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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 41 year-old female kumquat inspector visits you in the middle of the Gobi Desert, complaining of diplopia.
You note that most of the time that she is facing you and talking, she sits with her chin held down and her head tilted and turned with her right ear held close to her right shoulder.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Left lateral rectus

B) Right inferior oblique

C) Right superior oblique

D) Left medial rectus

E) Left 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 lateral rectus

This answer is incorrect.

This presentation is typical of a paresis of the left 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 her diplopia by looking at the world with her chin turned toward her left shoulder and her right eye adducted. (See References)


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B) right inferior oblique

This answer is incorrect.

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


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C) right superior oblique

This answer is incorrect.

This presentation is typical of a paresis of the left 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 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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D) left medial rectus

This answer is incorrect.

This presentation is typical of a paresis of the left superior oblique. A patient with a paresis of the left medial rectus muscle will have impaired adduction of the left eye, and is likely to try to minimize her diplopia by looking at the world with her chin turned toward her right shoulder and her right eye abducted. (See References)


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E) left superior oblique

This answer is correct.

This presentation is typical of a paresis of the left superior oblique. A patient with a paresis of the left superior oblique muscle will have impaired depression and inward rotation of the left 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 right ear held close to her right 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