1.

You are testing the extraocular muscles and their innervation in a patient who periodically
experiences double vision. When you ask him to turn his right eye inward toward his
nose and look downward he is able to look inward, but not down. Which nerve is most
likely involved?
Abducens
Nasociliary
Oculomotor, inferior division
Oculomotor, superior division
Trochlear
2. The outermost layer of the optic nerve sheath is a continuation of the:
Arachnoid membrane
Meningeal dura
Periosteal dura
Pia mater
Retina
3. The inner lining of the eyelid is called the:
Orbital septum
Palpebral conjunctiva
Periorbita
Sclera
Tarsal plate
4. What would the examining physician notice in the eye of a person who has taken a
sympathetic blocking agent?
Exophthalmos and dilated iris
Enophthalmos and dry eye
Dry eye and inability to accommodate for reading

Wide open eyelids and loss of depth perception

Ptosis and miosis (pin-point pupil)
5. You are examining a patient who has a pituitary tumor involving the cavernous sinus.
While doing a preliminary eye exam, you suspect the right abducens nerve of the patient
has been damaged by the tumor. In which direction would you have the patient turn his
right eye to confirm the defect?
Inward
Outward
Downward
Down and out
Down and in
Upward
Up and out
Up and in
6. You have a patient with a drooping right eyelid. You suspect Horner's syndrome. Which
of the following signs on the right side would confirm this diagnosis?
Constricted pupil
Dry eye (lack of tears)
Exophthalmos
Pale, blanched face
Sweaty face
7. Following endarterectomy on the right common carotid, a patient is found to be blind in
the right eye. It appears that a small thrombus embolized during surgery and lodged in the
artery supplying the optic nerve. What artery would be blocked?
Central artery of the retina
Infraorbital
Lacrimal

Nasociliary
Supraorbital
8. You are asked to check the integrity of the trochlear nerve in the right eye of a patient.
Starting with the eyes directed straight ahead, you would have the patient look:
Inward, toward the nose and downward
Inward, toward the nose and upward
Toward the nose in a horizontal plane
Laterally in a horizontal plane
Outward, away from the nose and downward
Outward, away from the nose and upward
9. The ducts of the lacrimal gland open into the:
Superior fornix of the conjunctiva
Inferior fornix of the conjunctiva
Lacrimal puncta
Lacrimal canaliculi
Lacrimal lake
10. Starting from a position gazing straight ahead, to direct the gaze downward, the inferior
rectus muscle must be active along with the:
Superior oblique
Inferior oblique
Medial rectus
Lateral rectus
Superior rectus
11. During a physical examination it is noted that a patient has ptosis. What muscle must be
paralyzed?
Orbicularis oculi, lacrimal part

Orbicularis oculi, palpebral part

Stapedius
Superior oblique
Superior tarsal (smooth muscle portion of levator palpebrae)
12. The extraocular muscle that does not originate at or near the apex of the orbit is the :
Inferior oblique
Inferior rectus
Levator palpebrae superioris
Superior oblique
Superior rectus
13. An adolescent boy suffers from severe acne. As is often the case he frequently squeezed
the pimples on his face. He subsequently develops a fever and deteriorates into a
confused mental state and drowsiness. He is taken to his physician and after several tests
a diagnosis of cavernous sinus infection and thrombosis is made. The route of entry to the
cavernous sinus from the face was most likely the:
Carotid artery
Mastoid emissary vein
Middle meningeal artery
Ophthalmic vein
Parietal emissary vein
14. If a person looking inward towards their nose is unable to look down, which nerve may
be injured?
Abducens (CN VI)
Inferior division of oculomotor (III)
Optic (II)
Superior division of oculomotor (III)
Trochlear (IV)

15. If a person is taking a sympathetic blocking agent, what would you notice in her or his
eyes?
Dry eyes and inability to accommodate for reading
Enophthalmos and teary eyes (III)
Exophthalmos and dilated pupil
Ptosis and constricted pupil
Wide open eyes and loss of depth perception (IV)