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Abducens nerve

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631:, hemorrhage, edema) that exerts downward pressure on the brainstem, causing the nerve to stretch along the clivus. This type of traction injury can affect either side first. A right-sided brain tumor can produce either a right-sided or a left-sided sixth nerve palsy as an initial sign. Thus a right-sided sixth nerve palsy does not necessarily imply a right-sided cause. Sixth nerve palsies are infamous as "false localizing signs." Neurological signs are described as "false localizing" if they reflect dysfunction distant or remote from the expected anatomical location of pathology. Isolated sixth nerve palsies in children are assumed to be due to brain tumors until proven otherwise. 41: 369: 593:. The affected eye is pulled medially. In order to see without double vision, patients will turn their heads sideways so that both eyes are looking sideways. On formal testing, the affected eye cannot abduct past the midline – it cannot look sideways, toward the temple. Partial damage to the sixth nerve causes weak or incomplete abduction of the affected eye. The diplopia is worse on attempted lateral gaze, as would be expected (since the lateral gaze muscle is impaired). 1135: 1087: 1123: 1147: 1099: 1111: 29: 412: 564:. The affected eye is pulled to look towards the midline. In order to see without double vision, patients will rotate their heads so that both eyes are toward the temple. Partial damage to the abducens nerve causes weak or incomplete abduction of the affected eye. The diplopia is worse on attempts at looking laterally. 616:. Wernicke–Korsakoff syndrome is caused by thiamine deficiency, classically due to alcoholism. The characteristic ocular abnormalities are nystagmus and lateral rectus weakness. Tolosa-Hunt syndrome is an idiopathic granulomatous disease that causes painful oculomotor (especially sixth nerve) palsies. 647:
that affects both eyes simultaneously. The abducens nucleus contains two types of cells: motor neurons that control the lateral rectus muscle on the same side, and interneurons that cross the midline and connect to the contralateral oculomotor nucleus (which controls the medial rectus muscle of the
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The central anatomy of the sixth nerve predicts (correctly) that infarcts affecting the dorsal pons at the level of the abducens nucleus can also affect the facial nerve, producing an ipsilateral facial palsy together with a lateral rectus palsy. The anatomy also predicts (correctly) that infarcts
388:. Axons from the facial nerve loop around the abducens nucleus, creating a slight bulge (the facial colliculus) that is visible on the dorsal surface of the floor of the fourth ventricle. The abducens nucleus is close to the midline, like the other motor nuclei that control eye movements (the 577:
involving the ventral pons can affect the sixth nerve and the corticospinal tract simultaneously, producing a lateral rectus palsy associated with a contralateral hemiparesis. These rare syndromes are of interest primarily as useful summaries of the anatomy of the brainstem.
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Peripheral sixth nerve damage can be caused by tumors, aneurysms, or fractures – anything that directly compresses or stretches the nerve. Other processes that can damage the sixth nerve include strokes (infarctions), demyelination, infections (e.g.
605:. Iatrogenic injury is also known to occur, with the abducens nerve being the most commonly injured cranial nerve in halo orthosis placement. The resultant palsy is identified through loss of lateral gaze after application of the orthosis. 659:(MLF), a nerve tract that connects the three extraocular motor nuclei (abducens, trochlear and oculomotor) into a single functional unit. Lesions of the abducens nucleus and the MLF produce observable sixth nerve problems, most notably 572:
of the intracavernous carotid artery. Mass lesions that push the brainstem downward can damage the nerve by stretching it between the point where it emerges from the pons and the point where it hooks over the petrous temporal bone.
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opposite eye). In normal vision, lateral movement of one eye (lateral rectus muscle) is precisely coupled to medial movement of the other eye (medial rectus muscle), so that both eyes remain fixed on the same object.
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The long course of the abducens nerve between the brainstem and the eye makes it vulnerable to injury at many levels. For example, fractures of the petrous temporal bone can selectively damage the nerve, as can
904:Ă–zveren, Mehmet Faik; Erol, Fatih Serhat; Alkan, Alpay; Kocak, Ayhan; Ă–nal, Cagatay; TĂĽre, UÄźur (1 February 2007). "Microanatomical Architecture of Dorello's Canal and Its Clinical Implications". 691:
15–40% of people with tuberculosis have some resulting cranial nerve deficit. The sixth nerve is the most commonly affected cranial nerve in immunocompetent people with tuberculosis.
