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cjdinurdreamz
im confused...doesnt the IR make the eye look down so if its trapped then why is upward gaze affected and not downward?
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nutmeg_liver
@cjdinurdreamz it does make your eye look down, so since it's trapped in a functionally shorter position you're trapped looking down, not up.
+5
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minion7
if IR muscle is affected it is impaired downward gaze!!!
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makinallkindzofgainz
@minion7, If the Inferior Rectus muscle is impaired (e.g. nerve dysfunction), then yes, downward gaze would be affected. However, the question states that there is ENTRAPMENT of muscles. Trapping the inferior rectus muscle essentially locks the eye into a downward gaze, therefore impairing upward gaze, as the inferior rectus muscle is essentially trapped in contraction.
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sahusema
I know you're right. I was just so uncomfortable picking an answer with "inferior rectus" because damage to the inferior rectus does nothing to explain the clinical findings of impaired upward gaze. Unless the muscle is physically stuck and can't relax or something
+7
emmy2k21
Agreed. Why would a dysfunctional inferior rectus contribute to impaired upward gaze??? I eliminated that answer choice and got it wrong :(
+2
dr_jan_itor
in the last sentence it asks you to assume an "entrapment", so it is actually the inferior rectus which is the cause of the upward gaze palsy. The entrapped muscle is functionally trapped in it's shortened position, thereby not allowing the orbit to gaze upward.
+16
chandlerbas
bam! dr_jan_itor just cleaned up that confusion
+2
weirdmed51
Why inferior oblique then? Doesnโt IO helps to look up ?
+1
freemanpeng
May be IR is stronger than IO in downward gaze?
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aishu007
hi, but inferior oblique moves up and in and not out
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submitted by โdr_jan_itor(87)
Option A is the only option where both muscles are part of the orbital floor. Also, the last sentence in the question stem is a total modifyer of what one would expect the question to be asking. It is not asking for you to assume that these muscles have been severed, paralyzed, or rendered flacid. It is asking you to assume that they have become "entrapped" if the muscle is entrapped, then it cannot allow the eye to move into whatever position it would be in when the muscle is at its lengthened position. So in this case, It is the inferior rectus being entrapped in a functionally shortened position that is preventing upward gaze.