00:02
Now let's take a look at the
muscles that move the eyeball,
we call these the
extraocular muscles.
00:10
We have four muscles
they're oriented
and more or less a straight
position hence the term rectus.
00:16
So we have four recti muscles.
00:20
We also have two muscles oriented
and more oblique orientation.
00:24
And we call those
the oblique muscles.
00:28
Very closely associated
in the superior aspect
is a muscle that acts
on the upper eyelid
called the levator
palpebrae superioris.
00:40
Here we see the LPS or
levator palpebrae superioris
sitting superior to all
of these other muscles.
00:49
If we remove it,
we can actually see some
of our rectus muscles.
00:55
And we see that
these rectus muscles
attached to a tendinous
ring near the orbital apex.
01:02
We have a lateral rectus
and a medial rectus,
as well as an inferior rectus
and a superior rectus.
01:12
One thing to note here
about the shape of the orbit
is that the inferior
and superior rectus
don't point directly
straight ahead,
they actually point somewhat
laterally as they move forward.
01:27
Now let's look at
the oblique muscles.
01:31
These don't attach to
the tendinous ring.
01:35
The superior oblique attaches
near it on the sphenoid bone.
01:39
But it actually
comes up through this
little pulley system
called the trochlea
before taking a turn and
attaching to the eyeball.
01:49
The inferior oblique attaches
to the floor of the orbit
and also takes an
oblique approach
to the attachment at
the back of the eyeball.
02:02
Let's look at the innervation.
02:04
We have the superior rectus,
medial rectus,
inferior oblique
and inferior rectus
as well as that eyelid muscle,
the levator
palpebrae superioris.
02:16
All being innervated
by cranial III,
which is also called
the ocular motor nerve
given its role in these
extra ocular muscles.
02:27
And his passing through the
superior orbital fissure
to innervate these structures.
02:34
Here we see the greater
wing of the sphenoid
and the lesser wing
of the sphenoid.
02:39
And between those two
is where we find that
superior orbital fissure.
02:43
One of the other structures
that pass through that
is the trochlear nerve,
or cranial nerve IV.
02:49
And that's what innervates,
the superior oblique.
02:52
And this name helps
us to remember that
because we said it
passes through this
pulley like structure
called a trochlea,
hence the name trochlear nerve.
03:02
Here we see the lateral rectus.
03:05
And this is innervated
by cranial nerve VI,
or the abducens nerve.
03:10
And that name also
helps us remember this
because the lateral rectus
being on the lateral side
will cause the eye to
abduct, hence its name.
03:22
So let's talk about the movements
of the eyeball for a second.
03:26
The lateral rectus,
as we just said,
based off of the
orientation of its fibers
will abduct the eye
or move it laterally.
03:35
Similarly, the medial rectus
will move the eye medially.
03:41
The superior rectus
won't move it directly upward,
it will move it up and out.
03:46
Again, keeping in
mind that orientation
of the superior
and inferior rectus
because as they move forward,
they actually start to
point out laterally.
03:57
Similarly, the inferior rectus
won't just move the
eyeball downward,
it'll actually move
it down and out.
04:04
Conversely, the inferior oblique
given the orientation
of its fibers
is going to move the
eye upward and inward.
04:13
Whereas the superior oblique
is going to move it
downward and inward.
04:21
So let's look at the
eyes working together
starting with the eyes
looking straight ahead
in the primary position.
04:30
In order to elevate
or look directly up,
the extra ocular muscles
are going to work in tandem,
that means the superior
rectus and inferior oblique
will both be activated.
04:43
Similarly for depression
or looking down,
both the inferior rectus and
superior oblique will be acting.
04:51
For dextroversion or
looking to the right,
the right eyeball will
move via the lateral rectus
and the left will move
via the medial rectus.
05:03
For looking up into the right,
the right eye only needs
to use the superior rectus
while the left only needs
to use the inferior oblique.
05:13
And similarly, by looking
downward and to the right,
only the inferior rectus
is needed on the right eye
and only the superior
oblique for the left.
05:24
In terms of laevoversion
or looking to the left,
it would be just the opposite.
05:28
In this case, the left eye
would use the lateral rectus
and the right I would
use the medial rectus.
05:34
And similarly for
looking up into the left
or left eye would
use superior rectus
and the right inferior oblique.
05:43
And looking down into the left,
same thing.
05:46
Or left eye would need
to use inferior rectus
and our right superior oblique.