HEENT

Question 1

CN I

Answer 1

Olfactory nerve

sensory: smell

Question 2

CN II

Answer 2

Optic Nerve

Sensory: eye

visual acuity, visual fields

Question 3

CN III

Answer 3

Oculomotor

Motor: all eye muscles except those supplied by IV (trochlear) and VI (abducens)

Levator palpebrae superiorsis

intraocular muscles: sphincter pupillae and cilliary muscle

Question 4

CN IV

Answer 4

Trochlear

Motor: superior oblique muscle (look down and inward)

Question 5

CN V

Answer 5

Trigeminal Nerve

Sensory: face, sinuses, teeth, etc (3 branches of innervation)

CN V₂: sensation of the anterior 2/3rds of the tongue

Motor: muscles of mastication

Question 6

CN VI

Answer 6

Abducents

motor: external rectus muscle

look to the side

Question 7

CN VII

Answer 7

Facial

Motor: muscles of the face

smile, puff cheeks, raise eyebrows, scrunch eyes and keep them closed

Question 8

CN VIII

Answer 8

vestibulocochlear

sensory: inner ear

hearing/balance

Question 9

CN IX

Answer 9

glossopharyngeal

motor: pharyngeal musculature
sensory: posterior part of tongue, tonsil, pharynx

soft palate rises with “ah”

Question 10

CN X

Answer 10

Vagus

Motor: heart, lungs, bronchi, GI tract

Sensory: heart, lungs, bronchi, trachea, larynx, pharynx, GI tract, external ear

Question 11

CN XII

Answer 11

Hypoglossal

motor: muscles of the tongue

tongue protrusion and tongue side to side

Question 12

CN XI

Answer 12

Accessory

motor: sternocleidomastoid and trapezius muscles

turning head, shrugging shoulders

Question 13

What ligament changes the shape of the lens?

Answer 13

• the suspensory ligament
• when the ciliary muscle relaxes, the suspensory ligament tightens and flattens the lens →distance vision
• when the ciliary muscle constricts, the suspensory ligament loosens and the lens bulges → close vision

Question 14

What would lead to loss of consensual pupillary light reflex?

Answer 14

CN III: oculomotor

Question 15

RED Flag symptoms for the eye

Answer 15

• moderate to severe eye pain
• photophobia
• visual disturbances
• red eye - especially if associated with pain or visual changes
• trauma

Question 16

What lesion would lead to loss of direct pupillary light reflex?

Answer 16

CN II lesion

Question 17

miosis

Answer 17

pupillary constriction

Question 18

mydriasis

Answer 18

pupillary dilation

Question 19

accommodation

Answer 19

the process of maintaining a clear visual image when the gaze is shifted from a near object to a different one and back

Question 20

convergence

Answer 20

turn both eyes inward toward the nose to ensure that only a single image of close object is seen

Question 21

cover uncover test tests for what

Answer 21

strabismus

Question 22

Esotropia

Answer 22

eye turns inward

Question 23

Hypertropia

Answer 23

eye turns upward

Question 24

Hypotropia

Answer 24

eye turns downward

Question 25

Exotropia

Answer 25

eye turns outward

Question 26

Muscles of the eye

Answer 26

Question 27

Muscle testing of the eye

Answer 27

Lateral rectus: controlled by abducens CN VI Superior oblique: controlled by cranial nerve IV: trochlear nerve LR6SO4 all other eye movements: controll by CN III: oculomotor

Question 28

Anatomy of the retina

Answer 28

see attached photo

Question 29

Anatomy of the TM

Answer 29

see attached image

Question 30

Weber Test

Answer 30

Do this after pt fails the whisper test: testing CN VIII: vestibulocochlear hold the tuning fork to the top of the pts head: **LATERALIZATION** * conductive hearing loss: * sound lateralizes to bad ear * sensorineural hearing loss: * sound lateralies to good ear

Question 31

Rinne Test

Answer 31

Do this after pt fails the whisper test: CN VIII: vestibulocochlear hold tuning fork behind pts ear on mastoid process **CONDUCTION** * conductive hearing loss: * BC=AC or BC \> AC * sensorineural hearing loss: * AC \> BC * Normal: * AC\>BC

Question 32

Which sinuses are present at birth:

Answer 32

* maxillary (first seen in radiology at 4-5 months) and ethmoid sinus (first seen in radiology at 1 year * sphenoid not present until 4 years * frontal sinus not present until 6 years Reaches adult size by teenage years

Question 33

What do turbinates look like when there are allergies:

Answer 33

boggy, pale pink or bluish gray

Question 34

anatomy of the face and neck

Answer 34

answers:

Question 35

OS, OD, OU

Answer 35

* OS: oculus sinister * OD: oculus dextrus * OU: both eyes