its about cranial nerve 4. a simple and straight word combination to understand easily the nerve function and disorder.

1. Trochlear nerve
Presentation By:
Ayesha Aamir
Nazia Asghar

2. Trochlear Nerve
 4th nerve
 Each of the fourth pair of cranial nerves, supplying the superior
oblique muscle (extraocular muscles) of the eyeball

3. origin
 it is the only cranial nerve that arises from the back of the brain stem.
It is the smallest cranial nerve ,
It follows the longest course within the skull of any
of the cranial nerves.

4. origin

5. Main nucleus
 It has only one motor Nucleus ( trochlear nucleus)

6. Functions
 Supplies the superior oblique muscles.
 Turn the eyeball downwards and laterally.

7. Clinical symptoms
1. Trochlear Nerve Paralysis
 It may not become symptomatic until later childhood
or adulthood
 Young children adopt a compensatory position head
tilt in order to compensate for the underacting
superior oblique muscle ( towards the contralateral
sides)
 Head is tilted as a compensatory adjustment, this
may be the first indication of a trochlear lesion.
 Patient cannot look downwards or inwards, has
difficulty in descending stairs.

9. Clinical symptoms
2. Facial asymmetry due to chorionic head tilt
3. Vertical diplopia

11. IV Cranial nerve Palsy- Clinical Features
 1- Lack of subjective features of torsion
(Torsion: rotation of vertical corneal meridians)
 2- Diplopia
 Following Cataract surgery
 Manifest transiently during pregnancy
 3- Neck Pain after years of head tilting.

12. Treatment
 Symptomatic cases can be
treated with Strabismus
Surgery.
 Prism lenses set to make
minor optical changes in the
vertical alignment may be
prescribed instead of or after
surgery to fine-tune the
correction.

13. Thank
You