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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 65 year-old male quail photographer visits you in the back of my friend's van, 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 oblique rectus

B) Left lateral rectus

C) Right inferior rectus

D) Right superior 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 oblique rectus

This answer is incorrect.

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


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B) left lateral 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 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 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) right superior 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 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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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