Chapter 12 Blumenfeild Abdullah Al-Salti R3 29 September 2010.

Chapter 12 Chapter 12 Blumenfeild Blumenfeild Abdullah Al-Salti R3Abdullah Al-Salti R3

29 September 201029 September 2010

Surface features of the Surface features of the brainstembrainstem

• What structures form the Tectum of midbrain?

• To which parts of the brainstem the cerebellum attach?

• In cross section how will differentiate between rostral and caudal medulla?

• Name three structures within the floor of the 4th ventricle?

• Which nerves commonly affected in cerebellopontine lesions?

Skull foramina and cranial Skull foramina and cranial nerve exit pointsnerve exit points..

1. Two VIPs cranial nerves?

2. Mention 2 vital skull foramina anatomically and pathologically important?

Sensory and motor Sensory and motor organization of the cranial organization of the cranial

nervesnerves. . • Similarity between spinal cord and cranial nerves? • Outline the classification of cranial nerve nuclei into

sensory and motor includes: Columns, nuclei, cranial nerves and functions?

• What is occipital somites and branchial arches?• Name 4th parasympathetic cranial nerves nuclei and

out line their functions?• What are the differences between nucleus

ambiguous and solitaries nucleus?

• Mention 3 cranial nerve nuclei with multiple C.Nv inputs?SAT

Functions and course of the Functions and course of the cranial nervescranial nerves

• Classify cranial nerves into pure motor, sensory and mixed?

• Outline the function of the mixed (sensory and motor) cranial nerves in functional categories and functions?

• Regarding the tongue, which are the cranial nerves contribute for sensation and taste?

Peripheral sensory and Peripheral sensory and parasympathetic gangliaparasympathetic ganglia..

• Which cranial nerves have peripheral ganglia?

• Name the parasympathetic ganglia with each cranial nerves?

CN: V TrigeminalCN: V Trigeminal • What is gasserian ganglion and where is it

located?• Remember (SRO) single room occupancy!• Mention others sensory area innervated by CN

V? • All primary sensory neurons nuclei located

peripherally except one neuron what is it?• What are the muscles innervated by V nerve? • Compare between trigeminal and spinal

sensory system? either by diagram or table?• Draw the monosynaptic jaw jerk reflex

(including UMN control)?

Trigeminal NeuralgiaTrigeminal NeuralgiaClinical features.Examination.Differential diagnosis.Managements.

Other causes of trigeminal nerve lesion?

Case 1.1Case 1.1

PATIENT PRESENTATION50 years old male ,admitted with GBSReceived 5 doses of I.V IgG.He

developed acute chest pain with severe facial pain.

His neurological exam : no new findings.

LabsLabs::

Troponin: 0.1 then 0.9Chest x-ray: normal ECG:

Case 1.1Case 1.1Differential diagnosis?

How can you explain his severe bilateral facial pain ?

Case 1.2Case 1.2

PATIENT PRESENTATIONA 51-year-old woman saw an ophthalmologist

because she noticed her left eye seemed to be bulging out increasingly for the past 3 to 4 years, and she had recently developed left-sided headaches.

KEY SYMPTOMS AND SIGNSLeft-sided headachesLeft proptosisDecreased sensation to touch and pinprick over

the left cheek

Case 1.2Case 1.2• RELEVANT ANATOMICAL &

CLINICAL CONCEPTS

– Trigeminal Nerve (CN V)– Skull Foramina Serving as Cranial Nerve

Exit Points– Differential Diagnosis?

Case 1.2Case 1.2FINAL DIAGNOSISMeningioma in region of left foramen

rotundum extending into left orbit

OUTCOMEMeningioma was resected neurosurgically

leading to complete recovery.