Inferior oblique muscle

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Inferior oblique
Eyemuscles.png
Rectus muscles:
2 = superior, 3 = inferior, 4 = medial, 5 = lateral
Oblique muscles: 6 = superior, 8 = inferior
Other muscle: 9 = levator palpebrae superioris
Other structures: 1 = Annulus of Zinn, 7 = Trochlea, 10 = Superior tarsus, 11 = Sclera, 12 = Optic nerve
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Sagittal section of right orbital cavity.
Details
Origin Orbital surface of the maxilla, lateral to the lacrimal groove
Insertion Laterally onto the eyeball, deep to the lateral rectus, by a short flat tendon
Artery Ophthalmic artery
Nerve Oculomotor nerve
Actions Extorsion, elevation, abduction
Identifiers
Latin musculus obliquus inferior bulbi
TA98 A15.2.07.019
TA2 2051
FMA 49040
Anatomical terms of muscle

The inferior oblique muscle or obliquus oculi inferior is a thin, narrow muscle placed near the anterior margin of the floor of the orbit. The inferior oblique is one of the extraocular muscles, and is attached to the maxillary bone (origin) and the posterior, inferior, lateral surface of the eye (insertion). The inferior oblique is innervated by the inferior branch of the oculomotor nerve.

Contents

Structure

The inferior oblique arises from the orbital surface of the maxilla, lateral to the lacrimal groove. Unlike the other extraocular muscles (recti and superior oblique), the inferior oblique muscle does not originate from the common tendinous ring (annulus of Zinn).

Passing lateralward, backward, and upward, between the inferior rectus and the floor of the orbit, and just underneath the lateral rectus muscle, the inferior oblique inserts onto the scleral surface between the inferior rectus and lateral rectus.

In humans, the muscle is about 35 mm long. [1]

Innervation

The inferior oblique is innervated by the inferior division of the oculomotor nerve (cranial nerve III).

Function

Its actions are extorsion, elevation and abduction of the eye.

Primary action is extorsion (external rotation); secondary action is elevation; tertiary action is abduction (i.e. it extorts the eye and moves it upward and outwards). The field of maximal inferior oblique elevation is in the adducted position.

The inferior oblique muscle is the only muscle that is capable of elevating the eye when it is in a fully adducted position. [2]

A montage of five pictures of the right eye of a male subject with partial heterochromia, demonstrating torsional eye movement Torsional eye movement with partial heterochromia.gif
A montage of five pictures of the right eye of a male subject with partial heterochromia, demonstrating torsional eye movement

Clinical significance

While commonly affected by palsies of the inferior division of the oculomotor nerve, isolated palsies of the inferior oblique (without affecting other functions of the oculomotor nerve) are quite rare.

"Overaction" of the inferior oblique muscle is a commonly observed component of childhood strabismus, particularly infantile esotropia and exotropia. Because true hyperinnervation is not usually present, this phenomenon is better termed "elevation in adduction". [3]

Surgical procedures of the inferior oblique include: loosening (also known as recession see Strabismus surgery), myectomy, marginal myotomy, and denervation and extirpation. It is also encountered and identified in lower lid blepharoplasty surgeries.

Additional images

Related Research Articles

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The abducens nerve or abducent nerve, also known as the sixth cranial nerve, cranial nerve VI, or simply CN VI, is a cranial nerve in humans and various other animals that controls the movement of the lateral rectus muscle, one of the extraocular muscles responsible for outward gaze. It is a somatic efferent nerve.

<span class="mw-page-title-main">Oculomotor nerve</span> Cranial nerve III, for eye movements

The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit through the superior orbital fissure and innervates extraocular muscles that enable most movements of the eye and that raise the eyelid. The nerve also contains fibers that innervate the intrinsic eye muscles that enable pupillary constriction and accommodation. The oculomotor nerve is derived from the basal plate of the embryonic midbrain. Cranial nerves IV and VI also participate in control of eye movement.

<span class="mw-page-title-main">Trochlear nerve</span> Cranial nerve IV, for eye movements

The trochlear nerve, also known as the fourth cranial nerve, cranial nerve IV, or CN IV, is a cranial nerve that innervates a single muscle - the superior oblique muscle of the eye. Unlike most other cranial nerves, the trochlear nerve is exclusively a motor nerve.

<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is 30 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Superior oblique muscle</span> Part of the eye

The superior oblique muscle or obliquus oculi superior is a fusiform muscle originating in the upper, medial side of the orbit which abducts, depresses and internally rotates the eye. It is the only extraocular muscle innervated by the trochlear nerve.

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<span class="mw-page-title-main">Levator palpebrae superioris muscle</span> Muscle in orbit that elevates upper eyelid

The levator palpebrae superioris is the muscle in the orbit that elevates the upper eyelid.

