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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 59 year-old male starfish rancher visits you in the Emergency Department, complaining of diplopia.
You note that most of the time that he is facing you and talking, he sits with his chin held down and his head tilted and turned with his left ear held close to his left shoulder.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Left inferior oblique

B) Left medial rectus

C) Right inferior rectus

D) Left inferior rectus

E) Right superior oblique

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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 right superior oblique. Paresis of the left inferior oblique muscle does not present in this way. (See References)


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B) left medial rectus

This answer is incorrect.

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


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C) right inferior rectus

This answer is incorrect.

This presentation is typical of a paresis of the right superior oblique. 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 his diplopia by looking at the world with his chin held down with no extraordinary tilting of his head. (See References)


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D) left inferior rectus

This answer is incorrect.

This presentation is typical of a paresis of the right superior oblique. 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 his diplopia by looking at the world with his chin held down with no extraordinary tilting of his head. (See References)


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E) right superior oblique

This answer is correct.

This presentation is typical of a paresis of the right superior oblique. 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 his diplopia by looking at the world with his chin held down and his head tilted and turned with his left ear held close to his 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