SlideShare a Scribd company logo
Oculomotor nerve
Dr / Hytham Nafady
Introduction
Oculomotor nerve consists of two components with
distinct functions:
Somatic motor
(general somatic efferent)
Supplies 4 of the 6 extraocular
muscles of the eye and the
levator palpebrae superioris
muscle of the upper eyelid.
Visceral motor
(general visceral efferent)
Parasympathetic innervation
of the constrictor pupillae and
ciliary muscles.
From To
Uncrossed
fibers
ipsilateral
oculomotor
nucleus
Medial rectus.
Inferior rectus.
Inferior oblique.
Crossed
fibers
Contralateral
oculomotor
nucleus
Superior rectus.
Crossed and
uncrossed
fibers
Both
oculomotor
nuclei
Levator palpebrae
superioris muscle.
Uncrossed
para-
sympathetic
fibers
Ipsilateral
Edinger
Westphal
nucleus
Constrictor pupliae
muscle.
Ciliary muscle.
•Medial rectus
•Inferior rectus
•Levator palpebrae
superioris
•Superior rectus
•Inferior oblique
Oculomotor nerve anatomy
Origin
Oculomotor nucleus:
• Tegmentum of midbrain at the level of
superior colliculus.
• Ventral to the peri-aqueductal grey matter.
• It is column shaped nucleus & consists of
complex subnuclei.
Edinger Westphal nucleus:
• The Edinger Westphal nucleus form the
parasympathetic general visceral efferent
(GVE) component of the nuclear complex.
• It is located medial to the rostral end of the
oculomotor nucleus.
Central segment
The central segment courses ventrally
• From the midbrain tegmentum,
• through the red nucleus,
• to emerge from the medial aspect of the
cerebral peduncle.
Cisternal segment
• Course ventrolaterally through the
interpeduncular cistern between the PCA
& SCA.
Cisternal segment of oculomotor nerve
Cn 3
Interpeduncular
cistern
Cisternal segment of oculomotor nerve
BA Cn 3SCA
PCA
Cisternal segment of oculomotor nerve
Cisternal segment of oculomotor nerve
Cisternal segment
ICA
Cavernous segment
• The oculomotor nerve enters the cavernous
sinus superior to the petro-clinoid ligament and
inferior to the inter-clinoid ligament.
• The cavernous segment of the oculomotor
nerve course through the lateral wall of the
cavernous sinus superiorly.
• It is surrounded by CSF dural cuff (oculomotor
cistern).
4 5 O
6
3
5 mx
Oculomotor cistern
Orbital segment
• The oculomotor nerve enters the orbit through
the superior orbital fissure within the annular
ring or Zinn.
• It divides into superior and inferior divisions.
• The superior division supplies the contralateral
superior rectus & levator palpebrae superioris
muscles bilaterally.
• The inferior divison supply the ipsilateral inferior
& medial recti & inferior oblique muscles.
Superior orbital fissure & annular ring of Zinn
Cn 3 i
Cn 3 s
Cn 6
Cn 4
Oculomotor palsy
Oculomotor nerve palsy
with pupillary sparing
(medical 3rd
Cn palsy)
• DM.
• Hypertension.
Oculomotor nerve palsy
without pupillary sparing
• Nucleus.
• Central segment.
• Cisternal segment.
• Cavernous segment.
• Orbital segment.
Oculomotor nucleus
Cisternal segment
Cisternal segment
PCoA aneurysm
Lymphoma
Lymphoma
Cavernous segment
Cavernous sinus lesion with 3rd
cranial nerve palsy
Schwannoma
3
Right carotid cavernous fistula with
3rd
& 4th
Cn palsy
Orbital segment
• Lesions of the orbital apex cause 3rd
, 4th
and 6th
cranial nerve palsies
Tolosa hunt syndrome
Tolosa Hunt syndrome
ophthalmoplegia
3
3
3
4
6
Testing accomdation reflex

More Related Content

What's hot

Orbit anatomy
Orbit   anatomyOrbit   anatomy
Orbit anatomy
Samuel Ponraj
 
Visual pathway
Visual pathway Visual pathway
Visual pathway
Laxmi Eye Institute
 
Anatomy OF ORBIT
Anatomy OF ORBITAnatomy OF ORBIT
Anatomy OF ORBIT
SSSIHMS-PG
 
Trochlear nerve
Trochlear nerveTrochlear nerve
Trochlear nerve
Priyanka Raj
 
3rd cranial nerve :Oculomotor nerve
3rd cranial nerve :Oculomotor nerve3rd cranial nerve :Oculomotor nerve
3rd cranial nerve :Oculomotor nerve
Kiran Suwal
 
