A 47-year-old man presents to you with gradual loss of voice and difficulty swallowing. Physical exam also reveals loss of taste on the posterior one-third of his tongue and palate; weakness in shrugging his shoulders, absent gag reflex and uvula deviates away from the midline. MRI scan was suggested which reveals a meningioma that compresses the cranial nerves leaving the skull. Which of the following openings in the skull transmit the affected cranial nerves?
Answer: (d) Jugular foramen NameTypePrincipal clinical function (other functions in parentheses)IOlfactorySensorySmellIIOpticSensoryVisionIIIOculomotorMotorMovements of eyeball: most orbital muscles. See also IV, VI (parasyra pathetic: ciliary m usde, accommodation of lens, etc.; iris muscle, pupilloconstriction)IVTrochlearMotorMovements of eyeball: superior oblique muscle. See also III, VIVTrigeminal Va: OphthalmicSensorySensation from eyeball, anterior scalp, upper face Vb: MaxillarySensorySensation from nasal cavity and sinuses, palate, mid face, maxillary teeth Vc MandibularMixedMuscles of mastication, tensor tympaniSensation from chin, temple,oral cavity, tongue, temporomandibular joint (TM J), mandibular teeth, ear, proprioception from muscles of masticationVIAbduoensMotorMovements of eyeball: lateral redus musde. See also III, IVVIIFacialMixedMuscles of facial expression, stapedius (middle ear)(par asympatheti c: 1 acrim al, nas a!, pal atin e, subm m di bul ar, sublingual glands) (taste: anterior tongue)VIIIVestibulocochlearSensoryHearing, balanceIXGlossopharyngealMixedSensation from oropharynx, posterior tongue, carotid body and sinus (taste: posterior tongue)(muscle: stylopharyngeus)(parasympathetic: parotid gland)XVagusMixedMuscles of larynx, pharynx (phonation, swallowing)Sensation from larynx, hypopharynx, heart, lung?, abdominal viscera (taste: epigfottic region, hypopharynx)(parasympathetic: cardiac musde; musdes and glands of forcgut and mid gut: intestinal activity)XIAecesso ryMotorMuscles: sternocfeidomastoid, trapeziusXIIHypoglossalMotorTongue musdes and movements ForamenStructures passing through foramenAnterior viewSupra-orbital foramenSupra-orbital nerve and vesselsInfra-orbital foramenInfra-orbital nerve and vesselsMental foramenMental nerve and vesselsLateral viewZygomaticofacial foramenZygomaticofacial nerveSuperior viewParietal foramenEmissary veinsInferior viewIncisive foraminaNasopalatine nerve; sphenopalatine vessels, termination of greater palatine vesselsGreater palatine foramenGreater palatine nerve and vesselsLesser palatine foraminaLesser palatine nerves and vesselsPterygoid canalNerve of Pterygoid canal and vesselsForamen ovaleMandibular nerve (V3), lesser petrosal nerve, accessory meningeal artery, emissary veinForamen spinosumMiddle meningeal artery & Meningeal branch of mandibular nerveForamen lacerumFilled with cartilage, emissary veinsCarotid canalInternal carotid artery and nerve plexusForamen magnumVertebral arteries and nerve plexuses; anterior spinal artery; posterior spinal arteries; roots of accessory nerve (XI); meninges, lower end of medullaCondylar canal Emissary veinsHypoglossal canal Hypoglossal nerve (XII) and vesselsJugular foramenInternal jugular vein; inferior petrosal sinus, 9,10,11 th cranial nervesStylomastoid foramenFacial nerve (VII)Other foramina:* Emissary sphenoidal foramen/ foramen of Vesalius: situated b/w foramen ovale & the scaphoi fossa. Opens internally b/w foramen ovale & foramen rotundum.* Canaliculus innominatus: b/w foramen ovale & foramen spinosum.
Foramen ovale
Foramen rotundum
Foramen magnum
Jugular foramen
Head & Neck