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Neuro-Ophthalmic Disorders MCQs
Neurology · MBBS / Medicine · 28 practice questions
- Vascular Supply of Visual Pathways
- Supranuclear Control of Eye Movements
- Cranial Nerve Nuclei
- Ocular Nerve Palsies
- Peripheral Visual Pathways
- Central Visual Pathways
- Approach to Diagnosis
- Extraocular Muscles
1. A patient has a stroke affecting the most posterior portion of the visual cortex bilaterally, with sparing of the tissue above and below the calcarine fissure. Which part of the visual field is most likely to be affected?
- APeripheral inferior visual field
- BCentral (macular) vision
- CPeripheral superior visual field
- DNasal visual field only
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B. Central (macular) vision The central region of the visual field (macula) is represented in the most posterior portion of the visual cortex, while superior and inferior peripheral fields are represented above and below the calcarine fissure respectively.
2. A patient presents with a fixed, dilated pupil, ptosis, and an eye that is partially abducted but cannot be adducted, elevated, or depressed. Which cranial nerve is most likely completely affected?
- AOptic (II) nerve
- BOculomotor (III) nerve
- CTrochlear (IV) nerve
- DAbducens (VI) nerve
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B. Oculomotor (III) nerve The oculomotor nerve supplies the medial, superior, and inferior rectus and inferior oblique muscles, the levator palpebrae, and parasympathetic pupillary fibers. A complete lesion causes a partially abducted eye that cannot adduct, elevate, or depress, with ptosis and a nonreactive pupil.
3. A patient has ophthalmoplegia with bilateral ptosis and superior rectus weakness in the eye contralateral to a suspected brainstem lesion. This pattern is most consistent with a lesion at which location?
- AOculomotor nerve fascicle in the midbrain periphery
- BTrochlear nerve nucleus
- CAbducens nerve
- DOculomotor nerve nucleus
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D. Oculomotor nerve nucleus Because fibers to the superior rectus originate in the contralateral oculomotor nucleus and the levator palpebrae receives bilateral nuclear innervation, ophthalmoplegia with bilateral ptosis or contralateral superior rectus palsy suggests a nuclear (rather than nerve) lesion.
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