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NMS 1 > Assessing Specific Cranial Nerves I and II > Flashcards

Assessing Specific Cranial Nerves I and II Flashcards

1
Q

C.N rarely tested in a clinical practice. Only done in response to a specific complaint rather than a screening test. Easily tested when done.

A

C.N. I

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2
Q

Most recognizable smells require olfaction, however, some strong irritating agents, like ______, can be recognized by the __________ and do not require an olfactory pathway

A

Ammonia

Nasal epithelium

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3
Q

T/F The olfactory nerve is considered a peripheral nerve

A

FALSE.

It is considered a CNS tract that terminates in the olfactory bulb

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4
Q

Second order ______________ (true olfactory nerves) pierce the cribiform plate of the ethmoid bone and terminates in the mucus membrane that lines the nasal cavity.

A

Ganglion nerve cells

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5
Q

What must happen to the molecules in the nasal cavity before a particular smell is able to reach the nerve endings?

A

The molecules must dissolve into mucus overlying the cribriform plate and supply chemical stimulation to the nerve endings in that location

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6
Q

Complete loss of smell

A

Anosmia

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7
Q

T/F Anosmia is a classical sign of a cortical lesion

A

FALSE

Anosmia is usually not indicative of a cortical lesion

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8
Q

Symptoms usually indicative of a cortical lesion

A

Perversion, hallucinations or diminution of smell

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9
Q

Anosmia is more indicative with these conditions

A
  • Viral infections
  • Allergic rhinitis
  • Aging
  • Head trauma (fracture of the cribriform plate)
  • Rhinorrhea (CSF drainage)
  • Backwash meningitis
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10
Q

T/F Neurons that attach to the cribriform plate can be sheared off even in the absence of fracture

A

True.

Head and neck injuries can cause the shearing off of nerves that transverse the cribriform plate

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11
Q

T/F The sense of smell may return secondary to injury, but often it doesn’t

A

True

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12
Q

Lesion of the __________ in the anterior temporal lobe may cause hallucinations of smell associated with strong feelings of _____ and are termed ________ or seizures

A

Uncinate gyrus
Deja vu
Unicinate fits

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13
Q

A decreased sense of smell

A

Hyposmia

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14
Q

An increased sense of smell

A

Hyperosmia

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15
Q

A perversion of smell

A

Parosmia

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16
Q

Abnormally disagreeable smell

A

Cacosmia

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17
Q

Procedure to check for sense of smell

A
  • One nostril must be occluded
  • Instruct the patient to close his or her eyes
  • The examiner should ask the patient to identify when he smells the object and what smell he is identifying
  • The substances should be non-irritating smells such as peppermint, coffee, lemon, or pine
  • When checking the other nostril, a second substance should be utilized
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18
Q

Common causes of bilateral anosmia

A
  • Blocked nasal passage
  • Common cold
  • Trauma
  • Relative loss occurs with aging
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19
Q

Primary neurons of C.N. I

A

Unmyelinated processes of the ciliated receptors in the upper part of the nasal mucosa are gathered into about 20 branches which pass through the cribriform plate of the ethmoid bone to the olfactory bulb.

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20
Q

Secondary neurons of C.N. I

A

Myelinated processes of the bipolar cells of the bulb from the olfactory tract and terminate in the primary olfactory cortex

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21
Q

Primary olfactory cortex

A

Periamygdaloid cortex

Prepiriform cortex

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22
Q

Tertiary neurons of C.N. I

A

Neurons extend from the primary olfactory cortex to the entorhinal cortex, lateral preoptic area, amygdaloid body, and medial forebrain bundle

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23
Q

Brodmann area for the entorhinal cortex

A

Area 28

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24
Q

Association fibers to the ____________ and ________ pass directly as 3rd order neurons from the anterior perforated substance and indirectly from the ________ via the fornix and olfactory projection tracts through the ______________ and anterior nuclei of the _____________

A 
Tegmentum 
Pons
Hippocampus
Mammillary bodies 
Thalamus
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25
Q

T/F Reflex connections established with nuclei of the other cranial and spinal nerves may be functionally significant in swallowing and digestion

A

True

26
Q

T/F Unlike C.N. I, C.N. II is a true nerve

A

FALSE.

C.N. I and C.N. II are both not true nerves but instead are fiber tracts of the brain

27
Q

1st order neurons of C.N. II

A

Rods and Cones

28
Q

3rd order neurons of C.N. II

A

Ganglion cells

29
Q

Cells that connect 1st order and 3rd order neurons in C.N. II

A

Bipolar cells

30
Q

What forms the optic nerve?

