Orbit: floor fracture: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Orbit: floor fracture

Sample item

A man is punched in the eye and has diplopia on looking upward, numbness of the cheek and upper lip, and enophthalmos. Which anatomical fact best explains these findings?

AThe roof of the orbit fractures, and the frontal nerve runs in itBThe thin orbital floor fractures, and the infraorbital nerve runs in a groove in itCThe thick lateral wall fractures, and the zygomatic nerve runs in itDThe lamina papyracea fractures, and the optic nerve runs beside it

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. The thin orbital floor fractures, and the infraorbital nerve runs in a groove in it

The floor of the orbit, formed mainly by the maxilla, is thin and contains the infraorbital groove and canal for the infraorbital nerve. In a blow-out fracture, orbital contents herniate into the maxillary sinus, trapping the inferior rectus and limiting upward gaze, and the nerve injury produces numbness of the cheek and upper lip. Enophthalmos follows loss of orbital volume support.

Option by option

A. The roof of the orbit fractures, and the frontal nerve runs in it
The roof fracture involves the anterior cranial fossa and gives different sensory loss over the forehead.
B. The thin orbital floor fractures, and the infraorbital nerve runs in a groove in it (correct)
Correct. The floor fracture explains the diplopia, the cheek numbness and the enophthalmos.
C. The thick lateral wall fractures, and the zygomatic nerve runs in it
The lateral wall is the thickest and strongest and is less often fractured.
D. The lamina papyracea fractures, and the optic nerve runs beside it
A medial wall fracture is possible but would not produce infraorbital numbness.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is B, The thin orbital floor fractures, and the infraorbital nerve runs in a groove in it. The floor of the orbit, formed mainly by the maxilla, is thin and contains the infraorbital groove and canal for the infraorbital nerve.

Why is "The roof of the orbit fractures, and the frontal nerve runs in it" not the answer?

The roof fracture involves the anterior cranial fossa and gives different sensory loss over the forehead.

Why is "The thick lateral wall fractures, and the zygomatic nerve runs in it" not the answer?

The lateral wall is the thickest and strongest and is less often fractured.

Why is "The lamina papyracea fractures, and the optic nerve runs beside it" not the answer?

A medial wall fracture is possible but would not produce infraorbital numbness.

What concept does this question test?

It tests Orbit: floor fracture in Anatomy. In a blow-out fracture, orbital contents herniate into the maxillary sinus, trapping the inferior rectus and limiting upward gaze, and the nerve injury produces numbness of the cheek and upper lip. Enophthalmos follows loss of orbital volume support.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Orbit: floor fracture?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.