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Neurology - step > cranial nerves > Flashcards

cranial nerves Flashcards

1
Q

what does the pineal gland do

A

melatonin, circadian rhythym

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2
Q

what is the superior colliculi for

A

vision

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3
Q

what is the inferior colliculi for

A

hearing (superior olive and MGN in thalamus)

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4
Q

what is parinaud syndrome

A

paralysis of conjugate vertical gaze due to lesions in superior colliculi

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5
Q

what causes paralysis of conjugate vertical gaze

A

stroke, hydrocephalus, pinealoma affecting the superior colliculi
parinaud syndrome

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6
Q

where are the cranial nerve nuclie located

A

in the tegmentum of the brainstem ie between dorsal and ventra postions

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7
Q

describe tne location of sensory vrs motor cranial never nuclei in the brain stem

A

alar plate/lateral nuclei - sensory SULCUS limitans - medial nucles - motor slash basal plate
lateral alar in bs to dorsal in spc SENSORY
medial basal in bs to ventral in spc MOTOR

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8
Q

what cranial nerve nuclei are in the midbrain

A

CN III IV

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9
Q

what crinal nerve nucle are in the pons

A

CN V, VI VII VIII

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10
Q

what cranial nerve nuclei are in the medulla

A

CN IX, X XII

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11
Q

where is cranial nere nucle of XI

A

spinal cord

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12
Q

name the CN: exits via cribiform plate

A

CN I

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13
Q

name the CN: exits via optical canal

A

CN II, ophthalmic artery, central retinal vein

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14
Q

name the CN: exits via superior orbital fissure

A

CN III, IV, VI, V1, ophthalmic vein, sympathetic fibres

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15
Q

name the CN: exits fia foramen rotundum

A

V2

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16
Q

name the CN: exits via foramen ovale

A

V3

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17
Q

name the CN: exits via foramen spinosum

A

jk, tis an artery - middle meningeal

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18
Q

name the CN: internal auditory meatus

A

CN VII and VIII

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19
Q

name the CN: jugular foramen

A

CN IX, X, XI and jugular vein

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20
Q

name the CN: hypoglossal canal

A

CN XII

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21
Q

name the CN: foramen magnum

A

spinal roots of Cn XI and brain stem and vertebral arteries

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22
Q

list if each CN is motor, sensory or mixed

A 
CN I - sensory
CN II - sensory
CN III - motor
CN IV - motor
CN V - both
CN VI - motor
CN VII - both
CN VIII - sensory
CN IX - both
CN X - both
CN XI - motor
CN XII - motor
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23
Q

what is the only sensory modalitit to not go thorugh the thalamus

A

olfactory CNI

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24
Q

what does CN III do

A

EOM movements SR IR IO MR
pupillary constriction via sphincter pupillae, edinger westphal nucles and muscarinic receptors
accommodation
eyelid opening - levator palpebrae

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25
Q

mastication

A

CN V3

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26
Q

functions of CN VII

A 
facila movement
tast from anterior 2/3 tongue
lacrimation
salviation ( not parotid,  just passes thorugh)
eyelid closing
stapedius im ear
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27
Q

salciation fo parotid gland

A

CN IX

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28
Q

muscle work of CN IX

A

stylopharyngeus - elevates pharynx and larnx

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29
Q

what are the three nuclei of the vaus nerve

A

nucleus solitaries
nucleas ambiguous
dorsal motor nucleus

30
Q

what is the function of the nucleus solitarious

A

visceral sensory information - taste, baroreceptors, gut distenstion
VII, IX X

31
Q

what is the function of the nucleus ambiguus

A

motor innervation of pharynx, larynx, upper esophagus - swallowing and palate elecvation
IX X XI (cranial portion)

32
Q

what is the function of the dorsal motor ucleus

A

autonomic/parasympathetic fibres to heart lungs upper GI

X

33
Q

name the CN associated with the nucleus solitarious

A

visceral sensory for taste VII, baroreceptors IX and gut distension X

34
Q

name the CN associated with the nucleus ambiggus

A

motor of pharynx, larynx and upper eosphagis

IX and X

35
Q

name the Cn associated with the dorsal motor nucleus

A

parasyma to heart, lung , gut

X

36
Q

describe the CN involved in: the corneal reflex

A

afferent V1 ophthalmic nasociliary branch

efferent VII - temporal branch to oribtalis oculi

37
Q

describe the CN involved in: lacrimation

A

afferent V1
efferent VII
loss of reflex does not preclude emotional tears

38
Q

describe the CN involved in: jaw jer

A

afferent V3 sensory muscle spindle

effecrent V3 masseter

39
Q

describe the CN involved in: pupillary reflex

A

afferent CN II

efferenet CN III

40
Q

describe the CN involved in: gag reflex

A

afferent IX

efferent X

41
Q

what happens when CN V is lesioned

A

jaw deviates TOWARDS side of lesion due to unopposed force from the opposite pterygoid

