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Optometric theory and techniques > extra ocular eye movement > Flashcards

extra ocular eye movement Flashcards

1
Q

importance of eye movement

A
  • the eyes move to initiate and maintain fixation by directing the line of sight , important to keep the image on the retina
  • also important to follow objects thought saccades and pursuits
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2
Q

listing plane

A

cuts eye transverse into posterior and anterior segments

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3
Q

axes of fick

A

the glob rotates on the this

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4
Q

X axis

A

eye rotates up and down

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5
Q

Y axis

A

eye makes torsional rotations like a wheel

tilt head side to side

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6
Q

Z axis

A

eye rotates from side to side

“zide to zide”

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7
Q

Duction

A

movement or rotation of one eye around the axes of fick (monocular)
evaluated with the other eye closed and having the pt move the eye in all directions of gaze

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8
Q

version

A

binocular, simultaneous and conjugate eye movements or rotation of both eyes

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9
Q

torsion

A

twist of the eye clockwise or counterclockwise around the axes of fick

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10
Q

intorsion

A

top of the eye rotates towards nose

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11
Q

extorsion

A

top of the eye rotates away from nose

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12
Q

conjugate eye movements

A

binocular movement where the visual axis of both eyes are in the same direction to maintain fixation with both eyes. Both eyes move in the same direction, by the same amount

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13
Q

conjugate torsion

A

twists the eyes in the same direction, clockwise or counterclockwise when the head is tilted to the right or the left

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14
Q

vergence

A

disoncjugate eye movement where the eyes rotate in opposite directions
-looking at a pen close to nose, eyes are not looking in the same direction

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15
Q

convergence

A

both eyes rotate in to maintain fixation, for instance, when reading
divergence

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16
Q

divergence

A

both eyes rotate out, hard to see

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17
Q

How many extraocular muscles are there?

A

6

4 recti, 2 oblique

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18
Q

recti muscles

A

superior rectus
inferior rectus
medial rectus
lateral recuts

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19
Q

oblique muscles

A

superior oblique

inferior oblique

20
Q

horizontal recti muscles

A

in primary gaze, they are horizontal movers around the vertical Z axis

21
Q

Medial rectus

A
  • moves the eye to the nose (ADDuction)
  • innervated by CN3
  • inserts 5.5mm from nasal limbus
22
Q

lateral rectus

A
  • moves eye away from the nose (ABduction)
  • CN6
  • inserts 6.9mm from temporal limbus
23
Q

vertical recti muscles

A

similar to horizontal recti muscles, they also insert in front of the equator

24
Q

superior rectus

A
  • primary action is to move the eye up (elevation)
  • secondary action: intorsion
  • tertiary action: ADDuction
  • CN3
  • inserts 7.7mm from superior limbus
25
Q

inferior rectus

A
  • primary action-move the eye down (depression)
  • secondary action- extortion
  • tertiary-ADDuction
  • CN3
  • inserts 6.5mm behinf inferior limbus
26
Q

Medial and lateral walls

A

45 degrees of each other. the orbital axis is about 23 degrees of the two walls.

27
Q

in primary gaze, the orbital axis…

A

is at 23 degrees of the visual axis

28
Q

What EOM run with the orbital axis?

A

Vertical recti (23 degrees of visual axis)

29
Q

2 oblique muscles insert..

A

behind the equator at 51 degree angle with the visual axis

30
Q

superior oblique

A
  • primary action-torsion
  • secondary-depression
  • tertiary-abduction
  • CN4
  • passes through trochlea found between the superior and medial walls, reflects backwards and inserts in the posterior quadrant of the globe
31
Q

inferior oblique

A
  • primary action-extortion
  • secondary-elevation
  • tertiary-abduction
  • CN3
  • originates at a small depression at orbital floor. it inserts in posterior lower temporal quadrant of the globe close to the macula
32
Q

EOM involved in abduction

A
  • lateral rectus
  • medial rectus
  • inferior oblique
  • superior oblique
33
Q

EOM involved in adduction

A
  • medial rectus
  • superior rectus
  • inferior rectus
34
Q

six cardinal points

A

represent the positions of gaze where one muscle is responsible for the movement into that position

35
Q

agonist-antagonist

A

pair of muscle in the same eye that move the eye in opposite directions
medial rectus is antagonist to the lateral rectus

36
Q

synergist muscle

A

muscles in the same eye that move the eye in the same direction
inferior oblique and the superior rectus

37
Q

Yoke Muscle

A

pair of muscles, one in each eye, that produce conjugate eye movements
Right inferior oblique is the yoked muscle of the left superior rectus

38
Q

Sherrington Law of reciprocal innervation

A

increased innervation to one muscle is accompanied by a reciprocal decreased innervation to its antagonist in the same eye.

increased innervation to the left medial rectus to contract makes the left lateral rectus relax. This helps in both versions and vergences

39
Q

Hearing Law of equal innervation

A

during conjugate eye movements, equal and simultaneous innervations flow to yoked muscles. This is useful when there is a palsy to a muscle, you will notice that the yoke muscle in the other eye will overact

40
Q

purpose of evaluating ocular motility

A

assess the ability to maintain fixation (conjugate movements)

41
Q

Equipment needed to assess ocular motility

A

penlight, small target or finger puppet

42
Q

set up for assessing ocular motility

A

no glasses because you want to be able to see any misalignment, fully illuminated room

43
Q

instructions to pt when assessing ocular motility

A
  • fixate on penlight 40cm away
  • follow penlight without moving head
  • have pt report double vision, pain, strain, discomfort
  • start in primary and do H pattern
  • look for ease, accuracy, and extent of movement
44
Q

how to report ocular motility assesment

A

full and smooth for accurate and full movements

if there is abnormalities noticed, note it

45
Q

what to expect when assessing ocular motility

A
  • full range of movement with no diplopia complaints

- end point nystagmus

46
Q

end point nystagmus

A

eyes “beat” if you go over too far

47
Q

order in which to assess ocular motility

A
  1. versions

2. ductions ONLY if there were any abnormalities

Optometric theory and techniques (4 decks)

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