The Fourth or Trochlear Nerve

The trochlear or pathetic (N. trochlearis) is the smallest of the cranial nerves. It arises from the anterior cerebellar peduncle just behind the corpora quadrigemina, curves outward and forward, pierces the tentorium cerebelli, and passes forward along the outer border of the maxillary nerve (Figs. , ). It emerges from the cranium through a small foramen immediately above the foramen lacerum orbitale or through the latter and passes forward along the inner wall of the orbit to end in the posterior part of the superior oblique muscle of the eyeball (Fig. ).

The fibers of the fourth nerve spring from a nucleus in the gray matter of the floor of the cerebral aqueduct behind the oculomotor nucleus. The fibers run backward in the tegmentum, then turn upward and inward and undergo total decussation with those of the opposite nerve in the anterior part of the anterior medullary velum. In addition to this peculiarity it is the only nerve which is connected with the dorsal aspect of the brain.