Eye and Head Movements Flashcards

1
Q

What are the two components for the control of gaze?

A

Oculomotor system

Head-movement system

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2
Q

What does the oculomotor system control?

A

Moves eyes in orbit while head is still

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3
Q

What structures does the oculomotor system include?

A

Extraocular muscles

Neural pathways coordinating movement of each eye

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4
Q

What does the head-movement system control?

A

Moves eye sockets as a whole while head moves

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5
Q

What structures does the head-movement system include?

A

Vestibular system

Oculomotor system

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6
Q

What are saccadic eye movements?

A

Shifts fovea rapidly to new visual target

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7
Q

What are smooth pursuits?

A

Keeps image of moving target on fovea

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8
Q

What is vergence?

A

Moves eyes in opposite directions

  • Convergence = going cross-eyed
  • Divergence impossible
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9
Q

What are vestibular ocular movements?

A

Holds image still on retina during brief head movements

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10
Q

What are optokinetic movements?

A

Holds image stationary during sustained head rotation/translation

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11
Q

How many extraocular muscles are there?

A

6

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12
Q

What are the rectus muscles?

A

Superior rectus
Inferior rectus
Medial rectus
Lateral rectus

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13
Q

What are the oblique muscles?

A

Inferior oblique

Superior oblique

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14
Q

Which muscle does superior oblique go underneath?

A

Superior rectus

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15
Q

Which muscle does inferior oblique go near?

A

Inferior rectus

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16
Q

What kinds of actions do extraocular muscles have?

A

Primary
Secondary
Sometimes tertiary

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17
Q

What is the primary action of superior rectus?

A

Elevation

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18
Q

What is the primary action of inferior rectus?

A

Depression

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19
Q

What is the primary action of medial rectus?

A

Adduction

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20
Q

What is the primary action of lateral rectus?

A

Abduction

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21
Q

Where do the rectus muscles insert?

A

At equator

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22
Q

Where does the superior oblique insert?

A

Well behind equator at oblique angle close to lateral rectus

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23
Q

Through which structure does the tendon of the superior oblique run?

24
Q

What is the primary action of superior oblique?

A

Torsion - down and in

25
Where does the inferior oblique insert?
Behind equator close to lateral rectus
26
What is the primary action of inferior oblique?
Torsion - up and out
27
Which muscles elevate and depress the eye when it is adducted?
``` Elevate = inferior oblique Depress = superior oblique ```
28
Which muscles elevate and depress the eye when it is abducted?
``` Elevate = superior rectus Depress = inferior rectus ```
29
What does the hierarchical control of eye movements involv?
LMNs = cranial nerves Brainstem eye movement centres = reticular formation Higher cortical area = frontal eye fields
30
Where are the frontal eye fields?
Near motor cortex
31
Which muscles are innervated by the oculomotor nerve?
Superior rectus Inferior rectus Medial rectus Inferior oblique
32
Which muscles are innervated by the trochlear nerve?
Superior oblique
33
Which muscles are innervated by the abducens nerve?
Lateral rectus
34
What is the medial longitudinal fasciculus (MLF)?
White matter tract > connects various cranial nerve nuclei
35
Which cranial nerve nuclei does the MLF especially connect?
III IV VI VIII
36
What is the reticular formation?
Coordinates action of nuclei controlling eye movements
37
What are the two reticular formations?
Pontine paramedian reticular formation | Mesencephalic paramedian reticular formation
38
What does the pontine paramedian reticular formation control?
Horizontal gaze centre Coordination of medial rectus and lateral rectus of each eye Coordination of CN III and CN VI
39
What does the mesencephalic paramedian reticular formation control?
Vertical gaze centre Coordination of superior oblique and superior rectus of each eye Coordination of CN III and CN IV
40
What are burst neurons?
Fire at high frequency just before movement Excitatory connections with ipsilateral abducens Inhibitory connections suppress activity of contralateral abducens
41
What are omnipause neurons?
Fire continuously except during saccade GABAergic Project to contralateral abducens nucleus
42
What is needed for neural control of saccades?
Simultaneous excitation of burst neurons and inhibition of omnipause neurons
43
What is the sequence of events for the horizontal neural control of saccades?
1. Frontal eye fields send signal 2. Ipsilateral excitatory burst neurons in PPRF depolarises 3. Excitatory synapse in ipsilateral abducens nucleus 4. Ipsilateral CN VI sends signal 5. Lateral rectus contracts 6. MLF sends signal from ipsilateral abducens nucleus to contralateral oculomotor nucleus 7. Contralateral CN III sends signal 8. Medial rectus contracts 9. Ipsilateral inhibitory burst neurons in PPRF send signal 10. Contralateral abducens nucleus inhibited 11. Contralateral CN VI inhibited 13. Contralateral lateral rectus relaxes 14. MLF sends signal from contralateral abducens nucleus to ipsilateral oculomotor nucleus 15. Ipsilateral oculomotor nucleus inhibited 16. Ipsilateral oculomotor nerve inhibited 17. Ipsilateral medial rectus relaxes
44
What are eye movements ultimately driven by?
Behaviour
45
Which upper motor neurons drive brainstem gaze centres?
Frontal eye fields Posterior parietal cortex Superior colliculus Basal ganglia
46
In which direction do frontal eye fields control saccades?
Contralateral direction
47
What happens when there is a lesion in the medial longitudinal fasciculus?
Internuclear ophthalmoplegia
48
What provides information about the position of the head in space?
Vestibular system
49
What is the role of the vestibular system in controlling eye movements?
Coordinates position of head and eyes
50
What structure gives information about head position?
Semicircular canals
51
What structure gives information about linear acceleration?
Otolith organs - Saccule - Utricle
52
How do the vestibular sensory receptors work?
Crystals and fluid inside vestibule over hair cells Hair cells have cilia Move head > move fluid > move cilia Hair cells depolarise or hyperpolarise
53
With which cranial nerves does the vestibulocochlear nerve communicate to coordinate eye movements when the head moves in the horizontal plane?
CN III and VI
54
Which nucleus receives vestibular information?
Vestibular nuclei in medulla
55
Describe the vestibular ocular reflex when you turn your head to the left?
Left horizontal semicircular canal senses left movement 1. CN VIII carries info to left vestibular nucleus 2. Excitatory signal from vestibular to abducens nucleus 3. Right lateral rectus contracts 4. Left MLF sends signal from right abducens nucleus to left oculomotor nucleus 5. Left medial rectus contracts 6. Left vestibular nucleus also sends signal to left oculomotor nucleus 7. Left lateral rectus and right medial rectus relax