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Year 2 Neuro > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

What are the 12 cranial nerves

A

Olfactory
Optic
Oculomotor
Trochlear
Trigeminal
Abducens
Facial
Vestibulocochlear
Glossopharyngeal
Vagus
Accessory
Hypoglossal

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2
Q

What are the Four main functions of the Cranial Nerves

A

“special” senses
“ordinary” senses
Control of muscle activity
Autonomic functions

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3
Q

What Nerves are responsible for special senses

A

Olfaction (I)
Vision (II)
Taste (VII, IX, X)
Hearing - and balance (VIII)

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4
Q

What nerves are responsible for ordinary sensation

A

Mainly Trigeminal Nerve
Area around ear (facial, glossopharyngeal nerves)

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5
Q

what nerves Control of Muscle activity

A

Eye muscles (III,IV,VI: SO4,LR6 rest 3)
Muscle of mastication - V trigeminal
Muscles of facial expression - VII facial
Muscles of larynx and pharynx - mainly vagus X
Sternomastoid and trapezius muscles - XI accessory
IX
XII - intrinsic and extrinsic muscles of tongue

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6
Q

what are the Autonomic functions (all parasympathetic) and the nerves that supply them

A

pupillary constriction (oculomotor)
Lacrimation (facial)
Salivation - submandibular and sublingual - facial VII
Salivation - Parotid gland - IX glossopharyngeal
Vagal (x) input to organs in thorax and abdomen

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7
Q

How to test Olfactory?

A

Smell test: unilateral/bilateral

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8
Q

How to test optic nerves

A

Visual acuity
visual fields
pupillary reactions
fundoscopy
colour vision

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9
Q

How to test III,IV,VI

A

looking at occulomotor, trochlear, abduncence
look for evidence of Ptosis (drooping eyelid)
pupil of equal size
pupillary reactions
Eye movements: vertical and horizontal (H)

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10
Q

How do we test trigmeninal nerve

A

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

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11
Q

How do we test the facial nerve

A

Muscle of facial expression
corneal reflex
Taste

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12
Q

How do we test Vestibulocochlear nerve

A

Hearing: Rhinne and Weber test
Vestibular function: Dix-Hallpike manoerve and Untenberger’s (marching on spot) test

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13
Q

How do we test the Glosopharyngeal and Vagal nerves

A

movement of the palate
Gag reflex
Quality of speech
quality of cough

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14
Q

How do we test the accessory nerve

A

Head turning and shoulder shrugging
(sternocliedomastoid and trapezius function)

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15
Q

How do we test the Hypoglossal nerve

A

Appearance, movement and power of the tongue.

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16
Q

What are the 4 Cranial nerve reflexes

A

Pupillary light reflex
Corneal reflex
jaw jerk
Gag Reflex

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17
Q

What are the afferent and efferent nerves in the pupillary reflex

A

Afferent: Optic (II), Efferent: Oculomotor (III)

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18
Q

What are the afferent and efferent nerves in the corneal reflex

A

Afferent: Trigeminal (V), Efferent: Facial (VII)

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19
Q

What are the afferent and efferent nerves in Jaw Jerk

A

Afferent and Efferent: Trigeminal (V)

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20
Q

What are the afferent and efferent nerves in the Gag reflex

A

Afferent: Glossopharyngeal (IX), Efferent: Vagus (X)

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21
Q

What is the afferent fibres role

A

to bring the sensory information to the CNS.

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22
Q

What is the efferent fibres role

A

To take the motor repsonse to from the CNS to the Limb.

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23
Q

What Cranial nerves nuclei are found in the Mid Brain

A

Occulomotor and Trochlear

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24
Q

Where are the Trochlear and Oculomotor nevre nuclei found

A

Midbrain

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25
Q

Where do the nuclei of the Trigeminal, Abducens, Facial lie

A

Pons

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26
Q

What Cranial nerve nuclei are found in the PONS

A

V, VI, VII (Trigeminal, Abducens, Facial)

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27
Q

What cranial nerve nuclei is found at the pontomedullary junction

A

Vestibulocochlear (VIII)

28
Q

Where is the Vestibulocochlear nuclei found

A

At the Pontomedullary Junction

29
Q

What cranial nerve nuclei lie in the Medulla

A

(IX–XII), Glossopharyngeal, Vagus, Accessory, Hypoglossal)

30
Q

Where do the nuclei of the Glossopharyngeal, Vagus, Accessory, Hypoglossal nerves lie

A

The Medulla

31
Q

What combination of cranial nerves are affected if theres a lesion at the Superior Orbital Fissure

A

III + IV + VI (oculomotor, trochlear, abducens)