<span class="mw-page-title-main">Superior rectus muscle</span> Extraocular muscle that elevates the eye

The superior rectus muscle is a muscle in the orbit. It is one of the extraocular muscles. It is innervated by the superior division of the oculomotor nerve (III). In the primary position, its primary function is elevation, although it also contributes to intorsion and adduction. It is associated with a number of medical conditions, and may be weak, paralysed, overreactive, or even congenitally absent in some people.

<span class="mw-page-title-main">Inferior rectus muscle</span>

The inferior rectus muscle is a muscle in the orbit near the eye. It is one of the four recti muscles in the group of extraocular muscles. It originates from the common tendinous ring, and inserts into the anteroinferior surface of the eye. It depresses the eye (downwards).

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The medial rectus muscle is a muscle in the orbit near the eye. It is one of the extraocular muscles. It originates from the common tendinous ring, and inserts into the anteromedial surface of the eye. It is supplied by the inferior division of the oculomotor nerve (III). It rotates the eye medially (adduction).

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The extraocular muscles, or extrinsic ocular muscles, are the seven extrinsic muscles of the eye in humans and other animals. Six of the extraocular muscles, the four recti muscles, and the superior and inferior oblique muscles, control movement of the eye. The other muscle, the levator palpebrae superioris, controls eyelid elevation. The actions of the six muscles responsible for eye movement depend on the position of the eye at the time of muscle contraction.

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<span class="mw-page-title-main">Sixth nerve palsy</span> Medical condition

Sixth nerve palsy, or abducens nerve palsy, is a disorder associated with dysfunction of cranial nerve VI, which is responsible for causing contraction of the lateral rectus muscle to abduct the eye. The inability of an eye to turn outward, results in a convergent strabismus or esotropia of which the primary symptom is diplopia in which the two images appear side-by-side. Thus, the diplopia is horizontal and worse in the distance. Diplopia is also increased on looking to the affected side and is partly caused by overaction of the medial rectus on the unaffected side as it tries to provide the extra innervation to the affected lateral rectus. These two muscles are synergists or "yoke muscles" as both attempt to move the eye over to the left or right. The condition is commonly unilateral but can also occur bilaterally.

<span class="mw-page-title-main">Hypertropia</span> Condition of misalignment of the eyes

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<span class="mw-page-title-main">Trochlea of superior oblique</span>

The trochlea of superior oblique is a pulley-like structure in the eye. The tendon of the superior oblique muscle passes through it. Situated on the superior nasal aspect of the frontal bone, it is the only cartilage found in the normal orbit. The word trochlea comes from the Greek word for pulley.

<span class="mw-page-title-main">Oculomotor nerve palsy</span> Medical condition

Oculomotor nerve palsy or oculomotor neuropathy is an eye condition resulting from damage to the third cranial nerve or a branch thereof. As the name suggests, the oculomotor nerve supplies the majority of the muscles controlling eye movements. Damage to this nerve will result in an inability to move the eye normally. The nerve also supplies the upper eyelid muscle and is accompanied by parasympathetic fibers innervating the muscles responsible for pupil constriction. The limitations of eye movement resulting from the condition are generally so severe that patients are often unable to maintain normal eye alignment when gazing straight ahead, leading to strabismus and, as a consequence, double vision (diplopia).

The term gaze is frequently used in physiology to describe coordinated motion of the eyes and neck. The lateral gaze is controlled by the paramedian pontine reticular formation (PPRF). The vertical gaze is controlled by the rostral interstitial nucleus of medial longitudinal fasciculus and the interstitial nucleus of Cajal.

<span class="mw-page-title-main">Roots of the ciliary ganglion</span>

The ciliary ganglion is a parasympathetic ganglion located just behind the eye in the posterior orbit. Three types of axons enter the ciliary ganglion but only the preganglionic parasympathetic axons synapse there. The entering axons are arranged into three roots of the ciliary ganglion, which join enter the posterior surface of the ganglion.

References

PD-icon.svgThis article incorporates text in the public domain from page 1023 of the 20th edition of Gray's Anatomy (1918)

  1. Riordan-Eva, P (2011). Vaughan & Asbury's General Ophthalmology (18th ed.). New York: McGraw-Hill Medical. ISBN   978-0071634205.
  2. "Eye Theory". Cim.ucdavis.edu. Archived from the original on 2014-05-27. Retrieved 2012-12-07.
  3. Kushner BJ (2006). "Multiple mechanisms of extraocular muscle 'overaction'". Arch Ophthalmol. 124 (5): 680–8. doi: 10.1001/archopht.124.5.680 . PMID   16682590.