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Neurology > Examination of Smell, Taste, and Hearing > Flashcards

Examination of Smell, Taste, and Hearing Flashcards

1
Q

Where is the olfactory epithelium located at the mucous membrane lining of the nasal cavity?

A

Inferior portion of the cribriform plate at the ethmoidal plate

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2
Q

What cells are responsible for olfaction?

A

Bipolar sensory cells

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3
Q

What is the main relay station for olfaction?

A

Olfactory bulb

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4
Q

What are the 3 olfactory striae (axons of olfactory bulb)? Which of these striae is the most important for smelling bcos this is where smells are pereceived?

A

Lateral olfactory striae - most important
Intermediate olfactory striae
Medial olfactory striae

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5
Q

What CN can be stimulated if u use alcohol or perfume for CN exam?

A

CN V1 - opthalmic division of the trigeminal nerve

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6
Q

What are the 4 conditions that can affect CN I?

A
  1. Fractures of cribriform plate of ethmoid bone
  2. Hemorrhage at base of frontal lobes
  3. Meningitis or abscess of frontal lobe
  4. Hypophyseal tumors
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7
Q

What condition is noted in px with olfactory groove or sphenoid ridge masses (meningiomas) or space occupying lesions of the frontal lobe?

A

Foster-Kennedy syndrome

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8
Q

What condition is noted in px w/ olfactory groove or sphenoid ridge masses (menangiomas) or space in the lesions of the frontal lobe?

A

Foster-Kennedy syndrome

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9
Q

What are the clinical presentation of Foster-Kennedy syndrome?

A

Ipsilateral anosmia
Ipsilateral optic atrophy
CL papilledema -> affected visual pathway

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10
Q

What CN I disorder is caused by a rare mutation that presents with congenital anosmia and hypogonadotropic hypogonadism?

A

Kallman syndorme

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11
Q

What gene is affected/mutated in Kallman syndrome?

A

KAL 1 gene

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12
Q

What are the imaging findings seen in Kallman syndrome?

A

Complete agenesis of the olfactory bulbs and sulci, OR medial orientation of the sulfatory sulci

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13
Q

What are the causes of Anosmia in COVID-19?

A
  1. Direct affectation of the virus through the Transmural pathway
  2. Hematogenous spread: breaking through the BBB
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14
Q

WHere are taste cells located?

A

Within the tongue epithelium

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15
Q

What is the innervation of the Anterior 2/3 of the tongue?

A

Chorda tympani (branch of CN VII)

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16
Q

What is the innervation of the posterior 1/3 of the tongue?

A

Afferents of the petrosal ganglion: CN IX

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17
Q

What innervates the epiglottis and larynx?

A

SUperior laryngeal nerve

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18
Q

Explain the GUstatory pathway?

A

Afferent tracts enter the brainstem —> synapses with ROSTRAL NUCLEUS OF THE SOLITARY TRACT —> gives afferent fibers to the IPSILATERAL pontine taste area as the CENTRAL TEGMENTAL TRACT —> IL Ventral-posteromedial nucleus of the thalamus —> IL primary gustatory area —> L hypothalamus & amygdala —> emotions with diff tastes

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19
Q

What are the objects used in examination of Gustation?

A

Sugar & salt soln
Disposable cotton applicator
Sterile gauze
H2O for drinking and gargling

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20
Q

What are the main indicators of localization for gustatory pathway?

A

Loss of appetite, smell, or taste
Bell’s palsy or idiopathic peripheral facial palsy

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21
Q

What CN is usually affected by UL loss of taste & at what side?

A

Ipsilateral CN VII

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22
Q

What is the medical torm for loss of taste due to affectation of taste buds?

A

Ageusia

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23
Q

Why is the sense of taste affected by COVID 19?

A

Virus binds to sialic acid receptors (taste bud) —> inflam & edema -> degradation & apoptiosis of taste receptors —> reduced salivary flow

24
Q

What are the structures of the external/outer ear?

A

Pinna/Auricule
External auditory canal
Tympanic membrane

25
Q

Where is the middle ear/tympanic cavity located?

