Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Neuromuscular > Lecture 2 - Cranial Nerves > Flashcards

Lecture 2 - Cranial Nerves Flashcards

1
Q

LMN Symptoms

A

Single limb paralysis

Flaccid muscle tone

Hyporeflexia

Muscular atrophy

Fibrillation/fasciculation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of Cerebellar Syndrome

A

Incoordination/ ataxia

Dysmetria

Dysdiadochokinesis

Intention Tremor

Rebounding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Incoordination/Ataxia

A

A complex movement is decomposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Dysmetria

A

Unable to measure distance or speed

Under- or Over-shooting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Dysdiadochokinesis

A

Alternate motion rate (pa pa pa)

Alternate sequential rate (pa ta ka)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Intention Tremor

A

Not resting tremor

Tremor when attempting to make an intentional movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Rebounding

A

Inability to judge when the resistance has disappeared

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms of Basal Ganglia Syndrome

A

Involuntary Movements:

Chorea

Dyskinesias

Hypokinesias

Athetosis

Rigidity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

UMN Symptoms

A

Hemiplegia

Spastic tone

Resistance to passive movement

Hyperreflexia

Atypical Reflexes
- Babinski

No atrophy

No denervation

Muscles are paralyzed but they don’t die because they are hyper reflexive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Branchial Arches

A

There are 6 branchial arches that turned into muscles when we were born.

They are classified as Special Visceral Efferent even though they are under voluntary control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First Arch

A

Moror branch of the Trigeminal Nerve

Special Visceral Efferent

Muscles of mastication

Additional muscles:
Mylohyoid, ant. belly of digastric, tensor tympani, tensor veli palatini

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Second Arch

A

Facial Nerve

Muscles of facial expression:
Buccinators, auricularis, frontalis, platysma, orbicularis oris, orbicularis occuli

Additional muscles:
stapedius, stylohyoid, posterior belly of digastric muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Third Arch

A

Glossopharyngeal Nerve

Innervates the stylopharyngeus muscle
- deals with swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Fourth and Sixth Arches

A

Vagus Nerve

5th arch disappears

Superior and recurrent laryngeal nerves

Pharyngeal and laryngeal muscles:
cricothyroid, levator veli palatini
- deals with swallowing and phonation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Unnumbered Gill Structures

A

Spinal accessory nuclei in C1-C5

Sternocleidomastoid and trapezius muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Functional Classifications

A

****Put in Picture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Classification - General Somatic Efferent

A

General Somatic Efferent = innervation of the skeletal muscles (somite)

Includes: 
Ocular muscles (CNs Oculomotor (III), Trochlear (IV), Abducens(VI)
Lingual muscles (CN hypoglossal (XII) 
   - All muscles of the tongue are somite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Classification - General Visceral Efferent

A

Synonym for Autonomic Nervous System

Smooth muscles to regulate pupillary reactions, gland secretion, and muscles of the heart, trachea, bronchi, esophagus, and viscera (ANS) :

Edinger-Westphal Nucleus (Oculomotor - III)
Superior Salivatory Nucleus (Facial - VII)
Inferior Salivatory Nucleus (Glossopharyngeal - IX)
Dorsal Motor Nucleus (Vagus - X)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Classification - Special Visceral Efferent

A

Branchial Efferent - muscles of face, mandible, pharynx, larynx, and neck. Includes:

Motor nucleus of the Trigeminal - V
Motor nucleus of the Facial - VII
Nucleus Ambiguous of Glossopharyngeal - IX, Vagus - X
Accessory motor nuclei (in upper cervical C1-C5 segments)
Motor nucleus of spinal accessory - XI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Classification - Special Somatic Efferent

A

Does not exist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Classification - General Somatic Afferent

A

Somesthetic input (pain, temperature, touch) from the skin and somatic muscles in the head, neck, and face includes:

Trigeminal - V sensory nerve
- chief sensory nucleus and spinal descending nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Classification - General Visceral Afferent

A

General sensation, pain, and temperature from visceral structures from pharynx, palate, larynx, aorta, and abdomen includes:

Glossopharyngeal - IX
Vagus - X

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classification - Special Somatic Afferent

A

Special senses

Includes:

Optic - II (vision)
Vestibulo-acoustic - VII (audition and equilibrium) Also proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Classification - Special Visceral Afferent

A

Gustation and smell (olfaction). Includes:

