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BMB 2 Leesy > B7.028 - Brain Stem and CN Lesions to S&S > Flashcards

B7.028 - Brain Stem and CN Lesions to S&S Flashcards

1
Q

CNs in the midbrain

A

CN 3 oculomotor/pupilomotor

CN 4 trochlear

CN 5 mesencephalic

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2
Q

CNs in pons

A

CN 6 abducens

CN 5 motor n trigeminal/proper, descending GSA tract

CN 7 facial

CN 7 s salivatory

CN 9 glossopharyngeal L salivatory

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3
Q

CNs in the medulla

A

CN 12 hypoglossal

nucleus ambiguous - CN 9, CN 10, CN 11

CN 10 dorsal N

CN 7 and 9 in Solitary N (gustatory)

descending tract of GSA CN 9, 10

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4
Q

which CN is in accesory nucleus in cevical SC

A

CN 11

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5
Q

manifestations of extraaxial oculomotor nerve lesion

A

CN 3

Binocular double vision, eyelid drooping, vision blurry

Eye down and out, ptosis, mydriasis

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6
Q

functions of CN 3

A

Medial recuts

superior rectus

inferior rectus

inferior oblique

lev. palbebrae

pupil constriction

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7
Q

manifestation of intraaxial lesion to CN3

A

contralateral weakness

contralateral proprioceptive and pain and temperature numbness

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8
Q

extra cranial lesion to CN 4 manifestations

A

binoculuar double vision

vertical or skewed

head tilt, 3 step test

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9
Q

function of CN 4

A

superior oblique (ipsa)

intorsion and depression when eye adducted

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10
Q

itra axial lesion to CN 4 manifestations

A

contralateral eye symptoms to lesion

contralateral motor weakness and numbness to touch and pain/temp

SO EYE SX WILL BE ON SAME SIDE AS WEAKNESS AND SENS LOSS!

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11
Q

way to remember which CNs innervate eye muscles

A

Lr6(SO4)3

Lateral rectus 6

Superior oblique 4

all the rest 3

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12
Q

extra axial CN 6 manifestations

A

binocular diplopia

horizontal double vision

estropia

worse wehn eyes look towards weak muscle

lateral rectus doesnt work

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13
Q

extracranial lesion of CN V

A

trigeminal

difficulty with mastication

Facial numbness without NUMBNESS OF ANGLE OF JAW

decreased sensation to pain and temperature and fine touch of face

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14
Q

intra axial lesion of CN 5 manifestations

A

contralateral loss of sensation below lesion

contralateral weakness below lesion

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15
Q

extraxial CN 7 manifestations

A

Facial

lacrimal gland wont work

facial expression muscles wont work ( upper and lower face weakness)

hyperacusis - stapedius

taste distorted ant 2/3 of tongue

earr egion sensation decreased

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16
Q

intraxial lesion of CN 7

A

CN 7 problems and CN6 (abducens) would be affected (decreased lateral rectus muscle action)

contralateral weakness, reduced sensation

17
Q

extracranial CN 8 lesion manifestations

A

reduced hearing and vertigo (a visual hallucination that the world is moving) nystagmus is associated with this

dizziness

hyperacusis

18
Q

extracranial CN 9 lesion manifestations

A

glossopharyngeal

reduced gag reflex on side of lesion

reduced sensation of post palate on side of lesion

difficulty initiating swallowing

reduced taste in back 1/3 of tongue

dry mouth potentially (parotid gland)

carotid body stimulated

19
Q

extracranial CN X lesion manifestations

A

vagus

pharyngeal and laryngeal weakness (hoarse voice)

decreased palatal elevation (uvula deviated toward opposite side)

difficulty swallowing (nasal regurg)

also affects aortic arch and baro/chemo receptors

PARA to viscera

20
Q

intra axial laterall medullary lesion effects

A

CN X affected - hoarsenes, uvular deviation opposite side

contralateral sensory loss (ALS)

horners syndroem bc descending SYM go thru this area

21
Q

extracranial CN 11 manifestations

A

sternocleidomastoid weakness when turning head on contralateral side of lesion

trapezeus weakness (shrugging)

22
Q

extracreanial lesion of CN 12 manifestations

A

tongue deviation towards side fo leison (“lick your wounds”)

toungue weakness/atrophy

23
Q

intraxial lesion to CN 12 manifestation

A

medial medullary lesion

contralateral touch and proprioception loss and corticospinal weakness

24
Q

compare and contrast which nerves are affected in lateral vs medial medullary lesions

A
25
Q

major blood vessels supplying brains stem

A

basialar midline artery

anterior spinal artery also midline

bilateral symmetric manifestations may be issues in these

PICA

AICA

SCA

all are circumferential arteries

PCA supplies occipital and midbrain

26
Q
A
27
Q

medulla arteries

A

supply paramedian area

28
Q

paramedian infarct in medulla

A

in medulla

affecting somatic efferents

29
Q

dorsolateral infarct in medulla

A

in medulla

more anterolateral system involvement

30
Q

artery supply in the pons

A

AICA

most blood supply comes off of basilar artery

31
Q

paramedian infarct in pons

A

affects 6th nerve with contralateral weakness and numbness

32
Q

dorsolateral infarct in pons

A

CN 7 and usually 6 affected

33
Q

midbrain blood supply

A

PCA or SCA

34
Q

effect of dorsolateral and paramedian infarcts on intra axial lesion in midbrain

A

BMB 2 Leesy (5 decks)

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