The superior rectus muscle is a

muscle Muscle is a soft tissue, one of the four basic types of animal tissue. There are three types of muscle tissue in vertebrates: skeletal muscle, cardiac muscle, and smooth muscle. Muscle tissue gives skeletal muscles the ability to muscle contra ...

in the

orbit In celestial mechanics, an orbit (also known as orbital revolution) is the curved trajectory of an object such as the trajectory of a planet around a star, or of a natural satellite around a planet, or of an artificial satellite around an ...

. It is one of the

extraocular muscles The extraocular muscles, or extrinsic ocular muscles, are the seven extrinsic muscles of the eye in human eye, humans and other animals. Six of the extraocular muscles, the four recti muscles, and the superior oblique muscle, superior and inferior ...

. It is

innervated A nerve is an enclosed, cable-like bundle of nerve fibers (called axons). Nerves have historically been considered the basic units of the peripheral nervous system. A nerve provides a common pathway for the electrochemical nerve impulses called ...

by the superior division of the

oculomotor nerve The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit through the superior orbital fissure and innervates extraocular muscles that enable most movements o ...

(III). In the primary position (looking straight ahead), its primary function is

elevation The elevation of a geographic location (geography), ''location'' is its height above or below a fixed reference point, most commonly a reference geoid, a mathematical model of the Earth's sea level as an equipotential gravitational equipotenti ...

, although it also contributes to intorsion and adduction. It is associated with a number of medical conditions, and may be weak, paralysed, overreactive, or even congenitally absent in some people.

Structure

The superior rectus muscle originates from the

annulus of Zinn The common tendinous ring, also known as the annulus of Zinn or annular tendon, is a ring of fibrous tissue surrounding the optic nerve at its entrance at the apex of the orbit. It is the common origin of the four recti muscles of the group of ext ...

. It inserts into the anterosuperior surface of the

eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...

. This insertion has a width of around 11 mm. It is around 8 mm from the

corneal limbus The corneal limbus (''Latin'': corneal border) is a highly vascularized and pigmented zone between the cornea, conjunctiva, and the sclera (the white of the eye) that protects and heals the cornea. The cornea is composed of three primary cell ty ...

Nerve supply

The superior rectus muscle is supplied by the superior division of the ipsilateral

(III). Each superior rectus muscle is innervated by contralateral oculomotor nucleus in the mesencephalon.

Relations

The superior rectus muscle is related to the other

, particularly to the

medial rectus muscle The medial rectus muscle is a muscle in the orbit near the eye. It is one of the extraocular muscles. It originates from the common tendinous ring, and inserts into the anteromedial surface of the eye. It is supplied by the inferior division of t ...

and the

lateral rectus muscle The lateral rectus muscle is a muscle on the lateral side of the eye in the orbit. It is one of six extraocular muscles that control the movements of the eye. The lateral rectus muscle is responsible for lateral movement of the eyeball, specif ...

. The insertion of the superior rectus muscle is around 7.5 mm from the insertion of the medial rectus muscle, around 7.1 mm from the insertion of the lateral rectus muscle, and around 7.9 from the corneal limbus. There is an intermuscular septum between it and the lateral rectus muscle.

Variation

Variations of the superior rectus muscle is rare. It may rarely have two muscle bellies parallel to each other. More rarely, it may be congenitally absent.

Function

The superior rectus muscle elevates,

adducts In chemistry, an adduct (; alternatively, a contraction of "addition product") is a product of a direct addition of two or more distinct molecules, resulting in a single reaction product containing all atoms of all components. The resultant is ...

, and helps intort (rotate the superior pole of the eye medially) the

Clinical significance

Testing

The superior rectus muscle is the only muscle that is capable of elevating the

when it is in a fully abducted position.

Exophthalmos

Much of the venous drainage of the orbit and the extraocular muscles passes close to the superior rectus muscle. Obstruction to this venous drainage can cause venous congestion in the eye, which may cause

exophthalmos Exophthalmos (also called exophthalmus, exophthalmia, proptosis, or exorbitism) is a bulging of the eye anteriorly out of the orbit. Exophthalmos can be either bilateral (as is often seen in Graves' disease) or unilateral (as is often seen in ...

(bulging eye ball). This may be shown with CT scans.

Weakness and paralysis

The superior rectus muscle may be weakened or paralysed by problems with nerve conduction of the

(III). This may be

congenital A birth defect is an abnormal condition that is present at childbirth, birth, regardless of its cause. Birth defects may result in disability, disabilities that may be physical disability, physical, intellectual disability, intellectual, or dev ...

, often with a familial genetic link, or acquired, most often caused by

head injuries A head injury is any injury that results in trauma to the skull or brain. The terms ''traumatic brain injury'' and ''head injury'' are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of inju ...

Overreaction

Local anaesthetics A local anesthetic (LA) is a medication that causes absence of all sensation (including pain) in a specific body part without loss of consciousness, providing local anesthesia, as opposed to a general anesthetic, which eliminates all sensation ...

used in

cataract surgery Cataract surgery, also called lens replacement surgery, is the removal of the natural lens (anatomy), lens of the human eye, eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artific ...

may weaken the

inferior rectus muscle The inferior rectus muscle is a muscle in the orbit near the eye. It is one of the four recti muscles in the group of extraocular muscles. It originates from the common tendinous ring, and inserts into the anteroinferior surface of the eye. It d ...

, despite efforts to use minimal anaesthetic and to avoid placing the needle into the muscle. Weakness of the inferior rectus muscle may strengthen the superior rectus muscle, causing it to be overreactive. This may elevate the eye, and prevent its use in normal vision. Treatment may involve

eye surgery Eye surgery, also known as ophthalmic surgery or ocular surgery, is surgery performed on the eye or its adnexa. Eye surgery is part of ophthalmology and is performed by an ophthalmologist or eye surgeon. The eye is a fragile organ, and require ...

that weakens or repositions the superior rectus muscle, which generally has good outcomes.

Absence

Very rarely, the superior rectus muscle may be congenitally absent. This may be caused by

Apert syndrome Apert syndrome is a form of acrocephalosyndactyly, a congenital disorder characterized by malformations of the skull, face, hands and feet. It is classified as a branchial arch syndrome, affecting the first Pharyngeal arch, branchial (or pharyn ...

. This causes a reduced ability to elevate the eye. It may be treated with

that uses parts of the

and the

to restore the functions normally performed by the superior rectus muscle.

Additional images

File:Gray891.png, The right eye in sagittal section, showing the fascia bulbi (semidiagrammatic). File:Trochlear and frontal nerves.jpg, Superior rectus muscle File:Slide2uu.JPG, Superior rectus muscle File:Slide1abaa.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection. File:Slide2abaa.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection. File:Slide4abab.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection. File:Slide6abab.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection. File:Slide8ababa.JPG, Extrinsic eye muscle. Nerves of orbita. Deep dissection.

References

External links

* * {{Authority control Muscles of the head and neck Human eye anatomy de:Augenmuskeln#Musculus rectus superior