What Is the Superior Rectus?

The superior rectus muscle starts from the striated muscle above the total tendon ring and stops at 7.7 mm above the limbus. The length is about 41.8 mm, the tendon length is 5.8 mm, the width of the attached tendon is about 10.6 mm, and the muscle width is 10.2 mm. This muscle walks at an angle of 23 ° to the visual axis of the eyeball. It is innervated by the oculomotor nerve, and the innervation point is 26 mm from the muscle stop. Its function is because the eye muscles run at an angle of 23 ° to the optic axis of the eyeball, the tendon attachment is slightly curved, and the nasal side is more forward than the temporal side. Therefore, when the first eye (original eye) contracts, the main function is to turn The secondary functions are introversion and internal rotation; when the external rotation of the eyeball is at an angle of 23 ° with the first eye position, the superior rectus muscle only plays a major role, and the secondary effect disappears; At an angle of 67 °, the muscle has only a secondary effect and the primary effect disappears due to the restriction of the ligament.

The superior rectus muscle starts from the striated muscle above the total tendon ring and stops at 7.7 mm above the limbus. The length is about 41.8 mm, the tendon length is 5.8 mm, the width of the attached tendon is about 10.6 mm, and the muscle width is 10.2 mm. This muscle walks at an angle of 23 ° to the visual axis of the eyeball. It is innervated by the oculomotor nerve, and the innervation point is 26 mm from the muscle stop. Its function is because the eye muscles run at an angle of 23 ° to the optic axis of the eyeball, the tendon attachment is slightly curved, and the nasal side is more forward than the temporal side. Therefore, when the first eye (original eye) contracts, the main function is to turn The secondary functions are introversion and internal rotation; when the external rotation of the eyeball is at an angle of 23 ° with the first eye position, the superior rectus muscle only plays a major role, and the secondary effect disappears; At an angle of 67 °, the muscle has only a secondary effect and the primary effect disappears due to the restriction of the ligament.

Chinese name

Superior rectus muscle

Foreign name

superior rectus muscle

Upper rectus clinically related diseases

Upper rectus high myopia restricted esotropia

1. Causes:

Except for the force that the rectus muscle moves down and produces a downward turn, the superior rectus muscle also shifts toward the nose, produces an introversion force, and even merges the inferior rectus muscle to shift upwards to the nose, and at the same time, the posterior pole of the eyeball A herniation to the temporal cone of the muscular cone, the extremely enlarged eyeball was mechanically restricted in the narrow orbital apex, and there was not enough room to turn in ^[1] . The hernia of the patient's eyeball is closely related to the weakness of the Pulley tissue at the posterior and temporal superiority of the eyeball. This part lacks extraocular muscle tissue and only the Pulley tissue, so the growth of the axial axis of patients with high myopia can easily break through the Pulley tissue. If the orbital space is large enough, although the axis of the eye grows, as long as the scope of the muscle cone is not exceeded, it will not cause the Pulley band to rupture. In contrast, the Sagging eye syndrome that occurs in non-highly myopic elderly people is also caused by the degeneration of the superior rectus muscle-external rectus muscle zone.

2. Treatment method:

Outer rectus abdominis temporal 1/2 muscle abdomen, upper rectus abdominis 1/2 muscle abdomen combined translocation, and combined with medial rectus retrograde surgery to correct the abnormalities of the extraocular muscles. . This operation is simple and convenient, and avoids the complications of scleral perforation caused by suture and fixation of the external rectus and superior rectus muscles on the scleral wall. The intermuscular membrane between the superior and superior rectus muscles is not separated, and the superior and superior rectus muscles are restored as much as possible. The pulley connection between them also avoids the mechanical limitation and rejection caused by the silica gel itself. In short, the surgical principle for this type of patients is to repair the connection between the superior rectus muscle and the external rectus muscle, restore the eyeball to the inside of the muscular cone, and restore the superior rectus muscle and outer rectus muscle to the normal anatomical position.

Congenital superior rectus paralysis

1. Causes:

It is a clinically rare eye movement disorder. It is characterized by simultaneous paralysis of the two upper turning muscles of one eye, and the affected eye has limited upward, medial, and lateral motion, and there is no abnormal movement in other directions. When the healthy eye is gazing, the paralyzed eye deflects downward and the upper eyelid is slightly drooping. When the paralyzed eye is gazing, the healthy eye deflects upward and the symptoms of paralysis of the upper eyelid disappear. Bell appears in most patients. In order to maintain the same vision in both eyes, patients often have a compensatory head position such as jaw lift. The disease is usually monocular and may be caused by neuromuscular dysplasia. Generally, it is divided into three cases: primary inferior rectus limitation, primary superior rectus paralysis, and congenital abnormalities of the innervation of the superior transflexor muscle. Simple superior rectus paralysis: limited upper and lower activity outside the eye and upper and inner activity nothing unusual. Most patients with ptosis are true ptosis.

2. Treatment method:

(1) For those who have no function of the superior rectus and oblique muscles, and the inferior rectus rectus surgery alone cannot completely relieve the symptoms, patients with rectus inferior rectus combined with internal and external rectus upward rectus transposition (Knapp surgery).

(2) For the healthy oblique and superior rectus muscles with hyperfunction, especially those with obvious superior rectus muscles, the patients can choose the surgery of receding inferior rectus muscles and superior rectus muscles. For patients with horizontal strabismus, horizontal muscle surgery can be performed at the same time to correct horizontal strabismus. For those with a greater degree of vertical strabismus, we use the method of fractional surgery. Generally, the oblique tendon severing and rectus rectus surgery are performed first; if the amount of surgery is insufficient, the second operation is performed 6 months after the first operation.