Archive for 2021
| No. | Cranial Nerves | Functions |
|---|---|---|
| I | Olfactory Nerve | Smell |
| II | Optic Nerve | Vision |
| III | Oculomotor Nerve | Eye movement, pupil constriction |
| IV | Trochlear Nerve | Eye movement |
| V | Trigeminal Nerve | Somatosensory information (touch, pain) from the face and head, muscles for chewing. |
| VI | Abducens Nerve | Eye movement |
| VII | Facial Nerve | Taste (anterior 2/3 of tongue), somatosensory information from ear, controls muscles used in facial expression. |
| VIII | Vestibulocochlear Nerve | Hearing, balance |
| IX | Glossopharyngeal Nerve | Taste (posterior 1/3 of tongue), Somatosensory information from tongue, tonsil, pharynx, controls some muscles used in swallowing. |
| X | Vagus Nerve | Sensory, motor and autonomic functions of viscera (glands, digestion, heart rate) |
| XI | Spinal Accessory Nerve | Controls muscles used in head movement. |
| XII | Hypoglossal Nerve | Controls muscles of tongue |
Stoneman syndrome or fibrodysplastic ossificans progressiva (FOP) or Munchmeyer's disease is a rare genetic disease of ectopic soft tissue calcification with hand and foot deformities leading to severe restriction of joint movements. It was first described in 1692 in a young patient who turned into wood. It may be sporadic or autosomal dominant. The disease is caused by mutation in the bone morphogenic protein (BMP) type I (Activin A receptor, type I [ACVR1]) leading to dysregulated bone formation.The incidence, as reported from Europe and United States, is around 1 in two million individuals.
Patient referred due investigation for multiple sclerosis.
AORTIC RUPTURE
Characteristics
● Eighty to ninety per cent of patients die before reaching hospital.
● Associated with deceleration injuries, such as a fall from a height or in road traffic accidents over 40 mph.
● The aorta usually ruptures at the aortic isthmus (in 88–95%), just distal to the origin of the left subclavian artery.
Clinical features
● An aortic rupture should be suspected from the mechanism of injury.
● Chest or inter-scapular pain will be present.
● Differential brachial blood pressures or different brachial and femoral pulse volumes are suggestive.
Radiological features
Chest radiograph
● Widened mediastinum (8 cm on a supine AP Chest radiograph (CXR)).
● Blurred aortic outline with loss of aortic knuckle.
● Left apical pleural cap.
● Left sided haemothorax.
● Depressed left/raised right main stem bronchus.
● Tracheal displacement to the right.
● Oesophageal NG tube displacement to the right.
CT Thorax
● Vessel wall disruption or extra-luminal blood seen in contiguity with the aorta is indicative of rupture.
Management
● Judicious fluid replacement.
● Adequate analgesia.
● Avoid hypertension (excess fluid replacement/pain, etc.).
● Urgent surgical involvement with a view to thoracotomy and repair.
M.Vinothraj
