Neuro Flashcards
(236 cards)
1
Q
Frontal lobe function (5)
A
- regulate and initiate motor function
- language
- cognitive functions
- attention
- memory
2
Q
Parietal lobe function (3)
A
- sensation – touch, pain
- sensory aspects of language
- spatial orientation and self perception
3
Q
Occipital lobe function (1)
A
process visual info
4
Q
Temporal lobe function (3)
A
- process auditory info
- emotions
- memories
5
Q
limbic lobe parts (4)
A
amygdala, hippocampus, cingulate gyrus, mamillary body
6
Q
limbic lobe functions (5)
A
- learning
- memories
- reward
- emotion
- motivation
7
Q
Which are white matter tracts (3)
A
- Association fibres
- Commissural fibres
- Projection fibres
8
Q
which association fibres connect which lobes (4 pairs)
A
- superior longitudinal fasciculus (frontal nad occipital)
- arcuate fasciculus (frontal and temporal)
- Inferior longitudinal fasciculus (temporal and occipital)
- Uncinate fasciculus (anterior frontal and temporal)
9
Q
characteristics of localisation of function in primary cortices
A
- function predictable
- organised topographically
- left right symmetry
10
Q
function of primary motor cortex
A
- controls fine, discrete precise voluntary movements
- provide descending signals to execute movements
11
Q
function of premotor area
A
planning movements (externally cued)
12
Q
function of supplementary area
A
planning complex movements (internally cued)
13
Q
function of primary somatosensory area
A
process somatic sensations from receptors in body (eg fine touch, vibration, proprioception, 2-point discrimination, pain, temp)
14
Q
function of somatosensory assocation
A
interpret significance of sensory info
15
Q
difference between broca’s area and wernicke’s area
A
Broca: speak, production of language
wernicke’s understanding of language
16
Q
what happens to frontal lobe lesions
A
change in personality and inappropriate behavior
17
Q
what happens to parietal lobe lesions (eg right hemisphere lesion)
A
contralateral neglect
lack of awareness of self on left side
lack of awareness of left side of extrapersonal space
18
Q
what happens to temporal lobe lesions
A
agnosia (inability to recognise), anterogade amnesia (cannot form new memories)
19
Q
what happens to broca’s and wernicke’s area lesions
A
broca: expressive aphasia (poor production of speech)
wernicke’s: comprehensive aphasia (poor comprehension of speech, production is fine)
20
Q
what happens to primary visual cortex lesion
A
blindness in corresponding part of visual field
21
Q
what happens to visual association lesion
A
deficits in interpretation of visual info
prosopagnosia (inability to recognise familiar or learn new faces
22
Q
what are some scans to assess cortical function
A
PET (positron emission tomography)
fMRI
EEG (electroencephalography)
MEG (magnetoencephalography)
TMS (transcranial magnetic stimulation)
tDCS (transcrania direct current stimulation)
23
Q
what are some scans to assess structures
A
DTI (Diffusion tensor imaging) –> based on diffusion of water molecules
24
Q
what is MS
A
autoimmune
loss of myelin from neurons of CNS
25
main symptoms of MS (5)
blurred vision
fatigue
difficulty walking
numbness and tingling
muscle stiffness
26
what are the blood supplies to brain
carotid artery and vertebral
artery
27
what are types of haemorrhage (4)
epidural, subdural, subarachnoid, intracerebral
28
what is extradural haemorrhage
trauma caused
immediate clinical effects (arterial, high pressure)
29
what is subdural haemorrhage
trauma caused
delayed presentation of clinical effects (venous, low pressure)
30
what is subarachnoid haemorrhage
ruptured anneurysm
31
what is intracererbral haemorrhage
spontaneous hypertensive
32
risk factors of stroke
age
hypertension
DM
smoking
cardiac disease
33
what are the cerebral artery perfusion for cerebrum
anterior, middle, posterior cerebral artery
34
what are anterior cerebral artery symptoms lesion
paralysis of contralateral structures (leg > arm) , loss of appropriate social behavior, disturbance of intellect, executive function &w judgement
35
what is middle cerebral artery symptoms lesion
classic stroke
contralateral hemiplegia (arm > leg)
contralateral hemisensory deficits
hemianopia
