Cranial Nerves/ophtho Flashcards
Signs that vertigo is central
NO nystagmus latency (nystagmus starts right after maneuver)
Nonfatiguing nystagmus, lasts > 1 min
Nystagmus not suppressed by visual fixation
VERTICAL nystagmus. pure torsional (rarely periph)
vertigo subjectively less severe in central vs periph
other neuro probs - gait issues, falls, ataxia
no hearing change or tinnitus
What runs thru cavernous sinus
The carotid siphon of the internal carotid artery, and cranial nerves III, IV, V (branches V1 and V2) and VI
signs that Bell’s palsy will have good prognosis
incomplete Bell’s
improvement in within 3 weeks
when to image “Bell’s palsy”
slowly progressing more than 3 weeks
no improvement at 6 months
slow vs fast phase nystagmus
slow phase towards affected/bad side, with fast correction towards good side.
amplitude increases looking towards good side
what are the vestibular sensory organs
semicircular canals and the otolithic organs (saccule and utricle)
what motions of head do semicircular canals and otolithic organs detect?
otolithic organs (saccule + utricle) - LINEAR/VERTICAL
semicircular canals - ANGULAR
which nerves innervate anterior and posterior bellies of the digastric muscle?
anterior - trigeminal
posterior - facial nerve
(fivecomesaheadof7)
VOR
communication between semicircular canals and oculomotor nerves to keep eyes fixed on object as head moves
cold calorics - normal healthy brain response?
causes tonic deviation of eyes to the same ear you are squirting cold water in (if intact brainstem), eventually followed by corrective fast nystagmus away from the cold water (if intact cortical circuits)
COWS - cold opposite, warm same
localize the facial nerve lesion: face weakness + altered taste and hearing. normal lacrimation.
lesion between the geniculate ganglion and stapedius nerve
localize the lesion: face weak + altered taste. normal hearing and lacrimation.
lesion between the stapedius nerve and chorda tympani
what branch of the facial nerve arises from the geniculate ganglion?
greater petrosal nerve - parasympathetic
travels to pterygopalatine ganglion, from which fibers travel to supply lacrimal and mucosal glands of nose and mouth
branches of facial nerve in order from proximal-distal
greater petrosal (from geniculate ganglion)
stapedius nerve
chorda tympani nerve
then all the face muscle branches
which nerve innervates all the glands in the head/face except the parotid glands?
facial nerve
which nerve innervates the parotid glands?
glossopharyngeal
which CN nucleus supplies parasympathetics to head/neck?
SSN - superior salivatory nucleus
nucleus tractus solitarius
involved in both taste(SALTITARIOUS) and baroreceptor reflexes
receives taste afferents from facial nerve (ant 2/3 of tongue), glossopharyngeal nerve (posterior 2/3 tongue) and vagus nerve (base of tongue, epiglottis, pharynx)
receives baroreceptor afferents from glossopharyngeal nerve –> nuc tractus solitarius –> dorsal motor nucleus of vagus is stimulated to slow HR
nucleus ambiguus
innervates muscles of larynx and pharynx (glossopharyngeal and vagus nerves)
superior salivatory nucleus
parasympathetic innervation to head and neck
inferior salivatory nucleus
innervates parotid gland via glossopharyngeal
cornea sensation
upper 1/2 - V1
lower 1/2 - V2
gasserian ganglion
where the 3 branches of trigeminal arise from
sphenopalatine ganglion
parasympathetic ganglion assoc with trigeminal nerve–> lacrimal glands, paranasal sinuses, glands of mucosa of nose and pharynx, gingiva, mucus membrane and glands of hard palate
this is what is involved in TACs
SCM vs trap localization
SCM - ipsi motor cortex
trap - contralateral motor cortex
where do the branches of trigeminal pass through?
V1 - superior orbital fissure
V2 - foramen rotundum
V3 - foramen ovale (o-valley - for lowest branch)