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The sixth nerve is one of the final common pathways for numerous cortical systems that control eye movement in general. Cortical control of eye movement (
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Motor axons leaving the abducens nucleus run ventrally and caudally through the pons. They pass lateral to the
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of the right eye. This individual tries to look to his right, but the right eye fails to turn to the side.
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Wilson-Pauwels L, Akesson EJ, Stewart PA. Cranial Nerves: Anatomy and Clinical Comments. Decker, 1998.
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Dissection showing origins of right ocular muscles, and nerves entering by the superior orbital fissure.
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Brodal A. Neurological Anatomy in Relation to Clinical Medicine, 3rd ed. Oxford University Press, 1981
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Dura mater and its processes exposed by removing part of the right half of the skull, and the brain.
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officially recognizes two different English translations: "abducent nerve" and "abducens nerve".
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Animations of extraocular cranial nerve and muscle function and damage (University of Liverpool)
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Victor, M, Ropper, AH. Adam's and Victor's Principles of Neurology, 7th ed. McGraw-Hill, 2001.
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Kandel ER, Schwartz JH, Jessell TM. Principles of Neural Science, 4th ed. McGraw-Hill, 2000
521:. This muscle is responsible for outward gaze. The abducens nerve carries axons of type GSE, 2132: 2106: 2096: 1885: 1875: 1752: 1692: 1511: 1490: 1480: 1433: 1387: 1351: 1182: 988: 915: 878: 451: 381: 377: 213: 201: 59: 1030:
Butler AB, Hodos W. Comparative Vertebrate Neuroanatomy, 2nd ed. Wiley-Interscience, 2005
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Figure showing the mode of innervation of the Recti medialis and lateralis of the eye.
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Federative Committee on Anatomical Terminology. Terminologia Anatomica. Thieme, 1998
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Carpenter MB. Core Text of Neuroanatomy, 4th ed. Williams & Wilkins, 1991.
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Damage to the peripheral part of the abducens nerve will cause double vision (
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Brodal P. The Central Nervous System, 3rded. Oxford University Press, 2004
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Blumenfeld H. Neuroanatomy Through Clinical Cases. Sinauer Associates, 2002
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Axial section of the Brainstem (Pons) at the level of the Facial Colliculus
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Patten J. Neurological Differential Diagnosis, 2nd ed. Springer, 1996.
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The Latin name for the sixth cranial nerve is "nervus abducens". The
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in humans and various other animals that controls the movement of the
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Martin JH. Neuroanatomy Text and Atlas, 3rd ed. McGraw-Hill, 2003.
439:. It runs upwards and forwards from this position to reach the eye. 45:
Inferior view of the human brain, with the cranial nerves labelled.
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Umansky, Felix; Elidan, Josef; Valarezo, Alberto (1 August 1991).
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The abducens nerve controls the movement of a single muscle, the
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Indirect damage to the sixth nerve can be caused by any process (
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at The Anatomy Lesson by Wesley Norman (Georgetown University) (
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Damage to the abducens nucleus does not produce an isolated
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Susan Standring; Neil R. Borley; et al., eds. (2008).
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Complete interruption of the peripheral sixth nerve causes
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Optometry (Journal of the American Optometric Association)
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Gray's Anatomy: The Anatomical Basis of Clinical practice
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uses "abducens nerve" in its Medical Subject Heading (
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Superficial dissection of brain-stem. Ventral view.
