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Clinical 1 > CN Neuro > Flashcards

CN Neuro Flashcards

1
Q

Which CNs come from midbrain?

A

CN3: oculomtor
CN4: trochlear

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2
Q

Which CNs come from pons?

A

CN5: trigeminal
CN6: abducens
CN7: facial
CN8: vestibulotrochlear

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3
Q

Which CNs come from medulla?

A

CN9: glossopharyngeal
CN10: vagus
CN11: hypoglossal
CN12: accessory

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4
Q

Function and name: CN1

A

Olfactory - smell

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5
Q

Function and name: CN2

A

Optic
Vision

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6
Q

Function and name: CN3

A

Oculomotor
- pupil contstriction
- accomodation
- upper eyelid
- palsy: down and out, can’t adduct eye

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7
Q

Function and name: CN4

A

Trochlear
Eye movements
Palsy - up and in
Superior oblique muscle - responsible for depression and intorsion of eye

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8
Q

Function and name: CN5

A

Trigeminal
Sensory of face
Motor - muscles of mastication

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9
Q

Function and name: CN6

A

Abducens
Eye movements
Palsy - in and stuck - cannot abduct eye, eye turns medially when looking forward

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10
Q

Function and name: CN7

A

Facial
Facial muscles of expression
Taste anterior tongue
Plasy: INCLUDES forehead

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11
Q

Function and name: CN8

A

Vestibulotrochlear
Hearing and balance

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12
Q

Function and name: CN9

A

Glossopharyngeal
Sensation posterior tongue + pharynx, taste posterior tongue

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13
Q

Function and name: CN10

A

Vagus
ANS
Larynx, pharynx, vocal cords
Palsy: uvula deviates away (because soft palate in deviated side dose not rise)

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14
Q

Function and name: CN11

A

Hypoglossal
Movement of tongue
Palsy: tongue deviates toward affected side

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15
Q

Function and name: CN12

A

Accessory
Motor trap and SCM

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16
Q

Rinnes test - explain

A

Tuning fork - hit, put on bone, say when can’t hear, put to ear

Normal or SNHL: air > bone
Conductive loss: bone > air

17
Q

Webber test - explain
Interpret

A

Shake tuning fork, put on middle of head
Normal: middle
Abnormal:
- conductive: heard in bad ear (with abnormal bone > air Rinne)
- SNHL: hear good ear (with normal Rinnes)

18
Q

Causes of conductive hearing loss

A

EXTERNAL EAR (before TM)
- debris, wax, FB
- congenital malformations: Aural atresia, microtia

MIDDLE EAR
- OM/ effusions
- Cholesteatomas (congenital or acquired keratinised squamous epithelium that forms a cyst)
- Otosclerosis (spongy bone replaced by sclerotic bone)

HEAD TRAUMA - previous temporal bone # can cause mixed HL

19
Q

What’s this? What’s type 4?

A

Microtia
Anotia

20
Q

What this?

A

Typanoscleorsis - grommets or recurrent OM

21
Q

Syndromes w conductive hearing loss

A

Treacher-collins: coloboma, micronatia, small mid face, normal IQ

Sticker syndrome: cleft plate and micrognatia (25% PRS), marfanoid habitus, hyperextensible joints, XR: dumbbell shaped long bones

22q11
BWS

22
Q

Causes of SNHL

A

Congenital:
- Syndromic (Waardenburg, Usher, Pendred, Alport, Jervel Lange-Nielsen)
- non-syndromic: most common connexin 26 mutation

Infection: CMV, toxoplasmosis, herpes, rubella

Ototoxic drugs: aminoglycosides (gent), frusemide, cisplatin

Autoimmune: SLE, RA

Unilateral:
Trauma - temporal bone #
Tumour - acoustic neuroma in NF2

23
Q

Syndromic causes SNHL

A

Jervell and Lange-Neissen sydrome: prolonged QTc - syncope, sudden death

Waardenburg: white forelock, bright blue eyes

Usher: hearing loss and visual impairment

Pendred: thyroid - goiter/ hypothyroid

Alport: XL, kidney, eye

24
Q

Invx for hearing loss

A

Audiology
CT - bones
MRI - mass, soft tissue
ENT rv
Speech developmental assessment -? Referral for neuropsych

Serology - CMV, toxo, rubella
Autoimmune? ANCA, ANA, dsDNA, ESR
Pendred - thryoid
Jervell and Lange-Neissen - ECG for prolonged QTc

25
Q

Which CN?
What branches each colour?
Where’s the SWS port wine stain?

A

CN 5: trigeminal
Green - V1: ophthalmic
Blue - V2: maxillary
Red - B3: mandibular

V1+V2 branches SWS

26
Q

What’s this?
Possible causes

A

UMN plasy - because forehead is spared!

Central lesion - malignancy, vascular, autoimmune

27
Q

What’s this?
Possible causes?

A

CN7 Facial nerve palsy
Forehead involved!

Idiopathic Bells palsy- ? Viral prodrome
Infection: Ramsay-Hunt Syndrome (VZV)
Neoplastic:
- meningioma (NF2)
- acoustic neuroma (NF2)
Stroke
Autoimmune: MS, GBS

28
Q

Asked to do motor cranial nerve exam

A

Eyes
Trigeminal (wasting jaw, jaw jerk)
Facial
Mouth (9, 10, 12)
Accessory - SCM, trap

(No olfactory, no sensation, no hearing tests)

Clinical 1 (11 decks)

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