Cerebrovascular Accidents & Cortical Arteries
A patient with a right-sided Pancoast tumor presents with lower extremity weakness due to an ischemic stroke. Examination reveals miosis, ptosis, and anhidrosis on the left side of the face. Which vessel is occluded?
What is the Anterior Cerebral Artery (ACA)?
These two cranial nerves serve as the respective afferent (sensory) and efferent (motor) pathways for the pupillary light reflex.
What are the Oculomotor (CN III) and Optic (CN II) nerves?
Unilateral shortening of this muscle produces torticollis, pulling the head into ipsilateral lateral flexion and contralateral rotation.
What is the Sternocleidomastoid (SCM)?
During a physical examination, a clinician touches the patient's right cornea with a wisp of cotton. The patient's left eye blinks, but the right eye does not. Which nerve is most likely impaired?
Right Facial Nerve
An ischemic stroke in this artery's distribution within the left hemisphere typically results in right-sided motor and sensory loss of the face and upper extremity, paired with expressive aphasia.
What is the Middle Cerebral Artery (MCA)?
This specific division of the trigeminal nerve provides the sensory afferent limb for the corneal blink reflex.
What is the Ophthalmic division (V1)?
What are the contents and boundaries of the Scalene Triangle?
Bounded by the anterior and middle scalene muscles and first rib; it houses the subclavian artery and brachial plexus
Following surgical resection of a tumor in the posterior triangle of the neck, a patient presents with a dropped shoulder, an inability to shrug, and severe medial border scapular winging. What two nerves were injured?
What are the Spinal Accessory and Long Thoracic Nerves?
A patient complains of hyperacusis (unpleasantly loud hearing) following a viral infection. Weakness in which muscle, and impairment of which nerve, is responsible?
Stapedius; Facial Nerve
Damage to this artery can lead to a contralateral loss of the visual field in both eyes along with memory impairments due to its deep temporal lobe and occipital lobe supply.
What is the Posterior Cerebral Artery (PCA)?
A patient presenting with total paralysis of one side of the face, including an inability to wrinkle the forehead on that same side, has a lower motor neuron lesion of this cranial nerve.
This structure is unique among laryngeal cartilages because it forms a completely closed anatomical ring, with its posterior wall significantly taller than its anterior side.
What is the Cricoid Cartilage?
A patient presents with a breathy, hoarse voice, a compromised gag reflex, and an inability to shrug the left shoulder against resistance. An MRI reveals a tumor compressing which specific cranial exit pathway?
What is the Jugular Foramen?
When asked to protrude their tongue, a patient's tongue deviates significantly to the right. Which muscle and nerve combination is dysfunctional?
Right Genioglossus; Right CN XII
A traumatic blow to the lateral skull near the pterion can rupture this specific vessel, causing an epidural hematoma characterized by a classic "lucid interval" before rapid deterioration.
What is the Middle Meningeal Artery?
When this specific cranial nerve undergoes a lower motor neuron injury, the patient's tongue will deviate toward the injured, weaker side upon protrusion.
What is the Hypoglossal Nerve (CN XII)?
This specific infrahyoid muscle is uniquely innervated by a branch from C1 via the hypoglossal nerve, rather than the main loop of the ansa cervicalis (C1\C3).
What is the Thyrohyoid?
A temporal bone fracture completely abolishes the efferent limb of the corneal reflex on the ipsilateral side, but touching that cornea still elicits a normal blink in the contralateral eye. What two cranial nerves are damaged?
What are the Facial (CN VII) and Vestibulocochlear (CN VIII) nerves?
A patient reports a severe headache located in the posterior cranial fossa. Which nerves are responsible for transmitting sensory information from the dura mater in this specific region?
C2 and C3 spinal nerves
Slow, venous bleeding from these structures causes a crescent-shaped subdural hematoma, commonly seen in elderly individuals weeks after a minor head impact.
What are Bridging Veins?
Misalignment of the eyes resulting in hypertropia (an upward resting axis of the eye) indicates a palsy of this cranial nerve.
What is the Trochlear Nerve CN IV
This branch of the vagus nerve is vulnerable during thoracic aortic surgeries because it loops directly underneath the aortic arch.
What is the Left Recurrent Laryngeal Nerve?
A patient reports food pocketing in the cheek, extreme sensitivity to everyday sounds, and sharp pain in the ear when chewing hard foods. This indicates concurrent dysfunction of which two middle ear and facial muscles?
What are the Stapedius and Tensor Tympani muscles?
A patient presents with vertical diplopia and mentions they have difficulty walking down stairs. During the exam, they tilt their head to the left to compensate for a right-sided deficit. Which nerve is most likely affected?
Right Trochlear Nerve