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The final aspect of testing eye movements is to move the tip of the pen in toward the patient’s face. As visual stimuli move closer to the face, the two medial recti muscles cause the eyes to move in the one nonconjugate movement that is part of gaze control. When the two eyes move to look at something closer to the face, they both adduct, which is referred to as convergence    . To keep the stimulus in focus, the eye also needs to change the shape of the lens, which is controlled through the parasympathetic fibers of the oculomotor nerve. The change in focal power of the eye is referred to as accommodation    . Accommodation ability changes with age; focusing on nearer objects, such as the written text of a book or on a computer screen, may require corrective lenses later in life. Coordination of the skeletal muscles for convergence and coordination of the smooth muscles of the ciliary body for accommodation are referred to as the accommodation–convergence reflex    .

A crucial function of the cranial nerves is to keep visual stimuli centered on the fovea of the retina. The vestibulo-ocular reflex (VOR)    coordinates all of the components ( [link] ), both sensory and motor, that make this possible. If the head rotates in one direction—for example, to the right—the horizontal pair of semicircular canals in the inner ear indicate the movement by increased activity on the right and decreased activity on the left. The information is sent to the abducens nuclei and oculomotor nuclei on either side to coordinate the lateral and medial rectus muscles. The left lateral rectus and right medial rectus muscles will contract, rotating the eyes in the opposite direction of the head, while nuclei controlling the right lateral rectus and left medial rectus muscles will be inhibited to reduce antagonism of the contracting muscles. These actions stabilize the visual field by compensating for the head rotation with opposite rotation of the eyes in the orbits. Deficits in the VOR may be related to vestibular damage, such as in Ménière’s disease, or from dorsal brain stem damage that would affect the eye movement nuclei or their connections through the MLF.

Vestibulo-ocular reflex

This diagram shows the compensating movement of the eyes in response to head rotation.
If the head is turned in one direction, the coordination of that movement with the fixation of the eyes on a visual stimulus involves a circuit that ties the vestibular sense with the eye movement nuclei through the MLF.

Nerves of the face and oral cavity

An iconic part of a doctor’s visit is the inspection of the oral cavity and pharynx, suggested by the directive to “open your mouth and say ‘ah.’” This is followed by inspection, with the aid of a tongue depressor, of the back of the mouth, or the opening of the oral cavity into the pharynx known as the fauces    . Whereas this portion of a medical exam inspects for signs of infection, such as in tonsillitis, it is also the means to test the functions of the cranial nerves that are associated with the oral cavity.

The facial and glossopharyngeal nerves convey gustatory stimulation to the brain. Testing this is as simple as introducing salty, sour, bitter, or sweet stimuli to either side of the tongue. The patient should respond to the taste stimulus before retracting the tongue into the mouth. Stimuli applied to specific locations on the tongue will dissolve into the saliva and may stimulate taste buds connected to either the left or right of the nerves, masking any lateral deficits. Along with taste, the glossopharyngeal nerve relays general sensations from the pharyngeal walls. These sensations, along with certain taste stimuli, can stimulate the gag reflex. If the examiner moves the tongue depressor to contact the lateral wall of the fauces, this should elicit the gag reflex. Stimulation of either side of the fauces should elicit an equivalent response. The motor response, through contraction of the muscles of the pharynx, is mediated through the vagus nerve. Normally, the vagus nerve is considered autonomic in nature. The vagus nerve directly stimulates the contraction of skeletal muscles in the pharynx and larynx to contribute to the swallowing and speech functions. Further testing of vagus motor function has the patient repeating consonant sounds that require movement of the muscles around the fauces. The patient is asked to say “lah-kah-pah” or a similar set of alternating sounds while the examiner observes the movements of the soft palate and arches between the palate and tongue.

Questions & Answers

structure of a serous membrane
Ziyanda Reply
are you asking?
In anatomy, serous membrane (or serosa) is a smooth tissue membrane consisting of two layers of mesothelium, which secrete serous fluid. The inner layer that covers organs (viscera) in body cavities is called the visceral membrane. A second layer of epithelial cells of the serous membrane, called th
The two layers of serous membranes are named parietal and visceral. Between the two layers is a thin fluid filled space.[2] The fluid is produced by the serous membranes and stays between the two layers to reduce friction between the walls of the cavities and the internal organs when they move with
a continuation from the 1st one:: A second layer of epithelial cells of the serous membrane, called the parietal layer, lines the body wall. Between the two layers is a potential space, mostly empty except for a few milliliters of lubricating serous fluid that is secreted by the two serous membranes
Name the two phases of metabolism
Grace Reply
reproduction and growth
how about anabolism and catabolism?
In Simply Anabolism means formation... Catabolism means breakdown
two phases of reproductio?
Anabolism indicates potential & catabolism potential converts to kinetic
Name the most important life process in the human body in terms of anatomy and physiology
Nervous system
Every system is important for body functions
what is the difference between the functions of the adhesion belt and the desmosomes?
Mason Reply
what are the derivatives of the germ layer?
Miriam Reply
Pls explain the atlas of the cervical vertebral column
Ifunanya Reply
why does the material not allow in mri
Simran Reply
what do you mean 'mri'
short for magnetic resonance imaging. "the researchers used MRI to record the brain activity" a medical examination performed using magnetic resonance imaging. "he's having an MRI to determine the extent of the injury" an image obtained by magnetic resonance imaging. "after looking at the MRI, the d
what is the meaning of sutures
Ibrahim Reply
i do not know
immovable joints btn two bones.eg the skull bones
Really,it's true
Sutures are immovable junction between two bones e.g those of the skull
what should I do to get or to know what to do for me to be excellent in the course of anatomy and physiology
Sandra Reply
study harder
Between the heart and the Brain which one is more important to human being... discuss
Faith Reply
well the brain is important for motor skills, the heart is important for involuntary muscle movement supporting body functions. the body can survive without brain involvement, but the body cannot last without the heart
granted the heart is important, but the brain gives the body purpose
the brain is more important
Even though the brain helps the human being to behave normally and purposefully, I think the heart is much more important cos human being cannot live without the heart
change the question
hello guys
it is difficult to select which organ is more important, now you can replace the heart with a mechanical device and the body could still function, and with technology today brain activity can also be replicated. But life would not be the same
there's coordination btn the two..so without any of them no life
the heart
The brain is important to humans.
what is homeostasis
Rebecca Reply
It is the condition when body feel comfortable
Wo feels hungry, thirty due to homeostasis
Is the maintenance of the internal environment of all the body cells for normal growth
what is the composition of saliva
Vijay Reply
ഫസ്റ്റ് ചാപ്റ്റർ ഇംപോർട്ടൻസ് പോസ്റ്റ്
Reshma Reply
nhi samjh aya
Nhi wt is this
I don't know
Okk wre frm u r
what is mean of? reshma
I don't know but would like to
D bone in d ankle joint re what ?
Ifunanya Reply
I thought that patella us the bone found in the knee cap
fib and tib join with tarsal form ankle joint
can one define a cell as a basic unit of a living organism
Michael Reply
cell is the structural and functional unit of living organisms
Which of the following hormones are responsible for the adolescent growth spurt? estrogen and testosterone, even in women?
Kepa Reply
estrogen hormone
yes estrogen hormone

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