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Clinical Neurology > Motor cranial nerves > Flashcards

Motor cranial nerves Flashcards

1
Q

The structures that initiate lateral gaze are:

A. Superior colliculus and medial geniculate body
B. Frontal eye fields and parapontine reticular formation
C. Abducens nucleus and oculomotor nerve complex
D. Rostral interstitial nucleus of Cajal

A

B

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2
Q

On looking to the left side (L) to copy a friend’s scantron, your classmate Derpina develops diplopia. She has no problem copying answers off a friend seated to her right (R). She has dysconjugate gaze due to:

A. Disconnected medial longitudinal fasciculus between L CN VI and R CN III
B. Non-functioning frontal eye field on the R side
C. A cerebellar lesion on the L side
D. Non-functioning parapontine reticular formation on the L side

A

A

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3
Q

The particular muscle to zero in while examining a patient with facial weakness to determine whether lesion is either upper or lower motor neuron is:

A. Frontalis
B. Nasalis
C. Buccinator
D. Orbicularis oris

A

A

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4
Q

One of the following muscles innervated by the CN V can be tested in the neurologic exam

A. Frontalis
B. Masseter
C. Orbicularis oris
D. Mylohyoid

A

B

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5
Q

In assessing the integrity of the motor component of CN V, the ball of the palm is placed on:

A. The maxilla
B. The mandible
C. The glabella
D. The chin

A

B

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6
Q

In assessing the integrity of the spinal accessory nerve, the ball of the palm is placed on:

A. The maxilla
B. The mandible
C. The glabella
D. The chin

A

A

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7
Q

A peripheral facial nerve weakness can be differentiated from a central facial nerve palsy by asking the patient to:

A. Wrinkle the forehead
B. Smile
C. Close the eyes tight
D. Pull the corners of the mouth downward forcefully

A

A

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8
Q

A lesion of the right CN XII or the supranuclear corticobulbar fibers on the right will be manifested by this finding on tongue protrusion

A. Remains in midline
B. Deviates to right on tongue protrusion
C. Deviates to left on tongue protrusion
D. Poor gag reflex

A

B

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9
Q

The cranial nerve that innervates the smallest skeletal muscle in the body

A. Oculomotor nerve
B. Trigeminal nerve
C. Abducens nerve
D. Facial nerve

A

D

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10
Q

Which structure has nothing to do with vertical gaze?

A. Oculomotor nerve
B. Trochlear nerve
C. Abducens nerve
D. Medial longitudinal fasciculus

A

C

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11
Q

The corneal reflex may be absent unilaterally due to a cervical cord lesion because:

A. Fibers descend from the principal nucleus to meet the gracile and cuneate tracts
B. Fibers descend as the spinal nucleus and tract to the 2nd cord segment
C. Fibers decussate at the level of the pons to join the medial lemniscus
D. Fibers descend and hitchhike on ascending fibers from CN XI

A

B

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12
Q

What do you call the lower motor neurons in the brainstem which the corticobulbar fibers from the motor cortex synapse with?

A. Cranial nerve motor nuclei 
B. Anterior horn cells 
C. Gamma motor neurons 
D. Interneurons 
E. Intrafusal cells
A

A

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13
Q

The upper motor neurons from the motor cortex do not synapse with which of the following cranial nerve nuclei?

A. Trigeminal nerve 
B. Oculomotor nerve 
C. Vestibulocochlear nerve 
D. Hypoglossal nerve 
E. Glossopharyngeal nerve
A

C

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14
Q

How does a left peripheral facial palsy manifest?

A. Paralysis of the left forehead
B. Paralysis of the right lower half of the face
C. Paralysis of the left lower half of the face
D. Paralysis of the entire right half of the face
E. Paralysis of the entire left half of the face

A

E

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15
Q

A monocular field defect suggests:

A. Lesion in the optic nerve
B. Lesion in the optic chiasm
C. Lesion in the optic radiation
D. Lesion at the occipital lobe

A

A

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16
Q

TRUE about technique on using the opthalmoscope to examine the patient’s right eye

A. Examiner uses the left hand to hold the opthalmoscope
B. Examiner uses the left eye to examine the patient’s eye
C. Examiner uses the right eye to examine the patient’s eye
D. Examiner uses the right hand to hold the opthalmoscope and uses the left eye

A

C

17
Q

Lesion of the right CN XII or of the supranuclear corticobulbar fibers on the right side will be manifested by this finding in tongue protrusion:

A. Remains midline
B. Deviates to right upon tongue protrusion
C. Deviates to left upon tongue protrusion
D. Poor gag reflex

A

B

18
Q

How does central facial palsy manifest?

A. Weakness of the entire half of the face ipsilateral to the lesion
B. Weakness of the entire half of the face contralateral to the lesion
C. Weakness of the lower half of the face ipsilateral to the lesion
D. Weakness of the lower half of the face contralateral to the lesion
E. Weakness of both sides of the lower half of the face

A

D

19
Q

How will the motor weakness manifest if there is a lesion in the left pons?

A. Right central facial palsy and weakness of the right arm and right leg
B. Left peripheral facial palsy and weakness of the right arm and right leg
C. Left peripheral facial palsy and weakness of the left arm and left leg
D. Left central palsy and weakness of the left arm and left leg

A

B

20
Q

All the following cranial nerve motor nuclei originate in the pons except?