Light reflex
Light reflexLight reflex
Light reflex
Dr.Nusrat Tariq
 
3rd, 4th and 6th cranial nerve
3rd, 4th and 6th cranial nerve3rd, 4th and 6th cranial nerve
3rd, 4th and 6th cranial nerve
saanvi2011
 
Abducens Nerve - Course and relation.
Abducens Nerve - Course and relation.Abducens Nerve - Course and relation.
Abducens Nerve - Course and relation.
Izmal Urooj
 
Anatomy of visual pathway and its lesions.
Anatomy of visual pathway and its lesions.Anatomy of visual pathway and its lesions.
Anatomy of visual pathway and its lesions.Ruchi Pherwani
 
The pupillary pathway and its clinical aspects
The pupillary pathway and its clinical aspectsThe pupillary pathway and its clinical aspects
The pupillary pathway and its clinical aspects
Laxmi Eye Institute
 
EXTRA OCULAR MUSCLES ANATOMY
EXTRA OCULAR MUSCLES ANATOMYEXTRA OCULAR MUSCLES ANATOMY
EXTRA OCULAR MUSCLES ANATOMY
Rabia Ammer
 
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
Bikash Sapkota
 
Anatomy of fourth and sixth cranial nerve 06.12.13
Anatomy of fourth and sixth cranial nerve 06.12.13Anatomy of fourth and sixth cranial nerve 06.12.13
Anatomy of fourth and sixth cranial nerve 06.12.13
DrYajuvendra Rathore
 
Visual pathways
Visual pathwaysVisual pathways
Visual pathways
SSSIHMS-PG
 
Visual pathway ppt
Visual pathway pptVisual pathway ppt
Visual pathway ppt
anupama manoharan
 
Orbital anatomy
Orbital anatomyOrbital anatomy
Orbital anatomy
Dr Kawshik Nag
 
Visual pathway and defects
Visual pathway and defectsVisual pathway and defects
Visual pathway and defectsPrashanth Reddy
 
Anatomy of the lacrimal apparatus
Anatomy of the lacrimal apparatusAnatomy of the lacrimal apparatus
Anatomy of the lacrimal apparatus
SSSIHMS-PG
 

What's hot (20)

Orbit anatomy
Orbit   anatomyOrbit   anatomy
Orbit anatomy
 
Visual pathway
Visual pathway Visual pathway
Visual pathway
 
Anatomy OF ORBIT
Anatomy OF ORBITAnatomy OF ORBIT
Anatomy OF ORBIT
 
4th cranial nerve
4th cranial nerve4th cranial nerve
4th cranial nerve
 
Trochlear nerve
Trochlear nerveTrochlear nerve
Trochlear nerve
 
3rd cranial nerve :Oculomotor nerve
3rd cranial nerve :Oculomotor nerve3rd cranial nerve :Oculomotor nerve
3rd cranial nerve :Oculomotor nerve
 
Light reflex
Light reflexLight reflex
Light reflex
 
3rd, 4th and 6th cranial nerve
3rd, 4th and 6th cranial nerve3rd, 4th and 6th cranial nerve
3rd, 4th and 6th cranial nerve
 
Abducens Nerve - Course and relation.
Abducens Nerve - Course and relation.Abducens Nerve - Course and relation.
Abducens Nerve - Course and relation.
 
Anatomy of visual pathway and its lesions.
Anatomy of visual pathway and its lesions.Anatomy of visual pathway and its lesions.
Anatomy of visual pathway and its lesions.
 
The pupillary pathway and its clinical aspects
The pupillary pathway and its clinical aspectsThe pupillary pathway and its clinical aspects
The pupillary pathway and its clinical aspects
 
EXTRA OCULAR MUSCLES ANATOMY
EXTRA OCULAR MUSCLES ANATOMYEXTRA OCULAR MUSCLES ANATOMY
EXTRA OCULAR MUSCLES ANATOMY
 
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
Anatomy of optic nerve (Optic Nerve Anatomy), Blood Supply & Clinical Signifi...
 
