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Old 11-10-2011
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Neuro Brain stem lesion with stroke

An individual experienced the following constellation of symptoms following a brainstem lesion associated with a stroke of that region: hoarseness, difficulty in swallowing, diminished gastric secretions, and loss of some cardiovascular reflex functions. To which of the following structures can these symptoms be attributed?

A. Cranial nerve VII
B. Cranial nerve IX
C. Cranial nerve X
D. Cranial nerve XI
E. Pontine reticular formation
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Old 11-10-2011
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C. Cranial nerve X
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Old 11-10-2011
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Hoarseness Xth nerve
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Cranial nerve X is a highly complex nerve. Special visceral efferent fibers innervate the constrictor muscles of the pharynx and the intrinsic muscles of the larynx. Damage to this division results in hoarseness and difficulty in swallowing. General visceral efferent fibers constitute part of the cranial aspect of the parasympathetic nervous system; thus, they are preganglionic parasympathetic fibers that innervate the heart, lungs, esophagus, and stomach. Damage to the descending vagus would reduce gastric secretions and disrupt cardiovascular reflex activity. Special visceral afferents include fibers from chemoreceptors for taste associated with the epiglottis and chemoreceptors in the aortic bodies that sense changes in O2-CO2 levels in the blood. General visceral afferent fibers arise from the trachea, pharynx, larynx, and esophagus and signal changes in blood pressure to the brainstem. Cranial nerve IX shares a number of similarities with cranial nerve X. However, damage to cranial nerve IX would not affect gastric secretions. Cranial nerve VII does not relate to functions such as swallowing, speech, and gastric secretions. Cranial nerve XI is a purely motor nerve. The reticular formation of the pons does not regulate gastric secretions, swallowing, or speech.
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