aphasia
36
what is posterior cerebral artery symptoms lesion
visual deficits (homonymous hemianopia, visual agnosia)
37
what are the 2 major descending tracts
pyramidal(pass thru pyramids of medulla) and extrapyramidal (dont pass thru pyramids of medulla)
38
what are the 2 pyramidal tract pathway
corticospinal
corticobulbar
39
what are the 4 extrapyramidal tract pathway
tectospinal
vestibulospinal
rubrospinal
reticulospinal
40
function of pyramidal tracts
voluntary movements of body and face
41
where nerve pass from in pyramidal tracts
motor cortex to spinal cord or cranial nerve nuclei in brainstem
42
function of extrapyramidal tracts
involuntary movements for balance and posture and locomotion
43
where nerve pass from in extrapyramidal tracts
brainstem nuclei to spinal cord
44
function of primary motor cortex
controls fine, discrete voluntary movements
provide descending signals to execute movements
45
function of premotor area
plan movements
regulate externally cued movements
46
function of supplementary area
plan complex movements (internally cued, speech)
47
function of vestibulospinal
stabilise head during body &head movements
coordinate head movements with eye movemetns
mediate postural adjustments
48
function of tectospinal
orientation of head and neck during eye movements
from superior colliculus of midbrain
49
function of reticulospinal
from medulla n pons
change in muscle tone asociated with voluntary ovement
postural ability
50
upper motor neuron lesion negative signs (3)
loss of voluntary motor function
paresis (graded weakness of movements)
paralysis (complete loss of voluntary muscle activity)
51
upper motor neuron lesion positive signs (5)
increased abnormal motor function due to loss of inhibitory descending inputs
spasticity (increase muscle tone)
hyper-reflexia (exaggerated reflexes)
clonus (abnormal oscillatory muscle contraction)
babinski's sign (abrnomal response in foot)
52
lower motor neuron lesion signs (6)
weakness
hypotonia
hyporeflexia
muscle atrophy
fasciculations (visible twitch)
fibrillations (twitching of individual muslce fibres, recorded in needle EMG)
53
what is motor neuron disease (MND)
neurodegenerative disorder of motor system
54
MND Upper Motor Neuron signs
spasticity (increased tone of limbs and tongue)
babinski's sign
brisk limbs and jaw reflexes
loss of dexterity
dysarthria(difficulty speaking)
dysphagia (difficulty swallowing)`
55
MND lower motor neuron signs
weakness
muscle wasting
tongue fasciulations and wasting
nasal speech
dysphagias
56
structure of basal ganglia
caudate nucleus
lentiform nucleus (lentiform +caudate = putamen)
caudate +putamen = striatum
substantia nigra (midbrain)
57
function of basal ganglia
decision to move
perform associated movements (change facial expression)
perform movements in order
suppress unwanted movements
58
signs of parkinson's disease
bradykinesia
hypomimic face
akinesia
rigidity
tremor at rest
59
what is parkinson's disease
degeneration of dopaminergic neurons that originate in substantia nigra and project to striatum
60
what is huntington's disease
degeneration of GABAergic neuron in striatium, caudate and then putamens
61
signs of huntington's
choreic movements
rapid jerky involuntary mvoements (hand--> face --> legs --> rest of body)
speech impairment
difficulty swallowig
dementia
cognitive decline
unsteady gait
62
what is ballism
from stroke affecting subthalamic nucelus
uncontrolled flinging
contralaterally
63
what is cerebellum separated from cerebrum by
tentorium cerebelli
64
signs of cerebella dysfunction
ataxia (impairment in movement coordination and accuracy)
dysmetria (inappropriate force and distance for target directed movement)
intention tremor
dysdiadochokinesian (inability to preform rapidly alternating movements)
scanning speech (staccato)
65
what is alpha motor neuron
LMN of brainstem and spinal cord
innervate extrafusal muscle fibres of skeletal muscles
activate muscle contraction
66
what are the 3 types of motor unit
S, type l
FR, type llA
FF, type llB
67
how do we regulate muscle force
recruitment and rate coding
68
motor unit type switching
llB to llA after training
l to ll in severe deconditioning or spinal cord injury
