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Neurology > Disorders of Cranial Nerves > Flashcards

Disorders of Cranial Nerves Flashcards

1
Q

How is the first cranial nerve tested?

A

Smell- unilateral or bilateral loss

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2
Q

How is the second cranial nerve tested?

A

Optic- visual acuity, visual fields, pupillary reactions, fundoscopy and colour vision

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3
Q

How are the third, fourth and sixth cranial nerves tested?

A

Evidence of ptosis?
Pupils of equal size?
Pupillary reactions
Eye movements

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4
Q

How is the fifth cranial nerve tested?

A

Sensation in the ophthalmic, maxillary and mandibular divisions
Power in the muscles of mastication
Corneal reflex
Jaw jerk reflex

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5
Q

How is the seventh cranial nerve tested?

A

Muscles of facial expression
Corneal reflex
Taste

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6
Q

How is the eighth cranial nerve tested?

A

Hearing using Rinne’s and Weber’s tests

Vestibular function using Dix-Hallpike manoevre and Untenberger’s test

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7
Q

How are the ninth and tenth cranial nerves tested?

A

Movement of the palate
Gag reflex
Quality of speech
Quality of cough

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8
Q

How is the eleventh cranial nerve tested?

A

Head turning

Shoulder shrugging

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9
Q

How is the twelfth cranial nerve tested?

A

Appearance, movement and power of the tongue

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10
Q

What is the afferent and efferent supply of the pupillary light reflex?

A

Afferent- second cranial nerve

Efferent- third cranial nerve

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11
Q

What is the afferent and efferent supply of the corneal reflex?

A

Afferent- fifth cranial nerve

Efferent- seventh cranial nerve

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12
Q

What is the afferent and efferent supply of the jaw jerk reflex?

A

Afferent- fifth cranial nerve

Efferent- fifth cranial nerve

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13
Q

What is the afferent and efferent supply of the gag reflex?

A

Afferent- ninth cranial nerve

Efferent- tenth cranial nerve

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14
Q

Where are the nuclei of the third and fourth cranial nerves found?

A

In the midbrain

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15
Q

Where are the nuclei of the fifth, sixth and seventh cranial nerves found?

A

In the pons

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16
Q

Where is the nuclei of the eighth cranial nerve found?

A

Lies at the pontomedullary junction

17
Q

Where are the nuclei of the ninth, tenth, eleventh and twelfth cranial nerves found?

A

Lie in the medulla

18
Q

Where can cranial nerves be damaged?

A

Within the brain
Crossing the sub-arachnoid space
Outside the skull

19
Q

What are the symptoms of optic neuritis?

A 
Monocular visual loss
Pain on eye movement
Reduced visual acuity
Reduced colour vision
Optic disc may be swollen
20
Q

What are the causes of dilated pupils?

A 
Youth
Dim lighting
Anxiety, excitement
"Mydriatic" eye drops
Amphetamine, cocaine overdose
Third nerve palsy 
Brain death
21
Q

What are the causes of constricted pupils?

A 
Old age
Bright light
"Miotic" eye drops
Opiate overdose
Horner's syndrome
22
Q

What is the difference between microvascular and compressive isolated third nerve palsies?

A

Microvascular- caused by diabetes or hypertension. Painless and pupil spared
Compressive- caused by posterior communicating artery aneurysm or raised ICP. Painful and affects pupil

23
Q

What are the causes of isolated sixth nerve palsy?

A

Idiopathic
Diabetes
Meningitis
Raised intracranial pressure

24
Q

What are the causes of nystagmus?

A 
Congenital
Serious visual impairment
Peirpheral vestibular problem
Central vestibular/brainstem disease
Cerebellar disease
Toxins
25
Q

What are the characteristics of trigeminal neuralgia?

A

Paroxysmal attacks of lancinating pain
Triggers
Middle age and older
Caused by vascular loop

26
Q

How is trigeminal neuralgia treated?

A

Medically with carbamazepine

Surgical options if medication resistat

27
Q

What are the characterstics of Bell’s palsy and how is it treated?

A 
Unilateral facial weakness
Lower motor neurone type
Often preceded by pain behind ear
Eye closure affected
Risk of corneal damage
Treated with steroids
28
Q

What are the symptoms of vestibular neuronitis?

A

Sudden onset
Disabling vertigo
Vomiting
Gradual recovery

29
Q

What are the signs and symptoms of pseudobulbar palsy and what lesions cause it?

A 
Caused by bilateral UMN lesions
Dysarthria
Dysphonia
Dysphagia
Spastic, immobile tongue
Brisk jaw jerk
Brisk gag reflex
30
Q

What are the signs and symptoms of bulbar palsy and what lesions cause it?

A 
Caused by bilateral LMN lesions affecting CNIX-XII
Wasted, fasciculating tongue
Dysarthria
Dysphonia
Dysphagia

Neurology (29 decks)

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