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NMS > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

If you have a lesion in the right optic nerve what loss would you expect?

A

Blindness in right eye

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2
Q

If you have a lesion in the optic chiasm what would you expect the loss to be?

A

Heteronymous bitemporal hemianopia

Tunnel vision/loss of peripheral vision

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3
Q

If you have a lesion in the RIGHT optic tract what loss would you expect?

A

Homonymous contralateral hemianopia

LEFT vision field loss of both eyes

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4
Q

If you had a lesion in the left geniculocalcarine tract what loss would you expect?

A

Homonymous contralateral hemianopia with macula sparing

RIGHT visual field loss of both eyes with macula not lost

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5
Q

Exams that test CN 2?

A
  • visual acuity
  • gross visual field test (AKA: peripheral vision/confrontation)
  • pupillary light reflex
  • swinging flashlight test
  • ophthalmoscopic exam
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6
Q

For the gross visual field test/peripheral vision/confrontation what are the directions and angles that patient should see object?

A

50- superior
60- nasal
70 - inferior
90- lateral

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7
Q

When doing pupillary light reflex and shining light in right eye what cranial nerves in each eye are being tested?

A

Right: CN. 2 & 3
Left: CN 3

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8
Q

What does the swinging flashlight test for?

A

Unilateral disease of afferent CN 2 (on side that causes both pupils to dilate)

(Marcus-Gunn pupils)

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9
Q

What condition areMarcus-Gunn pupils seen in?

A

Optic neuritis

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10
Q

What is Scotoma?

A

A patch of vision loss

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11
Q

What is the likely description of pain coming from the joint?

A

Sharp on motion

Constant

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12
Q

What is the likely descriptor of pain from the nerve

A 
Constant
Burning/hot
Sharp on no motion
Stabbing
Tingling/numbness
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13
Q

What is the description of pain with bone/ligament

A

Deep burning, dull pain

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14
Q

Description of pain from myofascial pain

A

Pinpoint pain over paraspinal tissue

Crawling sensation

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15
Q

Vascular pain description

A

Throbbing

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16
Q

Peripheral pain description

A

Well localized

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17
Q

Central pain description

A

Diffuse

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18
Q

5 relative contraindications

A
  1. Articulate hyper mobility /uncertain stability of joint
  2. Severe demineralization
  3. Benign bone tumors (spine)
  4. Bleeding disorders and anticoagulant therapy
  5. Radiculopathy with progressive neurological signs
19
Q

What is an absolute contraindication for cervical spinal manipulations

A

Vertebrobasilar insufficiency syndrome

20
Q

Area of pain with facet irritation of c2/3

A

Right lateral and posterior neck

21
Q

Area of pain in facet irritation pattern of c3/4

A

Left lateral and posterior neck to base of shoulder

22
Q

Area of pain in irritation of facets at c4/5

A

Right lateral and posterior bottom of neck and mid shoulder

23
Q

Area of pain in facet irritation of c5/6

A

Left posterior shoulder and above scapula

24
Q

Area of pain in irritation of facets c6/7

A

Right posterior shoulder and mid scapular region

25
Q

Order of diagnostic procedure

A

Obtain patient history
Develop working hypothesis
Select tests to confirm or refute hypothesis

26
Q

Sensitivity

A

Proportion of those with a positive test that will have the condition

SnNOut

27
Q

What does a positive test in regards to sensativity mean

A

SnNout

Positive result: may have condition—may not

High sensitivity, a negative test rules out the condition

28
Q

Negative test-sensativity

A

SnNout

Highly sensitive—negative test rules condidtion out

29
Q

Specificity

A

Proportion of patients with a negative test that do not have the condition

30
Q

Positive test-specificity

A

SpPIn

Highly specific-positive has condition

31
Q

Negative test-specificity

A

Negative-still might have the condidtion

32
Q

Highly sensitive meaning

A

Will catch all of the people who has the condition, but will catch people who don’t have the condition

33
Q

Highly specific meaning

A

All the positive tests are for sure positive, but might not catch all the people who have the condition

34
Q

Interpreting likelihood ratios:

>10

A

Large, conclusive shift

35
Q

Negative likelihood ratio of X

A

Large conclusive shift

36
Q

Likelihood ratio of 1-2

A

Small, not important

37
Q

Test clusters

A

Each test individually may have a lower LR but when multiple tests for same result combined, LR increases

38
Q

What is myelopathy

A

Spinal cord pathology

39
Q

Initial evaluation for strain/rupture

A

Active resistance

40
Q

Initial evaluation for tendinitis/tendonosis

A

Stretch and contraction

41
Q

Initial evaluation for tendon rupture

A

Lack of passive tension

42
Q

Initial test for sprain or rupture (ligament)

A

Stability testing

43
Q

Initial evaluation for synovitis

A

Capsular pattern of restriction

NMS (12 decks)

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