loss of l and ll but preferentially ll in ageing
69
what stimulates involuntary coordinated pattern
peripheral stimuli
70
example of descending control of reflexes
jendrassik manoeuvre
71
which dominates normal condition, inhibitory or excitatory control
inhibitory
72
which dominates decrebration condition, inhibitory or excitatory control
excitatory from suprasinal areas
73
what is order of descending control of reflexes
activate alpha motor neurons
activate inhibitory interneurons
activate propriospinal neurons
activate gamma motor neurons
activate terminals of afferent fibres
74
what motor neuron is hyper reflexia associated with
UMN lesion
75
what is clonus (abnormal, hyper reflexia) associated with
UMN lesion
involuntary and rhythmic muscle contractions
loss of descending inhibition
76
what is babinski's sign associated with
UMN lesion
big toe curl upwards in adults when sole stimulated with blunt instrument (normally curl downwards) --> positive babinski's sign
77
what is hypo-reflexia associated with
LMN disease
78
examples of primary headache
migraine
tension-type headache
cluster headache
79
what are secondary headache
spercipitated by other condition (eg tumor)
80
which is more long lasting -- tension type or cluster headache
tension type , migraine
they can last long but usualy shorter (30mins-1hr)
81
which is more short lasting -- tension type or cluster headache
cluster headche
but usually longer (45mins -3hrs)
82
key red flags of secondary headache
age, onset, systemic symptoms, neurological signs
83
migraine characteristics
unilateral
pulsating quality
moderate or severe pain intensity
aggravation by routine physical activity
last hrs or some days
84
does migraine associate with aura
can be with or without aura
85
symptoms associated with migraine
nausea and / or vomiting
photophobia and or phonophobia
86
what is visual aura in migraine
complex array of symptoms reflecting focal cortical or brainstem dysfunction
87
how long is the graded evolution of visual aura
5-20 mins (< 1hr)
88
describe aura in migraine
expanding C
elemental visual disturbance
89
4 phases of migraine
premonitory
aura
headache
recovery
90
acute treatment for migraine
paracetamol
NSAIDS
prokinetics
triptans
91
long term preventives of migraine
TCA (tricyclic antidepressants)
B-blockers
serotonin antagonists
ACEi
calcium channel blockers
anticonvulsants
92
is tension type headache episodic
yes
93
how will patients describe tension type headache
tight muscles ard head and neck
94
characteristics of tension type headache
bilateral
mild or moderate pain
not aggravated by any movements
no added features (eg N+V, photophobia phonophobia)
95
treatments for tension type headache
simple analgesics (paracetamol, aspirin)
96
characteristics of cluster type headache
unilateral pain
at least one of the following ipsilateraly (conjnctival redness, lacrimation, nasal congestion and/or hinorrhoea, forehead and facial sweating, miosis, ptosis, restlessness or agitation, not associated with brain lesion on MRI)
97
acute treatment for cluster headache
triptan (nasal or subcutaneous)
high flow O2
98
preventive management for cluster headache
verapamil (calcium channel blcokers)
99
what is the difference between vestibular and hearing organ
vestibular: capture low frequency (movement)
hearing: capture high frequency (sound)
100
what is the function of outer ear
capture sound and focus it to tympanic membrane
amplify upper range of speech frequencies by resonance in canal
protect ear from external threats
101
function of middle ear
mechanical amplification
102
what is the hearing part of inner ear
cochlea
103
function of cochlea
transduce vibration into nerve impulses
captures the frequency and intensity of sound
104
cochlea contain which 3 compartments
1. scala vestibuli
2. scala media
3. scala tympanic
105
function of scala vestibuli and scala tympanic
bone structure
contain perilymph
high in sodium
106
function of scala media
membranous structure
contains endolymph
high in potassium
location of Organ of Corti
107
where does organ of corti lie on
basilar membrane
108
how is basilar membrane arranged
tonotopically, same principle of xylophone
109
