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CLINICAL SKILLS > CRANIAL NERVES > Flashcards

CRANIAL NERVES Flashcards

1
Q

A 45-year-old patient presents with gradual loss of vision in the left eye. Visual acuity testing reveals the ability to count fingers held up about half a meter in front of the eye. What is the reported visual acuity for the left eye?
A) CF (counting fingers)
B) HM (hand movement)
C) LP (light perception)
D) NLP (no light perception)

A

A) CF (counting fingers)

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2
Q

A 60-year-old patient complains of difficulty reading. Visual acuity testing reveals the inability to read text with the right eye. What is the reported visual acuity for the right eye?
A) CF (counting fingers)
B) HM (hand movement)
C) LP (light perception)
D) NLP (no light perception)

A

B) HM (hand movement)

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3
Q

During visual fields testing, a patient is unable to distinguish one or two fingers in the right upper visual field. What visual field defect is most likely present?
A) Right homonymous hemianopia
B) Bitemporal hemianopia
C) Right homonymous superior quadrantanopia
D) Altitudinal defect

A

C) Right homonymous superior quadrantanopia

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4
Q

A patient with poor visual acuity and loss of visual fields undergoes fundoscopy, which reveals optic nerve glioma. What is the likely cause of these findings?
A) Trauma
B) Vascular pathology
C) Neoplastic pathology
D) Inflammatory pathology

A

C) Neoplastic pathology

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5
Q

A 30-year-old patient presents with sudden onset bitemporal hemianopia. What condition is commonly associated with this visual field defect?
A) Thyroid eye disease
B) Optic neuritis
C) Pituitary adenoma
D) Ischemia

A

C) Pituitary adenoma

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6
Q

A patient complains of painful unilateral visual loss over days to weeks. The visual loss may be associated with multiple sclerosis. What condition is most likely responsible for these symptoms?
A) Optic neuritis
B) Thyroid eye disease
C) Vascular pathology
D) Trauma

A

A) Optic neuritis

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7
Q

A 55-year-old patient presents with gradual loss of the right half of vision in both eyes. What visual field defect is described?
A) Left homonymous hemianopia
B) Bitemporal hemianopia
C) Right homonymous superior quadrantanopia
D) Altitudinal defect

A

A) Left homonymous hemianopia

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8
Q

A patient is unable to perceive light in either eye. What is the reported visual acuity for both eyes?
A) CF (counting fingers)
B) HM (hand movement)
C) LP (light perception)
D) NLP (no light perception)

A

D) NLP (no light perception)

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9
Q

A patient presents with loss of both lower visual fields in the left eye. What type of visual field defect is likely present?
A) Left homonymous hemianopia
B) Bitemporal hemianopia
C) Right homonymous superior quadrantanopia
D) Altitudinal defect

A

D) Altitudinal defect

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10
Q

A 25-year-old patient complains of poor visual acuity and loss of visual fields. On examination, the patient is found to have optic nerve compression due to hyperthyroidism. What is the likely diagnosis?
A) Optic neuritis
B) Thyroid eye disease
C) Vascular pathology
D) Trauma

A

B) Thyroid eye disease

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11
Q

During visual fields testing, a patient is unable to distinguish one or two fingers in the left lower visual field. What visual field defect is most likely present?
A) Right homonymous hemianopia
B) Bitemporal hemianopia
C) Left homonymous inferior quadrantanopia
D) Altitudinal defect

A

C) Left homonymous inferior quadrantanopia

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12
Q

A patient complains of blurred vision and headaches. Visual acuity testing reveals grossly normal vision. What test should be performed next to assess the patient’s visual fields?
A) Fundoscopy
B) Color vision testing
C) Snellen chart reading
D) Visual field testing

A

D) Visual field testing

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13
Q

A 40-year-old patient presents with a visual field defect characterized by the loss of temporal visual fields in both eyes. What is the most likely visual field defect?
A) Right homonymous hemianopia
B) Bitemporal hemianopia
C) Left homonymous superior quadrantanopia
D) Altitudinal defect

A

B) Bitemporal hemianopia

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14
Q

A patient with visual acuity loss undergoes fundoscopy, which reveals signs of optic nerve ischemia. What is the likely cause of these findings?
A) Trauma
B) Vascular pathology
C) Neoplastic pathology
D) Inflammatory pathology

A

B) Vascular pathology

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15
Q

A 50-year-old patient presents with decreased visual acuity and visual field loss. Examination reveals optic nerve compression by a meningioma. What is the likely diagnosis?
A) Optic neuritis
B) Thyroid eye disease
C) Optic nerve glioma
D) Optic nerve sheath meningioma

