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🍀الفائزين :
• الأولى : زينب رشيد
• الأول مكرر : محمد الميموني
• الثانية : رغد الأسطى
• الثالثة : مارية توفيق
• الرابعة : عصماء الحاج
❤️🔥❤️🔥
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سلام الله عليكم ورحمته وبركاته ، اتمنى تكونوا ب اتم الصحة والعافية 💚🍀
مستعدين للأختبار ؟
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🍀 دفعتنا الفخمة 42 🍀
بإذن الله، يوم الأربعاء الساعة 9:30 بيكون موعدنا مع مسابقة لل Pathology
📌 المواضيع:
- Cell Injury
- Inflammation
- Infection
🏆 4 فائزين:
- الأول: 25 نجمة ⭐
- الثاني: 15 نجمة ⭐
- الثالث: 15 نجمة ⭐
- الرابع: 15 نجمة ⭐
شيء بسيط، لكن الهدف منه التحفيز على المذاكرة والمنافسة 🤝💚
يلا ذاكروا ، ونلتقي بإذن الله يوم الأربعاء الساعة 9:30
مذاكرة موفقة للجميع، وبالتوفيق .
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Glossopharyngeal NerveGlossopharyngeal Nerve (CN IX) ● Origin : - Arises from the medulla oblongata. - Emerges from the posterolateral sulcus of the medulla. - Exits the skull through the jugular foramen. - Has superior and inferior sensory ganglia. ● Type : Mixed nerve: - Sensory (GSA & SVA). - Motor (SVE). - Parasympathetic (GVE). ● Function : 📌 Sensory Supply •General sensation from: - Posterior 1/3 of the tongue. - Oropharynx. - Middle ear. - Eustachian tube. - Taste from the posterior 1/3 of the tongue. - Sensation from the carotid sinus and carotid body. 📌 Motor Supply - Supplies the Stylopharyngeus muscle. - Helps in elevation of the pharynx during swallowing. 📌 Parasympathetic Supply - Supplies the parotid gland. • Pathway: - Inferior salivatory nucleus. - Tympanic nerve. - Lesser petrosal nerve. - Otic ganglion. - Auriculotemporal nerve → Parotid gland. 📌 Reflex ☆ Gag reflex: - Afferent limb → CN IX. - Efferent limb → CN X. 📌 Injury ● Common causes : - Brainstem lesions. - Skull base tumors. - Jugular foramen lesions. - Head trauma. - Surgical injury. ● Clinical Features : - Loss of sensation from the posterior 1/3 of the tongue. - Loss of taste from the posterior 1/3 of the tongue. - Loss of sensation from the oropharynx. - Loss of the afferent limb of the gag reflex. - Difficulty swallowing may occur. - Reduced parotid secretion. - Gag reflex is absent on the affected side when the sensory limb is tested. 📌 Clinical Test : - Test taste over the posterior 1/3 of the tongue when indicated. - Test sensation of the oropharynx. ☆Test the gag reflex: - Afferent → CN IX. - Efferent → CN X. • Assess swallowing. 🍀 High-Yield Points : - CN IX = Glossopharyngeal nerve. - Posterior 1/3 of tongue → General sensation + Taste. - Stylopharyngeus → Motor supply by CN IX. - Parotid gland → Parasympathetic supply by CN IX. - Gag reflex: IX = Afferent, X = Efferent. - Carotid sinus & carotid body → CN IX. - Lesion → Loss of posterior 1/3 tongue sensation/taste + Absent gag reflex (afferent limb). #Head_and_neck #CLINICAL_ANATOM
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Vestibulocochlear NerveVestibulocochlear Nerve (CN VIII) ● Origin : - Arises from the vestibular and cochlear nuclei at the pontomedullary junction. Has two divisions: - Cochlear nerve. - Vestibular nerve. - Enters the brainstem at the cerebellopontine angle. - Passes through the internal acoustic meatus together with CN VII. ● Type : Sensory (SSA). ● Function : 📌 Cochlear Division - Responsible for hearing. - Receives auditory information from the cochlea. 📌 Vestibular Division - Responsible for balance and equilibrium. - Receives information about: - Head position. - Head movement. - Acceleration. 📌 Injury ● Common causes : - Vestibular schwannoma (Acoustic neuroma). - Head trauma. - Inner ear infection. - Meningitis. - Cerebellopontine angle tumors. - Ototoxic drugs. ● Clinical Features : - Hearing loss. - Tinnitus. - Vertigo. - Loss of balance. - Nystagmus. - Difficulty maintaining posture and coordination. 📌 Clinical Test : - Whisper test → screening for hearing loss. - Rinne test → compares air conduction with bone conduction. - Weber test → assesses lateralization of sound. - Romberg test → assesses balance and vestibular function. - Caloric test → assesses vestibular function. ☆ Especially useful in unconscious/comatose patients to assess brainstem function 🍀 High-Yield Points : - CN VIII = Vestibulocochlear nerve. - Cochlear division → Hearing. - Vestibular division → Balance and equilibrium. - CN VIII is purely sensory (SSA). - CN VII and CN VIII pass together through the internal acoustic meatus. - Lesion → Hearing loss + Tinnitus + Vertigo + Balance disturbance. - Vestibular schwannoma commonly affects CN VIII and may also compress CN VII. #Head_and_neck #CLINICAL_ANATOM
