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Extraocular muscles

Topic: Anatomy

Created on Tuesday, July 11 2006 by

Last modified on Wednesday, December 31 1969.

A 88 year-old female dandelion taster 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 raised, with her head extended and tilted toward her right shouder.
Based on this information alone, you suspect that there may be a paresis of which extraocular muscle?

A) Right inferior rectus

B) Left superior oblique

C) Right superior oblique

D) Left oblique rectus

E) Left superior 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 incorrect.

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

This answer is incorrect.

This presentation is typical of a paresis of the left superior rectus. 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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C) right superior oblique

This answer is incorrect.

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

This answer is incorrect.

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


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E) left superior rectus

This answer is correct.

This presentation is typical of a paresis of the left superior 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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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