Mark Braford
Handout for Brown Bag Session on Collaborative Learning

By this point in the course you have gained an understanding of the organization of many of the major pathways in the spinal cord and the brain. By putting this information together with the class-generated information on the cranial nerves, you are now in a position to put your knowledge to work in solving problems.

Object: to localize, as precisely as possible, the point of damage (the lesion) in each case.

Rules:

1. Account for the deficits- if at all possible- by one lesion rather than multiple lesions.

2. Account for the deficits by the smallest lesion that can possibly account for them.

Each solution should include a labeled drawing in which the extent of the lesion is clearly indicated.

HINTS: Begin by considering each sign or symptom in turn and determining the structure(s) that might be damaged to produce that symptom. If a long pathway is involved, do not come to a hasty conclusion about where it is interrupted. Let the other information guide you to the correct location.

Here are two problems for practice:

I. A young painter fell off a ladder from a height of 20 feet and fractured his spine. Neurological examination revealed the following:

a. loss of two point discriminative touch on the left leg

b. loss of pain and temperature sensation on the right leg

c. loss of voluntary movement of the left leg

Where is the lesion?

2. A 45 year old man came to his physician complaining of problems with his right eye. Upon examination the physician noted the following: the right eyelid was drooped close (a right ptosis); the right eyeball was turned downward and outward; and the right pupil was dilated and did not respond to light.

Where is the lesion?

INSTRUCTIONS FOR SELF-STUDY OF CRANIAL NERVES IN TEAMS

TEAMS IA, IB, and IC: III, IV, VI and XII

TEAMS 2A, 2B, and 2C: V and VII

TEAMS 3A. 3B. 3C and 3D: IX. X and XI

Each team should prepare a handout [absolute limit of ONE double-sided page] for the class in which information concerning the team's assigned cranial nerves is presented in an organized manner. Diagrams are a valuable aid in conveying this information [don't forget about the possibility of reducing photocopying]. Be sure to include material that answers the following questions:

1. How many and which components are present in each of your assigned cranial nerves?

2. Which cranial nerve nuclei are associated with each of your assigned nerves?

3. Which, if any, ganglia (sensory or autonomic) are associated with your assigned nerves?

4. Is there anything highly unusual or unique about any of your assigned cranial nerves?

5. Are any of your assigned cranial nerves very similar to one another? If so, in what way(s)?

6. What deficits can result from damage to each of your assigned cranial nerves?

Your handout is due in class on Thursday March 13, Each member of the team should sign the handout This signature is your honor pledge that you contributed significantly to the work of the team.

(I will make photocopies for distribution to the class.)

We will use this information to help in solving problems in class on Thursday March 27.