Chapter 12
Blumenfeild
Abdullah Al-Salti R3
29 September 2010
Surface features of the
brainstem
• 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
nerve exit points.
1. Two VIPs cranial nerves?
2. Mention 2 vital skull foramina
anatomically and pathologically
important?
Sensory and motor
organization of the cranial
nerves .
• 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
cranial 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
parasympathetic ganglia.
• Which cranial nerves have peripheral
ganglia?
• Name the parasympathetic ganglia
with each cranial nerves?
CN: 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 Neuralgia
Clinical features.
Examination.
Differential diagnosis.
Managements.
Other causes of trigeminal nerve
lesion?
Case 1.1
PATIENT PRESENTATION
50 years old male ,admitted with GBS
Received 5 doses of I.V IgG.He
developed acute chest pain with
severe facial pain.
His neurological exam : no new
findings.
Labs:
Troponin: 0.1 then 0.9
Chest x-ray: normal
ECG:
Case 1.1
Differential diagnosis?
How can you explain his severe
bilateral facial pain ?
Case 1.2
PATIENT PRESENTATION
A 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 SIGNS
Left-sided headaches
Left proptosis
Decreased sensation to touch and pinprick over
the left cheek
Case 1.2
• RELEVANT ANATOMICAL &
CLINICAL CONCEPTS
– Trigeminal Nerve (CN V)
– Skull Foramina Serving as Cranial Nerve
Exit Points
– Differential Diagnosis?
Case 1.2
FINAL DIAGNOSIS
Meningioma in region of left foramen
rotundum extending into left orbit
OUTCOME
Meningioma was resected neurosurgically
leading to complete recovery.