hns

Question 1

skull anterior view

Answer 1

mandible 
maxilla 
zygoma 
frontal 
nasal bone

Question 2

lateral voew

Answer 2

frontal 
pariental 
occipital 
temparol 
sphenoid bone

Question 3

what is the weak spot

Answer 3

pterion

Question 4

inferior

Answer 4

occipital
temparol
mandilble

Question 5

posterior

Answer 5

parietal

occipital

Question 6

what is the suture between them

Answer 6

lamboid

Question 7

adult superior

Answer 7

coronal suture
saggital sutire
lamboid suture

Question 8

superior of neonatal

Answer 8

unfused bone- anteterior fonatanelle

Question 9

function

Answer 9

not fused so flexible incase bc is tight

Question 10

cranial base

Answer 10

anterior cranial fossa - frontal lobe
middle cf- temparol lobe
posterior cf- cerebullum/brain step

Question 11

whats formaina

Answer 11

holes in skull

Question 12

optic canal

Answer 12

optic nerve pass through

on the side of teh skull

Question 13

superior orbital fissure

Answer 13

control extrisic mussle of eye

Question 14

foramenal rotundum

Answer 14

maxilalry divion of trigemial nerve passes out of

Question 15

foramen overly

Answer 15

madibullar divission of tgmn

Question 16

cranial nerve examination

Answer 16

functionality of cranial nerve

Question 17

what are cranial nerve

Answer 17

pairs of nerves taht connect brain to different part of the

on trunk e.g. nose eye mouth

Question 18

how many are there

Answer 18

12

Question 19

what is the order based on

Answer 19

anatomical location

front to back

Question 20

which nerves are not originaated from brain stem

Answer 20

1 2

olfactury and optic nerve

Question 21

where are the nuclie of cn 3 and 4

Answer 21

mid brain

Question 22

where are the nuclie of cn 5 6 7 8

Answer 22

within pons

Question 23

where are the nuclie of cn 9 to 12

Answer 23

medulla oblongata

Question 24

what to do before examination

Answer 24

1) introduce you and position
2) explain purpose
3) state patient exposure and position
4) wash hands

Question 25

olfactory nerve CN1 function

Answer 25

specialised sensory nerve transmit info relating to smell

Question 26

anatomical course

where are the olfactory receptors

Answer 26

nasal epithelium, their axons forming the olfactory nerves

Question 27

where do the nerves enter from

Answer 27

which enter the intra-cranial cavity by passing through the cribriform plate in the ethmoid bone.

Question 28

what part of teh brain is smell deboted to

Answer 28

temparol lobe

Question 29

how does it get there from the ethmoid bone

Answer 29

primary olfactory cortex in the temporal lobe

Question 30

Test

Answer 30

1) ask if they have noticed changes in taste or smell
2) test smell of each nostril with strong smell, such as mint or vanilla. The patient’s eyes should be shut when carrying out the testing.

Question 31

what is loss in smell called

Answer 31

anosmia

Question 32

Temporary anosmia can be caused by

Answer 32

blocked nose from a common cold and other upper respiratory tract infections.

Question 33

Permanent anosmia has many causes such as

Answer 33

severe head injuries, or tumours that run along the olfactory nerves intracranial path. Also progressive anosmia may occur in neuro degenerative diseases, such as Alzheimer’s disease and some other brain disorders (such as multiple sclerosis).

Question 34

Optic Nerve (CN II) tests for

Answer 34

Testing Pupillary Light Reflex

Question 35

function

Answer 35

pupillary light reflex is a reflex that controls the size of the pupils in response to changes in the strength of light that lands on the retina of the eye

Question 36

how many afferent and efferent limbs

Answer 36

Each pupillary light reflex has an afferent limb (optic nerve) and two efferent limbs (parasympathetic fibres along the oculomotor nerves).

Question 37

Anatomical course

Answer 37

Light travels through the pupil of the eye and is turned into impulses by rods and cones of the photo-receptor layer of the retina. impulses are the transmitted from the retina through the intracranial cavity to the brain by the optic nerve (CN II) through the optic canal. These impulses then pass through the visual pathway within the brain to the primary visual cortex where we appreciate the vision.

Question 38

pupillary light reflex

Answer 38

takes a different and shorter path than the whole visual pathway, as the reflex does not require our appreciation of the light, it works independent of our thought and command.

Question 39

pupillary light reflex pathway

Answer 39

he optic nerve is the afferent limb of the pupillary light reflex, sending the sensory impulses via mid brain nuclei to trigger motor impulses through parasympathetic axons running along the oculomotor nerves (efferent limb) to innervate the pupillary sphincter muscles in the eye leading to pupillary constriction (miosis) of both the ipsilateral pupil (same side) and the contralateral pupil (other side).
direct pupillary reflex but also a consensual pupillary light reflex.

Question 40

Testing

Answer 40

Ask the patient to look at a distant target
Inspect the pupils for size, shape and colour and any presence of ptosis (drooping of eye lid)
S​hine one eye with a penlight - observe for the pupillary constriction in the same eye (ipsilateral)
T​ake away the light for a few seconds
S​hine the penlight in the same eye - observe the pupillary constriction in the other eye (consensual)

Question 41

clinical revelance

Answer 41

Direct and consensual pupillary light reflexes are tested to assess the integrity the function of both optic and oculomotor nerves.

Question 42

what is abnormal caused by

Answer 42

An Abnormal pupillary reflex can be caused by optic nerve damage, oculomotor nerve damage, brainstem injury, and depressant drugs.

Question 43

Anisocoria

Answer 43

is a condition characterised by an unequal size of the eyes’ pupils
Remember to inspect the size and shape of the pupils before testing the direct and consensual light reflexes with a pen torch.