Injuries

Question 1

Fracture of cribriform plate (ethmoidal bone fracture)

Answer 1

olfactory

loss of smell (anosmia)

Some people complain about loss or alteration of taste since these senses are connected

Runny nose from CSF loss

Question 2

Fracture of orbit

Lesion of optic pathway

Answer 2

optic

blindness; loss of afferent limb of pupillary light reflex

Question 3

Cavernous sinus thrombosis

Midbrain lesion

Aneurysm of posterior cerebral and superior cerebellar arteries

Answer 3

Oculomotor

Dilated pupil; ptosis; loss of accommodation and efferent limb of pupillary reflex; diplopia (double vision); external strabismus; downward and lateral gage deviation

Question 4

Cavernous sinus thrombosis

Fracture of orbit

Severe head injury

Answer 4

Trochlear

Inability to turn eye inferolaterally; trouble going downstairs

Question 5

Lesion of pons

Fracture or tumor in region of trigeminal ganglion

Answer 5

Trigeminal

Sensory loss on face; loss of mastication; jaw deviation toward lesion side; loss of afferent limb of corneal and sneeze reflexes

Question 6

Cavernous sinus thrombosis

Brain stem lesion

Fracture of orbit

Answer 6

Abducens

Diplopia

Inability to abduct eye

Internal strabismus

Question 7

Lesion of pons

Injury to internal auditory meatus

Laceration in parotid region

Fracture of temporal bone

Itnflammation in facial canal

Answer 7

Facial

Facial paralysis (Bell palsy); loss of efferent limb of corneal reflex; loss of taste to anterior two-thirds of tongue; loss of secretion of lacrimal, submandibular, sublingual, nasal and palatine glands

Question 8

Tumor in internal auditory meatus and at cerebellopontine angle

Answer 8

Vestibulocochlear

Loss of hearing and balance

Question 9

Brain stem lesion; penetrating neck injury

Answer 9

Glossopharyngeal

Loss of taste to posterior one-third of tongue; loss of receptors in carotid body and sinus; loss of parotid gland secretion; paralysis of stylopharyngeus muscle; loss of afferent limb of gag reflex

Question 10

Brain stem lesion; penetrating neck injury; skull base fracture

Answer 10

Vagus

Deviation of uvula toward normal side; vocal cord paralysis; paralysis of palate, pharynx, and larynx; loss of receptors in aortic body and arch; loss of efferent limbs of gag and sneeze reflexes and both limbs of cough reflex

Question 11

Penetrating injury to posterior cervical triangle; skull base fracture

Answer 11

Accessary

Inability to shrug shoulder; difficulty in turning head to opposite side

Question 12

Deep laceration of neck and basal skull fracture

Answer 12

Hypoglossal

Loss of tongue movements; tongue deviation toward lesion side

Question 13

Lesion of cervical sympathetic nerves; deep laceration of neck

Answer 13

Sympathetics to head

Horner syndrome: constricted pupil (miosis); ptosis; enophthaloms; anhidrosis; vasodilation (flushing face)

Question 14

optic neuritis (lesion of optic nerve)

Answer 14

Optic

May be caused by inflammatory,
degenerative, demyelinating, or toxic disorders and may result in blindness or diminished visual acuity and no pupillary light reflex in the effected eye

Question 15

Lesion of the optic chiasma

Answer 15

due to a pituitary tumor produces bitemporal hemianopsia or tunnel vision

Question 16

Lesion of optic tract

Answer 16

produces a loss of the opposite visual field, a contralateral homonymous hemianopsia.

Question 17

Lesion of oculomotor nerve

Answer 17

Causes paralysis of the levator palpebrae superi-ris (ptosis), paralysis of the medial rectus (external strabismus), paralysis of sphincter pupillae, resulting in dilation of the pupil (mydriasis is the result of unopposed sympathetic supply to the dilator papillae muscles), and paralysis of ciliary muscles, resulting in loss of accommodation (near vision) because of damage to the preganglionic parasympathetic fibers.

Lesion also causes loss of pupillary light reflex because of damage to parasympathetic fibers that mediate the efferent limb of the pupillary light reflex.

Question 18

Lesion of the trochlear nerve

Answer 18

Causes paralysis of the superior oblique muscle of the eye, which causes diplopia (double vision) and inability to look inferolater- ally.

Injuries are seen with severe head injuries or meningitis because of its long intracranial course.