A 35-year-old man develops hoarseness, loss of gag reflex on the right, weakness of right sternocleidomastoid and trapezius, and deviation of the uvula to the left. MRI demonstrates a tumour at the right skull base. Which foramen contains all the nerves implicated in this syndrome?

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

Explanation

This is Vernet syndrome, a jugular foramen syndrome involving the glossopharyngeal, vagus and accessory nerves, all of which exit the skull through the jugular foramen together with the inferior petrosal sinus and sigmoid sinus. Loss of glossopharyngeal function abolishes the gag reflex afferent limb, vagal loss causes uvular deviation away from the lesion and vocal cord paralysis, and accessory loss weakens the ipsilateral sternocleidomastoid and trapezius. The hypoglossal canal carries only the twelfth nerve.

Reference: Gray's Anatomy, 42nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.