reflex stimulation |
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Term
| Does aqueous production decline or increase with age? Which of the sexes has less production after age 30? |
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Definition
Decline (50% by age 65)
Females |
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Term
| Does the basal aqueous production vary during the day? When does basal aqueous secretion shut off? |
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Definition
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Term
| What is the most common cause of reflex aqueous secretion? |
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Definition
Stimulation of CN V
-cornea and conj: foreign body, trauma, enviornment
-nasal mucosa |
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Term
| Can emotion or pain cause a stimulus to secrete aqueous? |
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Definition
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Term
| Are the accessory lacrimal glands (Krauss and Wolfring) responsible for a large amount of total aqueous secretion? |
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Definition
| NO - Literature varies but around less than 10% |
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Term
| Structurally and functionally, the lacrimal gland is what type of gland? |
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Definition
| Tubuloacinar exocrine gland |
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Term
| The palpebral lobe of the lacrimal gland is located where? Orbital lobe? |
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Definition
Palpebral lobe is located in the superolateral fornix and can be seen with lid eversion
Orbital lobe is located against the frontal bone in the lacrimal fossa |
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Term
| The lacrimal gland and its acini converge to empty its contents into 12 ducts that open to where? |
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Definition
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Term
| What cells lie next to the basal surface of the acini and may act as a pump and also contain contractile protein? |
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Definition
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Term
| The electrolyte secretions of the lacrimal gland are driven by what? |
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Definition
| Na+K+ATPase pump - sets up an electrochemical gradient |
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Term
| Secretory fluid of acini is similar to what? |
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Definition
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Term
| The movement of water into the lumen is consequence of ion movement. How does water physically enter the lumen? |
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Definition
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Term
| The majority of protein secreted by the lacrimal gland is regulated by neurotransmitters and neuropetides in what process? What other way is protein secreted? |
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Definition
Exocytosis
Intrinsic or constitutive synthesis/secretion - Made and released immed. |
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Term
| Lacrimal gland protein secretion can also be autonomically regulated via the parasympathetic and sympathetic portion of the reflex arc. The secretory vesicles are stored and releaed upon stimulation of what pathways? |
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Definition
| G=protein or CAMP mediated pathways |
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Term
Hypertonic tears result from what?
Hypotonic tears result from what? |
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Definition
Decreased stimulation and/or evaporation
Increased stimulation (more fluid and less dissolved protein) |
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Term
| What is the largest protein present in tears? |
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Definition
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Term
| Lactoferrin is a tear specific pre-albumin protein. What is main function? |
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Definition
| It is bacteriostatic, possibly bacteriolytic. It binds to iron ions, which are essential for bacterial metabolism. |
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Term
| Lysozyme is a protein that is considered what? What does it dissolve? |
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Definition
Bacteriolytic
It dissolves gram positive cell walls |
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Term
| Proteins like epidemalGF, transformingGF, hepatocyteGF, and keratinocyteGF do what to the corneal epithelium? |
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Definition
| Have a role in healing, proliferation, and migration of epithelium |
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Term
| What protein acts on the cell membrane? |
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Definition
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Term
| What protein is an enzyme in high concentration that comes from corneal epithelium and corneal metabolism? |
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Definition
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Term
| What immunoglobulin provides antibody defense in the eye versus infectious agents? Who would have lower amounts of this immunoglobulin? |
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Definition
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Term
| What are the primary and secondary defense steps taken by IgA against infectious agents? |
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Definition
Primary - Prevent adhesion of microorganisms to ocular surface
Secondary - Induce phagocytosis by PMN's (neutrophils) |
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Term
| The tears are 98.2% what? |
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Definition
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Term
| Evidence in morphology and function reveal that which sexes acini are larger? |
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Definition
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Term
| Androgens have been shown to have an anti-inflammatory role as well as a cell maintenance role in the lacrimal gland. When do these androgens decrease? What treatment is Dr Connor working on? |
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Definition
During menopause
Treating dry eye with testosterone cream |
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Term
| Prolactin is a peptide hormone that is synthesized in what cells of the lacrimal gland? |
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Definition
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Term
| The prolactin receptors in the acinar cells of the lacrimal gland serve to do what? |
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Definition
Modulate cell activity and immune function of the gland
Moderate fluid balance, cell growth, and differentiation |
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Term
| What is an osmole? What is the difference between osmolarity and osmolality? |
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Definition
An osmole is the amount of substance that dissociates in solution to form 1 mole of osmotically active substance.
Osmolarity = osmols/L
Osmolality = osmols/kg
The two can be used interchangebly because at std pressure and std temp they are the same |
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Term
| The normal osmolality of tears is 304-318 mosm/L. Does the osmolality of tears increase or decrease with contact lens wear? |
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Definition
| It decreases in contact lens wearers initially and then increases back to normal with adaptation. |
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Term
| Dry eye syndrome (DES) is a condtion of increased tear osmolarity due to what two factors? |
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Definition
| Evaporation and reduced aqueous production |
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Term
| According to J Gilbard, MD, what are the four milestones of Dry-Eye Disease? |
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Definition
Increased tear osmolarity
Decreased goblet cell density and decreased corneal glycogen
Corneal desquamation
Decreased surface glycoproteins |
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Term
| Severe dry eye is called what? |
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Definition
| Keratoconjunctivitis sicca (KCS) |
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Term
| What is the systemic autoimmune disease that pathologically destroys all the bodies moisture producing glands? |
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Definition
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Term
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Definition
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Term
| Can dry eye be an inflammatory condtion? |
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Definition
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Term
| The pH of aqueous secretion is about 7.4 with a comfort range from 7.3 to 7.7. If the pH lowers below 6.6 or rises above 7.8, what can happen to the patient? |
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Definition
| Discomfort and increased lacrimation |
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Term
| Injuries tend to _____ alkalinity of the aqueous and bacterial infection seems to do what? |
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Definition
Increase
Infection causes the pH to lower to 5.2 because of the acidic by-products of bacteria |
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Term
| Which buffer is responsible for keeping the pH of the aqueous secretions close to 7.4? |
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Definition
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Term
| In the morning, what is the pH of the aqueous secretions? |
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Definition
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Term
| The temperature of the cornea surface is 35 degrees - 36 degrees Celsius. Does it increase or decrease with lid closure? With CL wear? |
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Definition
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Term
| At what temperature does all metabolism of corneal epithelium cease? |
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Definition
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Term
| In general, do anti-histamines and anti-depression drugs increase or decrease tear production? What about marijuana or pilocarpine? |
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Definition
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