眼球运动与Parks三步法检查.pptx

天津职业大学眼视光工程学院;;每个锥形眼眶的薄壁由多个骨骼组成;眼眶内容物包括, 眼球，眼球被大量眶周围脂肪保护;;Note that the AXIS OF THE ORBIT is not aligned with the VISUAL AXIS OF THE EYEBALL ;Seven extraocular muscles7条眼外肌;眼外肌的解剖及功能;;;;With the exception of the SUPERIOR OBLIQUE and the LATERAL RECTUS, the extraocular muscles are innervated by CN III (OCULOMOTOR N.);眼球可沿着垂直轴，水平轴自第一眼位向右，左转，向上、下转;在第一眼位上，眼球运动的方向包括：;;;ELEVATION and DEPRESSION occur around a MEDIOLATERAL AXIS through the center of the eyeball;ELEVATION and DEPRESSION occur around a MEDIOLATERAL AXIS through the center of the eyeball;单眼运动（Ductions） ;上直肌的功能;Adduction depression extortion ;内直肌;上斜肌;下斜肌;单眼运动中的主动肌,合作肌与拮抗肌 双眼运动中的配偶肌;眼外肌的合作与拮抗关系;眼球在第一眼位时眼外肌之合作关系;眼球在第一眼位时眼外肌之拮抗关系;;INFERIOR OBLIQUE ELEVATES ABDUCTS EXTORTS;双眼运动中眼外肌的合作与拮抗关系;Sherrington法则交互神经供给 每一条肌肉的收缩总是伴有一致的,成一定比例的拮抗肌的迟缓;眼球运动的幅度;配偶肌;双眼运动（version）;;HERRING氏法则 双眼的运动一定是相等和对称的.任何来自中枢神经系统使眼球转动的神经冲动,一定同时和等量的抵达双眼,神经冲动的大小是由注视眼决定的. ;;;第一斜视角： 健眼注视，斜视眼偏斜的角度;眼肌功能分析应用----A-V征分析;向下注视分析左右下直肌或左右上斜肌： 向下V形运动，双上斜肌麻痹； 向下A形运动，双下直肌麻痹;眼外肌的检查;Since some of the muscles share common actions (e.g. elevation and depression), it is essential to isolate and test each muscle separately; Isolating individual muscles which share elevation or depression functions is accomplished by moving the eye so as to place the selected muscle at maximal mechanical advantage, perpendicular to a transverse axis through the eyeball, and the synergist at a disadvantage, by first either abducting or adducting the eye, leaving the synergist parallel to the transverse axis;Visual axis (VA);Visual axis (VA);Visual axis (VA);Visual axis (VA);Isolating the DEPRESSORS ;Park’s three ;;非视觉??射—前庭-眼反射;This woman demonstrates a lesion of the left CN VI and INTERNAL STRABISMUS;Ptosis (drooping) of eyelid from paralyzed levator palpebrae superioris Eyeball “down and out” (abducted and slightly depressed) because LR(6) and SO(4) are unopposed无对手的 All muscles paralyzed except LR and SO ;RIGHT TROCHLEAR NERVE (CN IV) PALSY;Graves Ophthal