EOMs:introduction to eye movements & dynamics of extra-ocular muscle actions Flashcards
what do all of the 6 EOMs work to produce
ocular movement around the centre of rotation
what is the name of the EOM which is not apart of the other 6 EOMs
levator palpebrae superioris (LPS)
which EOMs does the 3rd CN oculomotor superior division innervate
- SUPERIOR rectus
- levator palpebrase SUPERIORIS
which EOMs does the 3rd CN oculomotor inferior division innervate
- medial rectus
- INFERIOR rectus
- INFERIOR oblique
which EOM does the 4th CN trochlear innervate
superior oblique (i.e. the name of its pulley is called trochlear)
which EOM does the 6th CN abducens innervate
lateral rectus (ie abducts the eye)
where is the anatomical origin of the 4 recti muscles
at the annulus of zinn
what does the mechanical origin of an EOM define
where the pull comes from e.g. for recti muscles it comes from behind
where are the muscle pulleys of the 4 recti located
10mm posterior to equator of globe
where are all 4 recti muscles inserted in the globe
anterior/in front of the equator
which direction does the cornea rotate when each 4 recti muscle contracts
cornea rotates towards the body of the muscle itself
what is the primary action of the medial rectus
inwards
what is the primary action of the lateral rectus
outwards
what is the primary action of the superior rectus
upwards
what is the primary action of the inferior rectus
downwards
where is the anatomical origin of the superior oblique EOM
annulus of zinn
where is the anatomical origin of the inferior oblique
anterior infero-nasal corner
what is the pulley of the superior oblique called
trochlear
where is the trochlear (pulley) of the superior oblique located i.e. where does it pull from (mechanical origin)
anterior supero-nasal corner or orbital rim
where does the inferior oblique pull from (mechanical origin)
- anterior & inferior to globe
- coupled to inferior rectus muscle
so where are the mechanical origins of both obliques located
anterior to the globe (as oppose to recti which are all posterior to globe)
where are both oblique EOMs inserted in the globe
behind the equator
as each oblique muscle contracts, where does the cornea rotate
away from the body of the muscle itself
what is the action of the superior oblique
downwards
what is the action of the inferior oblique
upwards
what type of arc around the limbus do the recti muscles form from their insertions
concave arc
how are the MR & IR insertions in relation to the limbus
concentric (follows the contour of the limbus adjacently)
how are the SR & IR insertions in relation to the limbus
- tilted slightly nasally
- closest to limbus on nasal side
what type of arc around the limbus to the oblique muscles form, from their insertions
- convex arc
- insertions fan out
how far behind the limbus is the MR inserted
5.5mm closest to limbus
how far behind the limbus is the IR inserted
6.5mm
how far behind the limbus is the LR inserted
7.0mm
how far behind the limbus is the SR inserted
7.5mm farthest from the limbus
which recti muscle does the IO muscle insertion lie under
lateral rectus
what does the posterior end of the IO overlie the position of
the fovea
which recti muscle does the SO muscle insertion lie under
superior rectus
in the primary position, where is the centre of rotation located
13.5mm behind the apex of the cornea
list the three axis of rotation of fick’s axis
z axis
x axis
y axis
which direction does the z axis run
vertically through the eye
which direction does the z axis allow us to look
horizontally
which EOMs look horizontally around the z axis
medial rectus & lateral rectus
Adduction and abduction
which direction does the x axis run
horizontally through the eye
which direction does the x axis allow us to look
vertically
which EOMs look vertically around the x axis
superior rectus inferior rectus inferior oblique superior oblique elevation and depression
which direction does the y axis run
obliquely through the eye (through the cornea)
which direction does the y axis allow us to run
cyclo rotation or torsionally
which EOMs look torsionally around the y axis
inferior oblique
superior oblique
superior rectus
inferior rectus
what is rotation of only ONE single eye termed
duction i.e. other eye is covered when doing adduction on a px etc
what are duction movements limited by
length of muscle + tendon, edge of orbit & soft tissue of the orbit
what does rotation of a SINGLE eye around the z axis produce
horizontal movement:
- adduction
- abduction
what does rotation of a SINGLE eye around the x axis produce
vertical movement:
- supraduction (elevation)
- infraduction (depression)
what is the duction (single eye) term for elevation
supraduction
what is the duction (single eye) term for depression
infraduction
what does rotation of a SINGLE eye around the y axis produce
torsional movement:
- excycloduction (extorsion) anti clockwise
- incycloduction (intorsion) clockwise
what is the duction (single eye) term for extorsion
excycloduction
what is the duction (single eye) term for intorsion
incycloduction
what are oblique movements a combination of
horizontal and vertical movements
moves the globe into various oblique positions e.g. up and to the right or down and to the left etc
what is primary position of gaze
when the eyes are looking straight ahead with body and head erect
