B7.028 - Brain Stem and CN Lesions to S&S Flashcards
CNs in the midbrain
CN 3 oculomotor/pupilomotor
CN 4 trochlear
CN 5 mesencephalic
CNs in pons
CN 6 abducens
CN 5 motor n trigeminal/proper, descending GSA tract
CN 7 facial
CN 7 s salivatory
CN 9 glossopharyngeal L salivatory
CNs in the medulla
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
which CN is in accesory nucleus in cevical SC
CN 11
manifestations of extraaxial oculomotor nerve lesion
CN 3
Binocular double vision, eyelid drooping, vision blurry
Eye down and out, ptosis, mydriasis
functions of CN 3
Medial recuts
superior rectus
inferior rectus
inferior oblique
lev. palbebrae
pupil constriction
manifestation of intraaxial lesion to CN3
contralateral weakness
contralateral proprioceptive and pain and temperature numbness
extra cranial lesion to CN 4 manifestations
binoculuar double vision
vertical or skewed
head tilt, 3 step test
function of CN 4
superior oblique (ipsa)
intorsion and depression when eye adducted
itra axial lesion to CN 4 manifestations
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!
way to remember which CNs innervate eye muscles
Lr6(SO4)3
Lateral rectus 6
Superior oblique 4
all the rest 3
extra axial CN 6 manifestations
binocular diplopia
horizontal double vision
estropia
worse wehn eyes look towards weak muscle
lateral rectus doesnt work
extracranial lesion of CN V
trigeminal
difficulty with mastication
Facial numbness without NUMBNESS OF ANGLE OF JAW
decreased sensation to pain and temperature and fine touch of face
intra axial lesion of CN 5 manifestations
contralateral loss of sensation below lesion
contralateral weakness below lesion
extraxial CN 7 manifestations
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
intraxial lesion of CN 7
CN 7 problems and CN6 (abducens) would be affected (decreased lateral rectus muscle action)
contralateral weakness, reduced sensation
extracranial CN 8 lesion manifestations
reduced hearing and vertigo (a visual hallucination that the world is moving) nystagmus is associated with this
dizziness
hyperacusis
extracranial CN 9 lesion manifestations
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
extracranial CN X lesion manifestations
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
intra axial laterall medullary lesion effects
CN X affected - hoarsenes, uvular deviation opposite side
contralateral sensory loss (ALS)
horners syndroem bc descending SYM go thru this area
extracranial CN 11 manifestations
sternocleidomastoid weakness when turning head on contralateral side of lesion
trapezeus weakness (shrugging)
extracreanial lesion of CN 12 manifestations
tongue deviation towards side fo leison (“lick your wounds”)
toungue weakness/atrophy
intraxial lesion to CN 12 manifestation
medial medullary lesion
contralateral touch and proprioception loss and corticospinal weakness
compare and contrast which nerves are affected in lateral vs medial medullary lesions
