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Author6 Posts
  #1

Hi Could anybody help to explain why CN III palsy causes down and out? I tried to deduce but LR (by CN VI) and SO (by CN IV) are unopposed. So I think it should be UP and Out. Thanks a lot.




  #2

You are right
SO depresses the eyeball -especially in adducted postion-so the eye ball is usually out-not that much down. But it can't be UP as both elevators (SR and IO) are supplied by 3rd nerve.

  #3

nod

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  #4

Remember - despite the name, obliquus superior attaches through a pulley system so pulls the orbit inferiorly and laterally (although most lateral movement is by rectus lateralis).

  #5

actions of eyball muscles are tough to remember. Use these fundas -

RAD I/E O/O

Recti are adductors RAD (of course logically lateral rectus isn't)
Inferiors are extorters I/E (thus superiors are intorters)
Obliques act in a direction opposite to their names O/O (all recti go with their names)

Read this in mudit khanna

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98/99/ CS passed (2nd att) / Certified / 3m extern / 3US LORs / non-US research & publications / Req H1 or J1 / Appl to 100 IM / 2nd Sept

  #6

CN4, that is Trochlear nerve innervates Superior Oblique only. The reason why it is called trochlear nerve is that oblique superior mucsle is fasten by a tendon called the Trochlear and act as a pulley system, thus paradoxically depresses the eye.

CN6, thatis Abducent nerve ofc Abduct the eye, the only muscle with that primary function is Lateral Rectus.

Basically the name of the CN says it all.

Hence with CN3 is out of function, these 2 muscles still work and without antagonists they Depress and Abduct the eye.

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