eye and eye movements Flashcards
what are the facial bones of the orbit ? what are the neurovasculaure that it contains
facial zygomatic lacrimal maxillary sphenoid ethmoid
- maxillary N. (changes to infra orbital N. in pteryogpalatine fossa)
- infraorbital A.
- zygomatic N. (of V2)
what bone is usually most affected in a orbital blow out fracture ? what side effects will occur?
- fracture of the orbital wall caused by indirect trauma causes a “blowout” medially and inferiorly affecting the maxillary bone. the maxillary break causes orbital contents to leak into the maxillary sinus and become entrapped
- symptoms: globe ptosis (descending eyeball), diplopia, exopthalamos
optical axis vs orbital axis
the optical exes (axes of gaze) are parallel to each, while the orbital axis make a 45 degree angle with each other do to the medial wall extending father from the lateral wall and exposing more of the lateral eye
function and innervation of levator palpebrae superiorsis M.
CN- 3 oculomotor
Fxn: elevated eyelid
function and innervation of superior oblique M.
CN-4 trochlear N.
Fxn: eye intorsion, depression, and abduction
function and innervation of inferior oblique ?
CN 3- oculomotor N.
Fxn: eye extorsion, elevation, abduction
function and innervation of superior rectus M.
CN 3- oculomotor N.
FXN: eye intorsion, elevation, and adduction
function and innervation of inferior rectus M.
CN 3 - oculomotor N.
FXN- eye extorsion, depression, and adduction
function and innervation of medial rectus M.
CN- 3 Oculomotor N.
FXN: eye adduction
function and innervation of lateral rectus M.
CN- 6 Abducens N.
FXN: eye abduction
eye muscles become fixated and trapped, unable to perform function, when ?
the axes of gaze is perpendicular to the muscle fiber direction
when the eye is abducted by lateral rectus, only __ muscles can elevate and depress the eye. when the eye is adducted by medial rectus only the ___ muscles can elevate and depress the eye. why is this important/
- rectus muscles (superior and inferior rectus)
- oblique muscles (superior and inferior oblique muscles)
* important for when considering H testing
where is the trigeminal cave
behind the orbit, lateral to the cavernous sinus. is the place where the trigeminal N. splits into V1, V2, V3
what nerve gives rise to the supraorbital and supratrochlear N.
trigeminal N. –> opthalmic N. (V1) –> frontal N.
-frontal N. wlll split into the 2 branches supratrochlear N. (medially) and supraorbital N. (laterally)
what are the 3 terminal branches of opthalmic N. (v1)
- splits in the orbit into
1. nasociliary N.
2. frontal N.
3. lacrimal N.
what are the branches off the nasocilary N. and what are there functions
- infratrochlear N.
- anterior ethmoidal N. (goes to nasal cavity mucosa )
- posterior ethmoidal N. (goes to nasal cavity mucosa)
- long ciliary N. (carries sensory to cornea, and SNS to dilator muscle )
- short ciliary N. (carries carries sensory to cornea and PNS too constrictor M. and SNS to Dilator M )
oculomotor N. supplies most of the eye muscles except 2. what muscles are innervated bu the superior branch ? inferior branch ?
superior: levator palpibrae superiorus M.. ; superior rectus M.
inferior : inferior oblique M. ; inferior rectus M. ; medial rectus M.
what makes up the common ring in the orbit? what nerves go through the common tendinous ring in the orbit
*made of all 4 rectus muscles
- oculomotor n. (inferior and superior divison) (CN3)
- nasociliary N.
- abducens N. (CN 6)
- optic N. (CN 2) (with central retinal A.)
**CN 2, 3, 6 and nasociliary (off V1 , off CN5)
[ trochlear n. ; frontal n. ; lacrimal n. DO NOT ]
a lesion causing trochlear palsy would cause what side effects
- affects superior oblique M.
- head will tilt away from affected side to compensate for decreased intorsion, and double vision will be worsened with downward gaze
a lesion causing abducen palsy would cause what side effects
- affects lateral rectus M.
- cannot look laterally with the affected eye
a lesion causing oculomotor palsy would have what side effects (possibly due to posterior cerebellar A. / posterior communicating A./ superior cerebellar A. aneurysm)
-affects superior/inferior/medial rectus M. and levator palpibrae M.
- affected eye will look down and out
- complete ptosis (from no eyelid opening)
- pupil dilation (from loss of PNS to pupil)
what is horner syndrome
loss of sympathetic innervation to eye.
- contriction of pupils (miosis)
- incoplete ptosis
- skin redness / warmth (vasodilation)
- no sweating (anyhydrosis)
what supplies the tarsus muscles in the orbit and what is there function
SNS fibers (traveling with CN 3 superior branch) to keep eyelid open
*CN3 uses levator palpibrae superioris to open eyelid, and SNS stimulation helps keep it open
what is the pathway that allows for the pupillary light reflex to occur
- optic n. allows sight of the light and sends afferent fibers back to the (olivary) pretectal nucleus
- cells from the pretecal nucleus will synapse in the edinger westphal nucleus , where PNS fibers join on CN 3
- presynaptic PNS fibers will travel on CN3 to synapse on the ciliary ganglion
- postsynaptic PNS fibers will send motor innervation to pupillary constrictor muscle
* consenual response in other eye = double constriction