Extraocular muscles
Topic: Anatomy
Created on Tuesday, July 11 2006 by
Last modified on Wednesday, December 31 1969.
A 22 year-old female botanist visits you in the back of my friend's van, complaining of diplopia.
You note that most of the time that she is facing you and talking, she sits with her chin turned toward her left shoulder and her left eye abducted.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?
A) Left superior oblique B) Right medial rectus C) Left inferior rectus D) Left inferior oblique E) Right superior oblique
This question was created on July 11, 2006 by .
This question was last modified on December 31, 1969.
ANSWERS AND EXPLANATIONS
A) left superior oblique
This answer is incorrect.
This presentation is typical of a paresis of the right medial rectus. A patient with a paresis of the left superior oblique muscle will have impaired depression and inward rotation of the left 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 right ear held close to her right shoulder. (
See References)
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B) right medial rectus
This answer is correct.
This presentation is typical of a paresis of the right medial rectus. A patient with a paresis of the right medial rectus muscle will have impaired adduction of the right eye, and is likely to try to minimize her diplopia by looking at the world with her chin turned toward her left shoulder and her left eye abducted. (
See References)
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C) left inferior rectus
This answer is incorrect.
This presentation is typical of a paresis of the right medial rectus. A patient with a paresis of the left inferior rectus muscle will have impaired depression and outward rotation of the left 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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D) left inferior oblique
This answer is incorrect.
This presentation is typical of a paresis of the right medial rectus. Paresis of the left inferior oblique muscle does not present in this way. (
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E) right superior oblique
This answer is incorrect.
This presentation is typical of a paresis of the right medial 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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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