what happens to the contraction of a muscle when that muscle axis of rotation coincides with one of fick’s axis or rotation e.g. z horizontal, x vertical or y torsional axis
contraction of that muscle will produce a rotation purely around that particular axis
e.g. if the lateral rectus axis of rotation coincides with the z axis, it will be purely horizontal or if it coincides with the x axis, it will be purely vertical
what is the muscle plane
a point where the muscle first touches the globe (tangental point) and the centre of rotation i.e. the orientation that is inserts into the eye
what is a muscle axis of rotation perpendicular to
the muscle plane (the orientation that it inserts into the eye) e.g. if a muscle inserts vertically it will only produce horizontal movements
in primary position what does the horizontal rectus muscles axis of rotation completely coincide with of fick’s axis and hat contraction does that muscle produce as a result
z axis of rotation, produces a pure rotation around the vertical axis so NO vertical nor torsional component
which EOMs have only one action which is their primary and only action
medial rectus - adduction
lateral rectus - abduction
in primary position which of fick’s axis does the superior rectus coincide with
z ONLY, not with x or y
in primary position what is the primary action of the superior rectus
elevation
in primary position what is the secondary action of the superior rectus
incyloduction
in primary position what is the tertiary action of the superior rectus
adduction
what does RADSIN stand for
Recti
ADduct
Superiors
INtort
which muscle does the superior rectus lie adjacent to and what does that result in when the eye elevates
adjacent to the levator palpebrae superioris
as eye elevates input to the LPS produces lid elevation
what angle does the superior rectus axis of rotation form with the x axis
23 degrees
what angle does the superior rectus axis of rotation from with the y axis
67 degrees
what does the superior rectus axis of rotation coincide with when the globe is abducted 23 degrees
x axis
when the superior rectus coincides with the x axis, what does it purely become
pure elevator
what does the superior rectus axis of rotation coincide with when the globe is adducted 67 degrees
y axis
when the superior rectus coincides with the y axis, what does it purely become
pure incycloduction
what angle does the inferior rectus axis of rotation form with the x axis
23 degrees
what angle does the inferior rectus axis of rotation form with the y axis
67 degrees
in primary position what is the primary action of the inferior rectus
depression
in primary position what is the secondary action of the inferior rectus
excycloduction
in primary position what is the tertiary action of the inferior rectus
adduction
what does RADSIN impose about recti muscles
recti ADDUCT
what does RADSIN impose about superior muscles
superiors INTORT
what does the inferior rectus axis of rotation coincide with when the globe is abducted 23 degrees
x axis
what does the inferior rectus axis of rotation coincide with when the globe is abducted 67 degrees
y axis
when the inferior rectus coincides with the x axis, what does it purely become
pure depressor
when the inferior rectus coincides with the y axis, what does it purely become
pure excycloduction
what angle does the superior oblique axis of rotation form with the x axis
54 degrees
what angle does the superior oblique axis of rotation form with the y axis
36 degrees
in primary position, what is the primary action of the superior oblique
incycloduction
in primary position, what is the secondary action of the superior oblique
depression
in primary position, what is the tertiary action of the superior oblique
abduction
when the superior oblique coincides with the y axis i.e. abducts 36 degrees, what does it purely become
pure incycloduction
when the superior oblique coincides with the x axis i.e. adducts 54 degrees, what does it purely become
pure depressor
what angle does the inferior oblique axis of rotation form with the y axis
39 degrees
what angle does the inferior oblique axis of rotation form with the x axis
51 degrees
in the primary position, what is the primary action of the inferior oblique
excylcoduction
in the primary position, what is the secondary action of the inferior oblique
elevation
in primary position, what is the tertiary position of the inferior oblique
abduction
which EOMs is the tertiary action of when in primary position
abduction
when the inferior oblique coincides with the y axis i.e. abducts 39 degrees, what does it purely become
pure excycloduction
when the inferior oblique coincides with the x axis i.e. adducts 51 degrees, what does it purely become
pure elevator
which EOMs have three actions in primary position
SR, IR, SO & IO
when the eye is adducted, what does the superior oblique produce
depression
when the eye is adducted, what does the inferior oblique produce
elevation
when the eye is abducted, what does the superior rectus produce
elevation
when the eye is abducted, what does the inferior rectus produce
depression
list which actions the superior oblique has in primary position
- elevation
- adduction
- intorsion
list which actions the inferior oblique has in primary position
- elevation
- abduction
- extorsion