Oculomotor nerve

Dr Craig Hacking and A.Prof Frank Gaillard et al.

The oculomotor nerve is the third of the cranial nerves and arises from the midbrain. It is responsible for the movements of four of the six extra-ocular muscles, the other two being innervated by the trochlear and abducens nerves.

Gross anatomy

Nucleus and cisternal portion

The oculomotor nucleus lies in the deep periaqueductal grey matter at the level of the superior colliculus anterior to the cerebral aqueduct. The fibers run through the tegmentum, red nucleus and medial aspect of the substantia nigra to emerge from the medial aspect of the cerebral peduncle into the interpeduncular cistern. The nerve then travel forwards, below the posterior cerebral artery (where it can be compressed by a posterior communicating artery aneurysm) and above the superior cerebellar artery, before piercing the dura mater and entering the cavernous sinus.

Cavernous sinus portion

Within the cavernous sinus the oculomotor nerve is located uppermost, above the trochlear nerve in the lateral wall of the sinus.

Orbital portion

It enters the orbit via the superior orbital fissure as two branches: superior division and inferior division, with the nasociliary nerve (a branch of the ophthalmic division of the trigeminal nerve) between them and the abducens nerve (CN VI) below all three. These four branches pass through the tendinous ring.

Superior division

The superior division, the smaller of the two, runs above the optic nerve and gives branches to superior rectus and levator palpebrae superioris muscles which it supplies with motor fibres. Additionally it also supplies the latter with sympathetic fibres derived from the internal carotid artery.

Inferior division

The inferior division supplies the inferior rectus, medial rectus (this branch passes below the optic nerve), and the inferior oblique. It also gives off the parasympathetic root to the ciliary ganglion.

Related pathology

Anatomy: Brain
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Article information

rID: 1760
Section: Anatomy
Synonyms or Alternate Spellings:
  • Oculomotor nerve (CN III)
  • Oculomotor nerve (III)

Cases and figures

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    Fig 1: midbrain anatomy
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    Fig 2: brain stem nuclei
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    Fig 3: orbital lateral view
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    Anterior view of ...
    Fig 4: orbital anterior view
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    Fig 5: cavernous sinus
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    Fig 6: orbital apex diagram
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    Fig 7: coronal MRI
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    Fig 8: axial MRI
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