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Zoe MCQ 10

Topic: Anatomy

Created on Saturday, November 26 2022 by zoe

Last modified on Saturday, November 26 2022.

54 year-old patient presents status-post fall while walking down the stairs at work. He reports diplopia while going down the stairs, contributing to the fall. While talking to the patient, there is no evident deviation of the eye, but he is tilting his head to the right. Which cranial nerve is likely damaged?

A) Oculomotor

B) Accessory

C) Abducens

D) Trochlear nerve

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This question was created on November 26, 2022 by zoe.
This question was last modified on November 26, 2022.

ANSWERS AND EXPLANATIONS

A) Oculomotor

This answer is incorrect.

Cranial nerve III supplies the levator palpebrae superioris (the principal elevator of the eyelid); medial, superior and inferior recti; and the inferior oblique. The eye ipsilateral to the lesion usually deviates laterally because the medial rectus is now paralyzed and the lateral rectus is unopposed (lateral strabismus). This patient did not have any obvious deviations. (See References)

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B) Accessory

This answer is incorrect.

Accessory nerve (XI) innervate the sternocleidomastoid and the trapezius (See References)

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C) Abducens

This answer is incorrect.

The patient is having diplopia while looking down. The abducens nerve (VI) is responsible for the lateral rectus which abducts the eye. (See References)

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D) Trochlear nerve

This answer is correct.

Trochlear nerve is responsible for superior oblique, which helps to move the adducted eye downward, as when this patient is descending down the stairs. Patients with lesions here may have diplopia while walking down the stairs. Lesions can lead to an extorted eye, resulting in the patient tilting his or head away from the lesioned side to compensate (See References)

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References:

1. Nolte Chapter 12: Pages 290-295

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anatomy
Zoe MCQ 10
Question ID: 112622082
Question written by zoe. (C) FrontalCortex.com 2006-2009, all rights reserved. Created: 11/26/2022
Modified: 11/26/2022
Estimated Permutations: 24