Question

A 58-year-old woman comes to a hospital and complains of progressive *loss of voice*, numbness, loss of taste on the back part of her tongue, and difficulty in shrugging her shoulders. Her magnetic resonance imaging (MRI) scan reveals a dural meningioma that compresses nerves leaving the skull. These nerves leave the skull through which of the following openings? (A) Foramen spinosum (B) Foramen rotundum (C) Internal auditory meatus (D) Jugular foramen (E) Foramen lacerum

Answer 1

The symptoms described by the woman are indicative of compression on the accessory, hypoglossal, glossopharyngeal, and vagus nerves, all of which exit the skull through the jugular foramen.

Step-by-step explanation:

The nerves affected by the dural meningioma as described are those that innervate the muscles responsible for shrugging the shoulders, supply sensation to the back part of the tongue and throat, and are connected to the vocal cords, indicating involvement of the accessory nerve (for shoulder movement), hypoglossal nerve (for tongue movement), glossopharyngeal nerve (for taste sensation), and the vagus nerve (for voice). These nerves exit the skull through the jugular foramen. This large, irregularly shaped opening is located inferior to the internal acoustic meatus and is the exit point for several cranial nerves including the ones mentioned above which are responsible for the symptoms the patient is experiencing.