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NEURO CLERKSHIP > Neuroanatomy 2 pages 23- > Flashcards

Neuroanatomy 2 pages 23- Flashcards

1
Q

where does the inferior oblique make the eye go?

A

looking up and in

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2
Q

where does the superior oblique make the eye go?

A

looking down and in

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3
Q

are CN3 nuclei close together? to they traverse laterally?

A

yes in midbrain

medially

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4
Q

what arteries does CN 3 travel between?

A

posterior cerebral artery and superior cerebellar artery

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5
Q

when does CN3 get trapped in herniation?

A

when temporal lobe uncus slips unter tentorium cerebelli

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6
Q

What nerves go through cavernous sinus?

A

CN 3, 4, V1, V2, 6

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7
Q

A lesion compresing CN3 externally will do what?

A

the parasympathetics fibers causing the pupil to dilate, it will have ptosis and extra-ocular muscle weakness

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8
Q

what commonly compresses CN3 that is not a herniation?

A

posterior communicating artery aneurysm

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9
Q

what are the key features of a CN3 palsy?

A

ptosis, mydriasis and ophthalmoplegia

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10
Q

what are the key feutrues of horners?

A

ptosis, miosis, anhidrosis

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11
Q

CN3 ophthalmoplegia looks like what?

A

down and out

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12
Q

diabetes damage of CN3 has what features?

A

ptosis and ophthalmoplegia

not miosis

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13
Q

CN4 originates in the posterior midbrain then it does what?

A

decussates behind sylvian aqueduct then circumnavigates the brainstem

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14
Q

what does a patient look like with a right CN IV palsy?

A

tilt their head to the left

defected depression of the adducted right eye

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15
Q

what lesion causes ipsilateral CN3 palsy and a contralateral hemiparesis?

A

lesion of the cerebral peduncle

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16
Q

A lesion of the tract near the red nucleus will result in what?

A

oculomotor palsy and a tremor

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17
Q

Midbrain damge often results in CNIII palsy plus damage to any one of the followin, what is the other symptom that matches each location- cerebral peduncle?, RAS?, red nucleus?

A

-contralateral hemiparesis
-coma
tremor

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18
Q

a lesion within the pons damaging the CN6 nuclesu will result in what? and if the nucleus of CN7 is involved? what if it involved the corticospinal tract?

A
  1. gaze palsy
  2. gaze palsy and facial palsy
  3. gaze palsy and associated contralateral hemiparesis
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19
Q

what nerve is commonly damaged due to incresed ICP due to its lengthy intracranial course?

A

CN6

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20
Q

how do we remember what cranial vault holes the V branches go?

A

standing room only
sup orbital fissure
rotundum
ovale

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21
Q

what are the 3 separate nuclei of the trigeminal system?

A

mesencephalic in midbrain
main sensory in pons
decending in medulla

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22
Q

a brainstem lesion affecting the descending nucleus is depicted with what pattern of sensory loss?

A

expanding circle

pain and temp

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23
Q

mesencephalic nucleus is concerned with?

A

proprioception

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24
Q

the main sensory trigeminal nucleus is concerned with what?

A

light touch

25
Q

what is the corneal reflex afferent? efferent?

A

V1

VII

26
Q

what might cause ptosis, ophthalmoplegia and sensory loss over V1 and V2?

A

cavernous sinus problems like thrombus

27
Q

extra axial facial nerve lesion may cause facial paralysis with what other findings although a lesion to the actual nucleus itself won’t?

A

taste salivation and lacrimation

an intra-axial lesion of just pons will never cause this

28
Q

does a lesion of CN7 lead to quiter sounds?

A

no louder sounds (hyperacusis)

29
Q

what part of the tongue does CN VII taste?

A

ant. 2/3

30
Q

a supranuclear lesion of CNVII will do what to the forehead and orbicularis oris?

A

spare it and let them blink

31
Q

CN 7 nucleus lesion or of the nerve spare the forehead?

