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Y6 Senior Med > Neuro cranial nerves > Flashcards

Neuro cranial nerves Flashcards

1
Q

Olfactory nerve function

A

olfaction

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2
Q

optic n function

A

vision

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3
Q

oculomotor nerve innervates…? what is their function

A

medial rectus, inferior rectus, superior rectus, inferior oblique > MOST EYE MOVEMENTS

palpebral muscles > HOLDS EYELIDS OPEN

ciliary muscles > PUPIL CONSTRICTION and ACCOMODATION

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4
Q

trochlear nerve innervates…? what is function

A

S4: superor obllique - down and out eye movement

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5
Q

trigeminal nerve innervates…? what is function

A

Sensation to face + corneal reflex
sensation anterior 2/3 of tongue
muscles of mastication

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6
Q

abducens nerve innervates…? what is function

A

L6: lateral rectus

OUT eye movement

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7
Q

facial nerve innervates…? what is function

A

facial muscles > facial movement
stapedius> controls acoustics of hearing (damage leads to HYPERACUSIS)
taste to anterior 2/3 of tongue

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8
Q

vestibulocochlear nerve innervates…? what is function

A

balance

hearng

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9
Q

glossopharyngeal nerve innervates…? what is function

A

poost 1/3 of tongue (taste+ sensation)

AND gag reflex

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10
Q

vagus nerve innervates…? what is function

A

sensation and motor to pharynx and laynx

include swallowing and speech

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11
Q

accessory nerve innervates…? what is function

A

SCM, trapezius

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12
Q

hypoglossal nerve innervates…? what is function

A

tongue muscles > tongue movement

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13
Q

what dermatome are the nipples

A

T4

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14
Q

what dermatome is the umbilicus

A

T10

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15
Q

CNIII palsy presentation

A

DOWN and OUT fixed eye gaze
ptosis (unable to open eye)
fixed dilated pupil (if PNS fibres also affected)

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16
Q

causes of CN3 palsy

A

stroke (posterior cerebral artery)
MS
basal skull fracture

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17
Q

What are causes of ptosis

A

Unilateral:

  • Horner’s
  • CN3 palsy

Bilateral:

  • Myasthenia gravis
  • Myotonic dystrophy
  • congenital absence of muscles

Either: infection, inflammation, tumour

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18
Q

What is Horner’s syndrome, and what general pathophysiology is it caused by

A

CAUSED BY DAMAGE to SYMPATHETIC TRYNK

TRIAD OF:

  • miosis (constricted pupil)
  • ptosis
  • facial anhydrosis
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19
Q

what can cause Horner’s syndrome

A

Vascular (carotid dissection, brainstem stroke)
Infection (pneumonia of lung apex)
Neoplasm (incl Pancoast tumour)
Idiopathic

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20
Q

Causes of Ptosis

A

nerve: (unilateral) CN3 palsy, Horner’s

NMJ: MG (bilateral)

muscle: myotonic dystrophy

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21
Q

How does pupil size vary between CN3 palsy and Horner’s

A

CN3: dilated

Horner’s: constricted

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22
Q

What is pupil like in MG

A

normal

23
Q

how does CN4 palsy present

A

unable to turn eye down and out + diplopia

24
Q

How does C5 palsy present

A

Loss of sensation to face (location depends on whether it is V1,2,3)
Absent corneal reflex (V1)
Muscle of mastication weakness (V3)

25
Q

How does CN6 palsy present

A

inability to abduct eye

26
Q

how doesC7 palsy present

A

Bell’s Palsy

27
Q

are cranial nerves UMN or LMN

A

They are LMN

They synapse with their UMN at the brainstem nuclei

28
Q

so what type of lesion is Bell’s palsy

A

LMN lesion

29
Q

sx of Bell’s palsy

A
  • ipsilateral paralysis of face incl forehead
  • inability to close eyes
  • hyperacusis (due to stapediius paralysis)
  • metallic taste in mouth
  • decrease in lacrimation
30
Q

How is an UMN lesion different to Bell’s palsy?

A

UMN lesion will be FOREHEAD SPARING

because forehead has dual UMN innervation

31
Q

What are causes of Bell’s palsy

A

Infective (otitis media, choleastatoma, VIRAL: HSV/CMV/EBV)

Neoplasm or trauma

32
Q

How do you manage Bell’s palsy

A

Oral Pred 10 days

consider acyclovir

33
Q

What are causes of UMN lesion facial droop

A

stroke
tumour
haematoma

34
Q

What is Ramsay Hunt syndrome

A

unilateral LMN facial palsy due to HERPES ZOSTER reactivation

35
Q

How does Ramsay Hunt syndrome present

A

severe ear pain, ipsilateral vertigo, hyperacusis, tintinnus

vescicles in ear, anterior 2/3 of tongue

36
Q

CN8 palsy presentation

A

sensorineural hearing loss
nystagmys
vertigo

37
Q

CN9 presentation

A

loss of gag reflex

38
Q

CN10 pallsy presentation

A

ulna deviates AWAY from lesion side

dysphagia

39
Q

CN12 palsy presentatin

A

atrophy of tongue + fasciculations

tongue deviates towards lesion

40
Q

Lesions where in the motor pathway cause ONLY MOTOR SYMPTOMSS?

A

Muscle
NMJ
Anterior Horn

41
Q

what is the difference in lesion location between spasticity and rigidity

A

spasticity: lesion in PYRAMIDAL TRACT (corticospinal)
rigidity: lesion in EXTRAPYRAMIDAL TRACT (rubrospinal / vestibulospinal)

42
Q

How does spastity present

A

INCREASED TONE which is:

  • velocity dependent
  • greatest at the initial part of movement
43
Q

How does rigidity present

A

INCREASED TONE which is

  • NOT velocity dependent
  • same resistance in all directions
44
Q

which pathway supplies the limbs

A

the LATERAL corticospinal tract (where UMN decussates at medulla)

45
Q

which pathway supplies trunk and axial muscles

A

the ANTERIOR corticospinal tract (where UMN do NOT decussate)

46
Q

what causes MONOOCULAR VISION LOSS

A

Lesion in optic nerve (ipsilateral side)

47
Q

what causes BITEMPORAL HEMIANOPIA

A

Lesion at optic chiams

48
Q

What lesion causes a HOMONOMOUS HEMIANOPIA

A

CONTRALATERAL lesion of OPTIC TRACT or OPTIC RADIATIONS (beyond the optic chiasm)

49
Q

What is a another name for. Relative Afferent Pupillary Defect

A

Marcus-Gunn pupil

50
Q

what test allows you to detect RAPD

A

Swinging torch reflex

51
Q

What occurss in RAPD

A

The afferent pathway of the eye is disripted

This leads to a non-responsive direct stimulation and a responsive indirect stimulation (light in the opposite eye)

52
Q

what conditions cause RAPD

A

MS

Glaucoma

53
Q

What is an Argyll Robertson pupil and what causes it

A

Small irregular pupils
present with accomodation reflex but without pupillary refleex

causes by diabetes or NEUROSYPHILIS (prostitute’s pulpil)

Y6 Senior Med (29 decks)

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