32
Q

Where might the lesion be if the VI and VII are affected

A

PONS

33
Q

Where might the lesion be if the V + VIII are affected

A

Cerebellopontine angle

34
Q

If there was Bilateral III signs where might the lesion be

A

Midbrain

35
Q

What would random patterns of affected nerves suggest

A

Chronic or malignant menigitis

36
Q

What would only motor signs (defects) in the face suggest

A

Myasthenia gravis

37
Q

What is Optic Neuritis

A

Demyelination within the Optic Nerve

38
Q

Symptoms and signs of Optic Neuritis

A

Monocular Visual Loss
Pain on eye movement
reduced visual acuity
reduced colour vision
optic disc may be swollen
(associated with Multiple scelorsis

39
Q

What Causes contriction of the pupil

A

Parasympathetic innervation from the oculomotor nerve on the sphincter pupillae

40
Q

What happens to pupillary response with lack of parasympathetic input

A

Results in Fixed Dilated pupil
Due to Complete Third nerve Palsy

41
Q

What causes dilatation of the pupil

A

Sympathetic innervation of the dilator pupillae by the long cilary nerves

42
Q

What does damage of the sympathetic innervation of the eye cause

A

Damage ANYWHERE within sympathetic pathway can lead to constricted pupil.

43
Q

What can cause dilated pupils (III damage/palsy)

A

Youth
Dim lighting
Anxiety, excitement
‘Mydriatic’ eye drops (relax eye muscles)
Amphetamine, cocaine overdose
Third Nerve Palsy
Brain Death
Brain Aneurysm

44
Q

What can cause Constricted Pupils

A

Old Age
Bright light
‘Miotic’ eye drops
Opiate overdose
Horner’s Syndrome

45
Q

What level does the sympathetic innervation arise from the spinal cord and its pathway

A

T1-T2 (synapse 1st -2nd order neurons)
crosses apex of lung
up carotid plexus (synpase (2nd - 3rd order neurons)
Long Ciliary nerve

46
Q

What are types of eye movement disorders

A

Isolated 3rd/4th/6th nerve palsy
combination of the above
Supranuclear Gaze palsy (neurodegenerative disease)
Nystagmus

47
Q

What can cause isolated 3rd nerve palsy

A

Microvascular: Diabetes, Hypertension (painless, pupil spared)
Compressive: Posterior Communicating artery aneurysm (Thunder Clap Headache), raised ICP: painful,Pupil affected

48
Q

What Causes Isolated sixth nerve palsy

A

Idiopathic
Diabetes
meningitis
raised intracranial pressure.

49
Q

What can cause Nystagmus

A

Congenital
Serious Visual impairment
Peripheral vestibular problem
Central vestibular/brainstem disease
Cerebellar disease
Toxins (medications and alcohol)

50
Q

What are signs of trigeminal neuralgia

A

Paroxysmal attacks of lancinating pain
triggers
Onset: middle age +

51
Q

What causes Trigeminal neuralgia

A

Caused by vascular loop: compresses fifth nerve in the posterior fossa (and irritates it)

52
Q

What is the treatment for trigeminal neuralgia

A

Medical: Carbamazepine
Surgical options if medication resistant.

53
Q

What is Bell’s Palsy and its signs/symptoms

A

Idiopathic Facial nerve Palsy
Lower motor neuron type

Unilateral facial weakness
pain behind ear
eye closure affected

54
Q

What are the risks and treatment of Bell’s Palsy

A

Risk of corneal Damage (eye management essential, due to inability to close eye)
Treated with steroids
Usually good recovery

55
Q

What is the difference between UMN and LMN facial palsy and examples

A

UMN (Stroke, tumour), Forehead and eyebrow not involved
LMN (Bell’s palsy, lyme, sarcoid) Forehead and eyebrow involved

56
Q

What are the Characteristics of Vestibular Neuronitis

A

Sudden onset
Disabling Vertigo
Vomiting
Gradual recovery
Uncertain cause? Viral.

57
Q

What is Dysarthia

A

Disordered articulation and slurring of speech

58
Q

What is it called if you have slurred speech

A

Dysarthia

59
Q

What is it called when you have difficulty swallowing

A

Dysphagia

60
Q

What is the difference between Bulbar and pseudobulbar palsy

A

Bulbar palsy: LMN
Pseudobulbar palsy: UMN

61
Q

What is Pseudobulbar Palsy

A

Bilateral UMN lesion (vascular lesions of both internal capsules, MND

62
Q

Pseudobulbar palsy symptoms

A

Dysphagia
Dysphonia
Dysarthia
Spastic, immobile tongue
Brisk Jaw jerk
Brisk Gag relfex

63
Q

What is Bulbar Palsy

A

Bilateral LMN lesions affecting IX-XII
(MND, polio, tumours, vascular lesion of the medulla and syphilis)

64
Q

Signs + symptoms of Bulbar palsy

A

Wasted, fasciculating tongue
dysarthia
dysphonia
dysphagia

65
Q

What is the danger with bulbar and pseudobulbar palsy patients

A

Feeding them, they may aspirate the food and develop pneumonia or LRTI.

Year 2 Neuro (14 decks)

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