Olfactory - I
Facial - VII
Glossopharyngeal - IX
Vagus - X

Special has very special receptors/cells
General is pain and touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Autonomic Nervous System
When the cell is outside the central nervous system its called a ganglia Vital organs Additional ganglion - pre and post ganglionic positions - cranial nerve nuclei - corticonuclear tract ******Images clustered CN nuclei, coriconuclear tract
26
Innervation Pattern HELP
**** Image blue background white brain Bilateral corticonuclear regulation of most CN LMNs Exceptions: - Lower face (VII) - SCM/Trap muscles (XI) - Lingual muscles (XII) Ocular muscles - the gaze center Coordination of both eyes - left frontal cortex to right center R gaze center - right and left recti contraction
27
Why are CN's so Complex?
Shared nuclei - salivatory, solitarius, ambiguus Shared CN functions - some CNs are doing more than one thing - Ocular movement - there are 3 CNs for eye movement - Tongue sensation - there are 2 CNs for tongue sensation, 2 for taste Look up Summary Table 17-3
28
Trigeminal Neuralgia
AKA Tic Doulaureux Loss of sensation due to damage to the trigeminal nerve Stabbing pain Trigger Point
29
Herpes Zoster
Caused by damage to the trigeminal nerve Painful disorder along the nerve
30
Masticator Palsy
Caused by damage to the trigeminal nerve Paralysis of the muscles of mastication Unilateral UMN = mild paresis because of bilateral innervations; mild effect on muscle strength Unilateral LMN = twitching, muscle atrophy, and jaw deviation to the side of the lesion Bilateral (UMN/LMN) lesions = profound impact on chewing,
31
Bell's Palsy
Due to damage to the Facial nerve Ipsilateral Facial Paralysis Sagging face Loss of taste on anterior ⅔ of tongue
32
Cranial Nerve I
Olfactory Function: Smell Classification: SVA Pathways: Clinical Considerations: - Anosmia = unilateral and bilateral lesions - Caused by TBI, sinusitis, upper respiratory infections, orbital tumors Assessment: Odor Identification Speech Relevance: N/A
33
Cranial Nerve II
Optic Function: Vison Classification: SVA Pathways: Clinical Considerations: - Blindness pattern - Field of loss patterns Assessment: Reporting on finger moving from periphery; reflexes Speech Relevance: N/A
34
Cranial III
Oculomotor Function: Eye Movement Classification: GSE, GVE Pathways: Clinical Considerations: - External ophthalmoplegia (ex. recti muscles are paralyzed) - Diplopia - Internal ophthalmoplegia (pupil is permanently dilated) - Ptosis (droopy eyelid) Assessment: - Ocular movement - Diplopia - Pupillary response to light Speech Relevance: N/A
35
Cranial Nerve IV
Trochlear Function: Eye Movement Classification: GSE Pathways: Clinical Considerations: - Diplopia - Peripheral Neuropathy Assessment: - Look for eyes moving in coordination Speech Relevance: N/A
36
Cranial Nerve V
Trigeminal Function: - Receives pain/touch from skin and muscles in the face, orbit, nose, mouth, forehead, teeth, meninges, ant. ⅔ of tongue, ext. auditory meatus, and ext. surface of the tympanic membrane. - Proprioception of jaw - Controls jaw movement Classification: GSA, SVE Pathways: Clinical Considerations: - Loss of sensation - Tic Doulaureux - Herpes Zoster - Masticator Palsy Assessment: - Symmetry during rest and action - Jaw movements Speech Relevance: - Dental sounds - Bilabial sounds
37
Cranial Nerve VI
Abducens Function: - Lateral Eye movements - Abducts eye via activation of the lateral rectus muscle Classification: GSE Pathways: Clinical Considerations: - Medial Strabismus = no gaze to affected side - Diplopia Assessment : Impaired Ocular movements Speech Relevance: N/A
38
Cranial Nerve VII
Facial Function: - Regulates secretions from the lacrimal and mucosal glands of the nasopharynx and salivary secretion from sublingual and submaxillary glands - Mediates taste sensation from anterior ⅔ of tongue and palate - Innervates muscles of facial expression, scalp, and stapedius Classification: GVE, SVA, SVE Pathways: Clinical Considerations: - Unilateral facial paresis - Secretions - Taste - Bell's Palsy - Hyperacusia Assessment: - Oral Secretion - Taste Sensation - Facial Symmetry - Ability to smile Speech Relevance: - Bilabial Sounds - Labiodental sounds - Sagging face - Drooling of food - Loss of taste
39
Cranial Nerve VIII
Auditory Function: Hearing, Equilibrium Classification: SSA Pathways: Clinical Considerations: - Hearing Impairments - Disequilibrium Assessment: - Repetition of words with masking - Weber Test - Rinne (Mastoid Placement) Speech Relevance: Hearing
40
Cranial Nerve IX