608:Rare causes of isolated sixth nerve damage include 140: 128: 116: 104: 92: 80: 75: 65: 55: 50: 21: 798: 474:. It enters the orbit through (medial end of) the 1063:(40th ed.). London: Churchill Livingstone. 975:Smith, Daniel E.; Blasi, Ashley (August 2009). 458:to run between the dura and the skull through 1215: 494:The human abducens nerve is derived from the 466:, it makes a sharp turn forward to enter the 293: 8: 380:is located in the pons, on the floor of the 1116:Hind- and mid-brains; postero-lateral view. 727:biomedical databases. The 39th edition of 560:), due to the unopposed muscle tone of the 1905: 1775: 1537: 1222: 1208: 1200: 865:"Dorello's canal: a microanatomical study" 848:: CS1 maint: location missing publisher ( 713:United States National Library of Medicine 300: 286: 169: 39: 27: 1082: 784: 172: 1152:Cerebrum.Inferior view.Deep dissection 914:(suppl_2): ONS1-7, discussion ONS7-8. 841: 731:(2005) also prefers "abducens nerve." 157: 18: 7: 818:Last's anatomy: regional and applied 811: 809: 807: 655:is mediated in the brainstem by the 419:The abducens nerve emerges from the 16:Cranial nerve VI, for eye movements 920:10.1227/01.neu.0000249229.89988.4d 14: 464:petrous part of the temporal bone 1145: 1133: 1121: 1109: 1097: 1085: 513:The abducens nerve supplies the 154:Anatomical terms of neuroanatomy 1177:GrossAnatomy/h_n/cn/cn1/cn6.htm 719:) vocabulary to index the vast 683:, not unilateral eye movement. 657:medial longitudinal fasciculus 33:The path of the abducens nerve 1: 2102:Dorsal nucleus of vagus nerve 816:Chummy S. Sinnatamby (2011). 820:(12th ed.). Edinburgh. 661:internuclear ophthalmoplegia 2230:Nerves of the head and neck 1881:Inferior salivatory nucleus 743:of the eye. In most other 610:Wernicke–Korsakoff syndrome 482:to reach and innervate the 2251: 1325:lateral geniculate nucleus 1286:anterior olfactory nucleus 993:10.1016/j.optm.2009.02.012 883:10.3171/jns.1991.75.2.0294 770: 643:, but rather a horizontal 537: 2005:Superior cervical cardiac 1698:Superior salivary nucleus 1451:spinal trigeminal nucleus 152: 38: 26: 2138:spinal accessory nucleus 1578:pterygopalatine ganglion 1369:Edinger–Westphal nucleus 749:musculus retractor bulbi 523:general somatic efferent 476:superior orbital fissure 344:responsible for outward 1520:no significant branches 1422:no significant branches 1262:no significant branches 870:Journal of Neurosurgery 747:it also innervates the 472:internal carotid artery 454:, and then pierces the 423:at the junction of the 1840:Stylopharyngeal branch 1600:submandibular ganglion 1585:Nerve to the stapedius 907:Operative Neurosurgery 773:anatomical terminology 706:Terminologia Anatomica 553: 478:, passing through the 416: 384:, at the level of the 373: 741:lateral rectus muscle 547: 529:Clinical significance 515:lateral rectus muscle 484:lateral rectus muscle 480:common tendinous ring 462:. At the apex of the 446:(more precisely, the 442:The nerve enters the 414: 371: 338:lateral rectus muscle 70:Lateral rectus muscle 1688:Facial motor nucleus 1384:parasympathetic root 962:www.orthobullets.com 667:Supranuclear lesions 614:Tolosa–Hunt syndrome 591:medial