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Neuro > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

What are the 12 cranial nerves?

A

Olfactory, Optic, Oculomotor, Trochlear, Trigeminal, Abducent, Facial, Vestibulocochlear, Glossopharyngeal, Vagus, Accessory and Hypoglossal

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2
Q

What does the glossopharyngeal nerve innervate?

A

Sensory - posterior tongue, tonsil and pharynx
Motor - pharyngeal musculature

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3
Q

What does the vagus nerve innervate?

A

Motor - heart, lungs, bronchi, GI tract
Sensory - Heart, lungs, bronchi, trachea, larynx, pharynx, GI tract and external ear

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4
Q

What does accessory nerve innervate?

A

SCM and trapezius muscle

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5
Q

What are the special senses of cranial nerves?

A

Olfactory - CNI
Vision - CNII
Taste - VII, IX, X
Hearing - VIII

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6
Q

What nerves cause ordinary sensation?

A

Mainly Vth - trigeminal
Ear - VII and IX

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7
Q

What nerves control muscle activity?

A

Eye muscles - III, IV and VI
Mastication - V
Facial expression - VII
Larynx and pharynx - mainly X
SCM and trapezius - XI

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8
Q

What nerve causes lacrimation?

A

Flow of tears - VII

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9
Q

What nerves cause salivation?

A

Submandibular and sublingual - VII
Parotid gland - IX

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10
Q

What nerve causes autonomic functions to organs in thorax and abdomen - parasympathetic?

A

Vagus - X

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11
Q

How do we test CN I?

A

Smell kit
Can be unilateral or bilateral loss
Usually presents in history

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12
Q

How do we test CN II?

A

Visual acuity, visual fields, pupillary reactions, fundoscopy and colour vision

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13
Q

How do we test CN III, IV and VI?

A

Ptosis, pupillary reflex, eye movements (H formation)
Ask for diplopia

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14
Q

How do we test CN V?

A

Sensation in ophthalmic, maxillary and mandibular divisions
Power of muscles of mastication, corneal reflex, and jaw jerk

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15
Q

How do we test CN VII?

A

Muscles of facial expression, corneal reflex for efferent pathway and sense of taste

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16
Q

How do we test CN VIII?

A

Hearing using Rinne’s and Weber’s tests
Vestibular function using Dix-Hallpike manoeuvre and Untenberger’s test

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17
Q

How do we test CN IX and X?

A

Movement of the palate, gag reflex, quality of speech and quality of cough

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18
Q

How do we test CN XI?

A

Head turning and shoulder shrugging

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19
Q

How do we test CN XII?

A

Appearance, movement and power of the tongue

20
Q

What cranial nerves are involved in the pupillary light reflex?

A

Afferent - II
Efferent - III

21
Q

What cranial nerves are involved in the corneal reflex?

A

Afferent - V
Efferent - VII

22
Q

What cranial nerve is involved in the jaw jerk reflex?

A

Afferent and efferent - V

23
Q

What cranial nerves are involved in the gag reflex?

A

Afferent - IX
Efferent - X

24
Q

Where is the location of the cranial nerve nuclei?

A

III + IV - Midbrain
V, VI + VII - Pons
VIII - Pontomedullary junction
IX, X, XI + XII - Medulla

25
Q

What combination of cranial nerves can show superior orbital fissure affected?

A

III, IV and VI

26
Q

What combination of cranial nerves can show cerebellopontine angle affected?

A

V and VIII

27
Q

How can cranial nerves become damaged?

A

Within the brain - ischemia or tumour
Crossing subarachnoid space - meningitis
Outside of skull - Base of skull tumours arising in nasopharynx

28
Q

Describe optic neuritis

A

Inflammation of optic nerve - demyelination
Monocular visual loss, pain on eye movement, reduced visual acuity + colour vision, optic disc can be swollen
Often associated with MS

29
Q

What is the parasympathetic pupillary response?

A

Constriction of pupil
Loss of this - results in fixed dilated pupil
Ex. complete CN III palsy

30
Q

What is the sympathetic pupillary response?

A

Pupillary dilatation
Damage anywhere within the sympathetic pathway can lead to constricted pupil

31
Q

What are come causes of dilated pupils?

A

Youth, dim lighting, anxiety, excitement, mydriatic eye drops, amphetamine, cocaine overdose, CN III palsy and brain death

32
Q

What are some causes of constricted pupils?

A

Old age, bright light, miotic eye drops, opiate overdose and Horner’s syndrome

33
Q

What are some eye movement disorders?

A

Isolated CN III palsy, VI palsy, VI palsy
Combination of above
Supranuclear gaze palsy
Nystagmus

34
Q

What are the 2 causes of isolated third nerve palsy?

A

Microvascular - diabetes, hypertension
Compressive - posterior communicating artery aneurysm and raised ICP

35
Q

What are symptoms of microvascular and compressive third nerve palsy?

A

Painless and pupil spared - microvascular
Painful (headache) and pupil affected - compressive

36
Q

What are some cause of isolated sixth nerve palsy?

A

Idiopathic, diabetes, meningitis, and raised ICP

37
Q

What are some causes for nystagmus?

A

Congenital, serious visual impairment, peripheral vestibular problem, central vestibular/ brainstem disease, cerebellar disease and toxins (alcohol and meds)

38
Q

Describe trigeminal neuralgia

A

Paroxysmal attacks of lancinating pain in face
Triggers are chewing, speaking, cold air
Middle age and older
Caused by vascular loop which compresses CN V in posterior fossa

39
Q

What is the treatment for trigeminal neuralgia?

A

Medically - carbamazepine and other antiepileptic medication
Surgical - if medication resistant

40
Q

Describe Bell’s palsy

A

Idiopathic facial nerve palsy
Unilateral facial weakness, LMN type, can have pain behind ear, eye closure, risk of corneal damage
Treated with steroids

41
Q

What is the difference between UMN and LMN facial paralysis?

A

UMN - caused by stroke or tumour. Involves forehead
LMN - caused by bell’s palsy, lyme, sarcoid. No involvement of forehead

42
Q

Describe vestibular neuronitis

A

Sudden onset disabling vertigo
Vomiting
Gradual recovery
Cause is uncertain - viral

43
Q

What is bulbar and pseudobulbar palsy?

A

Bulbar - LMN
Pseudobulbar - UPM

44
Q

Describe pseudobulbar palsy

A

Bilateral UMN lesions - internal capsule, MND
Symptoms - dysarthria, dysphonia, dysphagia, spastic immobile tongue, brisk jaw jerk and gag reflex

45
Q

Describe bulbar palsy

A

Bilateral LMN lesions affecting IX - XII - MND, polio, tumour, vascular lesion of medulla and syphilis
Symptoms - wasting, dysarthria, dysphagia, dysphonia

Neuro (40 decks)

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