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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 69 year-old male botanist visits you in the office, complaining of diplopia.
You note that most of the time that he is facing you and talking, he sits with his chin turned toward his left shoulder and his right eye adducted.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Left inferior oblique

B) Left lateral rectus

C) Right superior rectus

D) Right superior oblique

E) Right medial 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 lateral rectus. Paresis of the left inferior oblique muscle does not present in this way. (See References)


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B) left lateral rectus

This answer is correct.

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


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C) right superior rectus

This answer is incorrect.

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

This answer is incorrect.

This presentation is typical of a paresis of the left lateral 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 his diplopia by looking at the world with his chin turned toward his left shoulder and his left eye abducted. (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