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The levator palpebrae superioris muscle, also known as LPS, is the muscle in the orbit that elevates the upper eyelid. It is one of six or seven extraocular muscles in the orbit, which are extrinsic and separate from the eyeball. The LPS originates from the inferior surface of the lesser wing of the sphenoid bone, just above the optic foramen, and extends along the roof of the orbit. The LPS receives its blood supply from branches of the ophthalmic artery, specifically the muscular branches and the supraorbital artery. The superior tarsal muscle, a smooth muscle, is attached to the LPS and inserts on the superior tarsal plate.
| Characteristics | Values |
|---|---|
| Muscle Name | Levator palpebrae superioris |
| Muscle Type | Extraocular muscle |
| Location | Orbit |
| Origin | Orbital apex, inferior surface of the lesser wing of the sphenoid bone |
| Blood Supply | Ophthalmic artery, supraorbital artery |
| Innervation | Superior oculomotor nerve branch (CN III) |
| Associated Structures | Whitnall ligament, levator aponeurosis |
| Function | Elevates and retracts the upper eyelid |
| Related Conditions | Ptosis (eyelid drooping), Horner's syndrome |
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What You'll Learn
The levator palpebrae superioris muscle
The muscle receives innervation from the superior oculomotor nerve branch (CN III), which originates from the oculomotor nucleus in the midbrain. Lesions in CN III can cause ptosis, or drooping of the eyelid, as the levator palpebrae superioris muscle is unable to oppose the force of gravity without stimulation from the nerve. Myogenic or neurogenic problems with the muscle can also lead to ptosis.
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Superior tarsal muscle
The superior tarsal muscle, also known as the Müller muscle, is a smooth muscle that is attached to the levator palpebrae superioris muscle. It originates from the deep surface of the levator palpebrae superioris muscle and inserts on the superior tarsal plate of the upper eyelid. The superior tarsal muscle is innervated by the sympathetic nervous system and receives its vascular supply from the superior branches of the ophthalmic artery.
The main function of the superior tarsal muscle is to elevate the upper eyelid, particularly in states of sympathetic predominance such as excitement, fear, or surprise. This elevation of the eyelid serves to widen the visual field, which can be advantageous in life-threatening situations, triggering a fight or flight response. Additionally, the static tone of the superior tarsal muscle helps to maintain the eyes in an open position and keeps the size of the palpebral fissure constant during wakefulness.
The role of the superior tarsal muscle in eyelid elevation is more significant than previously thought. Research has shown that it transmits considerable power to the levator palpebrae superioris muscle during the act of elevating the eyelid. This highlights a synergistic interaction between the two muscles. The superior tarsal muscle is considered a structural component of the larger skeletal muscle of the eyelid, which is the levator palpebrae superioris muscle.
Damage to the superior tarsal muscle or disruption of its innervation can lead to partial ptosis, or drooping of the eyelid. This condition is often observed in Horner's syndrome, characterised by a triad of symptoms: partial ptosis, miosis (constricted pupil), and loss of hemifacial sweating (anhidrosis). The superior tarsal muscle is routinely addressed in oculoplastic surgery, particularly in procedures aimed at correcting ptosis.
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Corrugator supercilii muscle
The corrugator supercilii muscle is a small, narrow, pyramidal muscle of the face. It is located at the medial end of the eyebrow and draws the eyebrow downward and medially, producing the vertical "frowning" wrinkles of the forehead. It is often regarded as the principal muscle in the facial expression of suffering.
The muscle acts in tandem with the orbicularis oculi muscle and the frontal belly of occipitofrontalis. The corrugator supercilii muscle draws the eyebrows together medially and inferiorly, resulting in vertical wrinkles over the glabella. The corrugator supercilii muscles exist as a pair of small pyramidal muscles that lie deep to the frontal portion of the occipitofrontalis and the orbicularis oculi muscles. They arise from the medial supraorbital ridge of the frontal bone. The corrugator supercilii muscles have two heads: a transverse head and an oblique head. The transverse head arises from the superomedial part of the orbital rim and pulls the brows medially. The smaller oblique head runs parallel to the depressor supercilii and depresses the medial brow.
The muscle also contracts to prevent high sun glare, pulling the eyebrows toward the bridge of the nose to shield the eyes from bright sunlight or rain. The name corrugator supercilii comes from Latin, meaning "wrinkler of the eyebrows". The muscle is sometimes surgically severed or paralysed with botulinum toxin as a preventive treatment for some types of migraine or for aesthetic reasons.
