AQUEOUS S C C O 2212021 1 AQUEOUS

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AQUEOUS S. C. C. O. 2/21/2021 1

AQUEOUS S. C. C. O. 2/21/2021 1

AQUEOUS HUMOR LECTURE F Reading Assignment: Chapter 8, Adler's Physiology of the Eye. S.

AQUEOUS HUMOR LECTURE F Reading Assignment: Chapter 8, Adler's Physiology of the Eye. S. C. C. O. 2/21/2021 2

I. DEFINITION FUNCTION AND F A. Transparent, colorless liquid in the anterior and posterior

I. DEFINITION FUNCTION AND F A. Transparent, colorless liquid in the anterior and posterior chambers of the eye. Provides nutrition for ocular tissues, allows for waste product removal, and maintains eye pressure. S. C. C. O. 2/21/2021 3

II. PRODUCTION F A. Ciliary Body – 1. extends from the iris to the

II. PRODUCTION F A. Ciliary Body – 1. extends from the iris to the ora serrata. – 2. Principally unstriated muscle • a. longitudinal, radial and circular – 3. Two divisions • a. pars plicata - anterior third consisting of ciliary processes • b. pars plana - posterior 2/3 rds S. C. C. O. 2/21/2021 4

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II. PRODUCTION – 4. Ciliary processes approximately 70 ridges projecting inward from the pars

II. PRODUCTION – 4. Ciliary processes approximately 70 ridges projecting inward from the pars plicata S. C. C. O. 2/21/2021 7

II. PRODUCTION – 5. Firmly attached at the scleral spur – 6. Blood supply

II. PRODUCTION – 5. Firmly attached at the scleral spur – 6. Blood supply consist of the anterior and long posterior ciliary arteries • a. each ciliary process receives an arteriole and is drained by a venule which connects with the vortex system S. C. C. O. 2/21/2021 8

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II. PRODUCTION – 7. Nervous supply - long posterior and short ciliary nerves, parasympathetic

II. PRODUCTION – 7. Nervous supply - long posterior and short ciliary nerves, parasympathetic and sympathetic innervation S. C. C. O. 2/21/2021 10

II. PRODUCTION F B. Anatomy – 1. Stromal core surrounded by a layer of

II. PRODUCTION F B. Anatomy – 1. Stromal core surrounded by a layer of pigmented epithelium (cuboidal) and nonpigmented epithelium (columnar) – 2. Two layers of epithelium face apex to apex. • a. Bruchs membrane forms the basement membrane for the pigmented layer. • b. Basement membrane for the nonpigmented layer is the internal limiting membrane. S. C. C. O. 2/21/2021 11

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II. PRODUCTION – 3. Many connections between the two layers • a. desmosomes, gap

II. PRODUCTION – 3. Many connections between the two layers • a. desmosomes, gap junctions, tight junctions • b. tight junctions - at apex of nonpigmented cells, form a tight barrier • c. tight junctions and blood vessels with small fenestrations result in a blood-aqueous barrier – i. clinical consequences S. C. C. O. 2/21/2021 14

II. PRODUCTION F C. Mechanism of Aqueous Formation – 1. Three possible • •

II. PRODUCTION F C. Mechanism of Aqueous Formation – 1. Three possible • • • S. C. C. O. diffusion ultrafiltration active transport 2/21/2021 15

II. PRODUCTION – 2. Active transport • a. produces the bulk of the aqueous,

II. PRODUCTION – 2. Active transport • a. produces the bulk of the aqueous, requires energy • b. Na/K ATPase located along lateral cellular interdigitations of NPE • c. aqueous production decreases when use ouabain S. C. C. O. 2/21/2021 16

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II. PRODUCTION • d. Na+ transported out with Cl-, HCO 3 - and H

II. PRODUCTION • d. Na+ transported out with Cl-, HCO 3 - and H 2 O following • e. positive charge in aqueous near NPE wall • f. solute concentrated at region near the tight junction and decreases as you approach the posterior chamber S. C. C. O. 2/21/2021 18

II. PRODUCTION – 3. Ultrafiltration • a. a substance is forced across a membrane

II. PRODUCTION – 3. Ultrafiltration • a. a substance is forced across a membrane with the help of a hydrostatic driving force • b. produces a small amount of aqueous • c. hydrostatic pressure probably greater in opposite direction (out of eye) S. C. C. O. 2/21/2021 19

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II. PRODUCTION – 4. Diffusion • a. movement of a substance down its concentration

II. PRODUCTION – 4. Diffusion • a. movement of a substance down its concentration gradient • b. small amount of aqueous made this way S. C. C. O. 2/21/2021 21

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III. AQUEOUS COMPOSITION HUMOR F A. Initially compared concentration with that of plasma F

III. AQUEOUS COMPOSITION HUMOR F A. Initially compared concentration with that of plasma F B. Substances in the aqueous are used by all the surrounding tissues and the aqueous contains all their waste products (cornea, lens, vitreous and iris) S. C. C. O. 2/21/2021 23

III. AQUEOUS HUMOR COMPOSITION – 1. Osmolarity • a. slightly hyperosmotic to plasma –

III. AQUEOUS HUMOR COMPOSITION – 1. Osmolarity • a. slightly hyperosmotic to plasma – 2. Electrolytes • a. Na+ and K+ concentrations similar to plasma • b. Cl- higher and HCO 3 - lower than plasma level • c. Oxygen diffuses into aqueous from blood so lower concentration in aqueous • d. Glucose lower and lactate higher than plasma concentrations S. C. C. O. 2/21/2021 24

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III. AQUEOUS HUMOR COMPOSITION • e. Ascorbate - high concentration in aqueous (about 20

III. AQUEOUS HUMOR COMPOSITION • e. Ascorbate - high concentration in aqueous (about 20 X that of plasma) rises with increasing concentration in the blood until a ceiling of about 50 mg/100 ml is reached in the aqueous – i. thus, secreted actively by a specific carrier mechanism that can be saturated • f. Amino acids – i. most amino acids in higher concentrations in the aqueous than the plasma which indicates active transport – ii. different amino acids have different concentrations S. C. C. O. 2/21/2021 26

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III. AQUEOUS HUMOR COMPOSITION • g. Proteins are limited in the aqueous by the

III. AQUEOUS HUMOR COMPOSITION • g. Proteins are limited in the aqueous by the blood aqueous barrier (1/90) – i. low molecular weight proteins can get into the aqueous (albumin in high conc) • h. Immunoglobulins – i. Ig. G concentration of 3 mg/100 ml of aqueous – ii. Ig. D, Ig. A and Ig. M not normally found – iii. small quantities of complement can be found S. C. C. O. 2/21/2021 29

III. AQUEOUS HUMOR COMPOSITION • i. Other compounds found include hyaluronic acid, corticosteroids, lipids,

III. AQUEOUS HUMOR COMPOSITION • i. Other compounds found include hyaluronic acid, corticosteroids, lipids, vitamin B 12 and lens proteins. S. C. C. O. 2/21/2021 30

III. AQUEOUS HUMOR COMPOSITION F Clinical Significance – may aid in Dx • diabetes

III. AQUEOUS HUMOR COMPOSITION F Clinical Significance – may aid in Dx • diabetes mellitus • glaucoma S. C. C. O. 2/21/2021 31