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Facial NerveFacial Nerve (CN VII) ● Origin : - Arises from the facial nucleus in the pons. Has: - Motor root. - Nervus intermedius carrying sensory and parasympathetic fibers. - Emerges from the brainstem at the pontomedullary junction. - Enters the internal acoustic meatus with CN VIII. - Passes through the facial canal. - Exits the skull through the stylomastoid foramen. - Divides within the parotid gland into five terminal branches. ● Type : Mixed nerve: - Motor (SVE). - Sensory (GSA & SVA). - Parasympathetic (GVE). ● Function : 📌 Motor Supply - Supplies the muscles of facial expression. Also supplies: - Stapedius. - Stylohyoid. - Posterior belly of digastric. 📌 Sensory Supply -General sensation from a small area of the external ear. -Taste from the anterior 2/3 of the tongue via the chorda tympani. 📌 Parasympathetic Supply -Lacrimal gland → stimulates lacrimation. -Submandibular and sublingual glands → stimulates salivation. -Also supplies glands of the nasal and palatal mucosa. 📌 Terminal Branches - Temporal branch. - Zygomatic branch. - Buccal branch. - Marginal mandibular branch. - Cervical branch. 📌 Injury ● Common causes : - Bell’s palsy. - Facial nerve trauma. - Temporal bone fracture. - Parotid gland tumors or surgery. - Brainstem lesions. - Ramsay Hunt syndrome. ● Clinical Features : - Ipsilateral paralysis of muscles of facial expression. - Inability to close the eye. - Drooping of the corner of the mouth. - Flattening of the nasolabial fold. - Difficulty smiling, frowning, or puffing out the cheeks. - Loss of taste from the anterior 2/3 of the tongue if the lesion is proximal to the chorda tympani. - Hyperacusis due to paralysis of the stapedius muscle. - Reduced lacrimation or salivation depending on the site of the lesion. 📌 Clinical Test : - Ask the patient to: ☆Raise the eyebrows. ☆Close the eyes tightly. ☆Smile. ☆Show the teeth. ☆Puff out the cheeks. ☆Frown. ☆Test taste on the anterior 2/3 of the tongue when indicated. ☆Assess corneal reflex: • Afferent limb → CN V1 ( Ophthalmic branch ) . • Efferent limb → CN VII. 🍀 High-Yield Points : - CN VII = Facial nerve. - Supplies the muscles of facial expression. - Anterior 2/3 of tongue → Taste via Chorda tympani. - Corneal reflex: V1 = Afferent, VII = Efferent. - Stapedius paralysis → Hyperacusis. - Bell’s palsy → Ipsilateral paralysis of the entire side of the face. - Upper motor neuron lesion → Contralateral lower facial weakness with forehead sparing. #Head_and_neck #CLINICAL_ANATOM
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Abducent NerveAbducent Nerve (CN VI) ● Origin : - Arises from the abducent nucleus in the pons, near the pontomedullary junction. - Emerges from the anterior surface of the brainstem at the pontomedullary junction. - Passes through the cavernous sinus. - Enters the orbit through the superior orbital fissure. ● Type : Motor (GSE). ● Function : 📌 Motor Supply - Supplies the Lateral rectus muscle. Action: - Abducts the eye (moves the eye laterally). 📌 Injury ● Common causes : - Head trauma. - Increased intracranial pressure. - Microvascular ischemia (e.g., diabetes). - Brainstem lesions. - Cavernous sinus lesions. ● Clinical Features : - Diplopia, especially when looking toward the affected side. - Inability to abduct the affected eye. - The affected eye deviates medially (medial strabismus / esotropia) at rest. - Difficulty looking laterally toward the affected side. 📌 Clinical Test : - Ask the patient to follow an object in the H-pattern. - Test lateral movement (abduction) of both eyes. - Observe for medial deviation of the affected eye. 🍀 High-Yield Points : - CN VI = Motor nerve to the Lateral rectus muscle. - Lateral rectus → Abducts the eye. - Lesion → Inability to abduct the affected eye. - Lesion → Medial deviation + Diplopia. • CN VI palsy is commonly associated with increased intracranial pressure. #Head_and_neck #CLINICAL_ANATOM
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🍀Trigeminal neuralgia (Tic douloureux)
Explanation:
- Brief episodes of severe, stabbing/electric shock-like facial pain
- Commonly affects maxillary division (V2) → cheek pain
Triggered by light stimuli (touch, brushing teeth, chewing)
- No sensory loss or motor weakness between attacks
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🍀Trigeminal nerve (CN V) lesion
Explanation:
Loss of facial sensation → damage to sensory fibers of CN V
Absent corneal reflex → damage to ophthalmic division (V1) (afferent limb)
- Weakness of mastication → damage to mandibular division (V3) (motor fibers)
- Jaw deviation toward affected side → weakness of lateral pterygoid muscle on the affected side
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🍀QUESTIONS :
Q1 : A patient has loss of facial sensation, absent corneal reflex, weakness of the muscles of mastication, and the jaw deviates toward the affected side. The most likely diagnosis is:
Q2 : A 55-year-old woman presents with sudden, severe, electric shock-like pain over the right cheek triggered by brushing her teeth. Facial sensation is normal between attacks, and there is no weakness of mastication. What is the most likely diagnosis?
#VAGUS_CHANNEL
