Cranial Nerve Lesions Flashcards by Michelle Sanders

Blindness in one eye

Optic Nerve (CN II)

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Bi-temporal hemianopsia (tunnel vision)

Optic Chiasm

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Left homonymous hemianopia (only see right visual field)

Right Cortical Lesion (stroke)

Cutting all right cortex fibers

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Left homonymous superior quadrantopia

Meyer’s loop on right (lower retina cut)

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Ptosis

Occulomotor (CN III)

Levator palpebrae

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Diplopia (double vision)

Occulomotor (CN III)

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Lateral Strabismus

Occulomotor (CN III)

Medial rectus

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Pupil Dilation

Occulomotor (CN III)

Edinger-Westphal Nucleus

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Down and out eye movement lost

Trochlear (CN IV)

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Loss of pain and temperature in face

Trigeminal (CN V)

Spinal Nucleus in Medulla

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Loss of touch sensation in the face

Trigeminal (CN V)

Chief sensory nucleus in pons

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Weak muscles of mastication

Trigeminal (CN V)

Chief motor nucleus in pons

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Loss of Jaw Jerk reflexes

Trigeminal N (CN V)
Mesencephalic nucleus in the midbrain

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Medial Strabismus

Abducens (CN VI)

Lateral rectus

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Loss of tears

Facial (CN VII)

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Loss of saliva

Facial (CN VII)

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Loss of taste on anterior 2/3 of tongue

Facial (CN VII)

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Loss of all facial muscles

Facial (CN VII)

LMNL

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Loss of lower facial muscles

Facial (CN VII)

UMNL

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Hearing Loss

Vestibular (CN VIII)

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Vertigo

Vestibular (CN VIII)

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Loss of taste on posterior 1/3 of tongue

Glossopharyngeal (CN IX)

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Loss of afferent gag reflex

Glossopharyngeal (CN IX)

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Loss of efferent gag reflex

Vagus (CN X)

Causes dysphagia, hoarseness, and autonomic effects

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Weakness in Trapezius and SCM

Spinal Accesory N (CN XI)

Tongue protrusion to weak side

Hypoglossal (CN XII)

Loss of Pain and Temperature

Spinothalamic Pathway | Lateral Spinothalamic Tract

Loss of Pain and Temp on ipsilateral side

Spinothalamic Pathway First order neuron lesion Below Medulla

Loss of Pain and Temp Bilaterally

Anterior White Commissure Lesion | Below Medulla

Loss of Pain and Temp Contralaterally

Lateral Spinothalamic Tract | Second Order Neurons

Loss of Pain and Temp Contralaterally & Thalamic Syndrome (spontaneous pain)

Spinothalamic Tract | Third Order Neurons

Deep Touch, Proprioception, vibration, and 2-point discrimination

Dorsal columns of spinal cord and lemniscal system in brain stem

Anosmia

Olfactory (CN I)

Ipsilateral loss of tactile discrimination

Dorsal Columns | First Order Neurons

Contralateral loss of tactile discrimination

Dorsal Columns/Lemniscus Second Order Neurons Third Order Neurons

Loss of crude/light touch

Anterior Spinothalamic Tract

Loss of motor and sensory functions in extremeties (peripheral nerves)

Polyneuropathy

Loss of 2 point discrimination, touch, vibration, and proprioception in hands and legs

Posterior Lateral Sclerosis

- Loss of all sensations at level of injury - Ipsilateral loss of touch, vibration, 2-point discrimination, and proprioception - Contralateral loss of pain and temperature sensation

Brown-Sequard Syndrome (hemisection of spinal cord)

Loss of pain and temperature sensation in arms and across chest (cape)

Syringomyelia

Corneal Reflex Afferent Limb

Cranial Nerve V (Trigeminal N)

Corneal Reflex Efferent Limb

Cranial Nerve VII (Facial N) *innervates orbicularis oculi to close eyelid

Pupillary Light Reflex

CN III (Oculomotor N)

Accomodation Reflex

CN III (Oculomotor N)

Presbyopia

Inability to focus well on close object (CN III)

Neuron from brain to anterior horn cell

Upper Motor Neuron

Neuron from anterior horn cell to muscle

Lower Motor Neuron

Difficulty with fine motor skills and distal muscles

Corticospinal Tract

Lesion involving corticospinal or corticobulbar tract

Upper Motor Neuron Lesion

Lesion involving peripheral nerves

Lower Motor Neuron Lesion

Hypertonus, Hyperreflexia, Clonus

UMNL

Hypotonus, hyporeflexia

LMNL

Babinki Sign Present

UMNL

Wallerian Degeneration, marked atrophy

LMNL

Athetosis

slow, uncoordinated movements (corpus striatum) Extrapyramidal System Often seen in Cerebral Palsy

Chorea

involuntary, rapid jerks (fidgets) Extrapyramidal System Common in Huntington's Disease

Ballism/Hemiballism

wild flinging movements (contralateral subthalamic nucleus) | Extrapyramidal system

Dystonia

``` bizarre postures (corpus striatum) Extrapyramidal system ```

Hypokinesia, tremors, rigidity, flexed posture, shuffling gait

Parkinson's Disease (substantia nigra) | Extrapyramial system

Treatment for Parkinson's

L-dopa (precursor for dopamine synthesis) | Drugs that inhibit Ach in CNS and restore dopamine/Ach balance

Extension of both upper and lower extremities

Decerebrate Posture/Rigidity

Flexion of UE and Extension of LE

Decorticate Posture/Rigidity

Loss of voluntary motion in right LE

UMNL on right side

Bilateral Loss of proprioception and vibration

Dorsal Columns Lesion (gracile fasciculus)

Contralateral Signs and Symptoms are lesions in the...

Medial lemniscus

Ipsilateral Signs and Symptoms are lesions in the...

Dorsal Columns

Lesion of corticospinal tract above decussation

contralateral weaknesss

Lesion of corticospinal tract below decussation

ipsilateral weakness