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NEURO > cranial nerves > Flashcards

cranial nerves Flashcards

1
Q

role of CN II

A

Vision and direct pupillary light reflex

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2
Q

lesion in CNII

A

Blindness, loss of direct pupillary light reflex

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3
Q

role of trochlear IV

A

superior oblique, intorts eye and rotates down and out

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4
Q

lesion in CN IV

A

cant look at their nose

weakness of down gaze

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5
Q

role of CN III/Oculomotor

A 
medial rectus
inferior oblique
inferior rectus
superior rectus
LPS
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6
Q

lesion in CN III

A

dialted fixed pupil
ptosis
ipsilateral gaze fixed
DOWN and OUT

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7
Q

Role of CN V tirgeminal

A

opthalmic
maxillary
mandibular

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8
Q

lesion in CN V

A

loss of sensation in the face, eyes, nose and mouth

loss of corneal reflex

deviation of the jaw to the ipsilateral side

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9
Q

role of CN VI abducens

A

lateral rectus

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10
Q

lesion of CN VI

A

esotropia

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11
Q

role of VII facial

A

facial movement, taste, lacrimation, salivation

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12
Q

lesion of CN VII

A

facial palsy
loss of blink
loss of taste from the anterior 2/3 of the tongue

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13
Q

role of CNVIII vestibulocochlear

A

balance
Hallpike -> BPPV
unterberger

hearing
rinne’s and weber’s

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14
Q

lesion of CN VIII

A

vertigo, tinnitus, and deafness

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15
Q

role of CN IX, glossopharyngeal

A

taste
salivation
swallowing

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16
Q

lesion of CN IX

A

Loss of pharyngeal and gag reflex

loss of taste from posterior third of tongue

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17
Q

role of CN X- vagus

A

larynx and swallowing

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18
Q

lesion of CN X

A

dysarthria
- deviation away from side of lesion
- 􏰇 Lesions of recurrent laryngeal branch cause ipsilateral vocal cord
paralysis with dysphonia and a weak cough.
􏰇 Parasympathetic autonomic fibres travel in the vagus nerve to the
respiratory, GI, and cardiovascular systems.

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19
Q

role of CN XI - accessory

A

larynx and muscle in the neck

20
Q

lesion of CN XI

A

difficulty in turning the neck

drooping shoulder

21
Q

CN XII role hypoglossal

A

tongue movement

22
Q

lesion of CN XII

A

ipsilateral tongue paralysis

23
Q

causes if CNIII palsy/ oculomotor nerve palsy

A
  • diabetes mellitus
  • vasculitis e.g. temporal arteritis, SLE
  • false localizing sign* due to uncal herniation through tentorium if raised ICP
  • posterior communicating artery aneurysm
    — pupil dilated
    — often associated pain
  • cavernous sinus thrombosis
  • Weber’s syndrome: ipsilateral third nerve palsy with contralateral hemiplegia -caused by midbrain strokes
    other possible causes:
  • amyloid, multiple sclerosis
24
Q

Causes of anosmia

A

viral infections
head injury
IPD
alzheimers

  • > refsum
  • > olfactory groove meningioma
  • > superficial siderosis
  • > kallman’s syndrome (anosmia + hypogonadism + X-linked recessive)
  • > paraneoplastic disorders
  • > Sjogrens
25
Q

monocular field defect

A

ocular, retinal, or optic nerve disorders.

26
Q

cosntricted fields

A

glaucoma

chronic pailloedema

27
Q

homonymous hemianopia

site of lesion

aetiology

A

optic tract
optic radiation
occipital lobe

stroke
tumour

28
Q

junctional scotoma

site of lesion

aetiology

A

junction of optic nerve and chiasm

tumour

29
Q

tonic pupil (Adie’s)

test

A

Dilated pupil constricts slowly to accommodation.

Unreactive to light but will constrict on prolonged and intense illumination. Vermiform movements visible on slit lamp

generalised areflexia

0.125% pilocarpine constricts pupil

30
Q

monocular diplopia causes

A 
refractive error 
cataract
media opacity
macular disease
visual cortex disorder
31
Q

horizontal diplopia causes

A

weakness of medial rectus or lateral rectus

32
Q

what is jerk nysatgmus

A

eye followed by a corrective fast phase

33
Q

what is peripheral nystagmus

A

Unidirectional fast phase beating away from affected labyrinth
Associated with severe vertigo, vomiting, nausea
Amplitude increases with gaze towards the direction of the fast phase
Various components—horizontal, torsional, vertical
Suppressed by fixation (Fresnel goggles remove fixation)

34
Q

central vestibular nystagmus

A

Uni- or multidirectional

Mild symptoms. Other neurological signs, e.g. disconjugate eye movements, pyramidal signs

May be gaze-evoked

No change with fixation

35
Q

what is downbeat nystagmus

A
  • present in the primary position
  • accentuated on lateral gaze
    due to distrubance of vestibulocerbellum cause by arnold-chiari malformation, cerebellar degeneration
36
Q

upbeat nystagmus

A
  • present in primary position
  • due to lesion in the tegmental grey matter of brainstem
  • causes - MS, vascular, cerebellar degeneration
37
Q

CNVIIII glossopharyngeal

A

􏰇 Taste fibres from posterior third of the tongue.
􏰇 General sensation tympanic membrane, mucous membranes from
posterior pharynx, tonsils, and soft palate.
􏰇 Afferent part of the gag reflex.

38
Q

what type of lesion is required to witness significant dysarthria

A

bilateral lesion

39
Q

what is pseudobulbar palsy

A

disruption of both the right and left corticobulbar fibres supplying the motor nuclei of the brainstem

results in a spasti. dysartria, slow facial movements, emotional lability due to the loss of the connections from the frontal cortec to the brainstem that suppress emotional output

facial, palatal and jaw reflexes are brisk

40
Q

causes of bilateral UMN causinf dysarthria

A 
MS
MND
Bilateral subcortical ischaemic lesions/stroke
progressive supranuclea palsy
central pontine myelinolysis
41
Q

What is bulbar palsy

A

LMN lesions from damage to the motor nuclei of the 7, 10, 12

speech is slurred, indistinct, labial and lingual sounds are affected

nasal quality due to soft palate
nasal regurgitation with choking and aspiration

tongue wasted and may fasciculate

absent gag reflex, hoarse voice weak cough

42
Q

causes of LMN lesions causing bulbar palsy

A 
GBS
MND
Medullary tumours
syringobulbia
subacute/chronic infective
poliomyelitis
43
Q

speech in parkinsons

A

low volume monotonous trails off

festinating gait

44
Q

speech in chorea

A

hyperkinetis
loud and harsh, intonation is variable
short, breathless sentences

45
Q

speech in athetosis

A

athethoid cerebral palsy
loud and slow
dystonic speech
consonants are indistinctly pronounced

46
Q

what is ataxic dysarthria and causes

A

cerebellar lesions
slow and slurred with abnormal long pauses between syllables
rapid side to side movements of the tpngue

scanning with broken up into syllables

causes
MS
Vascular lesions ie infarcts and haemorrhages
tumours
inherited ataxias - spinocerebellar dysarthrias
alcoholic cerebellar degeneration

NEURO (30 decks)

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