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Lesion above the geniculate ganglion affects the greater petrosal nerve, chorda tympani, stapedius, and facial expression.
Facial nerve lesion above geniculate ganglion causes loss of:
1). Only facial expression
2). Taste + lacrimation + salivation + facial expression
3). Only taste
4). Hearing
The marginal mandibular branch runs deep to the platysma and is vulnerable during surgery in the submandibular region. It supplies muscles that depress the lower lip and angle of the mouth.
The marginal mandibular branch of facial nerve lies:
1) Deep to platysma but superficial to facial artery at mandible
2) Deep to facial artery
3) Within parotid only
4) Deep to masseter
Cluster headache presents as severe unilateral periorbital pain lasting 15 minutes to 3 hours, with circadian periodicity and autonomic features (lacrimation, rhinorrhea, Horner's syndrome) due to trigeminal-autonomic reflex and hypothalamic involvement.
Which features distinguish cluster headache from migraine and TN?
1). Unilateral periorbital severe pain with ipsilateral lacrimation, rhinorrhea, Horner's, nocturnal, male predominance
2). Bilateral throbbing headache
3). Electric shock pain
4). Aura present
The internal jugular vein begins at the jugular foramen as a continuation of the sigmoid sinus and joins the subclavian vein to form the brachiocephalic vein.
The internal jugular vein begins at:
1) Jugular foramen as continuation of sigmoid sinus
2) Foramen ovale
3) Carotid canal
4) Foramen lacerum
The spleen follows the long axes of ribs 9 to 11 and lies mostly posterior to the stomach, above the colon, and partly anterior to the kidney. It is attached to the stomach by a broad mesenterial band, the gastrosplemic ligament. Therefore, it is the most likely organ of the group to be pierced by a sharp object penetrating just above rib 10 at the posterior axillary line. Note that the pleural cavity, and possibly the lower part of the inferior lobe of the lung, would be pierced before the spleen. The ascending colon (choice 1) is on the wrong side (the right) to be penetrated by a sharp instrument piercing the left side.
Most of the duodenum (choice 2) is positioned too far to the right to be affected by this injury.
Even the third part of the duodenum, which runs from right to left, would still be out of harm's way. In addition, the duodenum lies at about levels L1 to L3, placing it too low to be injured in this case.
The superior pole of the left kidney (choice 3) is bordered by the lower part of the spleen. However, it is crossed by rib 12 and usually does not extend above rib 11. It would probably be too low and medial to be injured in this case because this penetration is at the posterior axillary line.
CN XI supplies sternocleidomastoid and trapezius. Injury causes shoulder droop and inability to shrug against resistance.
Accessory nerve (CN XI) supplies:
1). Trapezius and Sternocleidomastoid
2). Tongue
3). Pharynx
4). Masseter
The nerve to medial pterygoid arises from the main trunk of V3 and supplies the medial pterygoid, tensor tympani, and tensor veli palatini muscles.
Nerve to medial pterygoid also supplies:
1) Lateral pterygoid
2) Tensor tympani and tensor veli palatini
3) Mylohyoid
4) Buccinator
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