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Superior tarsal muscle: want to learn more about it?

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Superior tarsal muscle

Superior tarsal muscle (Musculus tarsalis superior)

Superior tarsal (Muller's muscle) is a small muscle found within the superior eyelid. It is a smooth muscle, but it is considered as a structural component of the larger skeletal muscle of the eyelid; levator palpebrae superioris. It extends from the deep aspect of levator palpebrae superioris to the upper margin of the superior tarsal plate of the eyelid.  

Being a smooth muscle, the superior tarsal is controlled by the autonomic nervous system, precisely its sympathetic division. The main function of this muscle is to elevate the upper eyelid in the state of sympathetic predominance, such as excitement, fear or surprise. Moreover, the static tone of the muscle also contributes to maintaining the eyes open and keeping the size of palpebral fissure constant in the state of awakeness.

Key facts about the superior tarsal muscle
Origin Deep surface of levator palpebrae superioris muscle
Insertion Superior tarsal plate of the eyelid
Action Elevates and retracts the upper eyelid
Innervation Sympathetic nervous system (via internal carotid plexus)
Blood supply Ophthalmic artery

In this article, we will discuss the anatomy and function of the superior tarsal muscle.

Anatomy

Superior tarsal is a smooth muscle of the upper eyelid. It originates from the deep surface of levator palpebrae superioris and inserts inferiorly, to the superior tarsal plate of the upper eyelid. 

The superior tarsal muscle receives its innervation from the sympathetic nervous system. More specifically, the postganglionic sympathetic fibers stem from the superior cervical ganglion and form the internal carotid plexus around the cervical segment of internal carotid artery. Following the petrous and cavernous segments of internal carotid artery, these nerve fibers enter the skull and traverse the cavernous sinus. Finally, the nerve fibers for the superior tarsal muscle access the orbit in a form of a tight nervous plexus wrapped around the ophthalmic artery, which is a branch of internal carotid artery. Note that the ophthalmic artery provides the blood supply for the superior tarsal muscle.

The main action of the superior tarsal muscle is to elevate the upper eyelid in the state of sympathetic predominance. The function of this action is to enable a wider visual field in states of acute life-threatening situations (fight or flight response). In addition, the muscle has a static tone, which adds up to the tone of the levator palpebrae superioris muscle. The tones of these two muscles are in balance with the opposing tone of orbicularis oculi, thereby maintaining the eyes open and defining the size of palpebral fissure.

Learn more about the structures of the upper eyelid with our articles, video tutorials, quizzes and atlas images.

Clinical relations

Horner's syndrome

Horner's syndrome occurs when the sympathetic nerve supply to the face and eye is damaged. This condition usually occurs due to trauma of the neck and shoulder regions and consequential injury of the cervical sympathetic ganglia and/or nerves. Injuries of this kind will result with a loss of effective innervation of the smooth muscles and glands in the head. Horner's syndrome is characterized by the triad of symptoms; partial ptosis (drop of the upper eyelid), miosis (constricted pupil) and loss of hemifacial sweating (anhidrosis). Sometimes, it can also be followed by the posterior displacement of the eyeball within the orbit (enophthalmos).

Superior tarsal muscle: want to learn more about it?

Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster.

What do you prefer to learn with?

“I would honestly say that Kenhub cut my study time in half.” – Read more. Kim Bengochea Kim Bengochea, Regis University, Denver

Show references

References:

  • Esperidião-Antonio, V., Conceição-Silva, F., De-Ary-Pires, B. (2010). The human superior tarsal muscle (Müller’s muscle): a morphological classification with surgical correlations. Anat Sci Int 85, 1–7.
  • Moore, K. L., Dalley, A. F., & Agur, A. M. R. (2014). Clinically Oriented Anatomy (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
  • Palastanga, N., & Soames, R. (2012). Anatomy and human movement: structure and function (6th ed.). Edinburgh: Churchill Livingstone.
  • Standring, S. (2016). Gray's Anatomy (41tst ed.). Edinburgh: Elsevier Churchill Livingstone.
  • Netter, F. (2014). Atlas of Human Anatomy (6th ed.). Philadelphia, PA: Saunders.

Illustrators:

  • Superior tarsal muscle (Musculus tarsalis superior) - Paul Kim
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