which 2 hair cells do organ of corti contain
inner hair cells (IHC)
outer hair cells (OHC)
110
what is above the hair cells
tectorial membrane
111
function of inner hair cells
carry 95% of affernet info of auditory nerve
transduction of sound into nerve impulse
112
function of outer hair cells
carry 95% of efferent info of auditory nerve
modulate sensitivity of response
113
name of hairs of hair cell
stereocilia
114
longest cilia name
kinocilium
115
what happens when deflection of stereocilia towards kinocilium
opens K+ channels
depolarise the cell releasing NT to afferent nerve which then depolarises
116
how does stereocilia deflection change according to amplitudes
higher amptitudes, cause greater deflection of stereocilia and K+channel opening
117
describe the auditory pathway
1. spinal ganglions via CN8 (vestibulo-cochlear nerve) travels to ipsilateral cochlear nuclei in brainstem (pons)
2. auditory info crosses at superior olivary complex , after that all connections are bilateral
3. signals then travel to lateral lemnisicus, then to the inferior colliculus, then to the medial geniculate body at thalamus
4. lastly to the auditory cortex
118
what are the types of hearing loss (3)
1. conductive hearing loss: problem in outer or middle ear
2. sensorineural hearing loss: problem at cochlear (hearing organ) or auditory nerve (nerve) (90% of hearing loss)
3. central hearing loss: problem at brain and brainstem (v. rare)
119
conductive hearing loss causes
outer ear: wax, foreign body
middle ear: otitis (inflammation, build up of fluid behind eardrum)
120
sensorineural hearing loss causes
cochlear: noise, presbycusis (age related), ototoxicity (drugs, chemotherapy)
auditory nerve: acoustic neuroma
121
clinical assessments for hearing loss
weber test, rinne test, tuning fork
122
what are otoacoustic emissions (OAEs)
normal cochlea produces low intensity sounds called (OAEs), these sound are produced by OHCs as they expand and contract
performed in newborn hearing screening and hearing loss monitoring
123
where is the vestibular organ
in inner ear, contain hair cells for hearing and balance
124
what are vestibular organs (4)
utricule, saccule, semicircular canals, cochlea
125
what joims the utricule and saccule
conduit, saccule also joined to cochlea
126
what are otolith organs
utricle and saccule
127
where are utricle and saccule
on maculae, placed horizontally in utricle and vertically in saccule
128
what are maculae
contain hair cells, a gelatinous matrix , with otoliths on top
129
which otolith for which movement
utricule --> horizontal
saccule--> vertical
129
what are functions of otholiths
they are carbonate crystals, help with deflection of hairs
130
where are hair cells in canals located in
crista on ampulla
131
what do the rest of the canal has
endolymph (high in potassium)
132
what are hair cells surrounded by
cupula, which helps hair cell movement
133
describe hair cells potentials
resting potential: basal discharge to nerve
depolarisation: move towards kinocilium
hyperpolarization: move away kinocilium , reduction in nerve discharge
134
what are vestibular reflexes(2)
vestibulo-ocular reflex (VOR)
vestibulo-spinal reflec (VSR)
135
what is vestibulo ocular reflex
keep images fixed in retina
connection between vestibular nuceli and oculomotor nuclei
eye movement in opposite direction to head movement but same velocity and amplitude
136
how do we categorise vestibular disorders
timing
laterality
137
in vestibular disorder, what complaints are in acute and unilateral
imbalance, dizziness, vertigo, nausea
138
in vestibular disorder, what complaints are in slow, unilateral or any bilateral loss
imbalance and nausea, BUT no vertigo
139
where are the problems for peripheral vestibular disorders
vestibular organ or CN VIII
BPPV (bnenign paroxysmal positional vertigo)
vestibular neuritis
140
where are the problems for central vestibular disorders
CNS (brainstem or cerebellum)
stroke, MS, tumors
141
core exams for vestibular disorders
eyes, ears, legs
142
red flags for vestibular disorders
headache, gait problems, hearing loss, prolonged symptoms,hyper-acute onset
143
timings for balance disorders:
vestibular neuritis and stroke?
