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Questions and Answers
The face problems suggest involvement of the trigeminal nerve. This important cranial nerve:
a. is associated with what roman number?
The face problems suggest involvement of the trigeminal nerve. This important cranial nerve:
a. is associated with what roman number?
V
The face problems suggest involvement of the trigeminal nerve. This important cranial nerve:
b. is classified as purely sensory, principally motor or mixed?
The face problems suggest involvement of the trigeminal nerve. This important cranial nerve:
b. is classified as purely sensory, principally motor or mixed?
The small mass location is associated with what specific peduncle?
The small mass location is associated with what specific peduncle?
Middle cerebellar peduncle
The language problem in this patient was due mainly to damage of the:
The language problem in this patient was due mainly to damage of the:
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The most likely cerebral gyrus/cortex that could account for the loss of sensation in his extremity is:
The most likely cerebral gyrus/cortex that could account for the loss of sensation in his extremity is:
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The above cerebral gyrus/cortex is found in which lobe?
The above cerebral gyrus/cortex is found in which lobe?
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Based on clinical history, as well as signs and symptoms developed after several hours, it is suspected rupture of which important cranial vessel?
Based on clinical history, as well as signs and symptoms developed after several hours, it is suspected rupture of which important cranial vessel?
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What is the most likely diagnosis?
What is the most likely diagnosis?
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In terms of CSF composition analysis, you will expect to find:
a. An INCREASE in which CSF level(s)?
In terms of CSF composition analysis, you will expect to find:
a. An INCREASE in which CSF level(s)?
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In terms of CSF composition analysis, you will expect to find:
a. An INCREASE in which CSF level(s)?
b. A DECREASE in which CSF level(s)? Why?
In terms of CSF composition analysis, you will expect to find:
a. An INCREASE in which CSF level(s)?
b. A DECREASE in which CSF level(s)? Why?
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For the female patient, what is the most likely diagnosis?
For the female patient, what is the most likely diagnosis?
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The most likely region affected by the stroke that could account for limb paralysis is:
The most likely region affected by the stroke that could account for limb paralysis is:
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The loss of speech in this patient was due mainly to damage of the:
The loss of speech in this patient was due mainly to damage of the:
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During routine surgery for appendicitis, a clot is released from the lung of a 75-year-old man, causing the patient to remain unconscious for a period of 1 week. Upon regaining consciousness, the patient finds that he is unable to maintain his balance and, further, displays tremors while attempting to produce a purposeful movement. In addition, the patient's movements are not smooth but jerky and lack coordination. The region affected most likely include the:
During routine surgery for appendicitis, a clot is released from the lung of a 75-year-old man, causing the patient to remain unconscious for a period of 1 week. Upon regaining consciousness, the patient finds that he is unable to maintain his balance and, further, displays tremors while attempting to produce a purposeful movement. In addition, the patient's movements are not smooth but jerky and lack coordination. The region affected most likely include the:
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A magnetic resonance image scan taken of a 60-year-old woman revealed the presence of a tumor on the base of the brain that was situated just anterior to the pituitary and that impinged upon the adjoining neural tissue. A likely deficit resulting from this tumor includes:
A magnetic resonance image scan taken of a 60-year-old woman revealed the presence of a tumor on the base of the brain that was situated just anterior to the pituitary and that impinged upon the adjoining neural tissue. A likely deficit resulting from this tumor includes:
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One region that would be directly affected by the tumor is the:
One region that would be directly affected by the tumor is the:
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The patient was diagnosed as having a subarachnoid hemorrhage. Which of the following changes are most likely in the composition of the cerebrospinal fluid of this patient?
The patient was diagnosed as having a subarachnoid hemorrhage. Which of the following changes are most likely in the composition of the cerebrospinal fluid of this patient?
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An adult male suffering from chills, fever, headache, nau-sea, vomiting, and pain in the back was admitted to the emergency room and diagnosed as having meningococcal meningitis. Which of the following changes are most likely in the composition of the cerebrospinal fluid of this patient?
An adult male suffering from chills, fever, headache, nau-sea, vomiting, and pain in the back was admitted to the emergency room and diagnosed as having meningococcal meningitis. Which of the following changes are most likely in the composition of the cerebrospinal fluid of this patient?
