Cranial Nerve Case – Part II
Mrs. Sula is a 44-year-old woman who recently presented in the emergency room after a bicycle accident. The ER nurses treated several lacerations and abrasions to the left side of Mrs. Sula’s face and her right arm. X-ray images showed a complete transverse fracture of her left wrist. The attending physician placed a cast on Mrs. Sula’s arm and proceeded to examine her for the extent of the head trauma. A CT scan of Mrs. Sula’s head confirms a small fracture to her left temporal bone that extends through the internal auditory meatus. Based on the location of the skull fracture, the physician suspects that Mrs. Sula may have damage to one or more of her cranial nerves. See Part II for the results of the physician’s exam.
The patient’s results (physician’s notes):
When asked to sniff vials of vanilla extract and coffee, the patient correctly identified the odors. An eye exam revealed that the patient’s visual acuity and peripheral vision were normal. The patient was asked to follow a penlight with her eyes as the light was moved to the patient’s right, left, up, down, and towards her nose. Both eyes tracked the light as normal. The patient was able to feel a warm or cold probe applied to her forehead, cheek, and chin. Some asymmetry of the face was noted including weakness in the eyebrows, lips, and forehead on the left side. Her left eyelid was drooping. A taste test revealed that the patient was unable to distinguish sweet and salty tastes on the anterior left side of her tongue. The patient was able to hear clearly through both ears and when a struck tuning fork was placed on her forehead she could hear it on both sides. The patient was able to walk with a normal, balanced gait and was able to balance on the left leg and the right leg. The patient’s speech and gag reflex were normal. When asked to clench her jaw, a strong and symmetrical contraction was observed.
You will use physical tests described in your lab manual to examine a control subject without any damage to the skull or cranial nerves. Use the description of the patient’s results in Part IIto formulate data for an experimental subject, your injured patient.Compare the data from the control subject (your lab partner) to the data for the experimental subject (the patient) to determine what sensory or motor deficits Mrs. Sula is experiencing. Use your knowledge of the anatomy and function of each cranial nerve to determine which cranial nerve or nerves were affected by her injuries. Compare your analysis from the test results to your hypothesis that was based only on the anatomy of the injury. To write your lab report, follow the format specified on the last page ofthis document and use the rubric provided to guide the content.
