Question 157

Question:

A patient presents to your clinic with a complaint of visual difficulties. On physical exam, you notice that when the patient looks to the left, only his right eye moves. The rest of the exam was within normal limits. The nerve responsible for this patient’s problem travels through which of the following structures?

Correct Answer: E.  Superior orbital fissure

The patient in the question stem presents with lateral rectus palsy on the left side. The nerve responsible for this muscle is the abducens nerve (cranial nerve VI). Due to its long path, this cranial nerve is the most susceptible to injury. During its path from the brainstem to the extraocular muscles, the abducens passes through the superior orbital fissure. Other nerves that pass here include cranial nerves III, IV, and V1. Cranial nerve V2 passes through the foramen rotundum. Cranial nerve V3 passes through foramen ovale. The optic nerve, ophthalmic artery and central retinal vein pass through the optic canal. Cranial nerves VII and VIII pass through the internal auditory meatus.