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Y2 Neurology > Disorders of Cranial Nerves > Flashcards

Disorders of Cranial Nerves Flashcards

1
Q

what are the four special senses?

A

smell
vision
taste
hearing/balance

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2
Q

what nerve is responsible for smelling?

A

olfaction

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3
Q

what nerve is responsible for smelling?

A

optic

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4
Q

what nerves is responsible for taste?

A

facial
vagus
glossopharyngeal

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5
Q

what nerve is responsible for hearing ?

A

vestibulocochlear

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6
Q

what nerve supplies sensation to the face?

A

trigeminal

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7
Q

what nerve supplies the lateral rectus ?

A

abducens

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8
Q

what nerve supplies the superior oblique ?

A

trochlear

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9
Q

what nerves supply the muscles of mastication ?

A

mandibular branch of trigeminal

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10
Q

what nerves supply the muscles of mastication ?

A

the facial nerve

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11
Q

what nerve supplies taste to the anterior part of the tongue ?

A

chorda tympani of the facial nerve

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12
Q

what nerve supplies the trapezius and SCM?

A

accessory nerve

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13
Q

what nerve supplies the muscles of the pharynx and larynx ?

A

vagus

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14
Q

what nerves contain parasympathetic fibres ?

A

3 - oculomotor
7 - facial
9 - glossopharyngeal
10 - vagus

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15
Q

what nerve causes pupillary constriction ?

A

oculomotor

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16
Q

what nerve causes tearing of the eye from the lacrimal gland ?

A

facial

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17
Q

what nerve causes salvation from the parotid gland ?

A

glossopharyngeal

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18
Q

what nerve causes salvation from the submandibular and sublingual gland ?

A

facial

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19
Q

what tests can be dine to test the optic nerve ?

A 
visual acuity 
visual fields 
pupillary reactions 
fundoscopy 
colour vision
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20
Q

what four tests can be done to test the trigeminal nerve ?

A 
sensation 
- light touch and neurotip 
power of muscles of mastication 
corneal reflex 
jaw jerk
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21
Q

what three tests can be done to test the facial nerve ?

A

muscles of facial expression
corneal reflex
taste

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22
Q

what facial movements should be done to test the facial nerve ?

A
  • raise eyebrows
  • clench teeth
  • bloat out cheeks
  • clench eyes together
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23
Q

what is the rinnes test ?

A

hearing test testing the vestibulocochlear nerve

- by placing a 512Hz tuning fork on the persons forehead and asking if they can hear the vibrations in both ears

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24
Q

what is webers test?