A

D) Optic nerve sheath meningioma

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16
Q

During visual fields testing, a patient is unable to distinguish one or two fingers in any visual field of the left eye. What visual field defect is most likely present?
A) Right homonymous hemianopia
B) Bitemporal hemianopia
C) Left homonymous hemianopia
D) Altitudinal defect

A

C) Left homonymous hemianopia

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17
Q

A patient presents with loss of both upper visual fields in the right eye. What type of visual field defect is likely present?
A) Left homonymous hemianopia
B) Bitemporal hemianopia
C) Right homonymous inferior quadrantanopia
D) Altitudinal defect

A

C) Right homonymous inferior quadrantanopia

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18
Q

Which cranial nerves run through the cavernous sinus and the superior orbital fissure?
A) Oculomotor nerve (CN III) and Trochlear nerve (CN IV)
B) Trochlear nerve (CN IV) and Abducens nerve (CN VI)
C) Oculomotor nerve (CN III), Trochlear nerve (CN IV), and Abducens nerve (CN VI)
D) Optic nerve (CN II) and Oculomotor nerve (CN III)

A

C

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19
Q

What is the typical presentation of CN III palsy caused by raised intracranial pressure?
A) Unilateral, dilated, unresponsive pupil
B) Inability to achieve full lateral gaze
C) Drooping eyelid and double vision
D) Medial deviation of the affected eye

A

A

20
Q

What is the characteristic eye position in a CN IV palsy?
A) Upward and outward deviation
B) Downward and inward deviation
C) Medial deviation
D) Lateral deviation

A

A

21
Q

What is the term for the back-and-forth movement of the eye that occurs at the extremes of gaze?
A) Nystagmus
B) Ptosis
C) Diplopia
D) Strabismus

A

A

22
Q
A
23
Q

Which cranial nerve is primarily responsible for the direct pupillary light reflex?
A) CN II
B) CN III
C) CN IV
D) CN VI

A

B) CN III

24
Q

A patient presents with an inability to feel any pain or light touch on the cheek, under the eye, and lateral to the nose. Which division of the trigeminal nerve is likely affected?
a) V1
b) V2
c) V3
d) V4

A

b) V2

25
Q

During corneal reflex testing, a patient blinks only in response to touching ONE eye. Which cranial nerve deficit is likely present?
a) CN V1 (sensation)
b) CN V2 (sensation)
c) CN V3 (sensation)
d) CN VII (motor)

A

C

26
Q

A patient complains of facial pain and experiences paroxysmal episodes of intense sharp pain in the distribution of CN V2 and CN V3. What is the most likely diagnosis?
a) Trigeminal neuralgia
b) Herpes zoster
c) Numb chin syndrome
d) Gradenigo’s syndrome

A

a

27
Q

During motor testing, asymmetrical muscle wasting is observed around the temples and jaw of a patient. Which cranial nerve is likely affected?
a) CN V1
b) CN V2
c) CN V3
d) CN VII

A

d) CN VII

28
Q

A patient demonstrates an exaggerated jaw jerk reflex. Which cranial nerve is responsible for this reflex?
a) CN V1
b) CN V2
c) CN V3
d) CN VII

A

C

29
Q

A patient has bilateral absence of blinking in response to unilateral touch during corneal reflex testing. Which cranial nerves are likely affected?
a) CN V1 and CN VII
b) CN V2 and CN VII
c) CN V3 and CN VII
d) CN V1 and CN V2

A

B

30
Q

A patient with shingles develops burning pain in the distribution of CN V1, followed by a vesicular rash. Which virus is responsible for this condition?
a) Varicella zoster virus
b) Herpes simplex virus
c) Human immunodeficiency virus
d) Epstein-Barr virus

A

A

31
Q

A patient presents with retroorbital pain, CN VI palsy, and otitis media. What syndrome is associated with these clinical components?
a) Trigeminal neuralgia
b) Herpes zoster
c) Numb chin syndrome
d) Gradenigo’s syndrome

A

D

32
Q

During a clinical examination, a patient is asked to raise their eyebrows. The wrinkling on one side of the forehead is not as prominent as on the other side. Which cranial nerve is responsible for this finding?
A) Cranial Nerve V
B) Cranial Nerve VI
C) Cranial Nerve VII
D) Cranial Nerve VIII

A

c

33
Q

A patient presents with an asymmetrical face and a drooping corner of the mouth. However, the forehead wrinkling is symmetrical when the eyebrows are raised. Which type of facial nerve palsy is most likely present?
A) Upper motor neuron (UMN) facial nerve palsy
B) Lower motor neuron (LMN) facial nerve palsy
C) Bell’s palsy
D) Cranial Nerve VIII palsy

