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(Finals) OSCE > Cranial Nerves > Flashcards

Cranial Nerves Flashcards

1
Q

CN1.

A

Olfactory

  • Q. symptoms
  • scent markers
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2
Q

CN2.

A 
Optic
-visual acuity
-visual fields
-visual inattention
-accomidation
-pupilarly reflex direct and consensual
(-colour vision/ishihara plates)
(-fundoscopy)
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3
Q

CN3.

A

Occulomotor
TEST: H shape tracking- double vision
Palsy: visible strabismus, double vision in most directions, down and out. ptosis.

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4
Q

CN4.

A

Throchlea
H shape tracking- double vision
Palsy: Vertical double vision, tilting of head, unable to look down and it (convergence)

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5
Q

CN5.

A

Trigeminal
TEST: soft touch forehead, cheek and jawline
Clench jaw, open mouth against resistance
(-corneal reflex)
(-jaw jerk)

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6
Q

CN6.

A

Abducens
H shape tracking- double vision
convergent squint on distance vision, unable to abductt

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7
Q

CN7.

A

Facial

  • raise eybrows
  • close eyes
  • puff out cheecks
  • smile show teeth
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8
Q

CN8

A

Vestibulocochlear
-whisper
-rinnes
webber

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9
Q

CN9

A

Glossopharengeal
(-gag reflex)
any changes to your sense of taste?

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10
Q

CN10

A

Vagal

  • open your mouth and say ahh (deviation uvula)
  • give me a cough
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11
Q

CN 11

A

Accessory

  • shrug shoulders against resistance
  • turn head, sternocleinomastoid, against resistance
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12
Q

CN 12

A

Hypoglossal

  • stick your tongue out
  • leave it there for a while (fasciculations)
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13
Q

Noticeable stabismus (cock eye) with double vision (side by side) in most directions and eye rests down and out

A

Cranial Nerve 3
Occulomotor nerve palsy (if pupils fixed surgical cause, if pupil spared medical cause)

(congenital / diabetes / posterior communicating artery occlusion/ infection / inflammation/ tumour / MG/ MS/ Cavernous sinus thrombosis / iatrogenic)

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14
Q

vertical plain diplopia, patient unable to converge eyes and tilts head to focus

A

Fourth nerve / trochlear palsy

longest intracranial and thinnest nerve, traumatic damage common. congenital

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15
Q

Convergent squint and unable to look outward on affected side, diploplia on transverse gaze.

A

6th nerve / abducens/ palsy

Early sign of raised ICP

vasculopathic (giant cell arteritis /cavernous sinus mass / multiple sclerosis, sarcoidosis/vasculitis, postmyelography/ lumbar puncture, stroke /Chiari Malformation, hydrocephalus, tuberculosis meningitis)

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16
Q

Altered sensation in the face, weakness of jaw muscles

A

Trigeminal (5th) nerve palsy

tumour
aneurysm
chronic meningitis
a lesion of the trigeminal ganglion:(acoustic neuroma meningioma)
fracture of the middle fossa
a lesion in the cavernous sinus
17
Q

Hemifacial paresis

A

7th /Facial/ palsy

Bells palsy (idiopathic) most common, often spares forehead. 
Central causes (stroke, tumour) do not spare forehead. 
other peripheral causes: Ramsay Hunt syndrome (herpes) Lyme disease, petrous bone fractures, chronic meningitis
18
Q

Hearing loss which is louder on air conduction and localises to unaffected side +/- tinnitus

A

Vestibulocochlear (8th) nerve palsy
Sesorineural hearing loss

Neurofibromatosis 2
vestibular schwanoma / acoustic neuroma 
pagets disease of bone
meneires disease 
lead / asprin poisoning
19
Q

Hearing loss which is louder on bone conduction and localises to affected side

A

Conductive hearing loss (infection, foreign body, eardrum damage)

20
Q

Loss of gag reflex unilaterally and altered sense of taste

A

cranial nerve 9 / glossopharyngeal palsy

very rare, normally combined with CNX

21
Q

deviation of uvula, ipsilateral loss of gag reflex and altered voice

A

Vagal nerve palsy

rare in isolation, can be severed surgically

22
Q

Loss of gag reflex, swallowing difficulties, strangled cough hoarse voice, wasted fasiculating tongue

A

Bulbar palsy (pseudobulbar palsy)

Lesion in cranial nerve motor nuclei
(supranuclear lesion affecting lower CN nerves -will have other symptoms too)

Causes: polio / MND / vascular insufficiency / brain stem tumour

23
Q

weak shoulder shrug and head turn

A

11th / accessory nerve palsy

commonly injured during surgery to the neck

24
Q

MN symptoms in tongue

wasting /tongue deviation /flacid /fasiculations /spastic

A

12th / hypoglossal/ palsy

Extremely rare in isolation

(Finals) OSCE (8 decks)

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