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E1 Nervous System + Pain > Cranial Nerve Tests > Flashcards

Cranial Nerve Tests Flashcards

1
Q

what is the origin of CN I?

A

forebrain

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2
Q

where do CN I fibers synapse?

A

olfactory glomeruli in olfactory bub

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3
Q

where does CN I project?

A

olfactory cortex of the temporal lobe

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4
Q

what is the clinical relevance for CN I?

A

cribriform plate is weak spot of anterior cranial fossa trauma/fracture here can lead to ANOSMIA

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5
Q

what is the origin of CN II?

A

forebrain

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6
Q

what passes through the optic canal?

A

retinal ganglion cell axons

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7
Q

where does info from optic nerve go?

A

optic chiasm, optic tract, left geniculate nuc, optic radiations

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8
Q

where does the optic radiations project?

A

occipital lobe

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9
Q

how can issue with the optic nerve present?

A

transection or pathologic damage can lead to anopsia (unilateral blindness)

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10
Q

what is the function of CN III?

A

somatic innervation to several extraocular muscles, sup/med/inf rectus, inf oblique, levator palpabrae

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11
Q

what is the parasympathetic function of CN III?

A

intraocular muscles
pupillary constrictor, ciliary muscle

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12
Q

where does CN III originate?

A

midbrain

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13
Q

where does CN III exit the skull

A

SOF

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14
Q

where are CN III nuclei?

A

in midbrain (including Edinger Westphal which are parasympathetic nuc)

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15
Q

where does CN III project?

A

frontal eye field in frontal lobe

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16
Q

what clinical presentation occurs with CN III lesions?

A

CN III palsy
ptosis, mydriasis, globe position down and out

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17
Q

what are some possible causes of CN III lesion?

A

trauma, aneurism, herniation in brain

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18
Q

what does CN IV do?

A

somatic control of superior oblique

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19
Q

what is the action of superior oblique?

A

intorsion
depression
abduction

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20
Q

where does CN IV originate?

A

dorsal midbrain (only CN to emerge dorsal)

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21
Q

where does info from CN IV go?

A

trochlear nucleus in midbrain

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22
Q

where does CN IV project?

A

frontal lobe

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23
Q

how might a CN IV lesion present?

A

-left eye elevated and adducted due to unopposed superior and medial rectus

-right eve extorted due to unopposed action if inferior oblique, compensatory head tilt to better align eyes

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24
Q

where is ganglia of sensory parts of CN V?

A

trigeminal sensory ganglion

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25
Q

where is the ganglia for the motor aspect of CN V3?

A

motor nucleus in pons

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26
Q

what is the job of CN VI?

A

somatic efferent innervation to lateral rectus

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27
Q

what is the origin of CN VI?

A

pontomedullary junction

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28
Q

where does CN VI exit skull?

A

SoF

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29
Q

where is CN VI nucleus?

A

abducens nucleus in pons

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30
Q

where does CN VI project?

A

frontal lobe

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31
Q

how might a CN VI palsy present?

A

ask pt to look straight and eye moves toward midline

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32
Q

where does CN VII project?

A

frontal lobe precentral gyrus

33
Q

how to treat bells palsy?

A

corticosteroids, usually self resolving, protect effected eye from drying out

34
Q

what does CN VIII do?

A

auditory and vestibular

35
Q

where does CN VIII originate?

A

pontomedullary junction

36
Q

where does CN VII have its nucleus?

A

vestibular and cochlear in pons/medulla

37
Q

where does CN VII project?

A

auditory: temporal
vestibular: parietal

38
Q

what is the sensory function of glossopharyngeal nerve?

A

general: posterior tongue, oropharynx, middle ear, Eustachian tube
special: taste posterior 1/3 tongue

39
Q

what is the motor innervation for CN IX?

A

autonomic: secretomotor to parotid gland

40
Q

where does CN IX originate?

A

medulla

41
Q

where does CN IX, X and XI exit skull?

A

internal jugular foramen

42
Q

where is the nuclei for CN IX?

A

medulla

43
Q

where does taste register for CN IX?

A

insular cortex

44
Q

what detects trigger for gag reflex?

A

sensory receptors for CN IX

45
Q

what is the sensory functions of CN X?

A

larynx and pharynx, visceral organs, special sense taste on eppigottis

46
Q

what is the motor function of CN X?

A

larynx, pharynx, soft palate

47
Q

where does CN X originate?

A

medulla (nuc here too)

48
Q

where does CN X project?

A

motor: frontal lobe
sensory: insular cortex

49
Q

what is special about the spinal part of spinal accessory nerve?

A

fibers ascend spinal cord and enter skull through foramen magnum

50
Q

what does CN XII innervate?

A

genioglossus
hyoglossus
styloglossus

51
Q

where does CN VII exit skull?

A

hypoglossal canal

52
Q

lesions superior to the hypoglossal nucleus will cause:

A

contralateral tongue deviation

53
Q

CBT to hypoglossal nucleus what happens?

A

decussates

54
Q

CN XII to genioglossus is

A

ipsilateral

55
Q

lesions inferior to the CN XII nucleus cause:

A

ipsilateral tongue deviation

56
Q

what is hypoalgesia?

A

(low pain) should feel pain but do not

57
Q

what is allodynia?

A

lowered pain threshold, feel pain where should not

58
Q

what is consciousness dependent on?

A

interaction between intact cerebral hemispheres and the upper brain stem where activating mechanisms reside

59
Q

how do you check CN I?

A

make sure nasal path is clear, check each side individually seeing if pt can smell different things

60
Q

what is anosmia?

A

loss of smell

61
Q

what can cause temporary loss of smell?

A

swelling or congestion

62
Q

what can cause permanent loss of smell?

A

fractures to cribriform plate, olfactory groove or tumors

63
Q

what four procedures is needed to examine the optic nerve?

A

-measurement of visual acuity
-test visual fields
-pupillary light reflex
-visualization of the fundus

64
Q

what does the afferent and efferent for pupillary light reflex?

A

CN II (afferent)
CN III (motor)

65
Q

what is pupillary light reflex?

A

light shone on one pupil, if both sensory and motor intact the other pupil will also constrict

66
Q

what can be done to test CN III, IV and VI?

A

eyelid position, pupillary light reflex, accommodation, extraocular eye movement

67
Q

what is accommodation?

A

allows eyes to focus on near objects, and then far by changing vergence, lens shape, and pupil size

68
Q

what symptoms present with oculomotor nerve palsy?

A

ptosis- inactivation of lev palp
mydriasis- decreased tone to P constrictor
down and out gaze

69
Q

what is anisocoria?

A

unequal size of the pupils

70
Q

what does cocaine do to pupils?

A

dilates

71
Q

what does opiates do to pupils?

A

makes smaller

72
Q

what is the corneal reflex?

A

touch cornea and both eye should blink

73
Q

what does an UMN lesion of CN VII cause?

A

contralateral lesion with forehead sparing

74
Q

what does lMN lesion oc CN VII cause?

A

damage from the facial nuc or lower causes ipsilateral paralysis

75
Q

how do you test for a CN X lesion?

A

listen for hoarseness in voice, look at back of throat if uvula is midline, gag reflex on both sides

76
Q

how do you test hypoglossal nerve?

A

stick out tongue straight, left then right
DEVIATE TOWARDS PARAIZED OR WEAK SIDE

77
Q

what is quantitative sensory testing?

A

offers incite on potential mechanisms contributing to individuals experience of pain

78
Q
A

E1 Nervous System + Pain (6 decks)

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