Podcast
Questions and Answers
Which cranial nerves supply the extraocular muscles?
Which cranial nerves supply the extraocular muscles?
- Cranial nerves 1, 2, and 3
- Cranial nerves 2, 3, and 4
- Cranial nerves 5, 6, and 7
- Cranial nerves 3, 4, and 6 (correct)
What is the main nerve supply to the eye?
What is the main nerve supply to the eye?
- Cranial nerve 3
- Cranial nerve 4
- Cranial nerve 6
- Cranial nerve 2 (correct)
Which bone forms the roof of the orbit?
Which bone forms the roof of the orbit?
- Sphenoid bone
- Maxillary bone
- Frontal bone (correct)
- Ethmoid bone
What is the shape of the orbit?
What is the shape of the orbit?
Which of the following can cause reduced perfusion to the eyeball and the optic nerve resulting in potential loss of vision?
Which of the following can cause reduced perfusion to the eyeball and the optic nerve resulting in potential loss of vision?
Which muscle is responsible for lifting the upper eyelid?
Which muscle is responsible for lifting the upper eyelid?
What is the consequence of total compression of the right optic nerve by an intraorbital tumor on the right side?
What is the consequence of total compression of the right optic nerve by an intraorbital tumor on the right side?
What is the function of the oblique muscles in the eye?
What is the function of the oblique muscles in the eye?
Which nerve provides somatic sensory innervation to the eye, lacrimal gland, orbit, and the skin around the orbit and forehead?
Which nerve provides somatic sensory innervation to the eye, lacrimal gland, orbit, and the skin around the orbit and forehead?
Which nerve runs just under the roof of the orbit and has two terminal branches, the supraorbital nerve and the supratrochlear nerve?
Which nerve runs just under the roof of the orbit and has two terminal branches, the supraorbital nerve and the supratrochlear nerve?
Which nerve carries pain and touch sensation from the cornea via its long posterior ciliary branches and supplies the structures of the eye itself, ethmoid sinus, and the skin over the nose?
Which nerve carries pain and touch sensation from the cornea via its long posterior ciliary branches and supplies the structures of the eye itself, ethmoid sinus, and the skin over the nose?
Which nerve carries somatic sensory information from the lacrimal gland, lateral conjunctiva, and a small area of skin over the lateral portion of the eyelids?
Which nerve carries somatic sensory information from the lacrimal gland, lateral conjunctiva, and a small area of skin over the lateral portion of the eyelids?
Which cranial nerve is responsible for innervating the medial rectus muscle?
Which cranial nerve is responsible for innervating the medial rectus muscle?
What is the clinical presentation of oculomotor nerve palsy?
What is the clinical presentation of oculomotor nerve palsy?
Why is abducens nerve palsy considered an ominous sign?
Why is abducens nerve palsy considered an ominous sign?
What is the function of the conchae in the nasal cavity?
What is the function of the conchae in the nasal cavity?
Which of the following sinuses is located within the frontal bone?
Which of the following sinuses is located within the frontal bone?
Which nerve(s) innervate the frontal sinus?
Which nerve(s) innervate the frontal sinus?
Which sinuses are innervated by both the V1 - Ophthalmic and V2 - Maxillary branches of the trigeminal nerve?
Which sinuses are innervated by both the V1 - Ophthalmic and V2 - Maxillary branches of the trigeminal nerve?
Which artery is involved in anterior nosebleeds?
Which artery is involved in anterior nosebleeds?
Which cranial nerves are involved in allowing and opposing superior movement of the eye?
Which cranial nerves are involved in allowing and opposing superior movement of the eye?
What structures of the orbit and nasal cavity can be identified on the CT scan?
What structures of the orbit and nasal cavity can be identified on the CT scan?
Which plane was the CT scan taken in?
Which plane was the CT scan taken in?
Which muscle is responsible for the inability to move the right eye superiorly when adducted?
Which muscle is responsible for the inability to move the right eye superiorly when adducted?
Are there any evidence of bone fractures in the CT scan?
Are there any evidence of bone fractures in the CT scan?
What was the main complaint of the patient when they came to the emergency department?
What was the main complaint of the patient when they came to the emergency department?
What nerve supplies the superior oblique muscle?
What nerve supplies the superior oblique muscle?
What is the main artery supplying the orbit?
What is the main artery supplying the orbit?
What is the result of a blockage of the central retinal artery?
What is the result of a blockage of the central retinal artery?
If a patient is asked to look up and to the right, which muscles of the left eye would you be testing?
If a patient is asked to look up and to the right, which muscles of the left eye would you be testing?
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Study Notes
Cranial Nerves and Eye Movement
- Cranial nerves III, IV, and VI supply the extraocular muscles
- The oculomotor nerve (cranial nerve III) is responsible for innervating the medial rectus muscle
- Cranial nerve III is also responsible for superior movement of the eye
- The trochlear nerve (cranial nerve IV) supplies the superior oblique muscle
- The abducens nerve (cranial nerve VI) is involved in lateral movement of the eye
Orbit and Eye Anatomy
- The frontal bone forms the roof of the orbit
- The orbit is conical in shape
- The levator palpebrae superioris muscle is responsible for lifting the upper eyelid
Nerve Supply to the Eye
- The nasociliary nerve provides somatic sensory innervation to the eye, lacrimal gland, orbit, and the skin around the orbit and forehead
- The frontal nerve runs just under the roof of the orbit and has two terminal branches, the supraorbital nerve and the supratrochlear nerve
- The nasociliary nerve carries pain and touch sensation from the cornea via its long posterior ciliary branches and supplies the structures of the eye itself, ethmoid sinus, and the skin over the nose
- The lacrimal nerve carries somatic sensory information from the lacrimal gland, lateral conjunctiva, and a small area of skin over the lateral portion of the eyelids
Clinical Presentations
- Oculomotor nerve palsy presents with drooping of the eyelid, double vision, and loss of eye movement
- Abducens nerve palsy is considered an ominous sign as it can indicate increased intracranial pressure or tumors
- Total compression of the right optic nerve by an intraorbital tumor on the right side can result in loss of vision
Nasal Cavity Anatomy
- The conchae in the nasal cavity function to warm, humidify, and filter air
- The frontal sinus is located within the frontal bone and is innervated by the supratrochlear and supraorbital nerves
- The ethmoid sinus is innervated by the nasociliary nerve
- The sphenoid sinus is innervated by the maxillary nerve
Imaging and Vasculature
- A CT scan can identify structures of the orbit and nasal cavity
- The CT scan is typically taken in the axial plane
- The ophthalmic artery is the main artery supplying the orbit
- A blockage of the central retinal artery can result in blindness
Clinical Scenario
- A patient presenting with inability to move the right eye superiorly when adducted may have a problem with the superior rectus muscle or the inferior oblique muscle
- The presence of bone fractures on a CT scan can indicate trauma
- A patient complaining of vision loss or double vision may have a problem with the cranial nerves or orbit.
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