Cranial Nerves and OME Findings Flashcards
What muscles are innervated by cranial nerve V (trigeminal)?
Masseter, temporalis, lateral pterygoid, medial pterygoid, tensor veli palatini, mylohyoid
What muscles are innervated by cranial nerve VII (facial)?
Obicularis oris, buccinator, posterior belly of digastric (elevates + retracts hyoid), frontalis (forehead and eyebrow raising), stylohyoid (elevates hyoid)
What muscles are innervated by cranial nerve IX (glossopharyngeal)?
Stylopharyngeus (elevates and shortens pharynx)
What muscles are innervated by cranial nerve X (vagus)?
Uvula, levator tensor palatini (raises soft palate), palatoglossal (anterior faucial pillars), palatopharyngeal (posterior faucial pillars), superior + medial constrictors (muscles of pharynx), thyropharyngeus (lower part of pharynx, forms UES), cricopharyngeus (main part of UES), salpingopharyngeus (elevates pharynx), palatopharyngeus (elevates pharynx + narrows oropharynx)
What muscles are innervated by cranial nerve XII (hypoglossal)?
Intrinsic muscles of the tongue (superior longitudinal, inferior longitudinal, verticalis, transverse), geniohyoid (moves hyoid anterior + superior), thyrohyoid (elevates larynx)
If it was an UMN lesion, what would you expect to see in a patient’s jaw?
Jaw deviates contralateral to side of injury
If it was a LMN injury, what would you expect to see in a patient’s jaw?
Jaw might hang lower, jaw deviates ipsilateral to side of lesion, might feel atrophy/weakness when palpating
If a patient had a UMN lesion, what would you expect to see in the face?
Drooping on contralateral side of lesion (includes nasolabial flattening), contralateral weakness (pucker/smile), able to raise eyebrows
If a patient had a LMN lesion, what would you expect to see in the face?
Drooping on ipsilateral side of lesion (includes nasolabial flattening), ipsilateral facial weakness (smile, pucker), UNable to raise eyebrows
If a patient had a UMN lesion, what would you expect to see in the palate/uvula?
Uvula deviates ipsilateral to side of lesion (side of strength), no elevation on contralateral side, potentially hyperactive gag reflex
(E.g. R side lesion = uvula deviates R, L side paralysis if CN X involved)
If a patient had a LMN lesion, what would you expect to see in the palate/uvula?
Uvula deviates to contralateral side (side of strength), no elevation on ipsilateral side
(E.g. R side lesion = uvula deviates to L, paralysis on R side)
If a patient had a UMN lesion, what would you expect to see in the tongue?
Tongue deviates to contralateral side of lesion on protrusion
If a patient had a LMN lesion, what would you expect to see in the tongue?
Tongue deviates to ipsilateral side of lesion on protrusion, fasciculations
If the client had a strained/strangled voice quality, what type of lesion is that associated with?
Bilateral UMN damage
If the patient had a weak/breathy voice, what type of lesion is that associated with?
Unilateral or bilateral LMN damage
If the client had a harsh voice, what type of lesion is that associated with?
Unilateral UMN damage
How would you assess CN X (vagus)?
Voluntary cough + coup, look for presence of voluntary swallow, observe secretion management, vocal resonance, vocal quality
How would you assess CN XII (hypoglossal)?
Observe tongue at rest (fasciculations? atrophy?), ask patient to protrude (tongue will deviate to side of weakness) and lateralize (assess ROM) tongue, DDK /ta/, infer strength with tongue depressor/resistance
How would you assess CN V (trigeminal)?
Observe jaw at rest and open, jaw resistance (infer strength), lateralize jaw (e.g. if unable to move L = R side paralysis), DDKs (expect /pa/ 10-15x in 5s trial), bite down to palpate bulk of masseter + temporalis
How would you assess CN VII (facial)?
Observe face and lips at rest, get pt. to wrinkle eyebrows (if they can’t = LMN), pucker lips and puff cheeks (obicularis oris), smile and oo-ee-oo (ROM)