A

hearing test testing the vestibulocochlear nerve

  • by placing the 512Hz tuning fork in front of the external ear canal and then placing it on the mastoid process on the temporal bone and asking if the person can hear both and which one is louder.
  • the one in front of the ear should be louder
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25
what is Dix-Hallpike manoeuvre used for ?
for vertigo and dizziness
26
what does the Untenbergers test involve ?
standing patient closing their eyes and checking if they fall over or not
27
what tests can be done to test the glossopharyngeal and vagus nerve ?
movement of palate gag reflex quality of speech quality of cough
28
what can be done to check the function of the hypoglossal nerve ?
appearance, movement and power of the tongue
29
how is the power of the tongue tested?
asking the person to push their tongue into the side of their cheek and feel how strong it is
30
what nerves nuclei lie in the mid brain ?
3rd and 4th | oculomotor and trochlear
31
what nerves nuclei lie in the pons ?
5th, 6th, 7th and 8th
32
which nerve nuclei lies in the pontomedullary junction ?
8th | - vestibulocochlear
33
what nerves nuclei lie in the medulla ?
9th, 10th, 11th and 12th
34
what condition results in loss of pure motor signs?
myasthenia gravis
35
give 3 examples of conditions which can damaged cranial nerves within the brain ?
- ischaemia - tumour - increased ICP
36
give an example of conditions which can damaged cranial nerves crossing the subarachnoid space ?
meningitis
37
give an example of conditions which can damaged cranial nerves outside the skull?
base of the skull tumours
38
what does optic neuritis result in, in relation to the optic nerve ?
demyelination within the optic nerve
39
what causes demyelination in the optic nerve during optic neuritis ?
inflammation
40
the symptoms does someone with optic neuritis experience ?
monocular visual loss pain on eye movement reduced visual acuity and colour vision
41
what condition is optic neuritis associated with ?
multiple sclerosis
42
what would be seen on fundoscopy fora patient with optic neuritis ?
optic disc may be swollen
43
what test can be done to test the conduction of the optic nerve ?
visual evoked response | - delayed response would suggest demyelination
44
what autonomic response causes pupil dilation ?
sympathetic
45
what autonomic response causes pupil constriction ?
parasympathetic
46
what would the pupil look like if the sympathetic fibres were damaged ?
fixed constricted
47
what would the pupil look like if the 3rd cranial nerve fibres were damaged ?
fixed dilated pupil
48
state some causes of dilated pupils?
- youth - dim lighting - anxiety, excitement - "mydriatric" eye drops - cocaine, amphetmine - third nerve palsy - brain death
49
state some causes of small pupils?
- old age - bright lights - "miotic" eye drops - opiates overdose - Horners syndrome
50
what are the two categories of causes of third nerve palsy ?
microvascular compressive
51
state some microvascular causes of 3rd nerve palsy?
HT | Diabetes
52
state some compressive causes of 3rd nerve palsy?
SAH Raised ICP Aneurysm
53
state the two clinical signs of microvascular 3rd nerve palsy
painless | pupil is spared
54
state the two clinical signs of compressive 3rd nerve palsy
painful | pupil is affected
55
state four causes of 6th nerve palsy ?
idiopathetic diabetes meningitis raised ICP
56
state some causes of nystagmus
``` congenital serious visual impairment peripheral vestibular problem central vestibular disease cerebellar disease toxins ```
57
what two toxins can cause nystagmus ?
alcohol | anti epileptics
58
what symptom is experienced with trigeminal neuralgia ?
paroxysmal (short frequent) attacks of laminating (piercing stabbing) pain
59
what age range is most effected by trigeminal neuralgia ?
middle aged and older people
60
what causes trigeminal neuralgia ?
compression of 5th nerve
61
what medication is used to treat trigeminal neuralgia ?
carbamazepine
62
as well as medication what other options are available for trigeminal neuralgia ?
surgical options when medication is resistant
63
what is the cause of idiopathic facial nerve palsy (bells palsy)?
unknown cause
64
what is the symptom of bells palsy ?
unilateral facial weakness
65
what can a complication be of a bells palsy patient when they can't come their eye properly ?
their eye can dye out and they can lose their vision | - risk of corneal damage
66
what is bells palsy treated with ?
steroids
67
how are UMN and LMN disorders involving paralysis of the face differ? - UMN
UMN disorders (stroke) - for example if the lesion was in the internal capsule on one side - then some fibres from the contralateral side of the lesion will ipsilaterally to the forehead - so patients with UMN will not have complete unilateral paralysis as the forehead may still be able to move
68
how are UMN and LMN disorders involving paralysis of the face differ? - LMN
LMN disorders (Bells palsy) - the lesion is lower down as the nerve has already left the brain stem - all fibres travelling to the contralateral side of the lesion will be affected so the forehead will not be able to move - therefore the patient will have complete unilateral paralysis
69
what is dysarthria ?
slurring of speech
70
what is dysphagia?
difficulty swallowing
71
what is dysphasia ?
difficulty to generate speech
72
is pseudo bulbar palsy an UMN or LMN disease?
UMN
73
is bulbar palsy an UMN or LMN disease?
LMN
74
are bulbar and pseudo bulbar palsy caused by unilateral or bilateral lesions ?
bilateral
75
what are two causes of pseudo bulbar palsy ?
vascular lesions in both internal capsules | motor neurone disease
76
what are some causes of bulbar palsy ?
``` motor neurone disease polio syphilis tumours lesions in the medulla ```
77
what cranial nerves are affected during bulbar palsy ?
9-12 nerves | - nerves passing out go the medulla
78
state some symptoms/clincal signs of pseudo bulbar palsy ?
``` dysarthria dysphonia dysphagia immobile tongue brisk jaw and gag reflex ```
79
what is dysphonia ?
loss in volume
80
what is dysarthria ?
difficulty to articulate speech as muscles don't work properly
81
state some symptoms and clinical signs for bulbar palsy ?
wasted, fasciculating tongue dysarthria dysphonia dysphagia

Y2 Neurology (52 decks)

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