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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 60 year-old female fisherman visits you in the Lincoln bedroom in the White House, complaining of diplopia.
You note that most of the time that she is facing you and talking, she sits with her chin raised, with her head extended and tilted toward her right shouder.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Left inferior oblique

B) Right lateral rectus

C) Left superior rectus

D) Right superior oblique

E) Right inferior rectus

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This question was created on July 11, 2006 by .
This question was last modified on December 31, 1969.

ANSWERS AND EXPLANATIONS

A) left inferior oblique

This answer is incorrect.

This presentation is typical of a paresis of the left superior rectus. Paresis of the left inferior oblique muscle does not present in this way. (See References)


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B) right lateral rectus

This answer is incorrect.

This presentation is typical of a paresis of the left superior rectus. A patient with a paresis of the right lateral rectus muscle will have impaired adbuction of the right eye, and is likely to try to minimize her diplopia by looking at the world with her chin turned toward her right shoulder and her left eye adducted. (See References)


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C) left superior rectus

This answer is correct.

This presentation is typical of a paresis of the left superior rectus. A patient with a paresis of the left superior rectus muscle will have impaired elevation and inward rotation of the left eye, and is likely to try to minimize her diplopia by looking at the world with her chin raised, with her head extended and tilted toward her right shouder. (See References)


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D) right superior oblique

This answer is incorrect.

This presentation is typical of a paresis of the left superior rectus. A patient with a paresis of the right superior oblique muscle will have impaired depression and inward rotation of the right eye, and is likely to try to minimize her diplopia by looking at the world with her chin held down and her head tilted and turned with her left ear held close to her left shoulder. (See References)


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E) right inferior rectus

This answer is incorrect.

This presentation is typical of a paresis of the left superior rectus. A patient with a paresis of the right inferior rectus muscle will have impaired depression and outward rotation of the right eye, and is likely to try to minimize her diplopia by looking at the world with her chin held down with no extraordinary tilting of her head. (See References)


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References:

1. Ross, R.T. (1999). How to Examine the Nervous System, 3rd Edition. Appleton & Lange, Stamford, Connecticut. Pp. 45-60


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anatomy
Extraocular muscles
Question ID: 0000003
Question written by . (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 07/11/2006
Modified: 12/31/1969
Estimated Permutations: 0