Eye and head movements Flashcards

1
Q

What are the components that control gaze and stabilise an image on the retina?

A

Oculomotor system: moves eyes in orbit whilst head is still

Head-movement system: moves eye sockets as a whole whilst head moves

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2
Q

Describe the different types of eye movements?

A

Saccadic: shift fovea rapidly to new visual target

Smooth pusruits: keep image of a moving target on fovea

Vergence: moves eyes in opposite directions

Vesticular ocular: holds image still on retina during brief head movements

Optokinetic: holds image stationery during sustained head rotation or translation

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3
Q

Describe the extraocular muscles?

A

4 rectus muscles: superior, inferior, lateral, medial

2 obliques: inferior, superior

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4
Q

Describe the movements that can be performed by the eye?

A

Elevation/depression

Abduction/adduction

Intorsion/extorsion

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5
Q

What determines the actions of the rectus muscles?

A

Their insertion onto the eyeball

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6
Q

Describe the primary actions of the rectus muscles?

A

SR: elevation

IR: depression

MR: adduction

LR: abduction

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7
Q

Describe the insertions of the oblique muscles?

A

Insert a long way down the back of the eyeball

SO: well behind equator at an oblique angle close to LR (tendon runs through trochlea)

IO: behind equator close to LR

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8
Q

Describe the primary actions of the oblique muscles?

A

SO: torsion (also involved in depression)

IO: torsion (also involved in elevation)

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9
Q

How can each of the six eye muscles be tested in isolation?

A
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10
Q

Which lower motor neurons are involved in the neural control of eye movements?

A

Oculomotor nerve (CN III): SR, IR, MR, IO

Abducens nerve (CN VI): LR

Trochlear nerve (CN IV): SO

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11
Q

Describe the neural control of eye movements?

A

Hierarchical control of eye movement involving:

LMNs (CNs)

Brainstem centres (reticular formation)

Higher cortical areas

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12
Q

How does the neural supply of CN IV to the SO muscle differ to the innervation of the other extraocular muscles?

A

CN IV innervates contralateral SO

Others all have ipsilateral innervation

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13
Q

Which structures are responsible for coordinating the movements from one eye with the other?

A

Medial longitudinal fasiculus

Reticular formation: PPRF (pontine paramedian reticular formation) and MPRF (mesencephalic paramedian reticular formation)

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14
Q

What is the MLF?

A

Medial longitudinal fasiculus

White matter tract that connects the various cranial nerve nuclei

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15
Q

What is the function of the pontine paramedian reticular formation?

A

Horizontal gaze centre

Coordination of MR and LR of each eye (CN III and CN VI)

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16
Q

What is the function of the mesencephalic paramedian reticular formation?

A

Vertical gaze centre

Coordination of SO and SR of each eye (CN IV and CN III)

17
Q

Where is a patient’s lesion if they cannot coordinate horizontal movement of the eyes?

A

Pons

18
Q

Where is a patient’s lesion if they cannot coordinate vertical movement of the eyes?

A

Midbrain

19
Q

Describe the neural control of horizontal saccades?

A

Requires simultaneous excitation of burst neurons and inhibition of omnipause neurons

Message from cortex > excites burst neurons > stimulates ipsilateral abducens > contraction of ipsilateral LR

At same time, activates neuron in MLF > stimulates part of contralateral oculomotor nucleus > contraction of contralateral MR

Communication from PPRF inhibits contralateral abducens nucleus > contralateral LR inhbited

At same time, via MLF, inhibitory signal from contralteral abducens nucleus to ipsilateral oculomotor nucleus > ipsilateral MR inhibited

20
Q

Describe the function of burst neurons in the PPRF?

A

Fire at high frequency just before movement

Two types: excitatory and inhibitory

Excitatory: provide excitatory connections with ipsilateral abducens

Inhibitory: suppress activity of contralateral abducens

21
Q

Describe the function of omnipause neurons in the MPRF?

A

Fire continuously during the saccade, excpet when the eyes move (tell eyeballs when to stop moving)

Project to contralteral abducens nucleus

22
Q

Which neurotransmitter do omnipause neurons in the MPRF use?

A

GABA

23
Q

What drives saccadic eye movements?

A

Higher cortical processing

Frontal eye fields, superior colliculus and basal ganglia play important roles

24
Q

How is the abducens nucleus connected to the contralteral oculomotor nucleus?

A

MLF

25
Q

How are we able to maintain focus on a stationary object while moving our heads, without loss of visual focus or dizziness?

A

Input from vestibular system

26
Q

How does the vestibular system help us to maintain focus on a stationary object when our head is moving?

A

Three semiciruclar canals provide information about the head in space (fluid movement across hair cells > neural signal)

In addition, otolith organs give information about linear acceleration

27
Q

How does neural signalling within semicicrcular canals alter eye movements?

A

When fluid goes in one direction through the semicircular canal > increase in AP firing

At the same time, fluid going through the oppsoite ear will cause a decrease in AP firing

This signalling goes to the vestibular nucleus in the brainstem > integrates with eye movement system (CN III, CN VI nuclei)

28
Q

Describe the vestibular-ocular reflex?

A