wikiamp

Tears



Tears are a clear liquid secreted by the lacrimal glands (tear gland) found in the eyes of all land mammals (except for goats and rabbits). Their functions include lubricating the eyes (basal tears), removing irritants (reflex tears), and aiding the immune system. Tears also occur as a part of the body's natural pain response. Humans are the only mammals known to produce tears as part of an emotional response, such as out of joy or grief. Tears have symbolic significance among humans (see crying). Emotional secretion of tears may serve a biological function by excreting stress-inducing hormones built up through times of emotional distress. Tears are made up of water, electrolytes, proteins, lipids, and mucins that form layers on the surface of eyes. The different types of tears—basal, reflex, and emotional—vary significantly in composition.. [[File:Tear system.svg|250px|thumb|Anatomy of lachrymation, showing ]]

Physiology



Chemical composition

Tears are made up of three layers: lipid, aqueous, and mucous. Tears are composed of water, salts, antibodies, and lysozymes (antibacterial enzymes), though composition varies among different tear types. The composition of tears caused by emotion differs from that of tears as a reaction to irritants, such as onion fumes, dust, or allergy. Emotional tears contain higher concentrations of stress hormones such as adrenocorticotropic hormone and leucine enkephalin (a natural pain killer), which suggests that emotional tears play a biological role in balancing stress hormone levels.

Drainage of tear film

The lacrimal glands secrete lacrimal fluid, which flows through the main excretory ducts into the space between the eyeball and the lids. When the eyes blink, the lacrimal fluid is spread across the surface of the eye. Lacrimal fluid gathers in the lacrimal lake which is found in the medial part of the eye. The lacrimal papilla is an elevation in the inner side of the eyelid, at the edge of the lacrimal lake. The lacrimal canaliculi open into the papilla. The opening of each canaliculus is the lacrimal punctum. From the punctum, tears will enter the lacrimal sac, then on to the nasolacrimal duct, and finally into the nasal cavity. An excess of tears, as caused by strong emotion, can cause the nose to run. [http://www.academy.org.uk/tutorials/dilate3.jpg] Quality of vision is affected by the stability of the tear film.

Types

There are three basic types of tears: basal, reflex and emotional.

Neurology

The trigeminal V1 (fifth cranial) nerve bears the sensory pathway of the tear reflexes. When the trigeminal nerve is cut, tears from reflexes will stop, while emotional tears will not. The great (superficial) petrosal nerve from cranial nerve VII provides autonomic innervation to the lacrimal gland. It is responsible for the production of much of the aqueous portion of the tear film.

Human culture

In nearly all human cultures, crying is associated with tears trickling down the cheeks and accompanied by characteristic sobbing sounds. Emotional triggers are most often sadness and grief, but crying can also be triggered by anger, happiness, fear, laughter or humor, frustration, remorse, or other strong, intense emotions. Crying is often associated with babies and children. Some cultures consider crying to be undignified and infantile, casting aspersions on those who cry publicly, except if it is due to the death of a close friend or relative. In most Western cultures, it is more socially acceptable for women and children to cry than men, reflecting masculine sex-role stereotypes. In some Latin regions, crying among men is more acceptable. There is evidence for an interpersonal function of crying as tears express a need for help and foster willingness to help in an observer.

Some modern psychotherapy movements such as Re-evaluation Counseling encourage crying as beneficial to health and mental well-being. An insincere display of grief or dishonest remorse is sometimes called crocodile tears in reference to an Ancient Greek anecdote that crocodiles would pretend to weep while luring or devouring their prey. In addition, "crocodile tears syndrome" is a colloquialism for Bogorad's syndrome, an uncommon consequence of recovery from Bell's palsy in which faulty regeneration of the facial nerve causes sufferers to shed tears while eating.

Pathology

Bogorad's syndrome

Bogorad's syndrome, also known as "Crocodile Tears Syndrome", is an uncommon consequence of nerve regeneration subsequent to Bell's palsy or other damage to the facial nerve. Efferent fibers from the superior salivary nucleus become improperly connected to nerve axons projecting to the lacrimal glands, causing one to shed tears (lacrimate) on the side of the palsy during salivation while smelling foods or eating. It is presumed that this would cause salivation while crying due to the inverse improper connection of the lacrimal nucleus to the salivary glands, but this would be less noticeable. The condition was first described in 1926 by its namesake, Russian neuropathologist F. A. Bogorad, in an article titled "Syndrome of the Crocodile Tears" (alternatively, "The Symptom of the Crocodile Tears") that argued the tears were caused by the act of salivation.

Keratoconjunctivitis sicca (dry eye)

Keratoconjunctivitis sicca, known as dry eye, is a very common disorder of the tear film. Despite the eyes being dry, sufferers can still experience watering of the eyes, which is, in fact, a response to irritation caused by the original tear film deficiency. Lack of Meibomian gland secretion can mean the tears are not enveloped in a hydrophobic film coat, leading to tears spilling onto the face.

Familial dysautonomia

Familial dysautonomia is a genetic condition that can be associated with a lack of overflow tears (Alacrima) during emotional crying.

Obstruction of the punctum, nasolacrimal canal, or nasolacrimal duct can cause even normal levels of the basal tear to overflow onto the face (Epiphora), giving the appearance of constant psychic tearing. This can have significant social consequences.

Pseudobulbar affect

Pseudobulbar affect (PBA) is a condition that is characterized by episodes of uncontrollable laughter or crying. It mostly occurs in people suffering from certain neurological injuries that affect the way their brain controls emotions. Scientists believe PBA may be a result of damage to the prefrontal cortex, which is the area of the brain that controls emotions. Because PBA often involves crying, the condition may be mistaken for depression. However, PBA is a neurological condition, while depression is psychological. People suffering from PBA do not experience some of the typical depression symptoms such as sleep disturbances or loss of appetite.