Anatomy of fourth and sixth cranial nerve 06.12.13
Anatomy of fourth and sixth cranial nerve 06.12.13Anatomy of fourth and sixth cranial nerve 06.12.13
Anatomy of fourth and sixth cranial nerve 06.12.13
 
Visual pathways
Visual pathwaysVisual pathways
Visual pathways
 
Trochlear nerve
Trochlear nerveTrochlear nerve
Trochlear nerve
 
Visual pathway ppt
Visual pathway pptVisual pathway ppt
Visual pathway ppt
 
Orbital anatomy
Orbital anatomyOrbital anatomy
Orbital anatomy
 
Visual pathway and defects
Visual pathway and defectsVisual pathway and defects
Visual pathway and defects
 
Anatomy of the lacrimal apparatus
Anatomy of the lacrimal apparatusAnatomy of the lacrimal apparatus
Anatomy of the lacrimal apparatus
 

Similar to Oculomotor nerve

ENT and Maxillofacial and Ophtha course.pptx
ENT and Maxillofacial and Ophtha course.pptxENT and Maxillofacial and Ophtha course.pptx
ENT and Maxillofacial and Ophtha course.pptx
samirich1
 
Lecture 1 orbit-by Dr. Noura- 2018
Lecture 1 orbit-by Dr.  Noura- 2018Lecture 1 orbit-by Dr.  Noura- 2018
Lecture 1 orbit-by Dr. Noura- 2018
Dr. Noura El Tahawy
 
Lecture 1 orbit dr. noura
Lecture 1 orbit  dr. nouraLecture 1 orbit  dr. noura
Lecture 1 orbit dr. noura
Dr. Noura El Tahawy
 
USMLE NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
USMLE   NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...USMLE   NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
USMLE NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
AHMED ASHOUR
 
Neuro-Ophthalmology_Dr. Bastola.pptx
Neuro-Ophthalmology_Dr. Bastola.pptxNeuro-Ophthalmology_Dr. Bastola.pptx
Neuro-Ophthalmology_Dr. Bastola.pptx
Dr. Pradeep Bastola
 
Extraocular muscles.pptx
Extraocular muscles.pptxExtraocular muscles.pptx
Extraocular muscles.pptx
Sundip Charmode
 
Anatomy of oculomotor nerve
Anatomy of oculomotor nerveAnatomy of oculomotor nerve
Anatomy of oculomotor nerve
Pankaj Sharma
 
Occulo motor nerve dnm
Occulo motor nerve dnmOcculo motor nerve dnm
Occulo motor nerve dnm
Dharma Niranjan Mishra
 
Anatomy of Fourth and sixth cranial nerve
Anatomy of Fourth and sixth cranial nerveAnatomy of Fourth and sixth cranial nerve
Anatomy of Fourth and sixth cranial nerve
AkshatTyagi38
 
Neuro ophthalmology 2016
Neuro ophthalmology  2016Neuro ophthalmology  2016
Neuro ophthalmology 2016
DINESH and SONALEE
 
Anatomy of Orbit
Anatomy of Orbit Anatomy of Orbit
Anatomy of Orbit
Ashwani Kumar
 
Orbit
OrbitOrbit
Eye optic nerve and visal pathway.pdf
Eye optic nerve and visal pathway.pdfEye optic nerve and visal pathway.pdf
Eye optic nerve and visal pathway.pdf
ssuser393009
 
Oculomotor nerve presentation (4).pptx
Oculomotor nerve presentation (4).pptxOculomotor nerve presentation (4).pptx
Oculomotor nerve presentation (4).pptx
HasnainAzam5
 
Anatomy of 3rd cranial nerve
Anatomy of 3rd cranial nerveAnatomy of 3rd cranial nerve
Anatomy of 3rd cranial nerve
OPTOM FASLU MUHAMMED
 
CN Pathways.pptx
CN Pathways.pptxCN Pathways.pptx
CN Pathways.pptx
JomarBulcase
 
Sensory phisiology
Sensory phisiologySensory phisiology
Sensory phisiology
Tukezban Huseynova, MD
 
2 eye bony orbic and ball
2 eye bony orbic and ball2 eye bony orbic and ball
2 eye bony orbic and ball
Muhammad Zeeshan Anwar
 
EXTRAOCULAR MUSCLES.pptx
EXTRAOCULAR MUSCLES.pptxEXTRAOCULAR MUSCLES.pptx
Cranial nerves priyanka sharma seminar
Cranial nerves priyanka sharma seminarCranial nerves priyanka sharma seminar
Cranial nerves priyanka sharma seminar
Dr.Priyanka Sharma
 

Similar to Oculomotor nerve (20)

ENT and Maxillofacial and Ophtha course.pptx
ENT and Maxillofacial and Ophtha course.pptxENT and Maxillofacial and Ophtha course.pptx
ENT and Maxillofacial and Ophtha course.pptx
 
Lecture 1 orbit-by Dr. Noura- 2018
Lecture 1 orbit-by Dr.  Noura- 2018Lecture 1 orbit-by Dr.  Noura- 2018
Lecture 1 orbit-by Dr. Noura- 2018
 
Lecture 1 orbit dr. noura
Lecture 1 orbit  dr. nouraLecture 1 orbit  dr. noura
Lecture 1 orbit dr. noura
 
USMLE NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
USMLE   NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...USMLE   NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
USMLE NEUROANATOMY 07 CR N 3, 4, 6 OCULOMOTOR (III) TROCHLEAR (IV) ABDUCENS...
 
