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Chika- SF2 > Cranial Nerves- Oyawusi > Flashcards

Cranial Nerves- Oyawusi Flashcards

1
Q

What are the only CN that have cerebral origin?

A

Olfactory (CN I) and optic nerve (CN II)

the rest have brainstem origin

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2
Q

What is the olfactory nerve (CN I)?

A
  • sense of smell
  • olfactory nerve ending picking up the stimuli of the aroma which is transmitted to the olfactory bulb which is then transmitted to the olfactory nerve which is transmitted to the hypothalamus
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3
Q

How do you test the sense of smell?

A
  • take non-toxic scent (spices, tea, coffee)

- occlude one nostril and have the patient smell the aroma

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4
Q

What is the optic nerve? How do you test?

A

-test for visual acuity with the Snellen Chart
-testing visual fields
(read onto the nasal hemiretina
temporal hemiretina)
-fundoscopy: ophthalmoscopy, also called funduscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or fundoscope)
-pupillary light reflex

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5
Q

If the optic nerve is lesioned what happens? What if the lesion occurs at the optic chiasma?

A
  • Optic nerve: the temporal fields will be lost

- Optic chiasma: bitemporal field defects ????

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6
Q

Which cranial nerves are of brainstem origin?

A
  • oculomotor (CN III)
  • trochlear (CN IV)
  • trigeminal (CN V)
  • abducens (CN VI)
  • facial (CN VII)
  • acoustic (Vestibulocochlear) (CN VIII)
  • glossopharyngeal (CN IX)
  • vagus (CN X)
  • accessory (CN XI)
  • hypoglossal (CN XII)
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7
Q

Which cranial nerve is considered as the cerebral extension and commonly involved in head trauma?

A

CN I- olfactory nerve

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8
Q

What is optic neuritis?

A

inflammation of the optic nerve which occurs often with multiple sclerosis and neuromyelitis

optica????

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9
Q

What is caused by the occlusion of ophthalmic artery?

A

amaurosis fugax

can see a pale region during the fundoscopic exam

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10
Q

Papilledema is a reflection of what?

A

swelling of the optic nerve which is due increased intracranial pressure

defect in CSF reabsorption; tumor (remember brain is a fixed box)

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11
Q

How should a normal fundoscopy look like?

A

the margins of the optic cup is well demarcated

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12
Q

What some lesion manifestations of the oculomotor nerve?

A
  • ptosis (eyelid droop)
  • opthalmoplegia (paralysis of extraocular muscles)
  • fixed dilated pupil
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13
Q

What clinical conditions have associations with the oculomotor nerve?

A
  • uncal herniation
  • posterior communicating artery aneurysm
  • diabetes
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14
Q

What are the two types of fibers oculomotor nerve?

A
  • fibers that control the iris to contract which makes the pupil narrow (that is used for accomodation)
  • fibers that control muscles that move the globe and levator palpebrae
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15
Q

Uncal herniation

A

will compress the outer fibers used to constrict the pupil causing pupil dilation

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16
Q

Diabetes

A

the central part of the oculomotor nerve does not receive adequate perfusion leading to ptosis

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17
Q

What is the significance of the proximity of oculomotor nerve to optic nerve?

A

if there is an aneurysm or atherosclerosis of the optic nerve compressing against the oculomotor nerve can result in clinical manifestations

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18
Q

inferior division of the optic nerve

A

-gives off to the ciliary ganglion which leads to constriction of the pupil

19
Q

superior division of the optic nerve

A

goes to the muscles that move the globe

20
Q

Which cranial nerve is the only crossed cranial nerve and is . the only nerve to exit dorsum of the brainstem?

A

trochlear nerve

  • comes off the posterior portion of the midbrains to come forward to innervate the superior oblique muscle
  • they are the thinnest cranial nerve
21
Q

What is the function of the superior oblique muscle?

A

depresses and introverts the globe of the eye

22
Q

What are examples of lesions along the trochlear nerve? What are some clinical manifestations of these lesions?

A

can occur by trauma anywhere along its path especially as it travels through the cavernous sinus can cause the pupil to be elevated which results in diplopia

  • contralateral superior oblique muscle
  • paralysis: eye does not depress when adducted
  • diplopia in the vertical plane when looking down and in
  • compensation by head tilt
23
Q

Describe the compensatory head tilt for lesion of the trochlear nerve

A

-chin moved to the direction on which lesion occurred

top portion of head is turned contralaterally

24
Q

What motor deficits will occur due to trigeminal nerve lesion?