A

A

34
Q

A patient exhibits full-face paralysis on one side, including the forehead, due to a lesion in the contralateral motor cortex. Which type of facial nerve palsy is most likely present?
A) Upper motor neuron (UMN) facial nerve palsy
B) Lower motor neuron (LMN) facial nerve palsy
C) Bell’s palsy
D) Cranial Nerve VIII palsy

A

A

35
Q

Which condition is characterized by idiopathic lower motor neuron (LMN) facial nerve palsy, resulting in full-face paralysis?
A) Bell’s palsy
B) Trigeminal neuralgia
C) Horner’s syndrome
D) Ménière’s disease

A

A

36
Q

Damage to the facial nerve caused by diabetes can result in which type of facial nerve palsy?
A) Upper motor neuron (UMN) facial nerve palsy
B) Lower motor neuron (LMN) facial nerve palsy
C) Bell’s palsy
D) Cranial Nerve VIII palsy

A

B) Lower motor neuron (LMN) facial nerve palsy

37
Q

A patient presents with hearing loss in their left ear. During Rinne’s test, the patient can hear the tuning fork vibrating against the mastoid (bone conduction), but when you hold it in the air beside their ear, they can’t hear it (air conduction). What type of hearing loss is likely present?
a) Sensorineural hearing loss
b) Conductive hearing loss
c) Normal hearing
d) Mixed hearing loss

A

b) Conductive hearing loss

38
Q

During Rinne’s test, a patient with sensorineural hearing loss can hear the tuning fork vibrating against the mastoid (bone conduction). However, when you hold it in the air beside their ear, they can’t hear it (air conduction). What does this indicate?
a) Normal hearing
b) Conductive hearing loss
c) Severe sensorineural hearing loss
d) Mixed hearing loss

A

a) Normal hearing

39
Q

During Weber’s test, a patient reports that the sound is louder in their left ear. What should be the next step in the evaluation?
a) Repeat Weber’s test on the right ear
b) Perform Rinne’s test on the left ear
c) Perform Rinne’s test on the right ear
d) Perform a comprehensive audiogram

A

c) Perform Rinne’s test on the right ear

40
Q

A patient presents with hearing loss in both ears. During Rinne’s test, the patient can’t hear the tuning fork vibrating against the mastoid (bone conduction), and when you hold it in the air beside their ear, they still can’t hear it (air conduction). What type of hearing loss is likely present?
a) Sensorineural hearing loss
b) Conductive hearing loss
c) Normal hearing
d) Mixed hearing loss

A

D

41
Q

A patient complains of hearing loss in their left ear. During Weber’s test, they report that the sound is louder in their right ear. What does this finding suggest?
a) Normal hearing
b) Conductive hearing loss in the left ear
c) Sensorineural hearing loss in the left ear
d) Sensorineural hearing loss in the right ear

A

c) Sensorineural hearing loss in the left ear

42
Q

During examination, a patient’s uvula is deviated towards the right side and one of the tonsillar arches appears lower than the other. Which cranial nerve is likely affected?
a) Cranial nerve IX
b) Cranial nerve X
c) Cranial nerve XII
d) Cranial nerve V

A

b) Cranial nerve X

43
Q

A patient presents with a cough that lacks an explosive start and sounds like a hiss of air. Which cranial nerves are likely affected?
a) Cranial nerves III and IV
b) Cranial nerves IX and X
c) Cranial nerves XI and XII
d) Cranial nerves V and VII

A

b) Cranial nerves IX and X

44
Q

Which of the following is a warning sign of possible cranial nerve damage affecting swallowing?
a) Symmetrical elevation of arches and uvula
b) A vigorous and explosive cough
c) Absence of the gag reflex
d) Ability to swallow a small sip of water without coughing

A

c) Absence of the gag reflex

45
Q

Which of the following is a normal finding during examination of the throat?
a) Deviation of the uvula towards one side
b) Asymmetrical elevation of the arches and uvula
c) Absence of the gag reflex
d) A weak and ineffective cough

A

b) Asymmetrical elevation of the arches and uvula

46
Q

A 45-year-old patient presents with a complaint of difficulty speaking and swallowing. Upon examination, you notice wasting of the tongue on the left side, along with fasciculations. When the patient sticks out their tongue, it deviates towards the right side. Which of the following muscles is most likely affected?
a) Genioglossus
b) Hyoglossus
c) Styloglossus
d) Palatoglossus

A

A

47
Q

During a neurological examination, a 35-year-old female patient is asked to protrude her tongue and rapidly move it from side to side and up and down by saying “la la la la” rapidly. The movements of the tongue are smooth and coordinated. Which of the following findings would be considered abnormal?
A) Tongue wasting
B) Fasciculations on the tongue
C) Slow and stiff tongue movements
D) Tongue deviation when stuck out

A

c

CLINICAL SKILLS (5 decks)

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