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57 Cards in this Set
- Front
- Back
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fick's axes |
-eye mvmts are rotations around one or more axes -the axes divide the globe into quadrants and intersect at center of rotation -center of rotation= nonmoving pt and geometric center of the eye 13.5mm behind the cornea -the center/roration can vary with ametropia more posterior in myopia more anterior in hyperopia |
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fick's axes |
x axis: the horizontal axis goes from nasal to temporal y axis: the sagittal axis goes from the anterior pole to the posterior pole (back to front of head) z axis: the vertical axis goes from superior to inferior (up and down) |
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ductions |
movements involving just one eye |
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adduction |
rotations around the vertixal axis moving the anterior pole of the globe medially |
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abduction |
rotations around the vertical axis moving the anterior pole of the globe laterally |
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elevation/supraduction |
rotation around the horizontal axis moving the anterior pole of the globe upward |
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depression/infraduction |
rotation around the horizontal axis moving the anterior pole of the globe downward |
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torsions/cycloratations |
-rotations around the sagittal axis -described in relation to a point at the 12oclock poisition on the superior limbus |
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intorsion/incyclorotation |
rotation nasally |
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extorsion/excyclorotation |
rotation temporally |
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vergence/version |
movement involving both eyes |
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vergence movements |
the eyes move in opposite left-right directions |
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convergence |
each eye is adducted |
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divergence |
each eye is abducted |
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version movements |
the eyes move in the same direction |
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dextroversion |
right gaze |
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levoversion |
left gaze |
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supraversion |
both eyes are elevated |
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intraversion |
both eyes are depressed |
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6 extraocular muscles |
medial rectus lateral rectus superior rectus inferior rectus superior oblique inferior oblique |
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common tendinous ring |
annulus of zinn -the origin for all 4 recti muscles |
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medial rectus moves the eye... is inervated by... |
-the largest of the extraocular muscles -moves the eye inward toward the nose -innervated by the inferior division of the cranial nerve III (oculomotor nerve) |
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lateral rectus moves the eye... is innervated by... |
-moves the eye outward away from the nose -innervated by cranial nerve VI (abducens nerve) |
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superior rectus moves the eye... is connected with... is innervated by... |
-moves the eye upward -the sheath of the levator muscle and the sheath of the superior rectus muscle are connected -this connection allows coordination of eye mvmt with upper eyelid position (eyelid elevates when you look up) -innervated by the superior division of cranial nerve III (oculomotor nerve) |
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inferior rectus moves the eye... part of it inserts... is innervated by... |
-moves the eye downward -part of the sheath of the inferior rectus muscle inserts into the tarsal plate -this insertion allows coordination of upper eyelid mvmt with eye mvnt (upper eyelid moves down when you look down) -innervated by the interior division of the cranial nerve III (oculomotor nerve) |
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superior oblique primary action... innervated by... |
-the longest and thininest of the extraocular muscles -its primary action is rotating the eye inward (intorsion) -innervated by cranial nerve IV (trochlear nerve) |
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inferior oblique originates on... primary action... innervated by... |
-originates on the maxillary bone where your teeth are -primary action is rotating they eye outward (extorsion) -innervated by the inferior division of cranial nerve III (oculomotor nerve) |
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___ of the 6 EOMs have a secondary and tertiary movement |
4 |
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medial rectus primary, secondary, tertiary action |
adduction no secondary no tertiary |
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lateral rectus primary, secondary, tertiary action |
abduction no secondary no tertiary |
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inferior rectusprimary, secondary, tertiary action |
depression extorsion adduction |
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superior rectusprimary, secondary, tertiary action |
elevation intorsion adduction |
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inferior obliqueprimary, secondary, tertiary action |
extorsion elevation abduction |
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superior obliqueprimary, secondary, tertiary action |
intorsion depression abduction |
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intorsion |
-the upper pole of the vertical meridian of the cornea rotates inward -performed by both the superior rectus and superior oblique (SR & SO) |
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extorsion |
-the upper pole of the vertical meridian of the cornea rotates outward -performed by the inferior rectus and inferior oblique (IR & IO) |
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abduction |
-the eye turns outward away from the nose -performed by the lateral rectus, inferior oblique, and superior oblique (LR, IO, & SO) |
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adduction |
-the eye turns in toward the nose -performed by the medial rectus, superior rectus, and inferior oblique (MR, SR, & IR) |
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elevation |
-the eye turns upward -performed by the superior rectus and inverior oblique (SR & IO) |
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depression |
-the eye turns downward -performed by the interior rectus and superior oblique (IR & SO) |
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agnoist muscles |
muscles that cause a movement |
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antagonist muscles |
muscles in the same eye, that move the eye in the opposite direction of an agonist muscle |
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stimulation of an agnoist muscle must have... |
simultaneous relaxation of an antagonist muscle ex. the medial rectus must relax in order for the eye to turn out as the lateral rectus to contract and vise versa |
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hirschberg test |
-a broad test for extraocular muscles -determines the aproximate position of the visual axes of the two eyes under binocular conditions at near |
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hirschberg test procedure |
-transilluminator towards eye 50-100 cm away -tell pt to look to the right -place your face directly behind the penlight and observe the location of the corneal light reflex in both eyes |
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hirschberg test possible positions for the corneal reflex |
-center of pupil -slightly nasal to the center of the pupil -slightly temporal to the center of the pupil |
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hirschberg test: if the reflexes are in the same relative positions, the patient has... |
no eye turn |
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hirschberg test: if the reflexes are not in the same relative positions, the patient has... |
an eye turn |
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the size of the eye turn can be extimated by measuring ____________ to ___________ |
measuring the distance from the position of the reflex in the deviated eye to the position where the reflex would be if the patient didn't have an eye turn measured in mm |
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one millimeter of deviation of the reflex is equal to ______ of eye turn |
22 diopters |
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normal reflex |
central to slightly nasal in both eyes |
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reflex is temporal |
eye is turned inward |
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reflex is nasal |
eye is turned outward |
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reflex is down |
eye is turned upward |
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recording hirschberg results |
-record the name of the test -no eye turn: record symmetry or ortho -eye turn: record the eye that's deviated, the size of the deviation in mm and direction of deviation Hirschberg: ortho Hirschberg: OS: 1mm nasal (22 diopters turned outward) Hirschberg: OD: 3mm temporal (66 diopters turned inward) |
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double H pattern: EOM assessment |
assessment of eye position and movements can be an imp tool in determining the integrity of the EOMs and associated nerves -note the position of each eye while the pt fixates on a target straight ahead -the most reliable way to determine a dysfunctional muscle is to put the eye into a position in which one muscle is primary |
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EOM procedure |
-test performed |
