Cranial Nerves & Neuro-ophthalmology

Question 1

central nystagmus

Answer 1

nonfatiguing, absent latency, not supressed by visual fixation, duration of nystagmus > 1 minutes, any direction, but purely torsional or vertical direction is classically central in origin

Question 2

central vertigo

Answer 2

subjectively less severe vertigo than peripheral, more prominent gait impairment, other neurologic signs coexist, absent hearing changes and tinnitus

Question 3

peripheral nystagmus

Answer 3

fatigable, latency present, suppression by visual fixation, duration of nystagmus < 1 minute, direction is unidirectional and usually horizontal with torsional component

Question 4

peripheral vertigo

Answer 4

subjectively more severe, walking typically preserved, hearing changes and tinnitus common

Question 5

taste anterior two-thirds of tongue

Answer 5

facial nerve (CN VII)

Question 6

tactile sensation anterior two-thirds of tongue

Answer 6

Trigeminal nerve (CN V)

Question 7

Taste posterior one-third of tonuge

Answer 7

Glossopharyngeal nerve (CN IX)

Question 8

parasympathetic source to head and neck

Answer 8

superior salvatory nucleus

Question 9

motor nuclei to pharyndeal and laryngeal muscles

Answer 9

nucleus ambiguus

Question 10

provides innervation to the parotid gland by glossopharyngeal nerve

Answer 10

inferior salivatory nucleus

Question 11

nuclei for taste sensation

Answer 11

rostral nucleus solitarius

Question 12

nuclei for baroreceptor reflex

Answer 12

caudal nuclus solitarius

Question 13

nuclei for parasympathetic output to chest, thorax, and GI tract

Answer 13

dorsal motor nucleus of vagus

Question 14

corneal reflex

Answer 14

afferent = trigeminal nerve (5)
efferent = facial nerve (7)

Question 15

gag reflex

Answer 15

afferent = glossopharyngeal nerve (9)
efferent = vagus nerve (10)

Question 16

pupil sparing thrid nerve palsy

Answer 16

diabetic pupil/diabetic cranial nerve palsy

Question 17

ptosis, miosis, anhidrosis (when proximal to carotid bifuration)

Answer 17

horner’s syndrome

Question 18

fourth nerve palsy

Answer 18

CONTRALATERAL head tilt

Question 19

argyll robertson pupil

Answer 19

neurosyphilis; ACCOMMODATION PRESENT, PUPILLARY REFLEX ABSENT

Question 20

Marcus Gunn pupil

Answer 20

APD: no response to direct light, but response to consensual light in contralateral eye present

Question 21

down & out

Answer 21

CN III palsy

Question 22

painful vision loss

Answer 22

optic neuritis

Question 23

painless vision loss

Answer 23

AION= anterior ischemic optic neuropathy

Question 24

cocaine 4% or 10% eye drops

Answer 24

confirmation of Horner’s pupil (no change in size of horner’s pupil; unaffected side dilates)

Question 25

hydroxyamphetamine 1% eye drops: Horner’s pupil dilates

Answer 25

first or second order neuros Horner’s pupil

Question 26

hydroxyamphetamine 1% eye drops: Horner’s pupil DOES NOT dilate

Answer 26

Third order neuro horner’s pupil