Aria’s Case – Part II
Aria is a 30-year-old woman who recently presented in the emergency room after a bicycle accident. The ER nurses treated several lacerations and abrasions to the right side of Aria’s head and her right arm. X-ray images showed a complete transverse fracture of Aria’s right wrist. An X-ray of Aria’s head show fractures to her right temporal bone that extend through the internal auditory meatus. The attending physician placed a cast on Aria’s arm and proceeded to examine her for the extent of the head trauma. Based on the location of the skull fractures, he suspects that Aria may have damage to one or more of her cranial nerves. See Part II for the results of the physician’s exam.
The patient’s results (physician’s notes):
When asked to sniff a vial of vanilla extract, the patient correctly identified the odor. An eye exam revealed that the patient’s visual acuity and peripheral vision were normal. The doctor then asked the patient to follow a penlight with her eyes as he moved the light to the patient’s right, left, up, down, and towards her nose. Both eyes tracked the light as normal. The patient was able to feel a warm probe applied to her forehead, cheek, and chin. The doctor examined the patient’s face for symmetry and observed some weakness in the eyelids, eyebrows, lips, and forehead on the right side. A taste test revealed that the patient was unable to distinguish sweet and salty tastes on the anterior right side of her tongue. The patient was unable to hear clearly through her right ear and when a struck tuning fork was placed on her forehead; she could hear it only on the left side. When asked to walk across the room, the patient was unsteady and complained of dizziness. The patient’s speech and gag reflex were normal. When asked to clench her jaw, the physician observed a strong and symmetrical contraction.
You will use physical tests described in your lab manual to examine a control subject without any damage to the skull or cranial nerves. Use the description of Aria’s symptoms in Part II to formulate data for an experimental subject, your injured patient. Compare the data from the control subject (your lab partner) to the data for the experimental subject (Aria) to determine what sensory or motor deficits Aria is experiencing. Use your knowledge of the anatomy and function of each cranial nerve to determine which cranial nerve or nerves were affected by her injuries. Compare your analysis from the test results to your hypothesis that was based only on the anatomy of the injury. To write your lab report, follow the format specified on the last page of this document and use the rubric provided to guide the content.
