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Year 2- CNS > Disorders of Special Sensory Function: The Cranial Nerves > Flashcards

Disorders of Special Sensory Function: The Cranial Nerves Flashcards

1
Q

Hehe lets recap-
CN I?

A

Olfactory

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2
Q

CN II?

A

Optic

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3
Q

CN III?

A

Oculomotor

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4
Q

CN IV?

A

Trochlear

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5
Q

CN V?

A

Trigeminal

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6
Q

CN VI?

A

Abducens

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7
Q

CN VII?

A

Facial

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8
Q

CN VIII?

A

Vestibulocochlear

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9
Q

CN IX?

A

Glossopharyngeal

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10
Q

CN X?

A

Vagus

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11
Q

CN XI?

A

Accessory

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12
Q

CN XII?

A

Hypoglossal

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13
Q

Name the special senses.

A

Olfaction
Vision
Taste
Hearing

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14
Q

Which cranial nerve has a role in olfaction?

A

CN I

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15
Q

Which cranial nerve has a role in vision?

A

CN II

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16
Q

Which cranial nerves have a role in taste?

A

CN VII, IX, X

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17
Q

Which cranial nerve has a role in hearing?

A

VIII

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18
Q

Which cranial nerve has a role in balance?

A

CN VIII

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19
Q

Which nerve mainly supplies ordinary sensation to the face?

A

Trigeminal nerve

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20
Q

Which nerves supplies the ear with ordinary sensation?

A

Facial nerve
Glossopharyngeal nerve

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21
Q

Which nerve controls the majority of the eye muscles?

A

Oculomotor nerve- CN III

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22
Q

Which nerves supplies the superior oblique muscle?

A

Abducent nerve- CN IV

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23
Q

Which nerve supplies the lateral rectus muscle?

A

Trochlear nerve- CN VI

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24
Q

Which cranial nerve supplies the muscles of mastrication?

A

Trigeminal nerve

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25
Q

Which nerve supplies the muscles of facial expression?

A

Facial nerve- CN VII

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26
Q

Which nerve supplies the muscles of the larynx and pharynx?

A

Mainly vagus nerve- CN X

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27
Q

Which nerve supplies the sternomastoid and trapezius muscles?

A

Accessory nerve- CN XI

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28
Q

Are all autonomic functions sympathetic or parasympathetic?

A

Parasympathetic

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29
Q

Which nerve causes pupillary restriction?

A

Oculomotor nerve

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30
Q

Which nerves cause salivation?

A

Submandibular and sublingual glands innervated by facial nerve

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31
Q

How do you test smell (olfactory nerve III)

A

-Unilaterally or bilaterally
-Usually history based
-Can use a smell test but rare

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32
Q

List the different areas that are tested when testing the optic nerve.

A

Visual acuity
Visual field
Pupillary reactions
Fundoscopy
Colour vision

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33
Q

What is used to test visual acuity?

A

Snellen chart

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34
Q

Which chart is used to assess colour vision?

A

Ishiara plate

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35
Q

When looking at a patient’s eye, what would be looked for?

A

-Ptosis- dropping of eyelid
-Equal pupil size
-Pupillary reactions
-Eye movements, both vertical and horizontal

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36
Q

When testing the trigeminal nerve, sensation in the ophthalmic, maxillary and mandibular regions must be tested.
How can sensation of these areas be tested?

A

Light touch, either with cotton wool or pin pricks

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37
Q

How are the muscles of mastication tested?

A

Asking patient to clench teeth and feel muscle bulk, feel for asymmetry.
Same thing while asking patient to open mouth

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38
Q

Which two reflexes are associated with the trigeminal nerve?

A

Corneal reflex
Jaw jerk reflex

39
Q

What is tested when testing the facial nerve?

A

-Muscles of facial expression
-Corneal reflex
-Taste

40
Q

How can the function of the vestibulocochlear nerve be tested?

A

Rinne’s and Weber’s tests

41
Q

How is the vestibular function assessed?

A

Using Dix-Hallpike manoeuvre
Utemberger’s test

42
Q

What is assessed when assessing the IX and X nerves?

A

Movement of palate
Gag reflex
Quality of speech

43
Q

What is assessed when assessing the accessory nerve?

A

Head turning and shoulder shrugging

44
Q

What do you look at when assessing the function of the hypoglossal nerve?

A

Appearance, movement and power of tongue

45
Q

In the pupillary light response, which nerves are responsible for the -
1. afferent pathway
2. efferent pathway

A
  1. CN II (optic)
  2. CN III (oculomotor)
46
Q

In the corneal reflex, which nerves are responsible for the -
1. afferent pathway
2. efferent pathway

A
  1. CN V (trigeminal)
  2. VII (facial)
47
Q

In the jaw jerk, which nerves are responsible for the -
1. afferent pathway
2. efferent pathway

A
  1. V (trigeminal)
  2. V (trigeminal)
48
Q

In the gag reflex, which nerves are responsible for the -
1. afferent pathway
2. efferent pathway

A
  1. IX (glossopharyngeal)
  2. X (vagus)
49
Q

In which part of the brain would you find the oculomotor and trochlear nerve nuclei (CN III & IV)?

