Your Daily Meds - 6 December, 2021 Your Daily Meds

Good morning and welcome to your Monday dose of Your Daily Meds.
Bonus Review: What is the difference between the blood-CSF barrier and the blood-brain barrier?
Answer: Whereas in the blood-CSF barrier, the barrier is due to the tight junctions between the epithelial cells (ependyma) of the choroid plexus; the blood-brain barrier involves a barrier of tight junctions between the capillary endothelial cells.
= BBB - tight junctions between capillary endothelial cells
= BCSFB - tight junctions between choroid plexus epithelial cells
Psych Question:
Marked fear or anxiety about which of the following is NOT consistent with a diagnosis of agoraphobia?
* Using public transportation
* Being in open spaces
* Being in enclosed spaces
* Standing in line or being in a crowd
* Allowing others into one’s home
Have a think.
Scroll for the chat.
Somewhat Anatomical:
The Eustachian tube is an osseocartilaginous passage connecting the nasopharynx and middle ear. Which of the following cranial nerves supplies general sensory innervation to the Eustachian tube?
* CN VII
* CN VIII
* CN IX
* CN X
* CN XI
Have a think.
Remember some rude mnemonics.
Scroll for the chat.
The Phobia:
Agoraphobia is essentially a disorder of excessive anxiety about being unable to escape a particular situation or place. Anxiety is a fearful response in the absence of a specific danger or threat, or in their anticipation. Anxiety is distinct from fear, which is a response to a realistic and immediate danger. Fear is adaptive in situations of stress or danger with priming of the physiological ‘fight or flight’ mechanism.
Agoraphobia is characterised by more than six months of excessive anxiety about being unable to escape a particular situation or place, in the context of at least two of the following:
* Using public transportation
* Being in open spaces
* Being in enclosed spaces
* Standing in line or being in a crowd
* Being outside of the home alone
The management of agoraphobia includes education around the symptoms of the patient’s anxiety and on how avoidance behaviours may be self-perpetuating. Relaxation techniques and graded exposure to a hierarchy of the patient’s feared situations may also be employed. 
So marked fear or anxiety about allowing others into one’s home is not consistent with a diagnosis of agoraphobia.
Tubes and Supply:
The Eustachian tube receives general sensory innervation from cranial nerve IX, the glossopharyngeal nerve. The glossopharyngeal nerve exits the skull through the jugular foramen and has motor innervation to the stylopharyngeus muscle and sensory innervation for taste and general sensation to the posterior 1/3 of the tongue.
Cranial nerve VII, the facial nerve, supplies taste sensation to the anterior 2/3 of the tongue; supplies motor innervation to the muscles of facial expression and the stapedius muscle; and supplies parasympathetic innervation to the salivary and lacrimal glands.
Cranial nerve VIII, the vestibulocochlear nerve, supplies sensory innervation to the cochlea and vestibular apparatus.
Cranial nerve X, the vagus nerve, supplies sensory innervation to many structures including the pharynx and larynx; supplies motor function to the soft palate, larynx, pharynx and upper oesophagus; and parasympathetic innervation to the cardiovascular, respiratory and gastrointestinal symptoms.
Cranial nerve XI, the accessory nerve, supplies motor innervation to the sternocleidomastoid and trapezius muscles.
Bonus: Tell me some functions of the Hypothalamus.
Answer in tomorrow’s dose.
Closing:
Thank you for taking your Meds and we will see you tomorrow for your MANE dose. As always, please contact us with any questions, concerns, tips or suggestions. Have a great day!
Luke.
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