Neuro-Ophthalmology_Dr. Bastola.pptx
Neuro-Ophthalmology_Dr. Bastola.pptxNeuro-Ophthalmology_Dr. Bastola.pptx
Neuro-Ophthalmology_Dr. Bastola.pptx
 
Extraocular muscles.pptx
Extraocular muscles.pptxExtraocular muscles.pptx
Extraocular muscles.pptx
 
Anatomy of oculomotor nerve
Anatomy of oculomotor nerveAnatomy of oculomotor nerve
Anatomy of oculomotor nerve
 
Occulo motor nerve dnm
Occulo motor nerve dnmOcculo motor nerve dnm
Occulo motor nerve dnm
 
Anatomy of Fourth and sixth cranial nerve
Anatomy of Fourth and sixth cranial nerveAnatomy of Fourth and sixth cranial nerve
Anatomy of Fourth and sixth cranial nerve
 
Neuro ophthalmology 2016
Neuro ophthalmology  2016Neuro ophthalmology  2016
Neuro ophthalmology 2016
 
Anatomy of Orbit
Anatomy of Orbit Anatomy of Orbit
Anatomy of Orbit
 
Orbit
OrbitOrbit
Orbit
 
Eye optic nerve and visal pathway.pdf
Eye optic nerve and visal pathway.pdfEye optic nerve and visal pathway.pdf
Eye optic nerve and visal pathway.pdf
 
Oculomotor nerve presentation (4).pptx
Oculomotor nerve presentation (4).pptxOculomotor nerve presentation (4).pptx
Oculomotor nerve presentation (4).pptx
 
Anatomy of 3rd cranial nerve
Anatomy of 3rd cranial nerveAnatomy of 3rd cranial nerve
Anatomy of 3rd cranial nerve
 
CN Pathways.pptx
CN Pathways.pptxCN Pathways.pptx
CN Pathways.pptx
 
Sensory phisiology
Sensory phisiologySensory phisiology
Sensory phisiology
 
2 eye bony orbic and ball
2 eye bony orbic and ball2 eye bony orbic and ball
2 eye bony orbic and ball
 
EXTRAOCULAR MUSCLES.pptx
EXTRAOCULAR MUSCLES.pptxEXTRAOCULAR MUSCLES.pptx
EXTRAOCULAR MUSCLES.pptx
 
Cranial nerves priyanka sharma seminar
Cranial nerves priyanka sharma seminarCranial nerves priyanka sharma seminar
Cranial nerves priyanka sharma seminar
 

More from Hytham Nafady (17)

What am i looking at
What am i looking atWhat am i looking at
What am i looking at
 
9, 10 & 11 cranial nerves
9, 10 & 11 cranial nerves9, 10 & 11 cranial nerves
9, 10 & 11 cranial nerves
 
Intussusception
IntussusceptionIntussusception
Intussusception
 
Pulmonary embolism
Pulmonary embolismPulmonary embolism
Pulmonary embolism
 
Mediastinal ln
Mediastinal lnMediastinal ln
Mediastinal ln
 
Ln of head & neck
Ln of head & neckLn of head & neck
Ln of head & neck
 
Phakomatoses
PhakomatosesPhakomatoses
Phakomatoses
 
Club foot deformity
Club foot deformityClub foot deformity
Club foot deformity
 
Sprengel's shoulder
Sprengel's shoulderSprengel's shoulder
Sprengel's shoulder
 
Hemophilia
HemophiliaHemophilia
Hemophilia
 
Thalassemia
ThalassemiaThalassemia
Thalassemia
 
Wegner's granulomatosis
Wegner's granulomatosisWegner's granulomatosis
Wegner's granulomatosis
 
Scleroderma
SclerodermaScleroderma
Scleroderma
 
TB
TBTB
TB
 
Emphysema
EmphysemaEmphysema
Emphysema
 
Bronchiectasis
BronchiectasisBronchiectasis
Bronchiectasis
 
CSF cisterns
CSF cisternsCSF cisterns
CSF cisterns
 

Oculomotor nerve