A

Midbrain

50
Q

In which part of the brain would you find the trigeminal, abducent and facial nerves?

A

Pons

51
Q

In which part of the brain would you find the vestibulocochlear nerve?

A

Pontomedullary junction

52
Q

In which part of the brain would you find the glossopharyngeal, vagus, accessory, hypoglossal cranial nerves?

A

Medulla

53
Q

If there was a III, IV and VI nerve palsy, which area of the brain would it arise from?

A

Superior orbital fissure

54
Q

If there was a V and VIII nerve palsy, which area of the brain would it arise from?

A

Cerebellopontine angle

55
Q

If you see an unusual combinations of cranial nerve lesions, what could this be?

A

Malignant meningitis

56
Q

If a patient presents with purely motor signs, what could this be?

A

Myasthenia gravis

57
Q

Apart from a cranial nerve lesion, when else may there be cranial nerve signs?

A

Eye movement disorders
Facial weakness
Difficulty swallowing after a stroke

58
Q

Which conditions may there be double vision despite a cranial nerve lesion?

A

Myasthenia gravis
Thyroid eye disease

59
Q

What can cause the cranial nerves in the brain to be damaged?

A

Ischaemia
Brain tumour

60
Q

What can cause the cranial nerves crossing the sub-arachnoid space to become damaged?

A

Meningitis

61
Q

What can cause the cranial nerves outside of the skull to become damaged?

A

Bases of skull fractures arising in the nasopharynx

62
Q

What causes optic neuritis?

A

Demyelination of optic nerve causing inflammation

63
Q

What can optic neuritis cause to happen?

A

Monocular visual loss
Pain on eye movement
Reduced visual acuity
Reduced colour vision

64
Q

In those with optic neuritis, what may be seen upon fundoscopy?

A

Swollen optic disc

65
Q

Which other condition can optic neuritis be associated with?

A

Multiple sclerosis

66
Q

Sympathetic- pupil constriction or dilation?

A

Dilation

67
Q

Parasympathetic- pupil constriction or dilation?

A

Constriction

68
Q

What can cause dilation of pupils?

A

Youth
Dim lighting
Anxiety
Cocaine overdose
Mydriatic eye drops

69
Q

What can cause constriction of pupils?

A

Old age
Bright lght
Miotic eye drops
Opiate overdose

70
Q

In which condition is there a smaller pupil in one eye?

A

Horner’s syndrome

71
Q

What are some of the causes of an isolated sixth nerve palsy?

A

Diabetes
Meningitis
Raised intracranial pressure

72
Q

What can cause nyastagmus?

A

Congenital
Serious visual impairment
Peripheral vestibular problem
Central vestibular/brainstem disease
Toxins e.g. medications or alcohol

73
Q

What happens in trigeminal neuralgia?

A

Paroxysmal attacks of lancinating pain

74
Q

What is trigeminal neuralgia caused by?

A

Compression of fifth nerve in the posterior fossa

75
Q

What is trigeminal neuralgia treated with?

A

Carbmazepine

76
Q

What happens in Bell’s Palsy?

A

Unilateral facial weakness

77
Q

Is Bell’s palsy an UMN or LMN issue?

A

Lower motor neuron

78
Q

What often precedes Bell’s palsy?

A

Pain behind the ear

79
Q

How is Bell’s palsy treated?

A

Steroids

80
Q

If there is face paralysis caused by an upper motor neuron, what could’ve been the cause?

A

Stroke or tumour

81
Q

If there is face paralysis caused by an lower motor neuron, what could’ve been the cause?

A

Bell’s Palsy
Lyme’s disease

82
Q

Describe what happens in vestibular neuronitis.

A

Sudden onset
Disabling vertigo
Vomiting continuously

83
Q

Dysarthria?

A

Disordered articulation, slurring of speech

84
Q

Dysphagia?

A

Difficulty swallowing

85
Q

When would dysphagia and dysarthria both be seen?

A

Bulbar and pseudobulbar palsy

86
Q

Is bulbar palsy upper or lower motor neuron lesion?

A

LMN

87
Q

Is pesudobulbar palsy upper or lower motor neuron lesion?

A

UMN

88
Q

In pseudobulbar palsy, the the UML unilateral or bilateral?

A

Bilateral

89
Q

What are some of the symptoms of pseudobulbar palsy?

A

Dysarthria
Dysphonia
Dysphagia
Immobile tongue
Brisk jaw jerk
Brisk gag reflex

90
Q

In bulbar palsy, the the UML unilateral or bilateral?

A

Bilateral

91
Q

Which nerves does bulbar palsy affect?

A

IX-XII

92
Q

What are some of the symptoms of bulbar palsy?

A

Wasted, fasciculating tongue
Dysarthria
Dysphonia
Dysphagia

->Fasiculation = involuntary movements of a muscle, relevant in neuro examination in clinical skills when observing upper and lower limbs

93
Q

What should you be careful of with patients with pseudobulbar and bulbar palsy?

A

Beware of feeding these patients due to swallowing difficulties, swallow assessment would need to be undertaken

94
Q
A

Year 2- CNS (49 decks)

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