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A 75-year-old man was admitted to the emergency room complaining that he had trouble walking and that he could not move his arms as well. A magnetic resonance image revealed the presence of a brain tumor. Tracer dye injected into the lateral ventricle did not appear in the lumbar cerebrospinal fluid, suggesting that the patient had developed a noncommunicating hydrocephalus. Which one of the following is the most likely location of the tumor?
A 75-year-old man was admitted to the emergency room complaining that he had trouble walking and that he could not move his arms as well. A magnetic resonance image revealed the presence of a brain tumor. Tracer dye injected into the lateral ventricle did not appear in the lumbar cerebrospinal fluid, suggesting that the patient had developed a noncommunicating hydrocephalus. Which one of the following is the most likely location of the tumor?
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A 22-year-old man was admitted to the emergency room after a motorcycle accident. A clinical examination showed that he had elevated intracranial pressure (ICP) due to head trauma. The patient suffered from severe bradycardia. Acting on which of the following brain regions would elevated ICP most likely cause bradycardia?
A 22-year-old man was admitted to the emergency room after a motorcycle accident. A clinical examination showed that he had elevated intracranial pressure (ICP) due to head trauma. The patient suffered from severe bradycardia. Acting on which of the following brain regions would elevated ICP most likely cause bradycardia?
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The diagram below represents a cross section of the cerebral cortex of a 65-year-old woman who suffered from a stroke and was admitted to an emergency room. The neurologist who examined her marked the infarcted region in her brain as a dark shaded area in the diagram. Occlusion of which one of the following arteries may have caused an infarction in the region represented by the dark shaded area in this diagram?
The diagram below represents a cross section of the cerebral cortex of a 65-year-old woman who suffered from a stroke and was admitted to an emergency room. The neurologist who examined her marked the infarcted region in her brain as a dark shaded area in the diagram. Occlusion of which one of the following arteries may have caused an infarction in the region represented by the dark shaded area in this diagram?
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A 70-year-old woman suffering from loss of motor control and sensation in her left leg was examined by her neurologist. Subsequent angiographic procedures performed on the patient revealed that one of the arteries supplying the brain was 80% occluded. Which one of the following arteries most likely was occluded in this patient?
A 70-year-old woman suffering from loss of motor control and sensation in her left leg was examined by her neurologist. Subsequent angiographic procedures performed on the patient revealed that one of the arteries supplying the brain was 80% occluded. Which one of the following arteries most likely was occluded in this patient?
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Flashcards
Trigeminal Nerve
Trigeminal Nerve
Cranial nerve associated with sensation of the face.
Cerebellar Peduncle
Cerebellar Peduncle
Connects the cerebellum to the brainstem.
Language Comprehension
Language Comprehension
Impairment due to damage in specific brain regions.
Precentral Gyrus
Precentral Gyrus
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Superior Temporal Gyrus
Superior Temporal Gyrus
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Cerebellum
Cerebellum
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Frontal Lobe Tumor
Frontal Lobe Tumor
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Caudate Nucleus
Caudate Nucleus
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Subarachnoid Hemorrhage
Subarachnoid Hemorrhage
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Meningeal Infection
Meningeal Infection
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Noncommunicating Hydrocephalus
Noncommunicating Hydrocephalus
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Bradycardia
Bradycardia
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Middle Cerebral Artery
Middle Cerebral Artery
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Cerebrospinal Fluid Analysis
Cerebrospinal Fluid Analysis
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Wernicke's Area
Wernicke's Area
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Inferior Frontal Gyrus
Inferior Frontal Gyrus
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Putamen
Putamen
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Cerebral Cortex
Cerebral Cortex
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Posterior Cerebral Artery
Posterior Cerebral Artery
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Spinal Cord
Spinal Cord
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Intracranial Pressure
Intracranial Pressure
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Acute Stroke
Acute Stroke
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Cerebellar Ataxia
Cerebellar Ataxia
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Gram-positive Pneumococci
Gram-positive Pneumococci
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Cerebral Angiography
Cerebral Angiography
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Cerebral Infarction
Cerebral Infarction
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Study Notes
Clinical Case #1
- Patient Presentation: A 35-year-old male with loss of sensation on the left side of his face, history of a small mass between the cerebellum and brainstem. Worried about mass enlargement causing sensation loss.
- Trigeminal Nerve Involvement: Facial problems suggest trigeminal nerve involvement. This nerve is (a) Roman numeral V, and (b) classified as mixed (sensory and motor).
- Mass Location and Peduncle: The small mass is located near a specific peduncle (not specified further).
