פרק 11 Chapter 11 Disorders of Smell and Taste

Question 1

ANOSMIA
כיצד מזהים?

Answer 1

Scratch and sniff – לוח הרחה מנורמל לגיל ומין, מעולה בזיהוי מלינגרינג
Air dilution olfactory dedection – מבחן רגיש לזיהוי ריחות.

Question 2

Answer 2

SLE

Question 3

Table 11-1MAIN CAUSES OF ANOSMIA

Nasal (3)

Olfactory epithelium (7)

Central (2)

Malingering and hysteria

Answer 3

Thus olfactory impulses reach the
cerebral cortex without a relay through the thalamus;
in this respect also, olfaction is unique among sensory
systems.

Question 4

מטופל עם בעיה בעיבוד מרכזי של ריחות
א. חלק מסינדרום וורניקה-קורסקוף
ב. קוקאין
ג. מתותרקסט
ד. אמינוגליקוזידים

Answer 4

Alcoholics with Korsakoff psychosis also have a defect in odor discrimination (Mair et al). In this disorder, anosmia is presumably caused by degeneration of neurons in the higher-order olfactory systems involving the medial thalamic nuclei.

Question 5

Answer 5

Sensory impulses for taste arise from several sites in the oropharynx and are transmitted to the medulla via several cranial nerves (V, VII, IX, and X).

Question 6

היכן נמצא
olfactory neuron?

                             א. Nasal mucous membrane
                             ב. Olfactory glomerulus
                              ג.Olfactory bulb
                             ד. Cribriform plate
                             ה. Olfactory groove

Answer 6

הנוירון האולפקטורי נמצא ב
Nasal mucous membrane

Question 7

Answer 7

umami

The taste receptors are activated by chemical substances in solution and transmit their activity along the sensory nerves to the brainstem. There are four primary and readily tested taste sensations that have been long known: salty, sweet, bitter, and sour; recently a fifth, umami, signifying a savory taste—the taste of glutamate, aspartate, and certain ribonucleotides—has been added

Question 8

שימוש באמוניה לבדיקת חוש ריח-

Answer 8

אינו מומלץ!
Ammonia and similar pungent
substances are unsuitable stimuli because they do not test
the sense of smell but have a primary irritating effect on
the mucosal-free nerve endings of the trigeminal nerves

Question 9

Answer 9

היסטריההה

Unilateral anosmia can sometimes be demonstrated in
the hysterical patient on the side of anesthesia, blindness,
or deafness. Bilateral anosmia, on the other hand, is a common complaint, and the patient is usually convinced that the sense of taste has been lost as well.
With tumors confined to one side, the anosmia may be strictly unilateral, in which case it will not be reported by the patient but will be found
on examination.
Bilateral anosmia has been a manifestation of malingering, now that it has been recognized as a compensable disability

Question 10

Answer 10

דכאון אנדוגני

The report of a n odor without stimulus, olfactory hallucination, is always of central origin. The patient perceives an odor that no one else can detect (phantosmia). Most often this a manifestation of temporal lobe seizures
(“uncinate fits”), in which circumstances the olfactory hallucinations are brief and accompanied or followed by an alteration of consciousness and other manifestations of epilepsy.
If the patient is convinced of the presence of what is in fact a hallucination and also gives it personal origin, the symptom assumes the status of a delusion (a fixed false belief). The combination of olfactory hallucinations
and delusions of this type signifies a psychiatric illness as
endogenous depression or schizophrenia.
* In schizophrenia, the olfactory stimulus is usually interpreted as arising externally, and as being induced by someone for the purpose of upsetting the patient.
* In depression, the perception is of the stimulus being intrinsic. The patient
may go to great lengths to rid himself of the perceived odor, the usual ones being excessive washing and use of deodorants; the condition may lead to social withdrawal.

Question 11

מה לא יגרום לאובדן חוש טעם חד צדדי ?
1. ageusia
2. . פגיעה בקורטקסהפריאטלי
3. Bell’s palsy
4. פגיעהבמדולה
5. פגיעהבתלמוס

Answer 11

פגיעה במדולה

Question 12

Table 11-2MAIN CAUSES OF AGEUSIA

Answer 12

Question 13

Figure 11-1. Diagram illustrating the relationships between the olfactory receptors in the nasal mucosa and neurons in the olfactory bulb and tract. Cells of the anterior olfactory nucleus are found in scattered groups caudal to the olfactory bulb. Cells of the anterior olfactory nucleus make immediate connections with the olfactory tract. They project centrally via the medial olfactory stria and to contralateral olfactory structures via the anterior commissure. Inset: diagram of the olfactory structures on the inferior surface of the brain (see text for details).

Answer 13