Cranial Nerves V, Vll, and Vlll with vocab Flashcards
What area does cranial nerve V spare?
the cutaneous area over the angle of the jaw
What innervates the cutaneous angle of the jaw?
the great auricular nerve of the cervicoplexus (dermatome C2, C3)
A lesion in the peripheral CN V will cause what and spares what?
loss of facial sensation but will spare the area over the angle of the jaw
What branch of CN V has a reccurent or meningeal branch that innervates the dura of the middle and anterior cranial fossae?
mandibular branch (accounting for cervical influence of head pain)
The motor portion of CN V supplies what (be specific)?
muscles of mastication
- masseter
- Temporalis
- Medial Pterygoid
What do the muscles of mastication function in?
closing the jaw
CN V also innervates the lateral pterygoids which function in what?
opening the jaw (used bilaterally) or lateral movement of jaw
What is the function of the RIGHT lateral pterygoid?
move the jaw to the LEFT
When there is sensory impairment of CN V it results in a sunken or hollowing out appearance of the temples and zygomatic arches. If the OPTHALMIC division is involve there may be corneal inflammation and ulceration termed what?
Neruroparalytic keratitis
What explains sharp, painful facial sensation in the clear distribution of the ophthalmic, maxillary, and mandibular divisions of CN V?
Trigeminal neuralgia
AKA
Tic Douloureux
LMN lesions of CN V can occur anywhere in the nerve cell body from pontine nucleus to the peripheral CN and will result in what?
Paralysis and denervation atrophy of mastication muscles
Corneal reflex may be absent in early cases of what disease?
MS
Can you adjust a patient day one if they have irritation?
Yes, b/c sensory, reflex, strength test are okay
Can you adjust a compression patient on day one?
NO b/c diminished tests
Should you adjust a patient that is hypermobile due to recent trauma?
NO, wait about 4-5 days for fibrinogen to strengthen and stabilize joint
A unilateral lesion involving the corticobulbar pathways will
- spare the forhead
- cause drooping of one side
- Spare the forehead
A contralateral lesion of the lower face will:
- spare the movement
- cause long term affects
- cause long term affects
(b/c the lower face requires unilateral movement and receives a greater amount of contralateral fibers)
Where does CN Vll divide and into what branches?
Parotid Gland
- Temporofacial
a) temporal
b) zygomatic
c) upper buccal branches - cervicofacial
a) lower buccal
b) mandiblar
c) cervical branches
What CN innervates the stapedius and what is the function of this muscle?
CN Vll; dampen movement of the tympanic membrane
Stimulation to the:
- parasympathetic fibers of CN Vll wiill cause what
- Sympathetic fibers will cause what
- increase secretion of thick watery saliva
- scant supply of thick and turbid saliva
What is prosopoplegia?
peripheral facial paralysis
Facial muscle paralysis is from a lesion where:
- peripheral (nuclear)
- Central (supranuclear)
EITHER
A lesion peripheral to the geniculate Ganglion will cause what?
Bells palsy
All lesions involving peripheral CN Vll paralysis will have one common factor:
flaccid paralysis (LMN) involving all ipsilateral facial muscles distal to lesion site
What happened to a patient that presents with a central type of paralysis, facial weakness due to bilateral innervation, FORHEAD SPARED, eyes partially affected, and the mouth and neck fully involved?
Stroke
A central lesion affecting CN Vll pathways will cause what?
MC spontaneous or perverted tastes
A peripheral lesion (PROXIMAL TO THE STYLOMASTOID FORAMEN) will cause what?
taste loss only on the ipsilateral side
What is ageusia?
complete taste loss
What is confirmed if there is a complete hemifacial paralysis w/o loss of taste on the ipsilateral anterior 2/3 of the tongue.
Bells palsy b/c the lesion was peripheral but not proximal the the stylomastoid foramen
What is the sole function of the cochlear division of CN Vlll
provide hearing
What is hypoacusis?
Decrease or loss of hearing
What is hyperacusis?
increase in hearing
Central lesions of CN Vlll are most often associated with:
- Hypoacusis
- Hyperacusis
- Hyperacusis (increased hearing)
What are the two major varieties of hearing loss?
Conductive and sensorineural
What are 4 common etiologies for conductive hearing loss?
- Auditory canal obstruction
- Tympanic membrane (direct or indirect) trauma
- Ossicles = trauma or aging
- Accumulation of fluid in the middle ear
NOTE: there are rarely chronic middle ear infections
What can sensorineural hearling loss usually be attributed to?
disease of the end organ (organ of corti) or auditory nerve
What ALWAYS accompanies vestibular diseases?
Vertigo
Unsteadiness w/o falling, nystagmus, and autonomic signs such as pallor, sweating, vomiting, and hypotension are all signs of what disease?
vestibular disease
In what direction is a nystagmus most common?
horizontal
If during a nystagmus the patients eye moves quickly to the right and slowly back to the left what direction is the nystagmus?
Right nystagmus
What is it called if there is no fast component of a nystagmus?
pendular
What are the two temperatures of water that can be used for caloric irrigation?
warm = 103 - 110 degrees F
Cold = a few drops of ice water
What is the mneumonic for caloric irrigation to remember what side the nystagmus will occur at?
COWS
C = cold
O= opposite
W = warm
S = same
What is Malingering Test?
A loud noise from out of sigt should cause the patient to blink (auditopalpebral reflex)
Which CN is the most important in deglutition (act of swallowing) and articulation (act of speaking)?
CN X
What happens if there is bilateral paralysis of CN X?
Patient is dead
What is Aphonia?
loss of voice
What is Dysarthria?
Faulty articulation
What is Anarthria?
no articulation
What is dyphagia?
faulty swallowing
What is aphagia?
no swallowing
What is Hypernasal?
Increased air entering nasal cavity
What is hyponasal?
Decreased air entering into the nasal cavity
What two CN’s can be tested clinically together?
lX and X
Is CN Xl primarily motor or sensory in function?
motor
What is the cardinal finding in CN Xll disease?
paralysis of the tongue
If there is a CN Xll lesion on the right and you instruct the patient to stick his/her tongue out, what direction will the tongue deviate to?
To the right
If you instruct the patient to say AHHHH while evaluating their soft palate elevation and the uvula deviates to the right what side is the lesion on for CN lX and X?
The left side
