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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 53 year-old male crabgrass salesperson visits you in the abandoned mine shaft, complaining of diplopia.
You note that most of the time that he is facing you and talking, he sits with his chin held down with no extraordinary tilting of his head.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Right inferior rectus

B) Left inferior oblique

C) Left lateral rectus

D) Left oblique rectus

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) right inferior rectus

This answer is correct.

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

This answer is incorrect.

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


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C) left lateral rectus

This answer is incorrect.

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

This answer is incorrect.

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


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E) right medial rectus

This answer is incorrect.

This presentation is typical of a paresis of the right 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 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