A

Myelinated axons arising from ganglion cells

31
Q

At the ________, the nerve fibers from the half of each retina decussate. The temporal fibers from each half of the retina are uncrossed.

A

Optic chiasm

32
Q

Fibers from the ipsilateral halves of the retina form the optic ________, passing along to the _________ geniculate bodies, ________ colliculi, and ________ region

A

Tract
Lateral
Superior
Pretectal

33
Q

Tract that contains the 4th order neurons from the lateral geniculate bodies and passes to the occipital cortex

A

Geniculocalcarine tract

34
Q

Fan-like radiating portion that curves around the inferior horn of the lateral ventricle

A

Meyer’s Loop

35
Q

Central connections of the optic nerve

A
  • Pretectal region to the Edinger-Westphal nucleus via the posterior commissure
  • Superior collicul via the tectobulbar and tectospinal tracts to other cranial and spinal nuclei
  • Occipital cortex to other cortical and subcortical areas
36
Q

Fibers from this region are responsible for the simple and consensual light reflexes

A

Pretectal region

37
Q

Tract concerned with visual perception. A continuation of the lateral geniculate body.

A

Geniculocalcarine tract

38
Q

Reflex fibers pass from the occipital cortex to other cortical centers and to the superior colliculi and thus through the tectobulbar and tectospinal tracts to:

A
  • Cranial and spinal nuclei for involuntary reflexes

- Pontine nuclei, via the corticopontine tract for postural reflexes

39
Q

Retinal area for central vision

A

Macula

40
Q

Small central pit composed of closely packed cones, where vision is sharpest and color discrimination most acute

A

Fovea centralis

41
Q

Cells stimulated by relatively high intensity light and are responsible for sharp vision and color discrimination

A

Cones

42
Q

Cells that react to low intensity light and function in twilight and night vision

A

Rods

43
Q

T/F Cones are more numerous in the retina than rods

A

FALSE.

Rods are more numerous

44
Q

Lesion of the optic nerve or tract, the most common cause is multiple sclerosis

A

Retrobulbar neuritis

45
Q

Lesion includes various forms of tetinitis

A

Optic or bulbar neuritis

46
Q

Commonly seen symptom of increased intracranial pressure due to brain tumors, abscesses, hemorrhage, hypertension, and other causes

A

Papilledema (chocked disc)

47
Q

Associated with decreased visual acuity and a change in the color of the optic disc to light pink, white, or gray

A

Optic atrophy

48
Q

Caused by processes that involve the optic nerve and do not produce papilledema

A

Primary optic atrophy

49
Q

A sequel of papilledema

A

Secondary optic atrophy

50
Q

May be due to tabes dorsalis , multiple sclerosis, or hereditary

A

Primary (simple) optic atrophy

51
Q

May be due to neuritis, glaucoma, or increased intracranial pressure

A

Secondary optic atrophy

52
Q

Corneal scars, arteriosclerotic changes, and tumors are all possible examples of this

A

Opacities of the lens

53
Q

May be caused by tumors at the base of the frontal lobe and is characterized by ipsilateral blindness and anosmia (with atophy of the optic and olfactory nerve) and contralateral papilledema

A

Foster-Kennedy Syndrome

54
Q

Cerebromacular degeneration with severe mental deficiency occurring in Jewish families and is associated with blindness, optic atrophy, and a dark cherry red spot in place of the macula lutea

A

Amaurotic familial idiocy (Tay-Sachs disease)

55
Q

Pupil that reacts only to accomodation. It has neither a direct or indirect reaction to light. It was once considered pathognomonic of tabes dorsalis (neurosyphilis), but it has now been found to occur as a diabetic complication

A

Argyll-Robertson pupil

56
Q

Characterized by a tonic pupillary reaction and the absence of one or more tendon reflexes. The pupil is myotonic which a very slow, almost imperceptible contraction to light and in near vision, a slower dilation upon removal of the stimuli

A

Holmes-Adie syndrome

57
Q

Deviation of bilateral eye alignment.

A

Heterotropia

58
Q

Outward/lateral deviation of the eye

A

Exotropia

59
Q

Inward/medial deviation of the eye

A

Esotropia

60
Q

Upward deviation of the eye

A

Hypertropia

61
Q

Downward deviation of the eye

A

Hypotropia

NMS 1 (10 decks)

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