- Neurologic Examination Findings: Further examination revealed loss of somatic sensation in the right lower limb, and language impairment (comprehension issues, but fluent speech). These symptoms started after excruciating head pain the day before.
- Language Problem Cause: Language impairment was due mainly to damage of the brain area responsible for language comprehension.
- Loss of Sensation Location: The most likely cerebral gyrus/cortex responsible for the loss of sensation in the extremity is the sensory cortex.
- Sensory Cortex Location: This cortex is located in a particular lobe (not specified further).
Clinical Case #2
- Patient 1 (Male): A 21-year-old male motorcycle accident victim brought to the ER unconscious.
- Presented dazed, headache, facial abrasions, swelling above right ear.
- After several hours, became stuporous, dilated right pupil, blood pressure 150/90, pulse 55 BPM, respiration 12/min
- Diagnosed with a possible important cranial vessel rupture.
- Likely Diagnosis: A likely diagnosis is not fully specified from clinical findings. Rupture of an important cranial vessel is suspected.
- Patient 2 (Female): A 20-year-old wife with fever, chills, depressed consciousness, minor injuries, 40°C (104°F) fever, a pulse rate of 140/min, rigid neck.
- Diagnosed with meningitis.
- Lumbar puncture revealed cloudy CSF, gram-positive pneumococcal, and other CSF composition abnormalities (WBCs, glucose, and protein).
- CSF Composition Changes: (a) Increased CSF levels are expected to be found, and (b) a decrease in certain CSF levels is probable (due to specific meningitis characteristics). Reasoning behind the decrease is needed.
- Diagnosis of Patient 2: Meningitis is the most likely diagnosis for the female.
Clinical Case #3
- Patient Presentation: A 79-year-old woman admitted to the ER after regaining consciousness after being unconscious in her apartment. She has right arm and leg paralysis, and speech loss.
- Stroke Location: The most likely region affected by the stroke causing the paralysis is the either the precentral gyrus or the postcentral gyrus, given the nature of the indicated symptoms.
- Speech Loss Region: The speech loss in this patient is primarily due to damage of the posterior part of the frontal lobe of the brain region (inferior frontal gyrus).
- 75-year-old Man (Surgery): During appendicitis surgery a blood clot from the lung caused the patient to remain unconscious for a week. After regaining consciousness, the patient cannot balance and presents with tremors. Affected region is most likely the cerebella because of loss of muscle coordination, and lack of smooth, purposeful movements.
- 60-Year-Old Woman (Brain Tumor): The presence of a tumor on the base of the brain near the pituitary gland suggests a likely deficit of speech impairment.
Clinical Case #4
- 45-Year-Old Man (Headaches): Recurrent headaches diagnosed with a tumor in the lateral wall of the anterior horn of the lateral ventricle. This does not cause hydrocephalus.
- Affected Region: The caudate nucleus will be the region impacted by the tumor.
- 50-Year-Old Man (Head Injury): Diagnosed with a subarachnoid hemorrhage following an automobile accident.
- CSF Changes: The CSF changes indicated are an increase in protein, normal glucose, and presence of red blood cells.
- Adult Male (Meningitis): Diagnosed with meningococcal meningitis, characterized by increased protein levels, decreased glucose, and leukocyte presence in CSF.
- 75-Year-Old Man (Walking Difficulties): A brain tumor (in noncommunicating hydrocephalus) caused trouble walking, difficulty controlling, and moving his arms. The tumor location is the interventricular foramen.
Clinical Case #5
- 22-Year-Old Male (Motorcycle Accident): Elevated intracranial pressure (ICP) due to head trauma; severe bradycardia is a symptom reported.
- A region of brain impacted heavily by the increase of ICP causing the bradycardia is the brainstem.
- 65-Year-Old Woman (Stroke): Occlusion of a particular artery caused a brain infarction. An impacted region within the cerebral cortex due to an artery occlusion is the middle cerebral artery.
- 70-Year-Old Woman (Loss of Function): A 70-year-old woman with motor and sensory loss in her left leg due to an occluded artery is most likely occluding the left anterior cerebral artery.
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Description
This quiz presents a clinical case involving a 35-year-old male with loss of sensation on the left side of his face and specific neurologic examination findings. Participants will delve into the relationship between trigeminal nerve involvement, mass location, and language impairment. Test your understanding of neurological assessments and their implications.
