ANATOMY OF LACRIMAL APPARATUS

DR.Anumeha

Lacremal apparatus
Concerned with tear formation and transport. Parts :-Main and accesory LG. Includes :-puncta , canaliculi , sac ,and NLD.

Main Lacramal Gland

Situation:-Focca for Lacramal Gland, formed by orbital plate of frontal bone in the Antrolatral part of roof of orbit. Divided in its ant aspect into:*superior orbital *Inferior Palpebral

ORBITAL PART: Two surfaces :a. Superior (CONVEX) b. Inferior (CONCAVE) . Two Borders :a. Anterior (SHARP) b. Posterior (ROUND) . Two Extremities:a. Medial (RELATED TO LPS) b. Lateral (REST ON LR)

Palpebral Part: 1\3rd size of orbital part . consists of two or three Lobules. Situated upon ducts of Orbital part, separated by LPS Muscles. Inferiorly related to superior fornix. Seen through the conjunctiva when upper lid everted. Posteriorly continued with orbital part.

Ducts of Lacrimal gland

10 to 12 Open in Lateral Part of Superior Fornix. 1 or 2 open in Lateral part of inferior Fornix. All pass through Palpebral part of Glands.

Structures of Lacrimal Glands

Branched , Tubulo ,Alveolar serous acinos gland. Similar structure to Salivary Gland. Microscopically :-Glandular Tissue, stroma ,Septa. Lined by capsule.

Glandular Tissue: Consists of Acini and Ducts arranged in Lobes and Lobules, seperated by fibrovascular septa. Acina lined by single layer of pyramidal cells :-serous type with eosinophilic granules nd round nucleus,secretes tears,expelled by contraction of myofibrils.

Stroma of LG
Formed by mesodermal tissue which contains C.T,elastic tissue,lymphoid tissue,plasma cells ,nerves nd blood vesels

Blood Supply of LG
Lacrimal artery-branch of ophthalmic art Sometimes-by branch of transeverse facial art. Lacrimal veins drains into ophthalmic veins.

Lymphatic Drainage
Pre-auricular lymph nodes Nerve Supply of LG 1.Sensory-Lacrimal n.,br of ophthalmic division of 5th C.N 2.sympathetic-Carotid plexes cervical sympathetic 3.Secretomotor fibres-frm superior salivory nucleus

Accessory Lacrimal Glands

1.Gld of Krause-lining subconjunctival tissue of fornix -40-42 in upper fornix -6-8 in lower fornix -ducts open in fornix 2.Gld of wolfring -2-5 in upper border of superior tarsus -2-3 in lower border of lower tarsus 3.Rudimentary Accessory LG

LACRIMAL PASSAGES
Lacrimal puncta -one each on upper lid(6mm from inner canthus) nd lower lid(6.5mm from inner canthus),at junction of ciliary nd lacrimal portion of lid margin. -situated upon lacrimal papilla. -surounded by ring of dense fibrous tissue,keeps patent.

Lacramal canaliculi
Join Puncta to sac. 0.5 mm in diameter. 2parts :-vertical(2mm),horizon(8mm) Junction of two portions :-Ampulla. 2 canaliculi unite to form common canaculous open in :-Lacramal sinus of Maier,2.5mm from apex of the sac. Structures (inside to outwards:-) epithilium ,Corium rich in elastic tissue,fibers of orbicularis called pars lacrimalis.

LACRIMAL SAC
Location :-Lacrimal focca, formed by lacrimal bone and frontal process of maxilla. Lacrimal Facia:-encloses lacrimal sac. Dimensions:-when distended ,Length 15mm , Breadth 5 to 6 mm , Volume 20cc. Parts:-3parts,(Fundus 3-5mm , Body 1012mm , and Neck )

RELATIONS OF LACRAMAL SAC

Medially :-upper part:-ant. Ethmoidal sinus. lower part:-middle metus of nose. Anterolateral (from deep to superficial.) 1.Lacramal facia. 2.Horners mus.(lacrimal fibres of orbicularies) 3.Medial palpebral ligament in upper part of sac. 4.Palpebral fibres of orbicularies. 5.Angular vein 6.Skin Posteriorly(frm ant to post) -Lacri fascia -fib of lacrimal part of orbicularis -septum orbitale.

NLD
Dim-L-18mm,Diam-3mm Direction-Down,Back,laterally External location-line join med meatus nd Ala Parts intraosseous-12.5mm,intrameatal5.5mm. Opening-30-40mm frm ant nares Lower end-valve of hasner

Blood supply of lacrimal passage

Art-sup. And inf. palpebral art.,angular art,infraorbital art,nasal br. Of sphenopalatine art. Venous drain-frm above-angular nd infraorbital -frm below-nasal vein Lymp drain-submandib nd deep cervical