Eye Muscles (Rectus lateralis, Rectus medialis, Rectus superior, Rectus inferior, Inferior
oblique, Superior oblique,
and Orbicularis oculi)
Rectus lateralis, Rectus medialis, Rectus superior, Rectus inferior
The Rectus lateralis, Rectus medialis, Rectus superior and Rectus inferior are muscles of the eye.
Anatomical Attachments:
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Rectus Superior and Inferior
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Rectus Lateralis and Medialis
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Attachments: These four muscles attach to the fibrous ring surrounding the superior, medial and inferior optic foramen after traversing the sclera. They attach to the tubercle of the great wing of the sphenoid, encompassing the optic nerve.
Action: Rectus Lateralis and Medialis translate the eye side to side along a horizontal plane. Rectus Superior elevates, adducts and medially rotates the eye. Rectus Inferior depresses, adducts and laterally rotates the eye.
Nerve Supply: Rectus Lateralis is supplied by the Abducens (Cranial nerve VI). Rectus Medialis is supplied by the oculomotor nerve (Cranial nerve III). Rectus Superior is supplied by the branch of the superior division of the oculomotor nerve (Cranial nerve III). Rectus Inferior is supplied by the branch of the inferior division of the oculomotor nerve (Cranial nerve III).
Vascular supply: Rectus Lateralis and Medialis are supplied by the inferior muscular branch of the ophthalmic artery. Rectus Superior is supplied by the supraorbital and superior branch of the ophthalmic artery. Rectus Inferior is supplied by the infraorbital branch of the maxillary and the inferior branch of the ophthalmic artery.
Inferior oblique
The Pointer Plus is an easy to use trigger point (TP) locator which
incorporates a push button stimulation feature to immediately treat
Trigger point pain.
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The Inferior oblique is a muscle of the eye.
Anatomical Attachments: Attaches to the floor of the orbit lateral to the lacrimal groove and inserts into the lateral sclera.
Action: Assists in rotating the eye laterally and superiorly.
Nerve Supply: Oculomotor nerve (Cranial nerve III).
Nerve Entrapment: Rarely entraps the greater occipital nerve.
Vascular supply: Ophthalmic.
Superior oblique
The Superior oblique is a muscle of the eye.
Anatomical Attachments: Attaches to the superior aspect of the optic foreman, superiorly and medially to the rectus superior. At the front part of the orbit, its tendon passes through a fibrocartilaginous ring or pulley; and traverses posteriorly and laterally into the sclera.
Action: Assists in inferior and lateral rotation of the eye.
Nerve Supply: Trochlear nerve (Cranial nerve IV).
Vascular supply: Superior branches of the ophthalmic artery.
Orbicularis oculi
The Orbicularis oculi is a muscle of the eye.
Anatomical Attachments:
- Origin: There are 3 parts to the orbicularis oculi: 1) the orbital part attaches from the medial orbital margin; 2) the palpebral part attaches from the palpebral ligament; 3) the frontal process anteriorly attaches to the lacrimal groove.
- Insertion: Attaches to the tissue of the eyelid.
Action: Provides protection from bright light by squinting (photophobia); it is also responsible for forceful closing of the eyelid, resulting in wrinkles to the lateral aspect of the eye. When the wrinkles become permanent in aging, they are known as crow’s feet.
Antagonist: Levator palpebrae.
Nerve Supply: Cranial nerve VII (Facial nerve).
Vascular supply: Zygomatic, the frontal branches of the superficial temporal and the angular branch of the facial artery.
Travell and Simons Trigger Point Pain Referral:
- Primary: The pain refers to the nose, cheek, and over the upper lip.
- Satellite or associated triggers: Sternocleidomastoid, Scalene, and Masticatory muscles.
Click on a small image to view an enlarged image
Trigger Point Signs and Symptoms: Inability to focus on typed words, nose pain.
Trigger Point Activating and Perpetuating Factors: Frowning, straining to see, TrP’s from surrounding muscles.
Differential Diagnosis: Tension headaches, Ankylosing Spondylitis, Benign Intracranial Hypertension, Brain Hemorrhage, Brain Tumors, Cataracts, Concussion, Conjunctivitis, Corneal Ulcers and Infections, Encephalitis, Eye Cancers, Retinitis
Pigmentosa, Glaucoma, Ophthalmic herpes zoster, Guillain-Barré Syndrome, Migraine, Hypertension, Hyphema, Hypoglycemia, Hypoparathyroidism, Hypotension, Nystagmus, Strabismus, Macular Degeneration, Multiple Sclerosis, Optic Neuritis, Stroke, Systemic Lupus Erythematosus, Uveitis and Iritis, Sinus headache, Sinusitis, Nose fracture, Nasal polyps, Frostnip, Chemical irritation secondary to recreational drug use (snorting), Systemic infections or inflammation, Nutritional inadequacy, Metabolic imbalance, Toxicity, Side effects of medication.
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