Glossopharyngeal Function: - Mediates gag and respiratory reflexes - Regulates salivary secretion - Transmits taste from posterior ⅓ of tongue - Contributes to swallowing reflex Classification: GVE, SVA, SVE Pathways: Clinical Considerations: - Palatal sensation - Gag reflex (afferent) - Swallowing - Taste (posterior ⅓) - Cutaneous senation Assessment: Speech Relevance: - Can't form bolus (swallowing) - Loss of taste - No gag reflex
41
Cranial Nerve X
Vagus Function: - Sensation from pharynx, larynx, thorax, carotid body, abdomen - Regulates Nausea, oxygen intake, and respiratory reflex - Innervates glands, cardiac muscles, trachea, bronchi, esophagus, stomach and intestine - Taste sensation - Controls muscles of larynx, pharynx, and soft palate Classification: GVE, SVA, SVE Clinical Considerations: Assessment: - phonation - voice quality - swallowing quality - resonance quality Speech Relevance: - Swallowing - Sensation - Dysarthria - Palatal Movement - Gag reflex - Pitch
42
Cranial Nerve XI
Spinal Accessory Function: - Controls head position by controlling trapezius and sternocleidomastoid muscles Classification: SVE Pathways: Clinical Considerations: - UMN - Contralateral Weakness - LMN - ipsilateral paralysis = dropped shoulders, deviated head Assessment: - Shrugging/Shoulder movement - Head turn against resistance Speech Relevance: N/A
43
Cranial Nerve XII
Hypoglossal Function: Controls motor movements of the tongue Classification: GSE Pathways: Clinical Considerations: - Unilateral LMN = ipsilateral paralysis - Bilateral LMN = loss of speech, swallowing, chewing - Unilateral UMN = contralateral muscle weakness with gradual recovery - Bilateral UMN = complete paralysis Assessment: - Visual appearance - Tongue movement against resistance - Alternate motion rate Speech Relevance: - Lingual sounds - Dental sounds - Swallowing
44
Multiple Nerve Innervation
Ocular Muscles Lingual Muscles Pharyngeal Muscles
45
Cranial Nerve Mediated Reflexes
Pupillary Reflex Corneal Reflex Gag Reflex Sneeze Reflex
46
Pupillary Reflex
Constriction Assess through: Shining light in eye CN III Efferent fibers CN II afferent fibers
47
Corneal Reflex
Eye blink Assess through corneal touch CN VII efferent fibers CN V afferent fibers
48
Gag Reflex
Effort to vomit Assess through pharyngeal touch CN X efferent fibers CN IX, X afferent fibers
49
Sneeze Reflex
Sneeze Assess through nasal irritation CN X efferent fibers CN V afferent fibers
50
Cranial Nerve Syndromes
Weber Syndrome Millard-Gubler Syndrome Locked-in Syndrome Wallenberg Syndrome Dejerine Syndrome
51
Weber Syndrome
Midbrain Structures = corticospinal fibers, Oculomotor nerve Symptoms: Contralateral hemiplegia Ipsilateral ocular paralysis Lateral eye deviation dilated pupil Possible ptosis
52
Millard-Gubler Syndrome
Lower Pons Coricospinal nerves, facial nerve, abducens, Contralateral hemiplegia Medial strabismus due to ocular paralysis Ipsilateral facial paralysis
53
Strabismus
Eyes don't look in the same direction at the same time
54
Locked-in Syndrome
Bilateral Basal Pons Motor fibers and Cranial Nerve VI Quadriplegia Preserved vertical eye movements Intact sensation and comprehension
55
Wallenberg Syndrome
Lateral Medulla Trigeminal spinal tract, nucleus ambiguous, spinal lemniscus Ipsilateral pain sensation loss from face Contralateral pain sensation loss from body Dysarthria
56
Dejerine Syndrome
Medial Medulla Hypoglossal Nerve, pyramidal fibers Contralateral hemiplegia Contralateral hemianesthesia - loss of sensation Dysarthria due to ipsilateral lingual paralysis
57
Neurological Motor Speech Assessment - Purpose
Identify the following: Nature of oral deficit Facial adequacy for speech Severity of disorder Implications for treatment
58
Neurological Motor Speech Assessment - Patient History
Ask: Onset and course Associated deficit: - dysphagia and dysarthria - fatigue - unintelligibility Perception of deficit by self and/or others Cognitive ability
59
Neurological Motor Speech Assessment - Salient Motor Features
Muscle Strength Movement speed Movement range Movement accuracy and steadiness Muscle tone
60
Assessment of Muscle Strength
Strength Dysfunction: - Failure to reach or sustain a level - Strength fall with sustained act - Inaccurate/excessive/lesser strength Implications: - respiration (incompetence) - Laryngeal (incompetence) - Palatopharyngeal (emission) - Articulatory (precision)
61
Assessment of Speed
Speed Dysfunction: - slow start - slow course & slow delay - slow movements with limited range Implications for speech, prosody, and resonance
62
Assessment of Range
Range Disturbance: - limited for single/repetitive movement - inaccurate and variable range Implications for speech: - prosodic dysfunctions - weak articulation
