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October 2023 Exam
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Demo Question
A young woman presents with pain in her tongue and says that she has developed some intermittent speech problems over the last few weeks.
A CT head is negative for any infarct.
On examination, she has normal power in muscles of mastication and facial expression. She does, however, have some marked weakness when asked to move her tongue to her left cheek compared to the right.
You suspect a cranial nerve lesion.
Given the nerve affected, where does it exit the skull?
Foramen Ovale
Foramen Rotundum
Internal Auditory canal
Hypoglossal canal
Jugular Foramen
Key Learning Point
The hypoglossal canal allows for exit of the hypoglossal nerve in the occipital bone.
Explanation
The affected nerve here is the hypoglossal nerve which is responsible for all of the motor control of the tongue.
The hypoglossal canal allows for exit of the hypoglossal nerve in the occipital bone.
The Foramen rotundum is responsible for the maxillary branch of the trigeminal nerve.
Foramen ovale allows for the exit of the mandibular branch of the trigeminal nerve.
The jugular foramen allows for passage of the glossopharyngeal, vagus and accessory nerves.
The internal auditory canal is responsible for exit of the facial and vestibulocochlear nerve.
