Cranial nerve questions Flashcards
from lecture slides
A patient presents with complaints of difficulty swallowing, decreased taste sensation at the back of the tongue, and impaired gag reflex. Upon examination, you observe a deviation of the uvula to one side when the patient says “ah.” Which cranial nerve is most likely affected in this patient, leading to these specific symptoms?
CN 9
A patient presents with weakness on one side of their face, and upon examination, you observe that they have difficulty closing their eye and drooping of the mouth on the affected side. Additionally, they report a loss of taste sensation on the anterior two-thirds of their tongue. Which cranial nerve is most likely affected in this patient, leading to these specific symptoms?
CN 7
A patient presents with weakness and atrophy of the right sternocleidomastoid and
trapezius muscles. On examination, you notice that the patient has difficulty turning
their head to the left and elevating their right shoulder. Which cranial nerve is most likely
affected in this patient?
CN XI (11)
A patient presents with difficulty speaking and swallowing, and upon examination, you observe that the patient’s tongue deviates to the left when they stick it out. Which cranial nerve is most likely affected in this patient?
CN 12 (XII)
A patient presents with a hoarse voice, difficulty swallowing, and impaired gag reflex. Upon examination, you notice that the patient has a deviation of the uvula to one side when they say “ah.” Additionally, they have a weak cough reflex and complain of choking while drinking fluids. Which cranial nerve is most likely affected in this patient?
CN 10 (X)
A patient presents with complaints of hearing loss and balance problems.
Upon examination, you notice that they have difficulty hearing sounds from one ear, and they exhibit signs of imbalance and dizziness. Which cranial nerve is most likely affected in this patient, leading to these specific symptoms?
CN 8 (VIII)
The vestibular ocular reflex (VOR) nerve nucleus anatomy
trochlear nucleus, medial longitudinal fasciculus, superior vestibular nucleus, and lateral vestibular nucleus.
consensual reflex
is the change in pupil size in the eye opposite to the eye to which the light is directed (e.g., if the light is shone in the right eye, the left pupil also constricts consensually).
Which descending vestibular pathway is ipsilateral and reaches sacral
levels of the spinal cord?
lateral vestibular pathway.
accommodation reflex
The accommodation reflex (or near response) is a three-part reflex that brings near objects into focus through lens thickening, pupillary constriction, and inward rotation of the eyes—eye convergence.
Three branches of CN 5?
V1 ophthalmic V2 maxillary V3 mandibular.
V1 ophthalmic is
one of three divisions of the trigeminal nerve (CN V), a cranial nerve. It has three major branches which provide sensory innervation to the eye, and the skin of the upper face and anterior scalp, as well as other structures of the head.
Case Study: A 78 year old male trips and falls down the steps. He reports the mechanism was visual impairment. Which muscle enables eyes to look downward and inward and which cranial nerve innervates this muscle?
SO(4) trochlear nerve.
Case Study: This 35 year old male is unable to abduct his left eye and complains of diplopia following a mild stroke. Which cranial nerve is affected?
abducens nerve. CN 6
Name at least 4 muscles controlled by the oculomotor nerve
*Levator palpebrae superioris - raises the upper eyelid.
*Superior rectus muscle - rotates the eyeball backward, “looking up”
*Medial rectus muscle - adducts the eye, “looking towards your nose”
*Inferior rectus muscle - rotates the eyeball forwards, “looking down”
Case Study: A 61 year old female with a history of an R acoustic neuroma presents with R sided facial paralysis and the inability to close her right eye.
Which Cranial nerve is likely affected and what may this condition be called?
CN VII (7) ; L MN Bell’s palsy.
Besides eye muscle innervation, what other functions does CN III have?
pupillary light reflex
Facial nerve innervates what
muscles that close the eye, lips, and produce facial expressions.
The temporalis, medial and lateral pterygoid, and masseter muscles are innervated by which of the following?
CN 5
Which reflex (es) involves the optic and oculomotor nerves?
Pupillary + Consensual + Accommodation
Which cranial nerve that carries sensory information does NOT travel through the
thalamus?
Olfactory, CN I
What symptoms would manifest after a complete lesion of the vagus nerve?
Difficulty speaking and swallowing, poor digestion, asymmetric elevation of the palate, and hoarseness
Which two cranial nerves are myelinated by oligodendroglia instead of Schwann cells and are therefore more vulnerable to diseases like MS?
CN 1 and CN 2
Which cranial nerve innervates the Tensor tympani muscle-within auditory system which dampens ossicular chain to protect inner ear from loud sounds?
Vestibulocochlear, VIII
Which cranial nerve(s) carry only sensory information?
CN 1, 2, 8
Case Study: A 50 year old female reports dysequilibrium, tinnitus, impaired hearing and dizziness following recovery from the shingles. Which cranial nerve is
likely affected?
CN 8. vestibulocochlear nerve
Which cranial nerve(s) carry only motor information?
CN 3, 4, 6, 11, 12
Which cranial nerve(s) carry mixed sensory and motor information?
CN 5, 7, 9, and 10.
How can cranial nerve XI be tested?
UT and levator scap muscle symmetry, atrophy, MMT.
When testing cranial nerves, your patient’s tongue deviates toward the right when asked to stick out her tongue. Which cranial nerve is most likely affected?
Left CN XII (12).
What term describes difficulty speaking? Name all cranial nerves that contribute
to normal speech production?
Dysarthria; CNs V, VII, X, & XII
Which CN # can bypass the THALAMUS and travel right to the cerebral cortex?
CN 1 Olfactory.
Glossopharyngeal nerve #9 has both motor and sensory functions T/F?
True
hypoglossal nerve#12 is motor or sensory?
primarily motor.
Which cranial nerves are also autonomic?
CN 7 and 10.