acute
144
timings for balance disorders:
BPPV
intermittent
145
timings for balance disorders:
migraine, meniere's disease
recurrent
146
timings for balance disorders:
schwannoma vestibular, degenerative conditions (MS)
progressive
147
what is HINTS exams for acute dizziness
Head Impulse test Nystagmus Test of Skew deviation
148
what is BPPV
peripheral disorder
otoliths (crystals) from utricle detach from maculae and float around semi-circular canals
induce bigger endolymph flow when head moves
149
what happens in alzheimers MRI
slightly large ventricle
narrowed gyri
widened sulci
atrophy
hippocampal atrophy (shrinkagemof hippocampus with space taken by CSF)
150
what is lewy bodies dementia
caused by aggregation of alpha synuclein
lead to lewy bodies deposition and internal symptoms
151
presentation of lew bodies dementia
preserved hippocampus volume
medial temporal lobe lower volume
reduced availability of dopamine transporter in caudate and putamen
152
presentation of AD
hippocampus atrophy
medial temporal lobe atrophy
153
what is meningitis and cause of it
inflammation of meninges caused by viral or bacterial infection
154
what is encephalitis and cause of it (2)
inflammation of brain caused by infection or autoimmune mechanisms
155
what is cerebral vasculitis
inflammation of blood vessel walls
156
functions of BBB
solutes that can exchange across peripheral capillaries cannot cross BBB
allows BBB to control the exchange of these substances using specific membrane transporters in and out of CNS
reduce entry of infectious agents into CNS tissue
157
what happens in BBB disruption (4steps)
1. endothelial layer disruption, BBB gets compromised (eg stroke / physical trauma)
2. blood component leas into brain including fibrinogen
3. astrocytes react to fibrinogen leakage, withdraw astrocyte end feet from vessel walls, compromising BBB
4. compromising BB leads to build up of collagen in basement membrane which narrows vessel walls leading to small vessel diseases
158
symptoms of encephalitis
- initially flu like symptoms (eg high temp and headache)
- then, confusion, disorientation, seizures, change in personality and behavior, weakness, loss of movement, speaking difficulty, loss of consciousness
159
encephalitis causes
viral infection (Herpes Simplex, Measles, varicella, rubella)
mosquito, tick, insect bites, bacterial and fungi infection, trauma, autoimmune
160
encephalitis treatment
antivirals (acyclovir)
steroids
antibiotics/antifungi
ventilation
analgesics
anti-convulsants
161
what is the cellular pathology of MS (4 steps)
inflammation
demyelination
axonal loss
neurodegeneration
162
what are some bacterial causes of meningitis
meningococcal
pneumococcal
haemophilus influenzae type B (Hib)
Streptococcal (esp in new borns)
163
what is myelitis
infection of spinal cord
164
what is encephalomyelitis
when both brain and spinal cord are involved in infection
165
hallmarks of encephalitis
fever
seizures
behvaioural changes
confusion and disorientation
166
hallmarks of meningitis
sudden fever
severe headache
n+v
double vision
drowsiness
sensitivity to bright light
stiff neck
rash
167
what are tests to diagnose meningitis / encephalitis
neurological exam
CT, MRI
lumbar puncture (CSF usually clear & colorless, low glucose in bacterial meningitis, increase WBC =infection)
blood and urine tests
168
what are common treatments for meningitis and encephalitis
AB, antivirals, corticosteroids, immune suppressors
169
what are the 3 layers of coat of eye
sclera -- hard and opaque
choroid -- pigmented and vascular
retina -- neurosensory tissue
170
what is characteristic of sclera
white of eye
high water content
protective outer coat layer
171
what is uvea
vascular coat of eyeball
172
where is uvea located
between sclera and retina
173
what does uvea consist of (3 parts from front to bk)
iris
ciliary body
choroid
(intimately connected and a disease of one part can affect the other portions but not necessarily the same degree)
174
function of retina
capture light rays that enter eyes
these light impulses are then sent to brain for processing via optic nerve
175
what does optic nerve connect to
connects to back of eye near the macula
176
what is the visible portion of optic nerve
optic disc
177
where is macula located
centre of retina, temporal to optic nerve
178
what is macula responsible for
detailed central vision eg reading
179
where is fovea
centre of macula (for detail central vision, contains only cones) so for sharper visions
180
what is blind spot
where the optic nerve meets retina and no light sensitive cells
181
which part has the highest cone photoreceptors
fovea
182
what is central vision responsible for
detail day vision
color vision
reading
facial regonsition
183
how to assess central vision
visual acuity assessment
184
what is peripheral vision responsible for
shape
movement
night vision
navigation vision
185
how to assess peripheral vision
visual field assessment
186
what happens when there is loss of visual field
unable to navigate in environment
pt need white stick
187
how many layers for retina
3
outer, middle, inner
188
function of retina outer layer
contains photoreceptors (1st order neuron)
for light detection
189