rectus muscle 562:medial rectus muscle 435:, and medial to the 320:, also known as the 2215:Human head and neck 2210:Otorhinolaryngology 2000:Recurrent laryngeal 1845:Pharyngeal branches 1623:Posterior auricular 1471:trigeminal ganglion 799:Gray's Anatomy 2008 629:pseudotumor cerebri 603:diabetic neuropathy 401:corticospinal tract 342:extraocular muscles 322:sixth cranial nerve 1983:Superior laryngeal 1850:Tonsillar branches 1548:Intermediate nerve 1364:oculomotor nucleus 771:This article uses 675:, smooth pursuit, 581:Peripheral lesions 554: 444:subarachnoid space 431:, superior to the 417: 374: 2187: 2186: 2115: 2114: 2081:Posterior gastric 1976:pharyngeal plexus 1971:Pharyngeal branch 1894: 1893: 1758:Scarpa's ganglion 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1275: 1271: 1263: 1260: 1259: 1257: 1253: 1252:septal nuclei 1250: 1249: 1247: 1246: 1244: 1241: 1237: 1233: 1225: 1220: 1218: 1213: 1211: 1206: 1205: 1202: 1195: 1194: 1189: 1188:cranialnerves 1186: 1184: 1181: 1179: 1178: 1174: 1171: 1169: 1165: 1162: 1161: 1157: 1148: 1143: 1136: 1131: 1124: 1119: 1112: 1107: 1100: 1095: 1088: 1083: 1078: 1072: 1066: 1062: 1057: 1056: 1052: 1051: 1047: 1044: 1041: 1038: 1035: 1032: 1029: 1026: 1023: 1020: 1019: 1010: 1007: 1002: 998: 994: 990: 986: 982: 978: 971: 968: 963: 959: 953: 950: 945: 941: 937: 933: 929: 925: 921: 917: 913: 909: 908: 900: 897: 892: 888: 884: 880: 876: 872: 871: 866: 859: 856: 851: 845: 837: 833: 829: 823: 819: 812: 810: 808: 804: 800: 795: 793: 791: 789: 785: 778: 774: 766: 764: 762: 758: 754: 750: 746: 742: 735:Other animals 734: 732: 730: 726: 722: 718: 714: 709: 707: 699: 694: 692: 686: 684: 682: 678: 677:accommodation 674: 666: 664: 662: 658: 654: 649: 646: 642: 634: 632: 630: 626: 625:hydrocephalus 622: 617: 615: 611: 606: 604: 600: 594: 592: 588: 580: 578: 574: 571: 565: 563: 559: 551: 546: 541: 533: 528: 526: 524: 520: 516: 508: 506: 504: 501: 497: 489: 487: 485: 481: 477: 473: 469: 465: 461: 457: 453: 449: 445: 440: 438: 434: 430: 426: 422: 413: 406: 404: 402: 397: 395: 391: 387: 383: 379: 370: 363: 358: 356: 354: 351: 347: 343: 340:, one of the 339: 335: 334:cranial nerve 331: 327: 323: 319: 315: 303: 298: 296: 291: 289: 284: 283: 281: 280: 274: 271: 269: 266: 265: 263: 262: 257: 253: 251: 247: 245: 241: 239: 235: 233: 229: 227: 223: 221: 217: 215: 211: 209: 205: 203: 199: 197: 193: 191: 187: 185: 181: 180: 179: 178: 175: 171: 161: 155: 151: 148: 145: 143: 139: 136: 133: 131: 127: 124: 121: 119: 115: 112: 109: 107: 103: 100: 97: 95: 91: 88: 85: 83: 79: 74: 71: 68: 64: 61: 58: 54: 49: 42: 37: 30: 25: 20: 1613:stylomastoid 1565:facial canal 1519: 1502: 1421: 1335:optic chiasm 1261: 1191: 1175: 1060: 1009: 984: 980: 970: 961: 952: 911: 905: 899: 874: 868: 858: 817: 738: 728: 710: 703: 690: 687:Tuberculosis 670: 650: 638: 618: 607: 595: 584: 575: 566: 555: 512: 493: 486:of the eye. 441: 437:facial nerve 418: 398: 375: 329: 328:, or simply 325: 321: 317: 313: 311: 219: 123:A14.2.01.098 86: 2160:Hypoglossal 1541:Near origin 1340:optic tract 753:vertebrates 679:) involves 621:brain tumor 496:basal plate 490:Development 256:Hypoglossal 76:Identifiers 2194:Categories 