COT EXAM STUDY-OCULAR MOTILITY
QUESTIONS AND ANSWERS. VERIFIED
2026.
Abduction - ANS Movement away from the midline of the body
aDduction - ANS Movement toward the midline of the body
When the MR contracts, the eye rotates toward the nose called _____ - ANS aDduction
When the LR contracts, the eye rotates temporally called _____ - ANS ABduction
The medial and lateral rectus muscle planes coincide with the visual axis when the eye is in the
primary position so they only have _______________ - ANS one action.
superior rectus - ANS SinRad
1.elevates the eye (primary action)
2.rotates eye nasally from the 12 o'clock position (intortion)
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,This is called the secondary action of the SR.
3. moves the eye somewhat nasally along the horizontal plane (adduction). This is the tertiary
action of the SR.
inferior rectus muscle - ANS primary action of the IR is DEPRESSION of the globe.
The secondary action of the IR is EXTORTION
the tertiary action is ADDUCTION
(Just like the SR, the primary action (depression) increases in abduction and decreases in
adduction. To test the action of the IR by itself, have the patient abduct the eye slightly (23
degrees to be exact) and look down.)
oblique eye muscles - ANS The superior oblique rotates the eye downward and medially. The
inferior oblique rotates the eye upward and medially.
oblique muscles have two primary functions #1 - ANS intortion or extortion of the globe to
keep the
eyeballs level as the head tilts. In right head tilt the right eye intorts and left eye extorts to keep
the eyeballs level.
oblique muscles have two primary functions #2 - ANS 2. create a counterbalancing force to
that of the rectus muscles. The rectus muscles are pulling the globe inward toward the back of
the bony orbit. The oblique muscles pull outwardly to keep the globe "floating" in the orbital
cavity.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Primary action of the superior oblique - ANS intorsion
Secondary action of superior oblique - ANS depression
Tertiary action of superior oblique - ANS abduction
Primary action of the IO is - ANS extortion
Secondary action of inferior oblique - ANS elevation - IO travels slightly posterior to anterior
from insertion to origin rotating bottom of eye forward and up
Tertiary action of inferior oblique: - ANS abduction - insertion of the IO is posterior to the
equator and on the temporal half of the globe so back of the globe is pulled nasally
Eye muscle actions - ANS SINRAD
ortho - ANS straight, correct
A patient who does not demonstrate a deviation of eye alignment
-tropia - ANS turning
a manifest eye turn or deviation that the patient has no, or very little control over. The patient is
unable to keep the eye straight with the power of fusion.
esotropia- RET - ANS inward turning of the eye
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
QUESTIONS AND ANSWERS. VERIFIED
2026.
Abduction - ANS Movement away from the midline of the body
aDduction - ANS Movement toward the midline of the body
When the MR contracts, the eye rotates toward the nose called _____ - ANS aDduction
When the LR contracts, the eye rotates temporally called _____ - ANS ABduction
The medial and lateral rectus muscle planes coincide with the visual axis when the eye is in the
primary position so they only have _______________ - ANS one action.
superior rectus - ANS SinRad
1.elevates the eye (primary action)
2.rotates eye nasally from the 12 o'clock position (intortion)
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,This is called the secondary action of the SR.
3. moves the eye somewhat nasally along the horizontal plane (adduction). This is the tertiary
action of the SR.
inferior rectus muscle - ANS primary action of the IR is DEPRESSION of the globe.
The secondary action of the IR is EXTORTION
the tertiary action is ADDUCTION
(Just like the SR, the primary action (depression) increases in abduction and decreases in
adduction. To test the action of the IR by itself, have the patient abduct the eye slightly (23
degrees to be exact) and look down.)
oblique eye muscles - ANS The superior oblique rotates the eye downward and medially. The
inferior oblique rotates the eye upward and medially.
oblique muscles have two primary functions #1 - ANS intortion or extortion of the globe to
keep the
eyeballs level as the head tilts. In right head tilt the right eye intorts and left eye extorts to keep
the eyeballs level.
oblique muscles have two primary functions #2 - ANS 2. create a counterbalancing force to
that of the rectus muscles. The rectus muscles are pulling the globe inward toward the back of
the bony orbit. The oblique muscles pull outwardly to keep the globe "floating" in the orbital
cavity.
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, Primary action of the superior oblique - ANS intorsion
Secondary action of superior oblique - ANS depression
Tertiary action of superior oblique - ANS abduction
Primary action of the IO is - ANS extortion
Secondary action of inferior oblique - ANS elevation - IO travels slightly posterior to anterior
from insertion to origin rotating bottom of eye forward and up
Tertiary action of inferior oblique: - ANS abduction - insertion of the IO is posterior to the
equator and on the temporal half of the globe so back of the globe is pulled nasally
Eye muscle actions - ANS SINRAD
ortho - ANS straight, correct
A patient who does not demonstrate a deviation of eye alignment
-tropia - ANS turning
a manifest eye turn or deviation that the patient has no, or very little control over. The patient is
unable to keep the eye straight with the power of fusion.
esotropia- RET - ANS inward turning of the eye
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
