Kruse 1 Flashcards
1
Q
CN I
A
Olfactory
- Anosmia: loss of sense of smell
- Testing: use whatever is on hand (hand sanitizer, lotion)
2
Q
Aniscoria
A
- Pupil Asymmetry, present in up to 20% of the population
- If the difference is consistent in varying levels of ambient light, its probably normal
3
Q
Miosis and mydriasis
A
- Miosis
- pupil constriction
- parasympathetic stimulation, light, looking at a near object
- mydriasis
- pupil dilation
- sympathetic stimulation, decrease in light, looking at a far object
4
Q
Pupillary reaction to light (direct/indirect)
A
- Direct puillary reaction to light
- light shown on the retina (afferent CN II) results in constriction of the IPSILATERAL pupil (efferent CN III)
- Indirect pupillary reaction to light
- light shown on the retina (afferent CN II) results in constriction of the CONTRALATERAL pupil (efferent CN III)
5
Q
Pupillary reaction to accomodation
A
- Pupils constrict when focused on a near object
6
Q
Marcus Gunn Pupil
A
Relative afferent pupillary defect
- Due to optic nerve or severe retinal disease
- direct pupillary resposne to light is absent, but the indirect response is intact because CN III remains intact
7
Q
Intact to accommodation but not the light
A
Hallmark of neurosyphilis
8
Q
Horner’s syndrome
A
- Loss of sympathetic tone
- Ptosis = droopy eyelid
- Miosis = pupil constricted
- anhydrosis = lack of sweating on that side of the face
9
Q
CN IV palsy
A
- inability to bring the eye in and down
- often leads to certical diplopia with reading or near vision
- often develop head tilt AWAY from the affected eye
10
Q
Saccades Vs Nystagmus
A
- Saccades = normal jumping movements of the eye with voluntary scanning (reading, etc)
- Nystagmus
- slow drift away from the focus with fast beat correction back to the focus
- NAMED FOR THE FAST PHASE
- cerebellar lesion: lateral, fast phase towards the side of lesion
- Vertical lesion: typically indicates a lesion in the midbrain
11
Q
UMN vs LMN in the face
A
- Forehead has bilateral UMN involvement but unilateral LMN involvement
- this means that an UMN lesion (eg STROKE) will cause facial drooping but spare the forehead
- a patient with an LMN lesion (eg BELLS PALSY) will cause facial drooping involving the forehead
12
Q
Conductive vs sensorineural hearing loss
A
- Conductive type hearing loss
- hearing loss is due to inefficient conduction fromthe outer ear to the ear drum to ossicles
- fluid in the middle ear, perforated ear drum, impacted cerumen, foreign body
- hearing loss is due to inefficient conduction fromthe outer ear to the ear drum to ossicles
- Sensorineural hearing loss
- damage to the inner ear apparatus or CN VIII
- med toxicity, genetic hearing loss, aging, trauma, infection, exposure to loud noises
- damage to the inner ear apparatus or CN VIII
13
Q
Weber vs rinne test
A
- Rinne test
- vibrating handle of the turning fork against the mastoid process until the sound fades, then move the tines to just outside the auditory meatus
- the sound should be LOUDER on AIR CONDUCTION than bone
- normal test is positive, abnormal is negative
- the sound should be LOUDER on AIR CONDUCTION than bone
- vibrating handle of the turning fork against the mastoid process until the sound fades, then move the tines to just outside the auditory meatus
- Weber test
- vibrating handle of the tuning fork agaisnt midline of the skull
- the sound should be equal in both ears
- louder in one ear is considered lateralizing to that side
- vibrating handle of the tuning fork agaisnt midline of the skull
14
Q
C2
C6
C7
C8
A
C2 = back of head
C6 = tumb
C7 = index and middle finger
C8 = ring and little finger
15
Q
T1
T4
T10
A
T1 = anterior axilla
T4 = nipple line
T10 = umbilicus
