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Block 5 > Ocular: Orbital And Ocular Innervation I > Flashcards

Ocular: Orbital And Ocular Innervation I Flashcards

1
Q

Superior division of the oculomotor nerve motor innervation:

A

-superior rectus
-lavatory palpabrae superioris

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2
Q

Inferior division of oculomotor nerve motor innervation:

A

-medial rectus
-inferior rectus
-inferior oblique

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3
Q

Trochlear nerve motor innervation:

A

Superior oblique

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4
Q

Abducent nerve motor innervation:

A

-lateral rectus

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5
Q

Facial nerve motor innervation:

A

-orbicularis oculi
-frontalis
-corrugator
-procerus

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6
Q

Optic nerve sensory innervation:

A

-transmits visual information (sight)

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7
Q

Ophthalmic nerve sensory innervation:

A

-globe
-superior eyelid
-medial regions of both eyelids

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8
Q

Maxillary nerve sensory innervation:

A

-lower eyelid

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9
Q

At the level of superior colliculus in the midbrain:

A

Oculomotor nucleus

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10
Q

At the level of the inferior colliculus in the midbrain:

A

Trochlear nucleus

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11
Q

Both oculomotor nucleus and Trochlear nucleus are located..

A

Ventral to cerebral aqueduct

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12
Q

Pons contains the:

A

Abducens, facial, and vestibular nuclei

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13
Q

Medial longitudinal fasciculus (MLF):

A

-myelinated tract enabling nerve fibers to cross over
-connects nuclei on each midline side

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14
Q

Central caudal nucleus (CCN):

A

-single, centrally located
-controls both lavator palpebrae muscles

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15
Q

Lesions at the brain stem are rare. True or false?

A

True

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16
Q

Edinger-Westphal nuclei (EWN):

A

-parasympathetic
-on each side of midline of oculomotor nucleus complex
-controls ciliary muscle and pupillary sphincter

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17
Q

Where does superior rectus sit in oculomotor nucleus complex?

A

Caudal/medial

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18
Q

Where does medial rectus sit in oculomotor nucleus complex?

A

3 different locations centrally

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19
Q

Where does inferior rectus sit in oculomotor nucleus complex?

A

Towards upper border

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20
Q

Where does inferior oblique subnuclei sit in oculomotor nucleus complex?

A

Between other nuclei

21
Q

What fibers from oculomotor nucleus continue ipsilateral?

A

Inferior rectus, medial rectus, inferior oblique

22
Q

What fibers decussate and continue contralateral from oculomotor nucleus complex?

A

Superior rectus sub nuclei

23
Q

Both levator palpebrae muscles come from a ____________________in oculomotor nucleus complex

A

Single sub nucleus

24
Q

CN 3 palsy:

A

-nerve damage including ischemia and compression (aneurysm)
-parasympathetic fibers from EWN travel peripherally relative to oculomotor fibers
-microvascular supply is more rich towards the surface (more superficial)

25
Q

Ischemic etiology in CN 3 palsy are less likely to affect..

A

parasympathetic pupillary fibers

26
Q

Aneurysm in CN 3 palsy affects…

A

Both fibers, sympathetic and parasympathetic

27
Q

Main feature of CN 3 palsy in patients

A

One eye of pt goes down and out

28
Q

Clinical features of CN 3 palsy:

A

-ptosis
-EOM deviation
-compressive causes fixed dilated pupil
-diplopia

29
Q

Trochlear nucleus is located at…

A

The midbrain at the level of inferior colliculus

30
Q

Trochlear nucleus is located:

A

-Anterior to cerebral aqueduct
-dorsal to medial longitudinal fasiculus
-inferior to oculomotor nucleus

31
Q

CN IV palsy:

A

-nerve damage including ischemia as well as compression
-motor fibers only!

32
Q

CN 4 is the only cranial nerve that emerges from…

A

Dorsal aspect of the brainstem

33
Q

CN 4 supplies the ________________ side as it decussates

A

Contralateral

34
Q

CN 4 is responsible for what movements of the eye?

A

Intorsion, depression, and abduction

35
Q

Which nerve have the longest intracranial course?

A

Trochlear nerve

36
Q

Clinical features of CN 4 palsy:

A

-torticollis (abnormal head posture)
-facial asymmetry
-strabismus (hypertropia, excyclotorsion, esotropia)
-diplopia

37
Q

Why does torticollis occur in CN 4 palsy

A

To compensate for the diplopia, pt may adopt head tilt and face turn to opposite side

38
Q

Abducens nuclei are located…

A

In the pons, lateral to the medial longitudinal fasciculus

39
Q

What nerve arcs around Abducens nerve?

A

Facial nerve (so damage here can affect both facial and Abducens nerve)

40
Q

CN 6 supplies the…

A

Ipsilateral lateral rectus

41
Q

CN 6 palsy

A

-deviations only occur in horizontal plane
-inability to abduct the eye leading to horizontal diplopia and eye sitting inward
-increased intracranial pressure

42
Q

Increased intracranial pressure can cause…

A

Downward herniation of the brainstem that can compress the nerve as it course over petrous ridge

43
Q

Cavernous sinus is located posterior to the…

A

Superior orbital fissure

44
Q

What courses through the cavernous sinus?

A

-CN 3, 4, and 6
-V1 and V2

45
Q

CN 2 travels superior to ____________________

A

Pituitary gland (above where nasal fibers decussate)

46
Q

How would CN 6 be the first nerve affected by an internal carotid artery aneurysm?

A

Located the closest to the internal carotid artery within the cavernous sinus

47
Q

Carotid-cavernous fistula (CCF)

A

-Abnormal connection between the carotid artery and/or its branches with the cavernous sinus
-can be direct (high-flow) or spontaneous (indirect/low flow)

48
Q

Symptoms of CCF:

A

-chemosis
-pulsatile proptosis
-ocular bruit (blood flow sounds coming from eye)

49
Q

Cavernous sinus receives venous blood from the…

A

Brain, orbit, and pituitary gland

Block 5 (13 decks)

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