The corrugator supercilii muscle receives arterial blood from the ophthalmic artery, which stems from the internal carotid artery. The muscle is innervated by the temporal branches of the facial nerve (CN VII). The supratrochlear artery, which traverses underneath the corrugator supercilii muscle, provides sensation and vascularity to the forehead.
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Retractor anguli oculi muscle
The levator palpebrae superioris muscle is the muscle in the orbit that elevates the upper eyelid. It originates from the inferior surface of the lesser wing of the sphenoid bone, just above the optic foramen. This muscle receives its blood supply from branches of the ophthalmic artery, specifically the muscular branches and the supraorbital artery. The levator palpebrae superioris is a skeletal muscle, and its function is to elevate and retract the upper eyelid.
The retractor anguli oculi lateralis muscle is a facial muscle. Unfortunately, I could only find limited information on this muscle.
The levator palpebrae superioris muscle can be affected by various factors, leading to different clinical conditions. For example, damage to this muscle or its innervation can cause ptosis, or drooping of the eyelid. This can be caused by lesions in CN III, which is the superior oculomotor nerve branch, as without stimulation from this nerve, the muscle cannot oppose the force of gravity. Ptosis can also be caused by damage to the adjoining superior tarsal muscle or its sympathetic innervation, which can occur in Horner's syndrome.
There are several treatments for ptosis, depending on the cause and severity. For congenital ptosis, a more aggressive shortening of the levator aponeurosis and muscle may be preferred. Alternatively, a Müllerectomy procedure may be performed, which involves resecting the conjunctiva and the Müller muscle, which is the superior tarsal muscle. Weights can also be surgically attached to the upper eyelids to counter the levator palpebrae superioris muscle's action and correct excessive upper eyelid retraction.
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Innervation and blood supply
The levator palpebrae superioris muscle is responsible for elevating the upper eyelid. This muscle has an abundant blood supply, primarily provided by the ophthalmic and supraorbital arteries, both of which are branches of the internal carotid artery. The lacrimal, supratrochlear, supraorbital, and muscular branches are the four arterial systems that direct blood to the levator palpebrae muscle from the ophthalmic artery. The superior tarsal muscle, a smooth muscle, is attached to the levator palpebrae superioris and is innervated by postganglionic sympathetic axons from the superior cervical ganglion.
The eyelid receives its blood supply from a variety of arteries, including the ophthalmic artery and its branches, such as the lacrimal, supraorbital, dorsal nasal, and supratrochlear arteries. The facial artery, specifically the angular branch, and the superficial temporal artery, particularly the transverse facial artery branch, also contribute to the blood supply of the eyelid. The eyelid is drained by a rich network of veins, with venous drainage occurring medially via the medial palpebral vein into the angular and ophthalmic veins, and laterally via the lateral palpebral vein into the superficial temporal vein.
The levator palpebrae superioris muscle receives motor innervation from the superior division of the oculomotor nerve, also known as the third cranial nerve (CN III). This nerve stimulates the levator palpebrae superioris muscle, enabling it to elevate the upper eyelid against the force of gravity. Additionally, the oculomotor nerve innervates the superior rectus muscle through its superior division. The oculomotor nerve also carries autonomic fibers that are destined for the ciliary ganglion and the intrinsic muscles of the eye.
The eyelid is supplied by three cranial nerves: CN III (oculomotor nerve), CN V (trigeminal nerve), and CN VII (facial nerve), along with sympathetic nerve fibers. The oculomotor nerve innervates the main upper eyelid retractor, the levator palpebrae superioris, and its inferior division innervates the inferior rectus muscle, contributing to lower eyelid retraction. The trigeminal nerve provides somatosensory innervation to the eyelid through its ophthalmic (V1) and maxillary (V2) divisions. The ophthalmic division further branches into the lacrimal, supraorbital, supratrochlear, and infratrochlear nerves, supplying the upper and medial aspects of the eyelids. The facial nerve innervates the orbicularis oculi, frontalis, procerus, and corrugator supercilii muscles, and its temporal and zygomatic branches supply the orbicularis oculi, supporting eyelid protraction.
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Frequently asked questions
The levator palpebrae superioris muscle elevates the upper eyelid.
The levator palpebrae superioris is a skeletal muscle. It is one of the six extraocular muscles in the orbit.
The main function of the levator palpebrae superioris is to elevate and retract the upper eyelid. It also contributes to facial expressions and aids in unhindered upward gaze.
The structures associated with the levator palpebrae superioris include the Whitnall ligament, levator aponeurosis, and the superior tarsal muscle (Müller's muscle).
Damage to the levator palpebrae superioris or its innervation can result in ptosis, or drooping of the eyelid. Congenital ptosis and excessive eyelid retraction can be corrected through surgical procedures involving this muscle.