1753:Vestibular 1665:mandibular 1638:stylohyoid 1628:Suprahyoid 1553:Geniculate 1491:mandibular 1481:ophthalmic 1434:Trigeminal 1352:Oculomotor 1168:NeuroNames 779:References 645:gaze palsy 599:meningitis 456:dura mater 415:The Clivus 390:oculomotor 348:. It is a 230:CN VIII – 214:Trigeminal 202:Oculomotor 106:NeuroNames 66:Innervates 2225:Neurology 2173:Branches 2121:Accessory 2041:posterior 2028:Pulmonary 1714:(CN VIII) 1655:zygomatic 1633:digastric 1516:Branches 1486:maxillary 1477:Branches 1418:Branches 1405:Trochlear 1375:Branches 1274:Olfactory 928:2332-4252 844:cite book 836:764565702 761:hagfishes 700:Etymology 570:aneurysms 550:abduction 519:human eye 500:embryonic 421:brainstem 359:Structure 254:CN XII – 250:Accessory 224:CN VII – 208:Trochlear 200:CN III – 190:Olfactory 2162:(CN XII) 2036:anterior 1993:internal 1988:external 1927:inferior 1922:superior 1918:Ganglia 1818:Tympanic 1797:inferior 1792:superior 1788:Ganglia 1670:cervical 1650:temporal 1534:(CN VII) 1503:Abducens 1393:inferior 1379:superior 1354:(CN III) 1240:Terminal 1164:hier-541 1001:19801340 944:36731926 936:17297359 767:See also 757:lampreys 673:saccades 587:diplopia 558:diplopia 509:Function 427:and the 268:Overview 248:CN XI – 236:CN IX – 220:Abducens 218:CN VI – 206:CN IV – 194:CN II – 184:Terminal 2177:lingual 2169:Nucleus 2145:Cranial 2129:Nuclei 2123:(CN XI) 2071:Hepatic 2053:Abdomen 1909:Before 1779:Before 1772:(CN IX) 1720:Nuclei 1615:foramen 1512:Nucleus 1505:(CN VI) 1467:Course 1442:Nuclei 1414:Nucleus 1407:(CN IV) 1360:Nuclei 1331:Course 1321:Nuclei 1315:(CN II) 1292:Course 1282:Nuclei 1258:Course 1248:Nuclei 891:2072168 755:except 745:mammals 721:MEDLINE 695:History 663:(INO). 517:of the 498:of the 429:medulla 364:Nucleus 350:somatic 332:, is a 242:CN X – 212:CN V – 188:CN I – 182:CN 0 – 99:D000010 51:Details 2150:Spinal 2090:Nuclei 2061:Celiac 2015:Thorax 1938:After 1902:(CN X) 1869:Nuclei 1808:After 1681:Nuclei 1660:buccal 1562:Inside 1532:Facial 1436:(CN V) 1276:(CN I) 1242:(CN 0) 1067:  999:  942:  934:  926:  889:  834:  824:  725:PubMed 534:Damage 452:clivus 407:Course 226:Facial 2066:Renal 1900:Vagus 1313:Optic 1053:Books 940:S2CID 330:CN VI 273:Table 244:Vagus 196:Optic 158:[ 147:50867 82:Latin 1963:Neck 1230:The 1065:ISBN 997:PMID 932:PMID 924:ISSN 887:PMID 850:link 832:OCLC 822:ISBN 759:and 723:and 717:MeSH 612:and 503:pons 425:pons 392:and 376:The 346:gaze 312:The 135:6283 118:TA98 94:MeSH 56:From 1611:At 1461:TMN 1446:PSN 1386:of 1166:at 989:doi 916:doi 879:doi 396:). 316:or 142:FMA 130:TA2 111:550 2196:: 1456:MN 1193:VI 995:. 985:80 983:. 979:. 960:. 938:. 930:. 922:. 912:60 910:. 885:. 875:75 873:. 867:. 846:}} 842:{{ 830:. 806:^ 787:^ 763:. 627:, 623:, 525:. 505:. 355:. 324:, 1223:e 1216:t 1209:v 1196:) 1073:. 1003:. 991:: 964:. 946:. 918:: 893:. 881:: 852:) 838:. 775:. 301:e 294:t 287:v 162:]

Index



Abducens nucleus
Lateral rectus muscle
Latin
MeSH
D000010
NeuroNames
550
TA98
A14.2.01.098
TA2
6283
FMA
50867
Anatomical terms of neuroanatomy
edit on Wikidata
Cranial nerves
Terminal
Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory

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