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Question 1

Lesion of the right inferolateral precentral gyrus

Answer 1

Tongue projects to the left when patient is asked to stick out their tongue (loss of upper motor innervation to the left hypoglossal nucleus)

Weakened ability to smile on the left side (loss upper motor innervation to the ventral half of the left facial motor nucleus)

Other lower motor nuclei are not affected since the left precentral gyrus is still projecting to both the right & left lower motor neuron nuclei

Question 2

Lesion of the right hypoglossal nucleus

Answer 2

Tongue projects to the right side when patient is asked to stick out their tongue

loss of the lower motor neurons of the right hypoglossal nucleus - nothing innervating the tongue muscles on the right side; left side of tongue dominates & pushes tongue to the right

Question 3

Lesion of the right trigeminal motor nucleus

Answer 3

Deviated mandible to the right side when asking the patient to open their mouth

loss of the lower motor neurons of the right trigeminal motor nucleus - nothing innervating the muscles of mastication on the right side

resulting in the left side dominating & pushing the mandible to the right side

Question 4

A lesion to the right CN IX immediately inferior to the jugular foramen is most likely to present with

Answer 4

Decreased gag reflex, abnormal sensation from posterior 1/3rd tongue, variable abnormal taste sensation from the right side

Question 5

A lesion to the left precentral gyrus is most likely to result in which of the following clinical presentations in regard to CN IX pathways?

Answer 5

No clinical level deficit of the stylopharyngeus muscle

Question 6

A lesion to CN X at the jugular foramen results in:

Answer 6

Ipsilateral sagging of the soft palate, uvula pulled to the contralateral (normal) side, & hoarseness

Question 7

A lesion to the right precentral gyrus is most likely to result in which of the following presentations in regard to CN X pathways ?

Answer 7

No clinical level deficit observed

Question 8

Damage to the left inferolateral precentral gyrus is most likely to result in which clinical presentation in regard to CN XI?

Answer 8

No clinical level deficit of the trapezius or sternocleidomastoid muscles

Question 9

Damage to the left (spinal) accessory nucleus is most likely to result in which clinical presentation in regard to CN XI?

Answer 9

Weakened ability to elevate the left shoulder and weakened ability to turn the chin to the right side

Question 10

somatic motor pathway for CN IX only has one target

Answer 10

stylopharyngeus muscle

Question 11

The parasympathetic pathway associated with CN IX only targets the

Answer 11

parotid gland

Question 12

Somatic Sensory for CN IX supplies pain & temperature and light touch (not discriminative touch) from the

Answer 12

posterior 1/3rd tongue & middle ear (including internal surface of tympanic membrane)

Question 13

Visceral Sensory for CN IX Targets include the

Answer 13

carotid body, carotid sinus, & oropharynx

Question 14

Taste (Special Sensory) for CN IX Supplies the

Answer 14

posterior 1/3rd of the tongue

Question 15

For CN X Parasympathetic (Visceral Motor) Targets include the

Answer 15

thoracic and abdominal viscera (up to the left colic flexure)

Question 16

For CN X Visceral Sensory
Targets include the

Answer 16

larynx, larygopharynx, and the thoracic and abdominal organs up to the left colic flexure

Question 17

For CN X Somatic Motor
Targets include most of the

Answer 17

pharyngeal muscles (except stylopharyngeus muscle), intrinsic laryngeal muscles, & most of the palatal muscles

Question 18

For CN X Somatic Sensory
Targets include portions of

Answer 18

external ear, external ear canal, & external aspect of the tympanic membrane.

Question 19

For CN X Taste (Special Sensory)

Answer 19

epiglottis

Question 20

for CN XI Somatic Motor
Targets =

Answer 20

sternocleidomastoid and trapezius muscles

Question 21

For CN XII Somatic Motor
Target =

Answer 21

all intrinsic and extrinsic muscles of the tongue except palatoglossus

Question 22

Damage to the left inferolateral precentral gyrus is most likely to result in which clinical presentation in regard to CN XII?

Answer 22

Tongue deviates to the right upon protrusion

Question 23

Damage to the left hypoglossal nucleus is most likely to result in which clinical presentation in regard to CN XII?

Answer 23

Tongue deviates to the left upon protrusion

Question 24

Posterior border of cavernous sinus

Answer 24

petrous temporal bone

Question 25

lateral border of cavernous sinus

Answer 25

dura mater

Question 26

anterior border of cavernous sinus

Answer 26

superior orbital fissure

Question 27

medial border of cavernous sinus

Answer 27

sella turcica of the sphenoid bone

Question 28

Which division(s) of the CN V contain both somatic sensory & somatic motor fibers?

Answer 28

CN V3

Question 29

A lesion to the right CN V between the brainstem and the trigeminal ganglion is most likely to present with:

Answer 29

Loss of sensory from the right side of the face and mandible deviates to the right when opening the mouth

Question 30

A lesion to the left precentral gyrus is most likely to result in which of the following clinical presentations in regard to CN V pathways ?

Answer 30

No clinical level deficit when opening the mouth

Question 31

Somatic Motor for CN VII Supplies muscles of

Answer 31

facial expression & pharyngeal arch 2 muscles (posterior belly of the digastric, stylohyoid, & stapedius)

Question 32

Parasympathetic pathways of CN VII are involved in supplying all of the major & minor

Answer 32

glands of the head except the parotid gland. CN VII supplies the lacrimal gland, submandibular gland, sublingual gland, nasal mucosal glands, & minor salivary glands of the palate and oral cavity.

Question 33

Special Sensory (Taste)
Taste from the anterior 2/3rd of the tongue and from the palate are conveyed by

Answer 33

CN VII

Question 34

somatic sensory of CN VII Conveys sensory from the variable area of the

Answer 34

external ear

CN VII may also convey sensory from the concha, a small area posterior to the ear, portions of the external acoustic meatus, & portions of the tympanic membrane

Question 35

A lesion to the left precentral gyrus is most likely to result in which of the following clinical presentations in regard to CN VII pathways ?

Answer 35

Inability to smile on the right side

Question 36

A lesion to the left facial motor nucleus is most likely to result in which of the following clinical presentations in regard to CN VII pathways ?

Answer 36

Inability to smile or raise the eyebrow on the left side

Question 37

A 44-year old presents with loss of sensation from the right side of the face. All other cranial nerve tests are normal. Which of the following is the most likely location of the lesion?

Answer 37

Trigeminal ganglion in the middle cranial fossa

Question 38

Damage to the solitary nucleus would affect which cranial nerve(s)?

Answer 38

CN VII, IX, and X

Question 39

Damage to the spinal trigeminal nucleus would affect sensory information from which cranial nerve(s)?

Answer 39

CN V, VII, IX, and X

Question 40

The EJV forms from the union of

Answer 40

posterior division of the retromandibular vein and the posterior auricular vein

Question 41

The internal jugular vein lies:

Answer 41

lateral to the common carotid artery

Question 42

The subclavian vein travels:

Answer 42

anterior to the anterior scalene muscle

Question 43

The facial and lingual veins either independently or through the common facial vein drain to the:

Answer 43

internal jugular vein

Question 44

The superior & middle thyroid veins drain to the:

Answer 44

internal jugular vein

Question 45

A laceration superficial to the sternocleidomastoid muscle is most likely to damage the:

Answer 45

EJV

Question 46

The roots of the brachial plexus travel:

Answer 46

with the subclavian artery posterior to the anterior scalene muscle