function of retina middle layer
bpolar cells (2nd order neuron)
for local signal processing to improve contrast sensitivity
190
function of retina inner layer
retinal ganglion cells (3rd order neuron)
for transmission of signal from eye to brain
191
2 main classes of photoreceptors
rods and cones
192
compare rods and cone photoreceptors
rod: x100 more sensitive to light , slow response to light , responsible for night vision , more rods than cones
cone: less sensitive to light, faster response, resposnsible for day light, fine vision and color vision
193
what lens in convex lens
converging lens
194
what lens in concave lens
diverging lens
195
what is emmetropia
perfect vision, parallel light rays fall on retina
196
what is ametropia
msimatch between axial length anad refractive power
parallel light rays don't fall on retina
197
what is near sightedness
myopia
198
what is far sightedness
hyperopia
199
what is myopia
parallel rays converge at a focal point anterior to retina
vision: not clear, genetic factor
need concave lens
200
causes of myopia
excessive long globe (long eye)
lens thinner in middle and thicker at edges
excessive refractive power
201
symptoms of myopia
blurred distance vision
headache
squint to try to improve vision
202
what is hyperopia
parallel rays converge at a focal point posterior to retina
need convex lens
203
causes of hyperopia
excessive short globe
insufficient refractive power
204
symptoms of hyperopia
visual acuity at near tends to blur relatively early
eyepain
headache in frontal region
burning sensation in eye
205
what is presbyopia
loss of accommodation for near objects naturally
start at 40yo
corrected b reading glasses to increase refractive power
206
what is near response triad
adaptations for near vision
207
steps for near response triad
pupillary miosis (reduce size of pupil) to increase depth of field (done by sphincter pupillae) thickening of lens
convergence to align both eyes towards near object (medial recti from both eyes)
accommodation to increase refractive power of lens for near vision (contraction of circular ciliary muscle)
208
visual pathway from eye to visual cortex
eye
optic nerve
optic chiasm
optic tract
lateral geniculate nucelus
optic radiation
primary visual cortex / Striate cortex
209
visual pathway of retina
first order neurons (rod and cone)
second order neurons( retinal bipolar cells)
third order neurons (retinal ganglion cells)
optic nerve (CN ll)
partial decussation at optic chiasm
optic tract
lateral geniculate nucleus in thalamus
210
how many ganglion fibres cross at optic chiasm
53%
211
what happens to crossed fibres at optic chiasm and where do they originate
originate from nasal retina
responsible for temporal visual field
212
what happens to uncrossed fibres at optic chiasm and where do they originate
originate from temporal retina
responsible nasal visual field
213
what happens to lesions anterior to optic chiasm
affect visual field in one eye only
214
what happens to lesions posterior to optic chiasm
affect visual field in both eyes
215
what happens to lesions at optic chiasm
damages crossed ganglion fibres from nasal retina in both eyes
bitemporal hemianopia (temporal field deficit in both eyes)
216
what happens to lesions posterior to optic chiasm
right side lesion-- left homonymous hemianopia in both eyes
left side lesion -- right homonymous hemianopia in both eyes
217
main cause of bitemporal hemianopia
pituitary gland tumor enlargemen
218
main cause of homonymous hemianopia
stroke
219
what is homonymous hemianopia with macular sparing
damage to primary visual cortex
often due to stroke
220
what happens to pupil in light
pupil constriction
increase depth of field
mediated by PNS in CN lll
cause circular muscle to contract
221
what happens to pupil in dark
pupil dilation
mediated by SNS
cause radial muscle contract
222
what is direct pupillary reflex
constriction of pupil of light stimulated eye
223
what is consensual pupillary reflex
constrcition of pupil of other eye
224
what is neurological basis of pupillary reflex
afferent pathway on either side alone will stimulate efferent pathway on both sides
225
what are afferent pathway of eye
sends messages from the pupil to the brain along the optic nerve to the optic tracts
226
what are efferent pathway of eye
sends the message back from the brain to the pupil via nerves, resulting in pupil constriction and dilation
227
what happens to right afferent defect
no pupil constriction in both eyes when right eye stimulated with light
normal constriction in both eyes when left eye stimulated with light
228
what happens to right efferent defect
pupil constriction
no right pupil constriction when right or left eye stimulated with light
left pupil constricts whether right or left eye stimulated with light
229
function of superior rectus
move eye up
CN lll
230
function of inferior rectus
move eye down
CN lll
231
function of lateral rectus
move eye towards outside (abduct)
CN Vl
232
function of medial rectus
move eye towards nose (adduction)
CN lll
233
function of superior oblique
move eye down and out in a diagonal pattern
CN lV
234
function of inferior oblique
move eye up and out in diagonal pattern
CN lll
236
