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Ocular appendages
Eyelids, conjunctiva, lacrimal organs, extraocular muscles, orbits
eye socket
1.
It is composed of 7 skulls, forming a quadrangular pyramid
2.
The orbit and paranasal sinuses are adjacent
3.
Holes, fissures and fossa of the orbit
Orbital contents
Eyeball, optic nerve, extraocular muscles, lacrimal glands, blood vessels, nerves, fascia, fat
Orbicularis oculi muscle
1.
Ring-shaped
2.
Innervated by the facial nerve
3.
Eyelid closure
Lift the eyelid muscles
1.
Innervated by the oculomotor nerve
2.
Raise the upper eyelids
Muller's muscle
Innervated by sympathetic nerves, the palpebral fissure widens when contracted
Tear vessel
1.
Lacrimal gland: in the lacrimal fossa above the outer orbit, tear fluid is secreted
2.
Lacrimal duct: lacrimal gland points, lacrimal tubules, lacrimal sacs, nasolacrimal ducts
Secretion and discharge of tears
Physiological functions of tears
1.
Moisten the cornea and conjunctiva
2.
Cleaning effect
3.
Bactericidal effect on extraocular muscles
Each eye has six and eye movements
Innervation of extraocular muscles
External rectus muscle – abductor innervation
Superior oblique muscle – trochlear nerve innervation
Oculomotor innervation – superior rectus, inferior rectus, medial rectus, inferior oblique
Four rectus muscles and two oblique muscles
Superior rectus muscle (pulls the eye up) Inferior rectus muscle (pulls the eye down)
Internal rectus muscle (pulls the eye inward) External rectus muscle (pulls the eye outward)
Superior oblique (pulls the eye outward and downward) Inferior oblique (pulls the eye inward upward)
The superior rectus and inferior rectus muscles are in tug-of-war
The medial rectus and external rectus muscles are in tug-of-war
The superior and inferior oblique muscles are in tug-of-war
Ocular motor nerve walking (lateral view)
Ocular motor nerve walking (back view)
The starting and ending point of the eye muscles:
1.
The inferior oblique muscle originates from the inner and lower edge of the orbital wall
2.
The remaining muscles originate from the orbital apical general tendon ring
3.
Each muscle stops at the sclera at different distances after the angular scleral margin
Ciliary ganglia
1.
Between the optic nerve and the lateral rectus muscle, 10 mm in front of the optic nerve foramen
2.
Sensory nerve (the first trigeminal nerve), parasympathetic nerve (oculomotor nerve), sympathetic nerve (cervical sympathetic nerve)
When the nerves are damaged, the muscles that innervate them become weaker
Abductor innervates the external rectus muscle
Function of the abductor nerve: pulling the eye straight outward
Abductor nerve palsy: weakness of the lateral rectus muscle, greater relative strength of the medial rectus muscle, and the eyeball is pulled inward
The trochlear nerve innervates the superior oblique muscle
Trochlear nerve paralysis >> a relative increase in upper oblique muscle weakness >> lower oblique muscle strength>> counterclockwise turning of the eyeball>> diplopia>> patients tilt their head (or to the left or vice versa for right paralysis) >> improve symptoms
The oculomotor nerve innervates the remaining 4 extraocular muscles
Oculomotor palsy causes abduction and trochlear innervation of relatively strong muscles (rectus lateral and superior oblique), which turn the eye outward and downward
.
By understanding the extraocular muscles and neuroanatomy that govern eye activity, we can understand the dysfunction of the eye muscles caused by the associated nerve damage
.
Diplopia occurs when both eyes are looking in the same direction and the corresponding eye muscles cannot move in the same direction, which can be accompanied by changes
in head position.
Oculomotor motor innervation of the upper eyelid muscle
Oculomotor nerve palsy, causing the eyelids to droop
The parasympathetic motor branch of the oculomotor nerve controls pupil size and lens shape
The oculomotor nerve is damaged, resulting in dilated pupils and increased curvature of the lens
If the parasympathetic motor branch of the unilateral oculomotor nerve is damaged, the ipsilateral eye directly reflexes to light disappear, indirect to light reflexes, and regulatory reflexes disappear.
Roll your big watery eyes and think about which muscles are moving and which nerves are innervating
.