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The Pupillary Pathway and its
Clinical Aspects
Outline
๏‚— Anatomy
๏‚— Physiology
๏‚— Clinical Examination
๏‚— Afferent Pathway defects
๏‚— Efferent Pathway defects
The Afferent Pathway
Optic tract
Nasal Fibers decussate in optic chiasm
Travels centrally along the optic nerve
Ganglion cells
Rods and cones AND
Melanopsin Retinal Ganglion cells
The Afferent Pathway(contd.)
The Accessory motar nuclei of
EW nucleus
New relay fibers partially cross
over
Pretectal Nucleus
Midbrain from Lateral side of
Superior colliculus
The Efferent Pathway
Located inferiorly as it enters the
orbit
Passes laterally to petroclinod
ligament and dorsum sellae
Lie on the superficial dorsomedial
aspect as it leave the brain stem
The axons of the EW nucleus extend
into the III n.
Inferior
division of III
n.
Ciliary
Ganglion
Via short
Ciliary
nerves
Sphincter
Pupillae
Sympathetic Pathway
Pathway of Convergence Reflex
Fibers form Medial Rectus m.
via III n.
Mesencephalic n. of V n.
Convergence Center in Tectal
or Pre Tectal Region
EW Nucleus
Efferent fibers travel along III
n.
Relay in Accessory Ganglion
Sphincter Pupillae
Pathway of Accommodation Reflex
Retina
Via Optic nerve,
Chaisma Optic Tract
Lateral Geniculate
Body
Striate Cortex
From the Para
Striate Cortex
Via
Occipitomesencephalic
Tract and Pontine center
EW Nucleus
Via III n. to
Sphincter Pupillae

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thepupillarypathwayanditsclinicalaspects-140606225628-phpapp02.pptx

  • 1. The Pupillary Pathway and its Clinical Aspects
  • 2. Outline ๏‚— Anatomy ๏‚— Physiology ๏‚— Clinical Examination ๏‚— Afferent Pathway defects ๏‚— Efferent Pathway defects
  • 3. The Afferent Pathway Optic tract Nasal Fibers decussate in optic chiasm Travels centrally along the optic nerve Ganglion cells Rods and cones AND Melanopsin Retinal Ganglion cells
  • 4. The Afferent Pathway(contd.) The Accessory motar nuclei of EW nucleus New relay fibers partially cross over Pretectal Nucleus Midbrain from Lateral side of Superior colliculus
  • 5. The Efferent Pathway Located inferiorly as it enters the orbit Passes laterally to petroclinod ligament and dorsum sellae Lie on the superficial dorsomedial aspect as it leave the brain stem The axons of the EW nucleus extend into the III n.
  • 6. Inferior division of III n. Ciliary Ganglion Via short Ciliary nerves Sphincter Pupillae
  • 8. Pathway of Convergence Reflex Fibers form Medial Rectus m. via III n. Mesencephalic n. of V n. Convergence Center in Tectal or Pre Tectal Region EW Nucleus Efferent fibers travel along III n. Relay in Accessory Ganglion Sphincter Pupillae
  • 9. Pathway of Accommodation Reflex Retina Via Optic nerve, Chaisma Optic Tract Lateral Geniculate Body Striate Cortex From the Para Striate Cortex Via Occipitomesencephalic Tract and Pontine center EW Nucleus Via III n. to Sphincter Pupillae

Editor's Notes

  1. Melanopsin Retinal Ganglion cells act via the input received from the rods and cones but also a direct transduction of light invokes a light reflex.
  2. Fibers pass into the midbrain from the lateral side of superior colliculus Reach the Pretectal nucleus where they terminate. New relay fibers partially cross the posterior commisurae ,go ventrally from the aqueduct They reach the Accessory motar nuclei of EW nucleus on both Ipsilateral and contra lateral side
  3. From the inferior division of the III n. by the way of its branch to Inf Oblique m . A short and a thick nerve trunk reaches the ciliary ganglion. Myelinated PG PS terminate in synapses with ganglionic neurons. The PG fibers innervate the sphincter pupillae.through the short ciliary
  4. Affeerent fibers from MR via III n. To Mesencephalic nuclei of 5th n To convergence center in Tectal or Pre Tectal region From convergence center to EW nucleus Efferent fibers travel along the III n. Relay in accessory ganglion Reaches the sphincter pupillae
  5. From Retina to Para striate cortex Via ON,chiasma,OT, LGB,optic radiation and Striate cortex Relay the impulses from para striate cortex to EW nucleus of both sides Via the occipito mesencephalic tract and the pontine center Efferent fibers travel along the III n. Relay in accessory ganglion Reaches the sphincter pupillae