Cranial nerves and eyes Flashcards
What does A&Ox3 mean?
alert, oriented to person, space, time
where is speech/fluency apart of in the brain? what’s it called when there’s a speech problem
Broca’s area in frontal cortex
**speech problem= aphasia= word slur
where is comprehension of speech located?
Wernicke’s area along the arcuate fasciculus between parietal and temporal lobes
what is the mini-mental status exam? (MMSE)
emphasize language and orientation.
**less to do w/ executive function and visuo-spatial function
what does CN1 govern? how do you test?
Cn1= olfactory -test= put various smells up to nose and ask pt. what it is with eyes closed
what does CN2 do?
optic nerve–> sensory!
- info sending to the brain via optic nerve–>lesion may be in chiasma and could get hemiaopia
- test with O-scope and VF defects
inability to recognize objects is called what? where’s it in the brain?
- Agnosia
- non-dominant parietal lobe
inability to follow orders is called? where is it at?
apraxia @ frontal lobe
what’s CN3 do? how do we test for lesions?
CN3–oculomotors= motor only!
- MR, IR, SR, IO, levators
- disease= eye down & out with ptosis and eyes dilated (parasymp affected)
what’s CN4 do? how do you test?
Cn4= trochlear n= MOTOR
- somatic SO muscle of the eye
- can ADduct when looking @ nose
- get diplopia and torticollis w/ lesions
what’s CN5 do? how do you test?
trigeminal= sensory AND motor
- corneal reflex test=sensory
- masseter muscle (clench teeth to check and jaw-jerk reflex to check UMN) =motor
what’s CN6 do? how do you test?
CN6= abducens= motor–> LR muscle for looking out
- ABduction–> check EOM’s
- may look ESOtrope if wrong
what’s CN7 do? how do you test?
CN7= facial= Sensory&motor
- motor= expression&lacrimal glands–test= smile w/ teeth to check hemiparesis
- sensory= 2/3 ant. tongue
- *Bell’s Palsy= LMN lesion on IPSI side!
what’s CN8 do? how do you test?
CN8=vestibulocochlear= mother & sensory= hearing
-test with Weber’s and Rinne test
what’s CN9 & CN10 do and how do you test it?
CN9= glossopharyngeal-M/S -motor=parotid gland & pharynx -sensory=carotid body CN10= vagus- M&S -uvula movement -TEST BOTH= open mouth and say AHHH
what’s CN12 and how do you test?
CN12= hypoglossal= motor–> tongue!
-test: stick tongue out–> will deviate to the side of the lesion
what is the Romberg test? what part of brain is it testing?
checks proprioception function (NOT just cerebellar, as cerebellar disease will sway w/ eyes closed or open)
-heels&toes together and close your eyes, can you stand still?
What is Adie’d Tonic pupil? what will you see?
- dilated, larger pupils that’s slow rxn to light–parasymp. disease
- parasymp. neuro disease
- (+) L-N dissociation (good @ N)
- (+ Babinski sign= (+) UMN=toes go UP= low deep tendon reflex
- anhydrosis (sweating)
what is Argyll-ROberts disease? How do you separate it from Adie’s Tonic pupil?
AR= bilateral miosis (constriction) of pupils
- (+) L-N dissociation (good @ N)
- problem on pathway through the EW nucleus
- due to sphyilis
- (-) Babinski sign–> deep tendon reflex is OK (vs. Adie’s is bad)
what is Horner’s syndrome? what are the 3 signs?
- ptosis in the bad eye
- miosis in the bad eye
- anhydrosis
- sympathetic system disease
- L-N is GOOD (normal @ light & N)
what happens in CN3 palsy?
- eye is down & out & cannot constrict properly
- parasymp system affected
- does not properly constrict @ N or with light
- ptosis in the dilated eye= bad eye
how do you test for cerebellum defects? what defects can you get?
- coordination & gaint
- DEFECTS: ataxia (uncoordination), dysdiadochokinesia ( alternating movements) dysmetria (finger nose test)
- *cerebellar vermis issue= truncal ataxia (“drunken sailor”)
Can you get anisocoria from an afferent pupil problem?
No, afferent means info going in is bad, so the info coming out will be equally bad= bilateral issue!
