John's Part pg 45-52

Question 1

The forehead movement area is usually moved in bilateral symmetry, and it usually spared in unilateral lesions involving corticobulbar pathways….why is its movements usually spared?

Answer 1

equal innervation from each cerebral hemisphere will keep the movements going….ask me for any question on this one, i tried to make it make sense

Question 2

what does the stapedius muscle do

Answer 2

dampens the movement of the tympanic membrane

Question 3

what supplies parasympathetic secretory and vasodilators to the submax and subling salivary glands and to the lacrimal glands, as well as the membrane of mouth and tonngue

Answer 3

the chordatympani

Question 4

what does parasympathetic stim of CN VII do to mucus

Answer 4

increase secretion of thin and watery mucus

Question 5

what does sympathetic stim of CN VII do to mucus

Answer 5

causes a scant supply of thick and turbid saliva

Question 6

what is “prosopoplegia”

Answer 6

peripheral facial paralysis

Question 7

where could a peripheral lesion of CN VII be located?

Answer 7

pontine nuclei, facial canal, geniculate ganglion, peripheral to geniuculate gang, but central to stapedius branch, peripheral to stapedius branch, but central to chordatympani nerve, body of the parotid, in the chordatympani

Question 8

where is the lesion of bells palsy?

Answer 8

peripheral to the geniculate ganglion

*all peripheral lesions of CN VII will have a “flaccid paralysis” of all ipsilateral face muscles distal to lesion

Question 9

so, what can happen with central lesions

Answer 9

it will show more as “signs of weakness” bc of the bilateral innervation to forehead…
eyes are only partially involved
mouth and neck are fully involved

Question 10

exam of CN VII

Answer 10

have them look up, examine wrinkles

have them smile and frown, puff out cheeks

Question 11

CN VII does some special sense, right? well, what does a central lesion do?

Answer 11

taste for anterior 2/3 of tongue, a lesion will rarely cause a complete loss of taste…
lesions in cranial nerve VII must be proximal to the stylomastoid foramen to affect taste

Question 12

what is a complete loss of taste called?

Answer 12

aquesia

Question 13

quick…the pathway of the cochlear nerve

Answer 13

leaves and goes to cochlear nuclei, to the ipsilateral lateral lemniscus, ascend to the inferior colliculus and the medial geniculate body, they terminate on the cortex of the hescel’s gyrus

Question 14

what is the loss of hearing

Answer 14

hypoacusis, with or without tinnitus

probably a conduction loss, receptor disease, or lesion

Question 15

the 2 major types of hearing loss

Answer 15

conductive and sensorineural

Question 16

sensorineural hearing loss will be caused by what

Answer 16

usually attributed to disease of organ of corti

Question 17

conductive hearing loss will be caused by what

Answer 17

auditory canal obstruction
tympanic membrane -> direct or indirect trauma
ossicles: trauma or advanced aging
accumulation of fluid in middle ear—rarely chronic ear infxns

Question 18

vestibular diseases are always accompanied by?

other symptoms?

Answer 18

vertigo

nausea, anxiety, and oscillopsia ( visual perception of rapid to and fro movements often accompanying nystagmus)

Question 19

caloric irrigation

COWS

Answer 19

Cold opposite - warm same

cold water causes nystagmus on opposite side

Question 20

cervicogenic proprioceptive disease test

Answer 20

patient, in swivel chair, grab their head and have them rotate shoulders, if reproduction of symptoms occurs, disease is suspected.

Question 21

what is schwabach’s test

Answer 21

place buzzing tuning fork in front of patients EAM, when they cannot hear it any longer then put it up next to your ear, use your own hearing to compare with the patients

Question 22

dont forget the other tests for CN VIII

Answer 22

watch tick, weber, rinne, finger rustle

Question 23

what is the malingering test

Answer 23

a loud noise from out of sight should cause the patient to blink