M2 Eye Preformative Quiz

A 19-year-old man is brought to the emergency room after he was punched in his right eye by an unknown person when he was walking back home in the middle of the night. His temperature is 36.6°C (98°F), pulse is 76/min, blood pressure is 116/74 mm Hg, and respirations are 14/min. Physical examinations of the right eye shows eyelid swelling, mild ecchymosis, posteriorly displaced eyeball, comparatively decreased visual acuity, limited superior gaze, and decreased sensation over the mid-third face. An entrapment of which of the following muscles most likely occurred? 

A 26-year-old woman comes to the physician because of a 1-day history of diplopia. She says that the symptoms are aggravated when she is walking downstairs. Her temperature is 36.7°C. (98.2°F), pulse is 76/min, blood pressure is 144/96 mm Hg, and respirations are 18/min. Physical examination shows that when she is asked to move her right eye inward toward her nose and look down, she can look inward but not down. An MRI of the head shows a proximal superior cerebellar artery aneurysm. A loss of function of which muscle is the cause of this patient’s symptoms?

A 58-year-old woman comes to the physician because of fatigue and weight loss for the past year. She has a 50-pack-per-year history of smoking. Physical examination shows drooping of the left eyelid, a constricted left pupil, and loss of sweating on the left side of her face. A CT scan of the chest shows a mass on the upper lobe of the left lung. Loss of function of which of the following muscles is responsible for the drooping of the eyelid in this patient?

A 14-year-old boy is brought to the physician because of headaches, fatigue, and loss of vision. He says that the headaches started about a month ago and have been getting worse. Physical examination shows bitemporal hemianopsia. An MRI of the head shows a tumor. A lesion in which of the following will lead to the visual deficits present in this patient? 

A 48-year-old woman is brought to the emergency department by her family after being found unconscious. The patient has a history of chronic headaches and her daughter says they seem to be getting worse lately. Physical examination shows no abnormalities. A CT scan shows a tumor in her brain. When the woman regains consciousness, her right eye is directed laterally and downward, with complete ptosis of her upper eyelid, and her pupil is dilated. Which of the following structures was most likely affected by the tumor to result in these symptoms? 

A 33-year-old woman is brought to the emergency department after falling and hitting her head. The patient is unresponsive but breathing. There is no obvious sign of bleeding. Physical examination shows responsive pupillary light test reflex bilaterally. The integrity of which of the following nerves is being checked during this reflex?

A 48-year-old man comes to the physician because of a 2-week history of double vision. The patient has not experienced any recent trauma. Physical examination shows that he is unable to adduct his left eye and lacks a corneal reflex on the left side. An MRI of the head confirms an intracranial lesion. Where is the most likely location of the lesion causing these symptoms?

A 48-year-old man comes to the physician because his wife recently noticed something strange with his right eye. Physical examination under normal lighting shows that the patient’s right and left pupil are 2 mm and 4 mm, respectively; when the lights are off, they are 2 mm and 6 mm, respectively. His vision in both eyes is normal. These findings are most likely because of a lesion involving which of the following right-sided structures?

A 22-year-old woman is brought to the emergency department after she was hit by a soccer ball in her right eye. She did not lose consciousness and her vital signs are within normal limits. Physical examination shows that her vision and extraocular eye movements are all intact and unchanged. The corneal reflex is tested and found to be normal. Which of the following nerves is responsible for the afferent limb of this reflex?

A 62-year-old woman is brought to the emergency department after a fall down a flight of stairs. The patient says she is feeling fine and she just fell because of double vision. Physical examination shows worsening diplopia when she attempts to look downward. A CT scan of the head shows no intracranial process or fracture. A lesion of which of the following nerves is most likely responsible for this patient’s complaint?