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Year 3 Examination > Cranial nerves > Flashcards

Cranial nerves Flashcards

1
Q

What questions do you ask before testing smell?

A

Have you noticed any changes in your sense of smell?

Have you had a blocked nose?

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2
Q

Causes of unilateral anosmia

A

Head trauma
tumour
nasal polpys

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3
Q

Causes of nasal polpys

A

Allergic rhinitis

CF

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4
Q

Causes of bilateral anosmia

A

Neurodegenerative e.g. parkinsons and alzhiemers disease
URTI
Kallman’s
Tumour

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5
Q

Give the name of a nose tumour

A

Subfrontal meningioma

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6
Q

What do you do when you inspect the eye?

A

Size
Shape
Symmetry

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7
Q

What do you call a dliated pupil?

A

Mydriasis

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8
Q

What is another name for exopthalmos?

A

Proptosis

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9
Q

Anisocoria

A

Assymetrical eyes

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10
Q

What’s the mnemonic for testing eyes?

A 
A acuity
F fields
R reflexes
O opthalmoscopy
C colour vision
A attention
B blind spot
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11
Q

How do you write up the snellen?

A

Distance from chart over lowest line number read + how many letters in the line you read e.g. if 2

e.g. 6/4

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12
Q

What happens if the patient can’t see anything on the snellen chart?

A

Reduce distance from 3m to 1m

If still not seen, ask pt to

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13
Q

Wat may cause decreased visual acuity?

A 
Myopia - near sightedness
Hyperopia - long sightedness
Presbyopia 
Astigmatism 
Ambylopia - lazy eye 
Cataracts 
Age related macular degenration
Optic neuritis
Lesions
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14
Q

How far must you be to do visual fields?

A

1m

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15
Q

What is the

A

homonymous hemianopia

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16
Q

what is the quarter vision called?

A

superior homonymous h

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17
Q

What are the two types of reflexes for the eye?

A

pupillary

accommodation reflex

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18
Q

What do you ask about after doing these

A

double vision or pain?

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19
Q

What would cause constriction of the eye? Myosis

A

Opiod overdose

Horners (sympathetic is affected)

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20
Q

What would cause dilation of the eye? Mydriasis

A

3 nerve palsy

Tropicamide

21
Q

What do you do to test for attention?

A

Put both fingers out and ask which one wiggles

22
Q

How do you test the blind spot?

A

Use the red pin

23
Q

Which of the AFROCAB would you offer to do?

A

Acuity
Opthalmoscopy
Colour vision
Blindspot

24
Q

How would you test for CN 3, 4 and 6 and what would you say?

A

Exaggerated H test (go all our, extend your arms)

Keep your head in the same position and only move your eyes

25
Q

When you go up, what must you do?

A

Tilt finger side ways when going up and down in the H test

26
Q

When you’re testing the eye, looking at the eye coming inwards (down and also up), which muscles are involved?

A

Oblique

27
Q

Where does the eye look in fourth nerve palsy?

A

Eye looks up and in

28
Q

Where does the eye look in sixth nerve palsy?

A

Eye looks medially

29
Q

What might cause 3rd nerve palsy?

A

Diabetes
Trauma
Surgery
Tumour

30
Q

Which eye conditions might come up in the OSCE?

A

Bitemporal
homonymous
Optic neuritis

31
Q

How do you test cranial nerve 5?

A 
Fine touch, sensation
Pinprick 
Assess temporalis and masseter
Try to open jaw against reflex 
Jaw jerk reflex (tap against the jaw like a knee reflex)
Corneal
32
Q

How would you test the motor and sensory

A 
Raise eyebrows
Screw up eyes
Puff out cheeks
Show gums (smile)
Any change in taste?
Troubled by loud noises?
33
Q

Differentials for

A

Ramsey Hunt - shingles

34
Q

If forehead does wrinkle, what does it suggest?

A

Upper motor neuron

35
Q

If forehead is not spared, what do we think?

A

Lower motor neuron

36
Q

How do you test for the sensory and motor

A

Lower motor neuron facial nerve

Right sided facial weakness and numbness
Incomplete eye closure
Loss of brow movement
Loss of smile and lip pucker 
Mouth drooping
37
Q

Look up teh rest of teh conditions which cause ear problems

A

???????????

38
Q

If the ear pain lateralises to the right, what can it be?

A

Right conductive, or left sensorineural

39
Q

Pelvic pain plus hearing loss

A

Bone remodelling disorder which can cause ear problems

40
Q

How do you test for CN 10?

A

Uvula

sensory = 9

41
Q

How do you test CN 12?

A

Ask pt to move tongue side to side

42
Q

UMN lesion

A

corticobulbar supply is affected

43
Q

What are the symptoms of pseudobulbar palsy?

A

Spasticity
Hyperreflexia
Expressionless face
Donald duck high pitched speech

44
Q

Bulbar palsy is upper or lower MN?

A

Lower motor neuron lesion

45
Q

Symptoms of bulbar palsy

A 
Hypo-gag and jaw jerk reflexia
Fasciculations
Wasting
Normal fascial expressions
Nasal speech
46
Q

Is pseudobulbar due to an upper motor or lower motor lesion? Which supply is affected?

A

corticobulbar supply is affected

UMN lesion

47
Q

Which cranial nerves are affected in pseudobulbar palsy?

A

5, 7, 9, 10, 11, 12

48
Q

What can cause lower motor neuron problems?

A

Guillian barre
Myasthenia gravis
Motor neuron disease

Year 3 Examination (8 decks)

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