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Nervous System > Cranial Nerve Disorders > Flashcards

Cranial Nerve Disorders Flashcards

1
Q

what cranial nerves have special senses?

A

> olfaction
vision
taste
hearing

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2
Q

what controls the muscles of mastication?

A

trigeminal nerve (V)

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3
Q

what controls the muscles of the larynx and pharynx?

A

vagus (X)

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4
Q

what cranial nerves have parasympathetic innervation?

A

> oculomotor (pupil constriction)
Facial nerve
glossopharyngeal (parotid)
vagus (thoracic and abdomen organs)

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5
Q

what does the facial nerve supply with parasympathetic innervation?

A

> lacrimation

> salivation: submandibular and sublingual glands

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6
Q

why would you only do the corneal test if the facial nerve is working?

A

it is an uncomfortable test and if the facial nerve is not working the patient cannot blink (showing the reflex is working). it will not tell you anything about the trigeminal nerve

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7
Q

how would you test vestibular function?

A

> dix-hallpike manoeuvre

> untenbergers test

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8
Q

in the pupillary light reaction what is the afferent component?

A

II: optic nerve

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9
Q

what is the efferent component in the pupillary light reaction?

A

III oculomotor nerve

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10
Q

what is the afferent component of the corneal reflex?

A

trigeminal V

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11
Q

what is the efferent component of the corneal reflex?

A

VII facial nerve

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12
Q

in the jaw jerk reflex in the trigeminal nerve the efferent or afferent component?

A

both!

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13
Q

what is the afferent component of the gag reflex?

A

glossopharyngeal nerve IX

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14
Q

what is the efferent component of the gag reflex?

A

vagus nerve X

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15
Q

where do the oculomotor and trochlear nuclei lie?

A

in the mid brain

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16
Q

where do the trigemina, abducent and facial nerve lie?

A

in the pons

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17
Q

where does the vestibulocochlear nerve lie?

A

at the pontomedullary junction

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18
Q

what nerves lie in the medulla?

A

> glossopharyngeal
vagus
accessory
hypoglossal

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19
Q

what does an unusual combination of cranial nerve signs suggest?

A

there is chronic or malignant meningitis

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20
Q

what do pure motor signs suggest?

A

myasthenia gravis

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21
Q

what can damage cranial nerves within the brain?

A

> ischaemia

> tumour

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22
Q

what can damage cranial nerves when crossing the subarachnoid space?

A

meningitis

23
Q

where can cranial nerves be damaged?

A

> within the brain
crossing the subarachnoid space
outside the skull

24
Q

what happens to the optic nerve in optic neuritis?

A

there is demyelination

25
Q

describe the symptoms and signs seen in optic neuritis

A 
> monocular visual loos
> pain on eye movement
> reduced visual acuity
> reduced colour vision
> swollen optic disc
26
Q

what condition is optic neuritis associated with?

A

multiple sclerosis

27
Q

what happens if there is loss of parasympathetic input to the eye (complete third nerve palsy)?

A

there is a fixed dilated pupil

28
Q

does the pupil dilate or constrict with the sympathetic system?

A

it dilates

29
Q

what can cause dilated pupils?

A 
> youth
> dim lighting
> anxiety
> mydriatic eye drops
> amphetamine
> third nerve palsy
> brain death
30
Q

what can cause constricted pupils?

A 
> old age
> bright light
> miotic eye drops
> opiate overdose
> horners syndrome
31
Q

what is horners syndrome?

A

damage to the sympathetic chain causing ptosis and hydrosis

32
Q

name some eye movement disorders

A 
> isolated third nerve palsy
> isolated fourth nerve palsy
> isolated sixth nerve palsy
> combination of above pasly's
> supranuclear gaze palsy
> nystagmus
33
Q

describe microvascular third nerve palsy

A

caused by diabetes and hypertension. it is painless and the pupil is spared

34
Q

describe compressive third nerve palsy

A

caused by posterior communicating artery aneurysm and raised ICP. this is painful and the pupil is affected.

35
Q

what can cause isolated 6th nerve palsy?

A

> idiopathic
diabetes
meningitis
raised ICP

36
Q

what can cause nystagmus?

A 
> congenital
> peripheral vestibular problem
> central vestibular/brainstem disease
> cerebellar disease
> toxins
37
Q

describe the attacks in trigeminal neuralgia

A

they are paroxysmal attacks of lancinating pain

38
Q

what causes trigeminal neuralgia?

A

vascular loop compression of the 5th nerve in the posterior fossa

39
Q

how is trigeminal neuralgia treated?

A

with carbamazepine

40
Q

is bells palsy upper or lower motor neuron?

A

lower motor neuron

41
Q

describe bells palsy facial weakness

A

> unilateral face weakness

> eye closure often affected, risk of corneal damage

42
Q

what can bells palsy be preceded by?

A

pain behind the ear

43
Q

what is bells palsy treated with?

A

steriods

44
Q

how is the forehead affected in an upper motor neuron condition?

A

it can still move at both sides as it bilaterally innervated

45
Q

how is the forehead affected in a lower motor neuron condition

A

half of it is affected and paralysed

46
Q

describe vestibular neuronitis

A

> sudden onset
disabling vertigo
vomiting
gradual recovery

47
Q

what is dysarthria?

A

disordered articulation, slurring of speech

48
Q

what is dysphagia?

A

difficulty swallowing

49
Q

in what condition can both dysarthria and dysphagia occur?

A

in bulbar and pseudobulbar palsy

50
Q

is bulbar palsy upper or lower motor neuron?

A

lower

51
Q

is pseudobulbar palsy upper or lower motor neuron?

A

upper

52
Q

what signs and symptoms are seen in pseudobulbar palsy?

A 
> dysarthria
> dysphonia
> dysphagia
> spastic immobile tongue
> brisk jaw jerk
> brisk gag reflex
53
Q

describe the lesion in bulbar palsy

A

> bilateral lower motor neuron affect IX-XII

54
Q

what signs and symptoms are seen in bulbar palsy?

A 
> wasted fasciculating tongue
> dysarthria
> dysphonia
> dysphagia
> BEWARE OF FEEDING THESE PATIENTS

Nervous System (45 decks)

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