Cranial nerves

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  • Cranial nerves are involved in head and neck function, and processes such as eating, speech and facial expression. This clinically oriented survey of cranial nerve anatomy and function was written for students of medicine, dentistry and speech therapy, but will also be useful for postgraduate physicians and general practitioners, and specialists in head and neck healthcare (surgeons, dentists, speech therapists, etc.). After an introductory section surveying cranial nerve organization and tricky basics such as ganglia, nuclei and brain stem...

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  • There are 12 pairs of cranial nerves although the optic nerve is really an extension of the brain rather than a peripheral nerve. The ability to test them swiftly, efficiently and to interpret the findings should be a core competency for general practitioncer.

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  • Harrison's Internal Medicine Chapter 134. Botulism Definition Botulism is a paralytic disease caused by potent protein neurotoxins elaborated by Clostridium botulinum. Illness begins with cranial nerve involvement and proceeds caudally to involve the extremities. Cases may be classified as (1) food-borne botulism, from ingestion of preformed toxin in food contaminated with C.

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  • The study of the neurosciences has undergone remarkable growth over the past two decades. To a large extent, such advancements have been made possible through the development of new methodologies, especially in the fields of neuropharmacology, molecular biology, and neuroanatomy. Neuroscience courses presented in medical schools and related schools of health professions generally are unable to cover all the material that has evolved in recent years.

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  • Recurrent unilateral labyrinthine dysfunction, in association with signs and symptoms of cochlear disease (progressive hearing loss and tinnitus), is usually due to Ménière's disease (Chap. 30). When auditory manifestations are absent, the term vestibular neuronitis denotes recurrent monosymptomatic vertigo. Transient ischemic attacks of the posterior cerebral circulation (vertebrobasilar insufficiency) only infrequently cause recurrent vertigo without concomitant motor, sensory, visual, cranial nerve, or cerebellar signs (Chap. 364).

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  • Migrainous neuralgia may be localized to the mouth. Episodes of pain and remission without identifiable cause and absence of relief with local anesthesia are important clues. Trigeminal neuralgia (tic douloureaux) may involve the entire branch or part of the mandibular or maxillary branches of the fifth cranial nerve and produce pain in one or a few teeth. Pain may occur spontaneously or may be triggered by touching the lip or gingiva, brushing the teeth, or chewing. Glossopharyngeal neuralgia produces similar acute neuropathic symptoms in the distribution of the ninth cranial nerve.

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  • Botulism is a paralytic disease caused by potent protein neurotoxins elaborated by Clostridium botulinum. Illness begins with cranial nerve involvement and proceeds caudally to involve the extremities. Cases may be classified as (1) food-borne botulism, from ingestion of preformed toxin in food contaminated with C. botulinum; (2) wound botulism, from toxin produced in wounds contaminated with the organism; and (3) intestinal botulism, from ingestion of spores and production of toxin in the intestine of infants (infant botulism) or adults.

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  • Oculomotor Nerve The third cranial nerve innervates the medial, inferior, and superior recti; inferior oblique; levator palpebrae superioris; and the iris sphincter. Total palsy of the oculomotor nerve causes ptosis, a dilated pupil, and leaves the eye "down and out" because of the unopposed action of the lateral rectus and superior oblique. This combination of findings is obvious. More challenging is the diagnosis of early or partial oculomotor nerve palsy.

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  • I am way past grammar school, believe me, but the words “Go look it up” still strike terror in my heart. Not because I do not like to look up new terms—far from it. The problem is that I cannot look up just one! I get side- tracked right away by intriguing entries that I just might want to use someday. In the interest of expediency, it is much easier to have someone tell me the meaning. Medicine has its own unique breed of terms, founded from Greek, Latin, and who knows where else. The cur- rent Stedman’s Medical Dictionary is a two-volume set… a place where I could...

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  • Infection of the submandibular and/or sublingual space typically originates from an infected or recently extracted lower tooth. The result is the severe, lifethreatening infection referred to as Ludwig's angina (see "Oral Infections," above). Infection of the lateral pharyngeal (or parapharyngeal) space is most often a complication of common infections of the oral cavity and upper respiratory tract, including tonsillitis, peritonsillar abscess, pharyngitis, mastoiditis, or periodontal infection.

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  • Abducens Nerve The sixth cranial nerve innervates the lateral rectus muscle. A palsy produces horizontal diplopia, worse on gaze to the side of the lesion. A nuclear lesion has different consequences, because the abducens nucleus contains interneurons that project via the medial longitudinal fasciculus to the medial rectus subnucleus of the contralateral oculomotor complex. Therefore, an abducens nuclear lesion produces a complete lateral gaze palsy, from weakness of both the ipsilateral lateral rectus and the contralateral medial rectus.

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  • Clinical Manifestations Food-Borne Botulism After ingestion of food containing toxin, illness varies from a mild condition for which no medical advice is sought to very severe disease that can result in death within 24 h. The incubation period is usually 18–36 h but, depending on toxin dose, can range from a few hours to several days. Symmetric descending paralysis is characteristic and can lead to respiratory failure and death. Cranial nerve involvement, which almost always marks the onset of symptoms, usually produces diplopia, dysarthria, dysphonia, and/or dysphagia.

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  • Complications Patients with meningococcal meningitis may develop cranial nerve palsies, cortical venous thrombophlebitis, and cerebral edema. Children may develop subdural effusions. Permanent sequelae can include mental retardation, deafness, and hemiparesis. The major long-term morbidity of fulminant meningococcemia is the loss of skin, limbs, or digits that results from ischemic necrosis and infarction. Diagnosis Few clinical clues help the physician distinguish the patient with early meningococcal disease from patients with other acute systemic infections. ...

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  • The vestibulocochlear nerve (also known as the auditory or acoustic nerve) is the eighth of twelve cranial nerves, and is responsible for transmitting sound and balance information from the inner ear to the brain. This is the nerve along which the sensory cells (the hair cells) of the inner ear transmit information to the brain. It consists of the cochlear nerve, carrying information about hearing, and the vestibular nerve, carrying information about balance.

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  • Chapter 13 - The peripheral nervous system and reflex activity (part b). This chapter define ganglion and indicate the general body location of ganglia, describe the general structure of a nerve, follow the process of nerve regeneration, name the 12 pairs of cranial nerves, indicate the body region and structures innervated by each.

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  • Table 84-2 Definition of TNM–Nasopharynx Primary Tumor (T) Stage Grouping TX Cannot assessed be 0 Stage Tis N0 M0 T0 No evidence I Stage T1 N0 M0 Tis Carcinoma in situ IIA Stage T2a N0 M0 T1 Tumor confined IIB Stage T1 N1 M0 to the nasopharynx T2 Tumor extends to soft tissues T2 N1 M0 T2a extends to Tumor the T2a N1 M0 oropharynx and/or nasal cavity parapharyngeal extension w/o T2b Any tumor with extension parapharyngeal T2b N1 M0 T3 Tumor involves T2b N1 M0 bony structures and/or paranasal sinuses T4 Tumor intracranial with e...

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