A

no- total ipsilateral facial paralysis

32
Q

what type of VIII lesion are more apt to cause imbalance or veering towards the side of the lesion?

A

central lesions

33
Q

a lesion of the pons damaging the vestibular nuclei results in what nystagmus?

A

vertical or horizontal/rotatory

34
Q

a lesion of the inner ear labyrinth or vestibulocochlear nerve results in what nystagmus?

A

horizontal

35
Q

a cerebellopontine angle lesion causes damage to what nerves?

A

CN5, 7, 8

ipsilateral deafness, vertigo, facial numbness and complete facial paralysis

36
Q

Lesions of pontine usually use CN VI and VII plus damage to the following structures, what are the signs of these- basis pontis? RAS? Trigeminal system? Spinothalamic pathway?

A
  • contralateral hemiparesis
  • coma
  • ipsilateral facial sensory loss
  • contralateral body sensory loss
37
Q

CN 9 and 10 motor fibers arise in what nucleus?

A

nucleus ambiguus- supply the laryngeal and pharyngeal muscles

38
Q

The parasympathetic fibers of the vagus nerve arise from what nucleus?

A

dorsal motor nucleus

39
Q

IX X an XI exit skull through where?

A

jugular foramen

40
Q

lesions of 3 nerves can occur at the jugular foramen- what are the signs?

A

dysphagia
dysarthria
shoulder droop

41
Q

where does the CN12 leave the medulla?

A

exit between the inferior olive and corticospinal tracts

42
Q

CN 12 lesions deviates toward what?

A

the lesion

43
Q

what 6 signs make up wallenburg syndrome?

A
  • ipsi facial pain/temp
  • contralateral body pain/temp
  • horner’s
  • ipsilateral gait
  • vertigo, nausea, vomit, nystagmus(vestibular nuclei lesion)
  • dysphagia and hoarseness
44
Q

What are the 3 signs that make up medial medullary syndrome?

A

1- tongue deviates toward lesion

  1. contralateral loss of vibration and proprioception
  2. contralateral hemiparesis sparing the face
45
Q

conjugate horizontal gaze from the FEF leads to what movement of what CNs?

A

ipsi CN 3 medial rectus

contra CN6 lateral rectus

46
Q

review the path of conjugate gaze –

A

FEF, brainstem decuss, PRPF CN VI, MLF, CNIII, contralateral medial rectus

47
Q

What’s the secrete for knowing it is a INO

A

paretic left medial rectus with right gaze becomes fully functional with convergence

48
Q

INO has what impairments?

A

impaired adduction of the ipsi eye with horizontal gaze

horizontal nystagmus of the contralateral abducted eye

49
Q

With a pontine lesion the gaze deviation is where?

A

away from the lesion with a contalateral hemiparesis

50
Q

warm water in the ear causes the patients eyes to do what?

A

eyes to drift in opposite direction with fast beating nystagmus towards the irrigated ear

51
Q

cold water in the ear makes the patienseyes to do what?

A

drift towards the irrigated ear with fast beating nystagmus in the opposite direction

52
Q

Is nystagmus present in a comatose patient with an intact brainstem?

A

no

53
Q

Does COWS apply to the comatose patients?

A

NO!!!! fast phase nystagmus absent in coma

54
Q

what is absent in oculocephalic reflex that tells you the patient is in coma?

A

saccades

55
Q

abnormal cold caloric testing or Doll’s head maneuver implicates what?

A

brainstem lesion damaging the RAS

56
Q

brow sequard?

A

ipsi motor and proprioception

contralateral pain and temp

57
Q

complete cord compression leads to what?

A

LMNs at first due to spinal shock, then spasticity, hyperreflexia, babinski positive and BOWEL / BLADDER. don’t forget

58
Q

an expanding central cord lesion has what type of sparing?

A

sacral sparing and usually the dorsal columns are spared

59
Q

what effects sacral roots resulting in saddle anestesia?

A

midline lesion of cauda equina

NEURO CLERKSHIP (7 decks)

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