{"id":12189,"date":"2022-10-20T11:15:22","date_gmt":"2022-10-20T09:15:22","guid":{"rendered":"https:\/\/www.physiotutors.com\/?post_type=wiki&p=12189"},"modified":"2022-10-20T11:15:22","modified_gmt":"2022-10-20T09:15:22","slug":"oculomotor-nerve","status":"publish","type":"wiki","link":"https:\/\/www.physiotutors.com\/wiki\/oculomotor-nerve\/","title":{"rendered":"Oculomotor Nerve"},"featured_media":12190,"template":"","class_list":["post-12189","wiki","type-wiki","status-publish","has-post-thumbnail","hentry"],"acf":{"sections":[{"acf_fc_layout":"page-header-detail-page","background":{"background_image":12190,"background_image_alt_text":"Oculomotor Nerve"},"heading":"Oculomotor Nerve | Cranial Nerve III \/ CN III Assessment","subheading":"Screening","content_editor":"","button_type":"internal_link","button_label":"Check our shop","button_style":"button-five","button_internal_link":4646,"button_anchor":"","button_url":"","button_file":"","label":""},{"acf_fc_layout":"submenu","links":[{"button_type":"anchor","button_label":"Learn","button_internal_link":null,"button_anchor":"section-number-3","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Assessment E-Book","button_internal_link":null,"button_anchor":"section-number-4","button_url":"","button_file":null},{"button_type":"anchor","button_label":"Reviews","button_internal_link":null,"button_anchor":"section-number-5","button_url":"","button_file":null}],"dropdown_label":"Go to","button_right":{"button_type":"internal_link","button_label":"Become a member","button_style":"button-three","button_internal_link":16662,"button_anchor":"","button_url":"","button_file":""},"button_description":"Find this wiki on the Physiotutors platform"},{"acf_fc_layout":"content-content","section_options":{"vertical_alignment":"top","column_right_box":false,"column_left_width":"col-12 col-lg-4 offset"},"column_left":{"content_editor":"

Learn<\/h4>"},"column_right":{"content_editor":"

Oculomotor Nerve | Cranial Nerve III \/ CN III Assessment<\/h2>\nEye movements are controlled by three cranial nerves: the oculomotor, trochlear, and abducens nerve. Weakness of one or more of the extraocular muscles impairs movement of the affected eye and restricts its ability to gaze in a particular direction.\n\nThe ability to move the eye in all other directions is controlled by the oculomotor nerve.\u00a0 It innervates the medial rectus, superior rectus, inferior rectus and inferior oblique muscles to cause orbital rotation. It can be distinguished from the trochlear nerve (CN IV), which controls downward eye movement toward the nose, and the abducens nerve (CN VI) which controls horizontal eye movement.\n
\n\n[embed]https:\/\/www.youtube.com\/watch?v=wtUBAD--fVI[\/embed]\n\n<\/div>\nPupil Assessment<\/strong>\n\nExamination of the cranial nerves III, IV & VI is usually carried out together and starts with the pupils. Inspect the size shape and symmetry of the pupils. The pupillary light reflex is elicited by shining a light into the eyes and assesses the oculomotor nerve which innervates the sphincter pupillae muscle constricting the pupil.\n\nShining a light into one eye should result in constricting of that eye's pupil, called the direct response, as well as constriction of the other pupil called the indirect response. Damage to the oculomotor nerve results in absence of the light reflex.\n\nNext assess the accommodation reflex. The patient is asked to first look into the distance and then focus on the tip of their nose in the second step. Here the pupil should also constrict.\nEye Movement Assessment<\/strong>\n\nEye movements in each direction can be assessed in six steps. Without moving the head, the patient is asked to gaze:\n
    \n \t
  1. Upward and to the right<\/li>\n \t
  2. Upward and to the left<\/li>\n \t
  3. Horizontally to the right<\/li>\n \t
  4. Horizontally to the left<\/li>\n \t
  5. Downward and to the right<\/li>\n \t
  6. And downward and to the left<\/li>\n<\/ol>\nAlternatively, ask the patient to follow a hatpin or pen in an H-Pattern.Ask the patient if they experience double vision and check for failure of movement.\n\n \n\n[cta]\n\n \n\nLearn more about the assessment of all cranial nerves below:\n