A
  • weakness in the muscles of mastication: temporalis, masseters, pterygoids
  • ipsilateral jaw deviation

if lesioned in the pons

25
Q

What sensory deficits will occur due to trigeminal nerve lesion?

A
  • sensory deficit of the face
  • absent corneal reflex

if lesioned in the lateral medulla to upper cervical region

26
Q

Describe the corneal and jaw reflex with respect to the trigeminal nerve.

A

Corneal reflex

Jaw reflex?????

27
Q

What are clinical conditions that have association with the

A
  • herpes Zoster
  • trigeminal neuralgia
  • lateral medullary lesions
28
Q

What are some lesion manifestations of the abducens nerve?

A
  • paralysis of lateral rectus

- diplopia in direction of action of paralyzed muscle

29
Q

What are some clinical conditions associated with abducens nerve?

A
  • increased intracranial pressure (most common nerve to be involved nonspecifically)
  • diabetes
30
Q

What muscles does the facial nerve innervate?

A
  • muscles of facial expression

- orbicularis oculi for eye closure

31
Q

What clinical manifestations can occur with lower motor neuron lesions of the facial nerve?

A
  • inability to close eye, wrinkle forehead, frown
  • droop of angle of mouth , drooling of saliva, flattened naso-labial fold, inability to puff out cheek
  • taste anterior 2/3 of tongue - chorda tympani branch to V3 division
32
Q

What clinical manifestations can occur with upper motor neuron lesions of the facial nerve?

A
  • sparing of the upper part of face- bilateral cortico-bulbar supply
  • weakness of only lower half of face on the contralateral side-ONLY unilateral contralateral corticobulbar supply
33
Q

What are clinical associations of lower motor neuron lesions of the facial nerve?

A
  • Bell’s palsy
  • Guillain Barre syndrome
  • Lyme disease; Basal meningitis (chronic) pontine lesions
34
Q

What are clinical manifestations of lesions of the vestibulocochlear nerve (acoustic nerve)?

A 
auditory nerve lesions: 
-hearing loss ipsilateral 
-tinnitus or ringing noises 
vestibular nerve lesions: 
-vertigo 
-nystagmus
35
Q

What are clinical associations of acoustic nerve lesions?

A
  • Schwannoma (neurofibromatosis type II)
  • Acute labyrinthitis
  • fractures of base of skull
36
Q

What is the function of the glossopharyngeal nerve (CN IX) and vagus nerve (CN X)?

A

control or function:

  • swallowing; phonation; gag reflex
  • IX: sensations posterior pharynx
  • X: elevation soft palate, pharyngeal, laryngeal muscles
37
Q

What are clinical manifestation of lesions to CN IX and CN X?

A
  • nasal twang
  • nasal regurgitation of liquids
  • palate does not elevate
  • absent gag reflex
38
Q

What are clinical conditions associated with glossopharyngeal nerve and vagus nerve?

A
  • brainstem strokes: lateral medulla
  • tumors
  • basal meningitis
39
Q

What are clinical manifestations of lesions of the accessory nerve (CN XI)?

A

weakness of trapezius and sternocleidomastoids

40
Q

What are clinical conditions associated with accessory nerve?

A

neck tumors

41
Q

What are clinical manifestations of lesions of the hypoglossal nerve (CN XII)?

A
  • weakness of ipsilateral half of tongue
  • deviation to weak side on protrusion
  • inability to push tongue over to opposite side
  • atrophy
  • fasciculations of ipsilateral half
42
Q

What are clinical conditions associated with hypoglossal nerve?

A
  • amyotrophic lateral sclerosis (motor neuron disease): bilateral worm like tongue
  • tumors
  • medial medullary lesions
  • stroke
43
Q

upper motor neurons
lower motor neurons

  • nasal (decussates at the optic chiasma) and temporal fibers of the optic visual field
  • get bilateral loss of peripheral vision with temporal ?????

pituitary gland tumor will press on the chiasma

  • gag reflex IX
  • soft palate X
  • fasciculation is byproduct of atrophy
  • look at the picture (understand slide 9)
A

?????

Chika- SF2 (63 decks)

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