Eye Movements

Question 1

Vertical gaze

Answer 1

Controlled by the Rostral nucleus of the medial longitudinal fasciculus (MLF).
Located in the midbrain

Question 2

Horizontal gaze

Answer 2

Controlled by the Paramedian pontine reticular formation.
Located in the Pons

Question 3

MLF connecs

Answer 3

III, IV and VI CN nuclei

Question 4

MLF is

Answer 4

Medial long fasciculus

Question 5

Why does MLF connect the III, IV and VI CN nuclei?

Answer 5

To coordinate eye movements

Question 6

Double vision is caused by

Answer 6

Damage in a cranial nerve innervating a muscle.
Cerebellar problems.
(If it persists with a single eye = psychiatric)

Question 7

Superior rectus movements

Answer 7

Supradduction + adduction

Question 8

Lateral rectus movements

Answer 8

Abduccion

Question 9

Inferior rectus movements

Answer 9

Infradduction + adduction

Moves the eye down

Question 10

Inferior oblique movements

Answer 10

Supradduction + adduction

Question 11

Medial rectus movements

Answer 11

Adduction

Question 12

Superior oblique movements

Answer 12

Infradduction + adduction

Rotates the eye
Moves the eye down + lateral

Question 13

Elevation of the eyelids

Answer 13

Tarsal muscle (S innervation)
Levator palpebrae superioris muscle (III CN)

Question 14

Horner syndrome cause

Answer 14

Damage of Tarsal muscles or its innervation

Question 15

Horner’s syndrome manifestations

Answer 15

Ptosis (dropping of the upper eyelid)
Myosis (small pupil size) as we lose sympathetic tone
Enophthalmos (posterior displacement of the eye, retracted)

Question 16

Damage to III CN or to Levator palpebrae muscle manifestations

Answer 16

Ptosis
Midriasis
Weakness in muscles innervated by the III CN

Question 17

Differences between III CN damage and Horner syndrome

Answer 17

III vs Horner

Pupillary size: large (midriasis) / small (miosis)
Response to light: depressed / normal
Eye movements: weakness in muscles innervated by III CN / normal

Question 18

Who gives the tone (pupils larger/smaller)?

Answer 18

Sympathetic system

Question 19

Who controls the reaction to light?

Answer 19

Parasympathetic system

(reaches the eye by exiting Edinger-Westphal nucleus in midbrain along with the III CN. Its effect is to cause miosis)

Question 20

Dilated pupil can be caused by

Answer 20

Peripheral damage to nerve, not urgent (expected symptom)

Brain hemorrhage or herniation, and as the pupil is contracted, this means it is advanced = very urgent! (III CN compressed)

Question 21

Throchlear nerve damage symptoms

Answer 21

When they tilt their head towards the side of the lesion, the affected eye won’t tilt with the head as this is an effect of the superior oblique, and its not working properly.

Tilt towards the other side will be accompanied by normal eye rotation.

Question 22

Movements controlled by the cortex

Answer 22

Smooth pursuit movements
Saccadic movements

Question 23

Smooth pursuit movements - cortex regions

Answer 23

Frontal, parietal, temporal lobes (esp: parietal)

Question 24

Smooth pursuit movements - movement

Answer 24

Voluntary
Smooth
Both eyes in = direction (exc: approaching smt to eye)
Precise and fast
Unconsciously, predictive

Question 25

Saccadiac movements - cortex regions

Answer 25

Frontal lobe

Question 26

Saccadiac movements - movement

Answer 26

We don’t look at faces as a whole -> patterns
Constantly moving the eyes (little tiny movements) to look at the different parts of the face