Neurology | Abducens Nerve: Cranial Nerve VI

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Ninja Nerds!
Join us in this lecture where Professor Zach Murphy will be discussing the abducens nerve, cranial nerve VI, highlighting its anatomy, function, and clinical significance. We begin by tracing its origin from the abducens nucleus located in the dorsal pons near the floor of the fourth ventricle, and follow its long intracranial course as it exits at the pontomedullary junction. The lecture emphasizes its pathway through the subarachnoid space, the cavernous sinus (traveling alongside the internal carotid artery), and finally through the superior orbital fissure to innervate the lateral rectus muscle.

We explore the primary function of the abducens nerve, which is to control abduction of the eye via the lateral rectus muscle, enabling coordinated horizontal gaze. Special attention is given to its vulnerability due to its long course and sharp bends, making it susceptible to injury from increased intracranial pressure, trauma, or lesions within the cavernous sinus.

Clinical correlations include recognizing an abducens nerve palsy, which presents with impaired lateral eye movement, horizontal diplopia, and a medial deviation of the affected eye at rest. We discuss how to differentiate isolated CN VI palsy from internuclear ophthalmoplegia or other gaze pathway lesions, and review the significance of associated neurological findings that may point toward brainstem or cavernous sinus pathology.

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