Neuro Review- First Aid- pg 472 -476 Flashcards
Dx?
- contralateral paralysis of lower face
- forehead spared (bc of bilateral UMN innervation)
facial UMN lesion
CNs of the medulla?
CNIX, X, XI, XII (9, 10, 11, 12)
CNV (5) motor lesion finding?
jaw deviates TOWARD side of lesion b/c of unopposed ptyerygoid muscle forces
CNs of the spinal cord?
nucleus of CNXI (11)
Name the muscles that close the jaw.
- Masseter
- teMporalis
- Medial pterygoid
*** M’s Munch- it takes More Muscle to keep your Mouth shut!
- Finding: uvula deviates AWAY from side of lesion (weak side collapses and uvula points away)
- Lesion?
CNX (10)
Dx?
- peripheral ipsilateral facial paralysis (drooping smile)
- inability to close eye on affected side
- cause = destruction of facial nucleus or its branching efferent fibers (facial nerve)
- idiopathic = Bell’s palsy (usu. self-limiting)
- risk factors = Lyme disease, herpes simplex and zoster, sarcoid, tumors, DM
- tx = corticosteroids
facial nerve palsy
pupillary reflex afferent and efferent CNs
- afferent = II (2)
- efferent =III (3)
lateral cranial nerve nuclei = ?
sensory (aLar plate)
gag reflex afferent and efferent CNs
- afferent = IX (9)
- efferent = X (10)
medial cranial nerve nuclei =
motor (basal plate)
facial nerve palsy
- peripheral ipsilateral facial paralysis (drooping smile)
- inability to close eye on affected side
- cause = destruction of facial nucleus or its branching efferent fibers (facial nerve)
- idiopathic = Bell’s palsy (usu. self-limiting)
- risk factors = Lyme disease, herpes simplex and zoster, sarcoid, tumors, DM
- tx = corticosteroids
What is the Weber hearing test and when will it be abnormal?
- tuning fork placed on top of pt’s head - ask which ear the sound is louder in
- normal = both ears equal
- abnormal = louder in defective ear
_____ frequency sounds are heard at the apex of the basilar membrane near the helicotrema.
Low
In sensorineural hearing loss, the Rinne test will show ____ and the Weber test will show ____.
- Rinne = normal
- Weber = louder in unaffected ear
CNs of the midbrain?
CNIII and IV (3 and 4)
CNs of the pons?
CNV, VI, VIII, VIII (5, 6, 7, 8)
Name the muscles that open the jaw.
only the lateral pterygoid (lateral lowers)
- Finding: weakness turning head to contralateral side of lesion (SCM) with shoulder droop on side of lesion (trapezius) *** the L SCM contract to help the head turn R ***
- Lesion?
CNXI (11)
CNXI (11) lesion finding?
- weakness turning head to contralateral side of lesion (SCM)
- shoulder droop on side of lesion (trapezius)
- *** the L SCM contracts to help the head turn R ***
In conductive hearing loss, the Rinne test will show ____ and the Weber test will show ____.
- Rinne = abnormal
- Weber = sound louder in affected ear
_____ frequency sounds are heard best at the base of the cochlea.
High
jaw jerk reflex afferent and efferent CNs
- afferent = V3 (5- sensory- muscle spindle from masseter)
- efferent = V3 (5- motor- masseter muscle)
What is the Rinne hearing test and when will it be abnormal?
- tuning fork against mastoid bone until pt can’t hear sound any longer, then move to air next to ear
- normal = can hear sound next to pinna after mastoid
- abnormal = conductive (bone > air)
- Finding: tongue deviates TOWARDS side of lesion (lick your wounds) due to weakened tongue muscles on the affected side
- Lesion?
CNXII (12)- LMN
Low frequency sounds are heard at the ____ of the basilar membrane near the _____.
apex; helicotrema
CNX (10) lesion finding?
uvula deviates AWAY from side of lesion (weak side collapses and uvula points away)
High frequency sounds are heard best at the _____ of the _____.
base of the cochlea
facial LMN lesion findings
ipsilateral paralysis of upper AND lower face
CNXII (12) lesion finding (LMN)?
tongue deviates TOWARDS side of lesion (lick your wounds) due to weakened tongue muscles on the affected side
Dx?
ipsilateral paralysis of upper AND lower face
facial LMN lesion
- Finding: jaw deviates TOWARD side of lesion b/c of unopposed ptyerygoid muscle forces
- Lesion?
CNV (5) motor lesion
facial UMN lesion findings
- contralateral paralysis of lower face
- forehead spared (bc of bilateral UMN innervation)
corneal reflex afferent and efferent CNs
- afferent = V1 (5- ophthalmic- nasociliary branch)
- efferent = VII (7- temporal branch- orbicularis oculi)
lacrimation reflex afferent and efferent CNs
- afferent = V1 (5- doesn’t mess with emotional tears, tho)
- efferent = VII (7)
