Diplopia Impaired Ocular Movement

ABDUCENS (VI) nerve

This nerve supplies the lateral rectus muscle

The nucleus lies in the floor of the IV ventricle within the lower portion of the pons. The axons pass ventrally through the pons without decussating.

Note the close association of the VI and VII nuclei.

Emerging from the brain stem the nerve runs up anterior to the pons for approximately 15 mm before piercing the dura overlying the basilar portion of the occipital bone.

Greater wing of sphenoid bone

VI nerve

Internal - auditory meatus

-- Foramen magnum of the eye.

Superior vestibular nucleus

tract

Cortico-

spinal tract

Medial longitudinal bundle

VI nerve nucleus

VII nerve , nucleus

Medial longitudinal bundle

VI nerve nucleus

VII nerve , nucleus

Medial lemniscus

VI nerve

Medial lemniscus

VI nerve

Under the dura the nerve runs up the petrous portion of the temporal bone and from its apex passes on to the lateral wall of the cavernous sinus and finally through the superior orbital fissure.

Note the long intracranial course and the proximity of the VI to the V cranial and greater superficial petrosal nerves at the apex of the petrous temporal bone.

VI nerve

Internal - auditory meatus

-- Foramen magnum

BASE OF SKULL

(relationship of V and VI nerves)

DIPLOPIA Paralysis

r r s ^^ 1 \ lateral impairment of movement of one eye / io\\ \ rectus results in projection of the image upon the macular area in the normal eye and to one side of the macula in the paretic eye; two images of the single object are thus perceived.

The image seen by the paretic eye is the false image-, that seen by the normal eye is the true image. The false image is always outermost-, this may lie in the vertical or the horizontal plane.

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