Ophthalmoplegia

Question 1

1. ) 6 Muscles
2. ) CN3 Action
3. ) CN4 Action
4. ) CN6 Action

Answer 1

1.) SR, IR, MR, IO
SO
LR

2.) Nucleus originates at superior colliculus level at midbrain.
Eye movements and Pupils & accommodation
Levator palpebrae superioris (opens upper eye lid)

3. ) Trochlear nerve emerges from trochlear nucleus in midbrain, decussates at the brainstem and Innervates SO on contralateral side.
4. ) Nucleus located in the pons. Abducens nerve innervate LR muscle.

Question 2

Ocular Motor Palsy presentation

Answer 2

Down and out - Exotropia
Ptosis
Mydriasis (Pupil dilation)

Question 3

Trochlear Nerve Palsy presentation

Answer 3

Long intracranial route and thin - causing it to be vulnerable to trauma.
Up and out when affected.
Vertical double vision

Question 4

Abducens Nerve Palsy

Answer 4

Esotropia - type of strabismus causing one eye or both to move inwards.
More far distance than close distance.
Horizontal diplopia. (esp when looking towards affected side).

Question 5

Ocular motor causes

Answer 5

V - diabetes, aneurysm (post comm), heart disease, IHD. 
      Cavernous sinus thrombosis 
I - inflammation, infection
T - Trauma 
A - Myasthenia Gravis
M
I 
N - Space occupying lesion - tumours. 

C - congenital - genetic defect
D - MS
E -
F -

Question 6

6th Nerve palsy cause

Answer 6

Ischaemic - stroke etc. 
Trauma 
Neoplasm 
Aneurysm 
Raised ICP
Vasculitis - GCA 
Intracranial Hypertension

Question 7

4th Nerve Injury cause

Answer 7

Injury most common cause
Poor perfusion due to diabetes
Idiopathic 4th nerve palsy