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Kaplan Qbank USMLE



Author6 Posts
  #1

A neurologic examination of a 47 y.o XX 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 2/3 of the right tongue

f.-Ptosis of the left eye.


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  #2

b.Hyperacusis of the left ear


  #3

Choice B


  #4

pr20 wrote:
b.Hyperacusis of the left ear

nodnod

The corneal reflex is tested by touching a cotton wisp to the eye. A normal response would be blinking of the ipsilateral eye as well as the contralateral eye ( consensual reflex). The afferent limb of the corneal reflex is contained within the ophtalmic division of the ipsilateral of the ophtalmic nerve(V1), the efferent limb is by both (right and left) facial nerves (VII).

This woman had a normal corneal reflex in her right eye, indicating a normal right V1 an right VII. However, she lacked a consensual reflex, indicating an abnormal left VIIth nerve.

A lesion in the left VIIth nerve would also produce HYPERACUSIS (increased sensitivity to sound) in the left ear because of paralysis of the STAPEDIUS muscle, which ordinarily dampens sound transmission through the middle ear.


Edited by jean robert on 02/21/08 - 05:30 PM

___________________
Great works are performed not by strength, but by perseverance.

  #5

jean robert wrote:
e.-Loss of taste from the anterior 2/3 of the right tongue



right tongue?raised eyebrow


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we are all in the gutter but some of us looking at the stars

  #6

pr20 wrote:
b.Hyperacusis of the left ear

nodnod


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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."







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