Neuroanatomy

Question 1

Frontal lobe function?

Answer 1

Planning, executive function
Pre-central gyro - motor cortex
Broca’s area - expressive speech

Question 2

Frontal lobe dysfunction?

Answer 2

Primitive reflexes
Anosmia
Gait apraxia
Expressive dysphasia

Question 3

Parietal lobe function?

Answer 3

Post-central gyrus - sensory cortex

Secondary sensory cortices

Question 4

Parietal lobe dysfunction?

Answer 4

Fluent, amnesic nominal aphasia
Difficulty w speech repetition
Acalcula, agraphia, left/right disorientation
Neglect, inattention

Question 5

Temporal lobe function?

Answer 5

Auditory processing
Semantic memory
Wernicke’s area

Question 6

Temporal lobe dysfunction?

Answer 6

Memory loss
Fluent aphasia (word salad)

Question 7

Occipital lobe function?

Answer 7

Vision

Question 8

Occipital lobe dysfunction?

Answer 8

Homonymous hemianopia

Question 9

Cerebellar function?

Answer 9

Coordination, fluency of movement

Question 10

Cerebellar dysfunction?

Answer 10

Ataxia
Nystagmus
Dysdiadokoineses

Question 11

CN 1?

Answer 11

Olfactory nerve
Sensory
Innervates olfactory epithelium via olfactory bulb
Smell

Question 12

CN2?

Answer 12

Optic nerve
Sensory
Innervates retina
Vision

Question 13

CN3?

Answer 13

Oculomotor nerve
Motor- all eye movements except lateral and medial/downward
Motor - eyelids (levator palpebrae)
Parasympathetics - pupillary constriction/accommodation

Question 14

CN4?

Answer 14

Trochlear nerve

Motor - eye movement medial/downward

Question 15

CN5?

Answer 15

Trigeminal nerve
Sensory & motor
V1 ophthalmic - sensory only, upper 1/3 of face
V2 maxillary - sensory only, mid 1/3 of face
V3 mandibular - sensory and motor, lower 1/3 of face and muscles of mastication and tensor tympani

Question 16

CN6?

Answer 16

Abducens nerve

Motor - eye movement lateral only

Question 17

CN7?

Answer 17

Facial nerve
Sensory - tase anterior 2/3 of tongue
Motor - facial expression, stapedius
Parasympathetics - salivary and lacrimal glands

Question 18

CN8?

Answer 18

Vestibulocochlear nerve

Sensory - hearing and proprioception of head and balance

Question 19

CN9?

Answer 19

Glossopharyngeal nerve
Sensory - pharynx, posterior 1/3 of tongue
Chemo/baroreceptors in carotid bodies
Motor - swallowing
Parasympathetics - salivary

Question 20

CN10?

Answer 20

Vagus nerve
Sensory - external ear, abdominal/thoracic viscera
Chemo/baroreceptors in aorta and arch
Motor - speech and swallowing
Parasympathetics - resp, GI, CVS

Question 21

CN11?

Answer 21

Accessory nerve

Motor - head and shoulders

Question 22

CN12?

Answer 22

Hypoglossal nerve

Motor - tongue movement

Question 23

Child presents with acute unilateral facial weakness, including forehead weakness, a couple of weeks after a cold sore. Mild pain associated. Not tolerating bells and noise in ED cubicle. Not interested in food, described as weird/no taste. Dx?

Answer 23

Bells Palsy - CNVII

Question 24

Treatment of Bells Palsy? Parent asks you if child will make a full recovery?

Answer 24

Supportive - eye drops and pad eyes shut at night
Antivirals if VZV rash present
Pred may be of benefit
85% recover spontaneously with no residual deficit
5% have permanent facial weakness

Question 25

Ex-term baby presents with weakness/paralysis of multiple facial muscles from birth. Was an elLUSCS for breech and no instrumentation required with easy delivery of head. Doesn’t follow your finger with lateral eye movements. Possible dx?

Answer 25

Mobius Syndrome

Question 26

Child presents with facial weakness. On exam you see a rash in their ear and it is very painful to touch. Dx?

Answer 26

Ramsay-Hunt Syndrome VII
Likely to also have loss of taste
Might have tinnitus, loss of hearing or vertigo due to proximity to VIII