Orbit, Eye, & Vision Part 2 - Herring

Question 1

Muscles work _____ & work in _____

Answer 1

together ; teams

** think about it, you look to the left and the left eye uses a muscle to look laterally and the right eye uses a muscle to look medially **

Question 2

Vertical axis movements of the eye = what directions?

Answer 2

medially or laterally (left and right)

Question 3

Transverse axis movements of the eye = what directions?

Answer 3

Superior or inferior (up and down)

Question 4

Anteroposterior axis movements of the eye = what directions?

Answer 4

Medial rotation (intorsion) or lateral rotation (extorsion)

(In and out aka towards the nose or not)

Question 5

Anatomical movements of the eye ALWAYS starts from eye looking directly _______

Answer 5

forward

Question 6

Isolation of Muscles or “Clinical” testing = ________ the muscle and starts from either eye in the ______ or _______ position

Answer 6

isolates ; medial ; lateral

Question 7

What muscles of the eye are responsible for movements of eyeball or raising upper eyelid

Answer 7

Extrinsic (extra-ocular)

Question 8

What muscles of the eye are responsible for controlling shape of lens & size of the pupil

Answer 8

Intrinsic

Question 9

Why do Anatomical Movements ALWAYS start from eye looking directly forward (primary position; eye at rest)

Answer 9

Due to angled approach from origin to insertion, some muscles will have complex actions

Question 10

Rectus Muscles originate as a group from

Answer 10

common tendinous ring

Question 11

What muscles = fibrous cuff that surrounds optic canal & part of superior orbital fissure

Answer 11

rectus muscles

Question 12

Rectus Muscles - Structures traveling through the common tendinous ring:

Answer 12

CN II

ophthalmic artery

nasociliary nerve

CN VI

superior & inferior division of CN III

Question 13

The rectus muscles attach to _____ ½ of eyeball (same aspect as the pupil)

Answer 13

anterior

Question 14

Anatomical Movements - Medial Rectus

Answer 14

Adducts the pupil which brings the pupil in medially (toward the nose)

Question 15

Anatomical Movements - Lateral Rectus

Answer 15

Abducts the pupil

Brings the pupil out laterally (away from the nose)

Question 16

Apex of orbit medial to axis of eyeball is the origin of what muscles

** they also pass laterally to attach to the eyeball **

Answer 16

Superior & Inferior Rectus

Question 17

Anatomical Movements - Superior Rectus

Answer 17

Elevates pupil with adduction

Brings the pupil “up & in”

Question 18

Anatomical Movements - Inferior Rectus

Answer 18

Depresses the pupil with adduction

Brings the pupil “down & in”

Question 19

What muscles do NOT originate from common tendinous ring and angle to insertion

Answer 19

Oblique muscles

Question 20

What muscles attach to the posterior 1/2 of the eyeball on the side opposite the pupil

Answer 20

Oblique muscles

Question 21

Anatomical Movements - Superior Oblique

** also, where does it attach to on the eyeball?

Answer 21

Depresses the pupil with abduction

Brings the pupil “down & out”

Attaches to posterolateral half of the eyeball

Question 22

Anatomical Movements - Inferior Oblique

Answer 22

Elevates the pupil with abduction

Brings the pupil “up & out”

Question 23

Isolation of Muscles or “Clinical” testing - Starting position for elevation/depression movements is with the pupil in the _______ or _______ position (not looking straight ahead)

Answer 23

medial or lateral

Question 24

To isolate lateral & medial rectus

Answer 24

Keep in horizontal plane (not any different than anatomical movements)

*** just asking them to look medially and laterally **

Question 25

To isolate superior rectus, have patient:

Answer 25

Bring eye lateral (using lateral rectus) Then UP

Question 26

To isolate inferior rectus, have patient:

Answer 26

Bring eye lateral (using lateral rectus) Then DOWN

Question 27

To isolate superior oblique, have patient

Answer 27

Bring eye medial (using medial rectus) Then DOWN

Question 28

To isolate inferior oblique, have patient

Answer 28

Bring eye medially (using medial rectus) Then UP

Question 29

Eye misalignment One eye is turned in a different direction than the other eye

Answer 29

Strabismus

Question 30

Eye points downward

Answer 30

Hypotropia

Question 31

Eye points outward

Answer 31

Exotropia

Question 32

Eye points upward

Answer 32

Hypertropia

Question 33

Eye points inward

Answer 33

Esotropia

Question 34

Reduced vision in one eye due to abnormal visual development early in life (lazy eye)

Answer 34

Amblyopia

Question 35

Oculomotor nerve (CN III) has ________ innervation

Answer 35

somatic motor

Question 36

Superior division of CN III innervates what 2 muscles

Answer 36

Levator palpebrae superioris, superior rectus

Question 37

Inferior division of CN III innervates

Answer 37

Medial rectus, inferior rectus, inferior oblique

Question 38

PS pathway of CN III has what kind of fibers

Answer 38

PreGPS fibers

Question 39

PS pathway of CN III The preGPS fibers synapse on what ganglion

Answer 39

Ciliary

Question 40

the ciliary ganglion of CN III is composed of ________ cell bodies

Answer 40

PostGPS

Question 41

PostGPS fibers of CN III hitch a ride on ____ ciliary nerves

Answer 41

short

Question 42

PS pathway of CN III innervates what 2 muscles

Answer 42

sphincter pupillae and ciliary muscles

Question 43

When CN III is lesioned, we can expect what 3 signs/symptoms

Answer 43

Dilated pupil Ptosis (droopiness) of upper eyelid Pupil is directed “down & out” at rest

Question 44

CN VI has _________ innervation

Answer 44

Somatic motor

Question 45

Lesion to the right CN VI when following your finger to the left:

Answer 45

Normal function of right medial rectus (Both eyes look to the left normally)

Question 46

Lesion to the right CN VI when following your finger to the right:

Answer 46

Abnormal function of right lateral rectus (Right eye looks straight ahead while left eye looks right)

Question 47

Lesion to the right CN VI When the eyes are at rest (looking straight ahead)

Answer 47

Right eye in medial position due to unopposed action of medial rectus (Right eye is inward a bit and left eye is looking straight ahead)

Question 48

CN IV has __________ innervation to the _________ muscle

Answer 48

somatic motor ; superior oblique muscle

Question 49

Lesion to the right CN IV right pupil at rest (looking straight ahead) demonstrates slight

Answer 49

elevation

Question 50

Lesion to the right CN IV Right pupil demonstrates decreased depression from the ______ position

Answer 50

medial

Question 51

Lesion to the right CN IV Patient also presented with a mild head tilt to the ______

Answer 51

left (opposite side)

Question 52

some muscles take an _________ approach because their origin is near the apex of the orbit

Answer 52

angled

Question 53

Pull insertion towards the

Answer 53

origin

Question 54

What are the extrinsic (extra-ocular) muscles

Answer 54

Levator palpebrae superioris, rectus mm, & oblique mm

Question 55

What are the intrinsic eye muscles

Answer 55

Ciliary muscle, sphincter pupillae, dilator pupillae

Question 56

Where is the common tendinous ring

Answer 56

apex of orbit

Question 57

What is the only extraocular muscle with an anterior starting point

Answer 57

inferior oblique

Question 58

What muscles elevate the pupil when looking straight ahead

Answer 58

superior rectus inferior oblique

Question 59

What muscles depress the pull when looking straight ahead

Answer 59

inferior rectus superior oblique

Question 60

once CN III is in the orbit, it divides into what 2 divisions

Answer 60

superior division inferior division

Question 61

The parasympathetic pathway of CN III only travels as part of the __________ division

Answer 61

inferior