A

within the temporal bone

26
Q

What structure in the middle ear separates the middle and inner ear?

A

Oval and round windows

27
Q

What are the parts of the bony ossicles?

A

Malleus
Stapes
Incus

28
Q

What are the muscles found in the middle ear/tympanic cavity?

A

Tensor tympani
Stapedius

29
Q

Where is the inner ear found?

A

Petrous portion of the temporal bone

30
Q

What are the 2 systems of canal in the inner ear/

A

Osseus/bony labryinth
Membranous labyrinth

31
Q

In the perilymph found in the Osseus/bony labyrinth, what cation is found in high concentraiton?

32
Q

In the endolymph found in the Membranous labyrinth, what cation is found in high concentration?

33
Q

What are the 2 cavities of the membranous labyrinth?

A

Utricle - posterior with semicircular canal
Saccule - anterior with cochlea

34
Q

What are the sensory areas of the membranous labyrinth and what part of the inner membrane are they located?

A

Maccule utriculi - L wall of the utricle
Maccule sacculi - floor of the saccule

35
Q

What is the Organ of corti composed of?

A

Hair cells + Supporting cells

36
Q

What are the main sensory/auditory receptors of the ear?

A

Hair cells

36
Q

What are the main sensory/auditory receptors of the ear?

A

Hair cells

37
Q

What stimulates hair cells near the oval window & hair cells near the apex of the cochlea?

A

Hair cells near apex of the cochlea -> LOWER frequencies/tone

Hair cells near oval window -> HIGHER frequencies/tone

38
Q

What is the first order neuron in the auditory pathway?

A

neurons of spiral ganglion

39
Q

What are the second order neuron in the auditory pathway?

A

Cochlear nuclei

40
Q

in the cochlear nuclei, what structure receives fibers that innervate HIGH FREQUENCY basal hair cells?

A

Dorsal Cochlear nucleus

41
Q

in the cochlear nuclei, what structure receives fibers that innervate LOW FREQUENCY basal hair cells?

A

Ventral cochlear nucleus

42
Q

What are the structures found in the central nucleus of the inferior colliculus?

A
  1. Dorsal acoustic striae -> from DORSAL COCHLEAR NUCLEUS
  2. Intermediate acoustic striae -> from DORSAL PART OF VENTRAL COCHLEAR= NUCLEUS
  3. Ventral acoustic striae -> from the VENTRAL COCHLEAR NUCLEUS
43
Q

Where does the ventrial acoustic striae terminate?

A

IL & CL reticular formation, superior olivary nuclei, and nuclei of the trapezoid body

44
Q

Where are the third order neurons found?

A

Inferior colliculus

45
Q

Where in the medial geniculate body of the thalamus can LOW.& HIGH freq fibers end up?

A

Apical & L areas = LOW FREQ fibers
Middle portion of the nuclear mass = HIGH FREQ fibers

46
Q

Where are the fourth order neurons found?

A

Medial geniculate nucleus

47
Q

What cortex does the fourth order neuron project to?

A

primary auditory cortex (BA 41, 42) in the superior temporal gyrus

48
Q

In the primary auditory cortex, where do high & low frequencies terminate?

A

Medially = HIGH freq
Laterally = LOW freq

49
Q

How do you diagnose if it is a Conductive hearing loss?

A

Weber test = Lateralizes to the ABNORMAL ear
Rinne test = Bone conduction > Air conduction

50
Q

What part of the ear is affected in Conductive hearing loss?

A

conduction of sound waves in the middle ear

51
Q

What causes Conductive hearing loss?

A

impacted cerumen
chronic otitis media
otosclerosis

52
Q

How do you diagnose Sensorineural hearing loss?

A

Weber test = lateralizes to the NORMAL side
Rinne test = AC > BC

53
Q

Where is the problem in sensorineural hearing loss?

A

inner ear = Organ of corti, CN VIII, cochlear neuclei of the pons, central auditory pathway

54
Q

What are the causes of sensorineural hearing loss?

A

any central cause for the hearing loss

Neurology (8 decks)

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