A. Facial Nerve 
B. Trigeminal Nerve 
C. Oculomotor Nerve 
D. Vagus Nerve 
E. Abducens Nerve
A

C

21
Q

True about cranial nerves EXCEPT:

A. The afferent arc of the corneal reflex is through sensory CN V; the efferent arc is mediated by CN VII
B. The afferent arc of the jaw jerk is mediated through sensory CN V; the efferent arc by motor CN V
C. The afferent arc of the pupillary light reflex is CN II while the efferent arc is CN VII
D. The afferent arc of the gag reflex is CN IX while the efferent arc is CN X

A

C

22
Q

Things that you check when you examine the pupils using the flashlight EXCEPT:

A. Exact size of the pupil that is measured in millimetres
B. Symmetry of pupils where a right anisocoria means the right pupil is smaller than the left
C. Shape (round, oval or irregular)
D. Direct and consensual light reflex

A

B

23
Q

Using the swinging flashlight test, if eye ‘A’ is blind due to damaged optic nerve:

A. When light is shine on eye ‘A’: no response in either eye (negative direct and consensual responses)
B. When light is shine on eye ‘B’: positive direct on eye B and consensual response on eye A
C. Both statements are true
D. Both statements are false

A

C

24
Q

Using the swinging flashlight test,

A. If eye A had damaged CN 3, there will be negative direct, but positive consensual response of eye B
B. If eye B had damaged to CN 2, there will be negative direct, but positive consensual response of eye A
C. Both statements are true
D. Both statements are false

A

A

25
Q

All eye muscles are controlled by CNIII EXCEPT:

A. Lateral rectus by CN 6
B. Superior oblique by CN 4
C. A and B
D. None of the above

A

C

26
Q

All eye muscles are controlled by CNIII EXCEPT:

A. Lateral rectus by CN 6
B. Superior oblique by CN 4
C. A and B
D. None of the above

A

B

27
Q

True about CN 7 EXCEPT:

A. The more obvious the facial asymmetry , the more a peripheral facial palsy is entertained
B. The right and left upper motor neurons (UMN’s) each innervate both the right and left lower motor neurons (LMN’s) that allow the forehead to move up and down
C. The LMN’s that control the muscles of the lower face are only innervated by the UMN from the opposite side of the face
D. None of the above (all are true)

A

D

28
Q

To check for the sensory function of facial nerve(CN7):

A. CN 7 is responsible for carrying taste sensations from the anterior 2/3 of the tongue
B. Taste is often tested only when specific pathology of the facial nerve is suspected
C. Sugar, salt or lemon juice on a cotton swab is applied to the lateral aspect of each side of the tongue and patient identifies the taste
D. A, B and C
E. A and B only

A

D

29
Q

TRUE about CN IX and CN X

A. If CN IX and CN X on the left is not functioning, the uvula will be pulled to the right
B. CN IX is responsible for taste in the posterior 1/3 of the tongue
C. CN X provides parasympathetic innervations to the heart
D. A, B and C
E. A and B only

A

D

30
Q

TRUE in testing the spinal accessory nerve (CN

A. Tested by placing your hands on top of the patient’s shoulder asking patient to shrug his shoulder while your provide resistance

B. Tested by placing your open left hand against the patient’s right cheek and ask them to turn into your hand while you provide resistance

C. Difficulty or weakness of the head turning to the right against examiner’s resistance suggests lesion of the right spinal accessory nerve

D. A, B and C

E. A and B only

A

E

31
Q

TRUE regarding the Hypoglossal nerve EXCEPT:

A. CN XII is a purely motor cranial nerve
B. Inspect for fasciculation and atrophy while tongue is protruded out and not while resting inside the floor of the
mouth
C. If there is any suggestion of deviation to one side/ weakness, direct them to push the tip of their tongue into either cheek while you provide counter pressure from the outside
D. If the face is asymmetrical, the tongue may falsely appear to deviate

A

B

32
Q

If a 23-year old seamstress develops sudden double vision and is unable to look to the right

A. The lesion is in the right frontal eye field
B. The lesion is in the left parapontine reticular formation
C. The lesion is in the right parapontine reticular formation
D. The lesion is in the left superior colliculus

A

C

33
Q

If a 40-year old housewife developed sudden left-sided weakness and tongue deviation to the right

A. The lesion is in the right pons
B. The lesion is in the left dorsolateral medulla
C. The lesion is in the right ventral medulla
D. The lesion is in the right internal capsule

A

C

34
Q

Which of the following does not transmit pain mpulses within the head and neck?

A. Trigeminal nerve
B. Facial nerve
C. Vestibulocochlear nerve
D. Glossopharyngeal nerve

A

C

35
Q

The dermatomal landmark for the 10th thoracic cord segment

A. Floating rib
B. Nipple
C. Anterior superior iliac spine
D. Umbilicus

A

D

36
Q

Pain within the posterior cranial fossa is transmitted by

A. Facial nerve
B. Glossopharyngeal nerve
C. Vagus nerve
D. B and C

A

B

Clinical Neurology (10 decks)

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