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B-26 Marauder Units of the MTO (Osprey Combat Aircraft 73) by Mark Styling

By Mark Styling

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It ascends in the neck until it synapses, and follows the carotid artery into the skull and orbit. It dilates the pupil in response to the “fight or flight” stimulus. Damage to this nerve causes Horner’s syndrome (Fig. 98): miosis, ptosis, and decreased sweating (anhidrosis). Pupillary light reflex (Fig. 99) Light shining on the retina stimulates the optic nerve and then the optic chiasm and optic tract. Here, it exits from the visual pathway to stimulate the Edinger–Westphal nucleus in the midbrain.

It also stimulates lacrimal secretion. The common CN VII paralysis in adults is called Bell’s palsy and is usually due to ischemia or a virus (Fig. 88). Fig. 87 Facial nerve to orbicularis oculi and oris muscles. Minor eyelid spasms of the orbicularis muscle which the patient senses as a twitching of the muscles of the lid, and usually unnoticed by an observer, is called myokymia. It may be related to stress, fatigue, or too much caffeine, and often disappears in weeks. Blepharospasm (Fig. 89) is a more severe spasm of the orbicularis muscle causing the eyelids to close involuntarily.

Poor cosmetic appearance Tropias that cannot be corrected with spectacles may be cosmetically unacceptable and the patient may desire surgery. 3. Loss of fusion Fusion occurs when the images from both eyes are perceived as one object, with resulting stereopsis (three-dimensional vision). Many patients with tropias never gain the ability to fuse. Finer grades of fusion are assessed by using the Wirt stereopsis test. Wirt stereopsis test Fig. 64 Wirt stereopsis. (Fig. 64) While wearing polarized glasses, the patient views a special test card.

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