A 50-year-old man develops hoarseness, difficulty swallowing, loss of the gag reflex on the left, and weakness of the left sternocleidomastoid and trapezius. MRI shows a mass at the skull base. Which structure contains the affected nerves?

• A Foramen ovale
• B Internal auditory meatus
• C Jugular foramen ✓
• D Hypoglossal canal

Explanation

This is Vernet syndrome, the jugular foramen syndrome. CN IX, CN X, and CN XI leave the skull together through the jugular foramen, so a lesion there produces loss of the gag reflex and palate sensation (IX), hoarseness and dysphagia from vocal cord paralysis (X), and ipsilateral sternocleidomastoid and trapezius weakness (XI). The hypoglossal canal carries only CN XII, which would add ipsilateral tongue deviation and wasting, which are absent here.

Reference: Gray's Anatomy for Students, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.