42
Q

what happens when CN X is lesioned

A

uvula deviates AWAY from side of lesion - weak side collapses and uvula points away

43
Q

what happens when CN XI is lesioned

A

weakness turning head away from lesion - shoulder dropp on side of lesion
(left SCm helps turn head to the right)
feel your own SCM to help with this

44
Q

CN XII lesion

A

tongue deviates towards side of lesion

LICK YORU WOUNDS due to weakened tongue muscles on affected side

45
Q

what is the cavernous sinus

A

collection of venous sinuses on either side fo the pituitary

receives blood from eye and superficial cortex that then drains through the cavernous sinus to the internal jugular vein

46
Q

what CN are int eh cavernous sinus

A

those that pass through the superior orbital fissure
CN III, IV, VI, V1 and sometimes V2 and post ganglionic sympathetic fibres
carvernous portion fo internal carotid as well

47
Q

describe cavernous sinus syndrome

A

presents with variable ophthalmoplegia
decrased corneal sensation
horner syndrome
occasional decreased maxiallary sensation

48
Q

what causes cavernous sinus syndrome

A

secondary to pituitary tumor mass effect, carotid-cavernous fistula, cavernous sinus thrombosis related to infection

49
Q

which CN is most susceptible to damage in cavernous sinus ysndrome

A

CN VI

50
Q

variable opthalmoplegia (usually VI)
decreased corneal sensation
horner syndrome
occasional descreased maxillary sensation

A

cavernous sinus syndrome
pituitary tumor mass effect
carotid cavernous fistula
cavernous sinus thrombosis

51
Q

whatst the role o the outer ear

A

transfers sounds waves via vibration of the eardrum

52
Q

what constitutes the outer ear

A

visible portion of ear/pinna the auditory canal and eardrum

53
Q

whats the roel of the middle ear

A

ossciles conduct and amplify soundfrom eardrum to inner ear

54
Q

what constitutes the middle ear

A

air filled space with three boens called the osciels - malleus, incus, stapes

55
Q

what is the inner ear

A

snail shaped fluid filled cochlea that contains the basila membrane that vibrates secondary to sound waves = transduced by specialized hair cells to the breain stem

56
Q

describe the tonotopy of the basilar membrane

A

helicotrema - low frequency - wide and flexible

base - high frequency - thin and rigid

57
Q

describe hearing loss in elderly

A

high frequency at the thin and rigid base of the cochlea

58
Q

describe test results in conductive hearing loss

A

weber - will localize to affected ear

rhinnes - bone > air

59
Q

describe test results in sensorineural hearing loss

A

weber - will localize to unaffected ear

rhinnes - air > bone ie normal

60
Q

describe hoice induced hearing loss

A

damage to stereociliated cells in the organ of corti; loss of high frequency hearint first (at base)

sudden extremely loud noiss can produce hearing loss due to tympanic membrane rupture

61
Q

what is a cholesteatoma

A

overgrowth of desquamated keratin debris in the middle ear space

62
Q

who cares about chlesteatoma

A

overgrowth of desquamated keratin debris in the middle ear space may erode the ossicles, mastoid air cells elading to conductive hearing loss

63
Q

describe an UMN of the facial nerve

A

will see contralateral lower face
no effect on ipsi face or upper contralateral face

tis a lesion between the motor cortex and the facial nucleus

64
Q

describe a LMN of the facial nerve

A

will see contralateral lower and upper face paralysis

65
Q

what is facial nerve palsy

A

complete destruction of the facial nucleus itself or its branchial efferent fibres - the facial nerve proper

66
Q

describe clinical presentation of facial nerve palsy

A

peripheral ipsilateral facial paralysis - absent forehead creases and dropping smile with inability to close eye on involve side

67
Q

what is bell palsy

A

idiopathic facial nerve palsy - gradual recovery in most cases

68
Q

what diseases are associated with facial nerve plasies

A 
LYME DISEASE ~*~*
herpes simplex
herpes zoster (RAMSEY HUNT SYNDROME)
sarcoidosis 
tumors 
diabetes
69
Q

how to treat facial nerve pals

A

corticosteroids

70
Q 
what are these?
lyme disease
herpes simplex
herpes zoster
diametes
tumor
sarcoidosis
A

conditions associated with facial nerve palsy

71
Q

what are the mastication muscles

A 
OPEN JAW:
masseter
temporalis
medial pterygoid 
CLOSE JAW:
lateral pterygoind
''it takes more muscles to keep your mouth shut''

Neurology - step (10 decks)

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