63
Assessment of Movement Accuracy
Accuracy Disturbance: - Over/Under shooting Implications: - random breakdown in speech - prosodic variations
64
Assessment of Movement Steadiness
Steadiness Disturbance: - Tremor - Chorea - Involuntary Movements Implications: - Articulatory fluctuation - Unsustained articulation - Premature articulations - Random Prosodic interruptions
65
Assessment of Confirmatory Signs of Motor Dysfunction - Non-Speech Symptoms
Gait: - Clumsy - with wide-based gait - Standing - body swaggering from side to side - Not walking from heel to toe or in a straight line Pathological Reflexes Palsy: - Single or multiple sets of muscles Slow and awkward movement Object dropping Foot dropping while walking Unexplained fatigue
66
Assessment of Confirmatory Signs of Motor Dysfunction - Speech Symptoms
Sound distortions Slurred and imprecise speech Impaired resonance Slow rate of speech: - articulatory duration - increased pauses Reduced loudness Altered phonation
67
Examination of Motor Speech
Symmetry is very important in the brain Testing Conditions: - Rest - Non-speech motor activity - Sensation - Speech activity
68
Assessment - Face
``` Rest Condition: Check for symmetry of - eyes - nasolabial fold - mouth angle - philtrum and its ridges - cheek curve - forehead wrinkles - facial bulk ```
69
Assessment of Facial Signs of Weakness
Masked face Sagging face/lip Lack of wrinkles Absence of nasolabial fold Wide pallbearer fissure Flat philtrum Asymmetric facial contours
70
Assessment of Facial Muscles - MN Involvement
Facial muscles are needed for speech and non-speech tasks Sensation of oral facial muscles Unilateral UMN – no problem, the patient should be able to make expressions (the other side will take over) Bilateral UMN – nothing can do, expression less, very few movements Unilateral LMN – one side is affected Bilateral LMN (both facial nerves are damaged)– patient cannot do anything, both sides of the face are affected **profound affects with bilateral
71
Assessment of Mandibular Muscles
At rest condition: - manidble asymmetry and bulk - bilateral jaw sagging Non-speech activities: - jaw opening/closing with or without resistance - lateral jaw movement against force - bulk during jaw clenching - holding tongue depressor Sensation Assessment Speech Tasks LMN/UMN/Bilateral involvement - Bilateral = big issue
72
Assessment of Tongue
At rest condition: - Symmetry - Fibrillations at edges Non-Speech Motor Activities: - Protrusion - Movements - Movements against resistance Sensation: - 3 CNs for tongue sensation = Speech Tasks UMN/LMN/Bilateral Involvement UMN - unilateral = contralateral problem with tongue LMN = ipsilateral problem with the tongue Bilateral = devastating
73
Assessment of Palatopharyngeal Port
At rest condition: - Symmetry of arch while saying "ah" - Unilateral palatal asymmetry (deviates to good side) - Bilateral palatal asymmetry (affects gag reflex because whole palate comes down Sensation Speech Tasks - Produce "ah" and "ga" - Deviation to good side - Lower excursions LMN/UMN/Bilateral Involvement: Unilateral UMN = asymmetry, but minimal Unilateral LMN = vagus or trigeminal nerve; one side will go down, ipsilateral Bilateral = whole thing comes down
74
Assessment of Larynx
At rest condition: - Position of head and shoulders Sensation Non-speech tasks: - Coughing/Throat clearing Speech tasks: - Roughness, hoarseness, breathiness UMN/LMN/Bilateral Involvement: Unilateral UMN (ALWAYS CONTRALATERAL): no profound impact because of bilateral innervation Bilateral UMN – profound impact on vocal folds (present the same as bilateral LMN) Uni LMN = ipsilateral, LMN (ALWAYS IPSILATERAL): one vocal fold would be fixed in para-medium position (hoarseness, diplophonia, breathiness) Bilateral LMN: both vocal folds would be fixed in para-medium position
75
Assessment of Respiratory Capacity
At rest condition: - Posture - changed or abnormal posture - Shortness of breath - Abnormal breathing patterns - chest breathing Speech tasks: - Water glass manometer (bubble generation)
76
Assessment of Speech Quality
Contextual Attributes of Spontaneous Speech: - Intelligibility - Intensity - Resonance characteristics - Naturalness Intelligibility and naturalness go when there is any kind of dysarthria
77
Additional Aspects of Assessment
Stress reading - Need to read with lots of energy/stress Vowel Prolongation - Duration, steadiness, loudness Sequential Motion Rate = Alternate Motion Rate = Speed and regularity of movements

Neuromuscular (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions