ywliu888
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A neurological examination of a 47-year-old woman reveals a normal corneal reflex in her right eye, but no consensual corneal reflex in her left eye. Which of the following additional findings might be expected?
A. Absence of pupillary light reflex of the left eye
B. Hyperacusis of the left ear
C. Inability to abduct the right eye
D. Loss of pain and temperature of the left face
E. Loss of taste from the anterior two-thirds of the right tongue
F. Ptosis of the left eye
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| mjl1717
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answer-a
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| ywliu888
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Could you please give your reasoning? Thanks!
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| robin082006
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B
Corneal reflex: afferent is V1, efferent is VII
This patient has no corneal reflex in the left eye--> lesion of left V1 or left VII
Now analyze choices:
A. Absence of pupillary light reflex of the left eye : exlude because this relates to nerve II and III
B. Hyperacusis of the left ear: yes, VII innervates stapedius, affecting stapedius leads to hypercurasis
C. Inability to abduct the right eye : exclude because this relates to nerve III or VI
D. Loss of pain and temperature of the left face: exclude because of not relevat to V1 and VII
E. Loss of taste from the anterior two-thirds of the right tongue: this is right VII
F. Ptosis of the left eye: this is left III
Edited by robin082006 on 06/25/06 - 08:56 AM
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| nadiabarati
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yes B
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| Dr.Papez
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B-robin has explained it
explanation for excluding D- even if total anesthesia of left side present, consensual on left with touching of right cornea should be present if efferent (VII) on left is intact.
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| waqastariq
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yes its B
for excluding E
tongue gets the bilateral innervation for taste... so not E
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| waqastariq
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Option B
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| Dr.Papez
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For excluding E, it is on the right side-if it had been left, it would have been equally appropriate as B
Taste can be affected in unilateral facial palsy Correct me if worng
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| waqastariq
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