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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 76 year-old female circus performer visits you in the Emergency Department, complaining of diplopia.
You note that most of the time that she is facing you and talking, she sits with her chin held down with no extraordinary tilting of her head.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Right medial rectus

B) Left inferior rectus

C) Left superior rectus

D) Right superior oblique

E) Left oblique 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) right medial rectus

This answer is incorrect.

This presentation is typical of a paresis of the left inferior 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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B) left inferior rectus

This answer is correct.

This presentation is typical of a paresis of the left inferior 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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C) left superior rectus

This answer is incorrect.

This presentation is typical of a paresis of the left inferior 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 inferior 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) left oblique rectus

This answer is incorrect.

This presentation is typical of a paresis of the left inferior rectus. The left oblique rectus is not a real muscle. (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