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Eyesight Associates of Middle - part 4

Tham khảo tài liệu 'eyesight associates of middle - part 4', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | 36 Chapter 3 Figure 3-2. Schematic cross-section of conjunctival topography. Reprinted with permission from Medical Sciences for the Ophthalmic Assistant SLACK Incorporated. Plica Semilunaris The plica is a pale half-moon shaped fold of tissue just lateral to the caruncle. It represents the junction of the bulbar conjunctiva described below and muscle tissue. It is loosely attached and when the patient abducts the eye you can see the plica stretch and unfold. Documentation plica normal Palpebral Conjunctiva The inside of the lids is lined with a mucous membrane called the palpebral conjunctiva Figure 3-2 . This membrane is tightly adherent to the underlying tissue. The palpebral conjunctiva of the lower lid may be easily examined by pulling the lid down. To see under the upper lid you will have to evert the lid see Chapter 2 . The palpebral conjunctiva is normally pale pink and may be slightly bumpy. See Chapter 5 regarding follicles and papillae which are abnormalities. You might see a few fine yellow lines running just underneath the surface. These are meibomian glands. Documentation palpebral conjunctiva clear Bulbar Conjunctiva The bulbar conjunctiva is a thin mucous membrane that lies over the globe up to the point of the limbus. After the limbus only the very surface cells epithelium of the conjunctiva blend into the corneal epithelium. It is normally clear in caucasians. The conjunctiva of dark-skinned individuals may be totally or partially pigmented. While the palpebral conjunctiva that lines the lids is tightly anchored to the tissue beneath the bulbar conjunctiva is loose and moveable. The bulbar conjunctiva contains blood vessels which normally are so tiny that they are nearly transparent. The bulbar conjunctiva also contains accessory glands that are not visible. The bulbar conjunctiva joins with the palpebral conjunctiva in the fornix. When the word conjunctiva is used without designating bulbar or palpebral the bulbar conjunctiva is usually what is .