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(coco) #1

318.A 87-year-old man is having difficulty swallowing and often chokes
on his food. You check his gag reflex by touching the posterior one-third of
his tongue and palatine tonsil area. Which of the following cranial nerves
provides the afferent limb of the gag reflex?


a. Cranial nerve I
b. Cranial nerve II
c. Cranial nerve III
d. Cranial nerve IV
e. Cranial nerve V
f. Cranial nerve VI
g. Cranial nerve VII
h. Cranial nerve VIII
i. Cranial nerve IX
j. Cranial nerve X
k. Cranial nerve XI
l. Cranial nerve XII


319.You are called to the room of a 93-year-old nursing home patient
during morning rounds. She is quite upset because she has awoken with
double vision and an inability to open her left eye completely. Your pres-
ence calms her down somewhat, and you start asking her questions as you
perform a complete cranial nerve exam. Her left eye, under her drooping
eyelid, is dilated and rotated down and out. It lacks the normal light reflex
when you shine light in either eye. There is no evidence of papilledema in
either eye. The rest of the cranial nerve exam is normal. Which of the fol-
lowing is the most likely explanation for this condition?


a. An aneurysm of the left posterior cerebral artery compressing cranial nerve III
b. An aneurysm of the right anterior cerebral artery compressing cranial nerve III
c. A tumor at the left optic canal
d. Glaucoma
e. A left parotid gland tumor compressing cranial nerve VII


Head and Neck 429
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