The Trochlear Nerve (CN IV) - Course - Motor - TeachMeAnatomy https://teachmeanatomy.

info/head/cranial-nerves/trochlear-nerve/

Original Author: Anand Radhakrishnan

This site uses cookies: Find out more. Last Updated: December 22, 2017
THE TROCHLEAR NERVE (CN IV) Revisions: 25

Contents

1 Anatomical Course
2 Motor Function
3 Clinical Relevance
3.1 Examination of the Trochlear Nerve
3.2 Palsy of the Trochlear Nerve

The trochlear nerve is the fourth paired cranial nerve. It is the smallest cranial nerve (by number of
axons), yet has the longest intracranial course. It has a purely somatic motor function.

In this article, the anatomical course, motor functions and clinical relevance of the nerve will be
examined.

Anatomical Course
The trochlear nerve arises from the trochlear nucleus of the brain, emerging from the posterior
aspect of the midbrain (it is the only cranial nerve to exit from the posterior midbrain).

It runs anteriorly and inferiorly within the subarachnoid space before piercing the dura mater
adjacent to the posterior clinoid process of the sphenoid bone.

The nerve then moves along the lateral wall of the cavernous sinus (along with the oculomotor
nerve, the abducens nerve, the ophthalmic and maxillary branches of the trigeminal nerve and the
internal carotid artery) before entering the orbit of the eye via the superior orbital fissure.

1 of 4 3/1/2019, 6:47 PM
The Trochlear Nerve (CN IV) - Course - Motor - TeachMeAnatomy https://teachmeanatomy.info/head/cranial-nerves/trochlear-nerve/

Fig 1.0 – The trochlear nerve and superior oblique muscle

Motor Function
The trochlear nerve innervates a single muscle – the superior oblique, which is a muscle of
oculomotion. As the fibres from the trochlear nucleus cross in the midbrain before they exit, the
trochlear neurones innervate the contralateral superior oblique.

The tendon of the superior oblique is tethered by a fibrous structure known as the trochlea, giving
the nerve its name. Although the mechanism of action of the superior oblique is complex, in clinical
practice it is sufficient to understand that the overall action of the superior oblique is to depress and
intort the eyeball.

2 of 4 3/1/2019, 6:47 PM
The Trochlear Nerve (CN IV) - Course - Motor - TeachMeAnatomy https://teachmeanatomy.info/head/cranial-nerves/trochlear-nerve/

Fig 1.1 – Lateral view of the extraocular muscles.

EDIT THIS ARTICLE

3 of 4 3/1/2019, 6:47 PM
The Trochlear Nerve (CN IV) - Course - Motor - TeachMeAnatomy https://teachmeanatomy.info/head/cranial-nerves/trochlear-nerve/

The Abducens Nerve (CN VI)

Axonal Pathfinding in Sight
TeachMeAnatomy Paula A. Kiberstis, Sci Signal
The Oculomotor Nerve (CN III) Lack of Efficacy of an Epidural Blood Patch in
TeachMeAnatomy Treating Abducens Nerve Palsy After an
Unintentional Dura Puncture
The Cavernous Sinus
Joseph W. Szokol et al., Regional Anesthesia &
TeachMeAnatomy
Pain Medicine
The Extraocular Muscles
Anatomical study of the innervation of posterior
TeachMeAnatomy
knee joint capsule: implication for image-guided
The Midbrain intervention
TeachMeAnatomy John Tran et al., Regional Anesthesia & Pain
Medicine

Case of intracranial penetration of a metallic pipe

through the orbit
Laila Malani Mohammad, TSACO

Innervation of the heart and its central medullary

origin defined by viral tracing
A Standish et al., Science

Powered by

The medical information on this site is provided as an information resource only, and is not to be used or relied on for any diagnostic or
treatment purposes. This information is intended for medical education, and does not create any doctor-patient relationship, and
should not be used as a substitute for professional diagnosis and treatment.

By visiting this site you agree to the foregoing terms and conditions. If you do not agree to the foregoing terms and conditions, you
should not enter this site.

4 of 4 3/1/2019, 6:47 PM