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Neurophysiology > Neurological exam 2 > Flashcards

Neurological exam 2 Flashcards

1
Q

Cranial n. emerge from the brain via?

A

Skull foramina

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2
Q

Where is CNI nuclei found?

A

Cortex

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3
Q

Where is CNII nuclei found?

A

Thalamus

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4
Q

CNIII & CNIV nuclei found?

A

midbrain

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5
Q

CNV, VI, VII, VII nuclei found?

A

pons

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6
Q

CN IX, X, XI, XII nuclei found?

A

medulla

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7
Q

CN I Function, pathway, entry/exit point?

A

CN1: olfactory, Sensory
FNC: Smell
PATHWAY: nasal cavity > olfactory bulbs > temporal/frontal lobes

EXIT/ENTRY Point: cribriform plate (ethmoid bone)

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8
Q

CN I test?

A

-ask pt to identify distinctive smell with eye closed

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9
Q

Anosmia?

A

-loss of sense of smell
-Cause: infections, head injuries

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10
Q

CN II function, pathway, entry/exit point?

A

CN II: Optic, Sensory
FNC: vision
PATHWAY: retina > thalamus > occipital lobe
ENTRY/ EXIT POINT: Optic foramen (canal)

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11
Q

CN II Tests (5)?

A
  1. Snellen eye chart (central vision)
  2. Peripheral field tests (peripheral vision)
  3. Asses retina (w/ ophthalmoscope
  4. Pupillary movements
  5. Rapid eye movements
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12
Q

CNIII, CNIV, CNVI Function & entry/exit points?

A

CNIII: Occulomotor
CNIV: Tochlear
CNVI: Abducens

ALL MOTOR
FNC: Eye movements (somatic motor)
ENTRY/EXIT: Superior orbital fissure

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13
Q

CNIII, CN IV, CNVI pathways?

A

CN III: midbrain > m. around eye (most eye movements + pupil)

CN IV: midbrain > superior oblique (directs gaze don & outwards)

CN VI: pons > lateral rectus (directs gaze laterally)

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14
Q

CNIII, CN IV, CNVI Test?

A

H Test

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15
Q

CN V function, pathway, entry/exit points?

A

CN V: Trigeminal, BOTH

SENSORY: sensation over face
1. Superior orbital fissure: upper face
2. Foramen rotundum: mid face (maxillary)
3. Foramen ovale: lower face

MOTOR: m. of mastication, some neck, middle ear
1. Foramen ovale

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16
Q

CNV Test?

A
  1. SENSORY: sharp, dull, light touch over face
  2. MOTOR: clench jaw, movements of jaw
17
Q

CN VII Function & pathway?

A

CN VII: Facial n, BOTH

SENSORY:
1. Taste of tongue (anterior 2/3)
2. Somatic sensation ear canal

MOTOR:
1. Facial movements (except tongue, eye, mastication)
2. Autonomic input to glands (salivary, nasal)

pons > internal acoustic meatus & facial canal > stylomastoid foramen

18
Q

CN VII Test?

A

Ask pt to do different facial expressions

19
Q

CN VIII function, pathway?

A

CN VIII: Vestiobulocochlear, SENOSRY
FNC: Hearing & balance

Internal acoustic meatus > pons > thalamus > temporal lobe

20
Q

Sound conduction path?

A

sound waves > ear canal > vibration of typanic membrane > movement of middle ear bone (malleus, incus, stapes) = Inc. amplitude > cochlear (inner ear) > vibration in cochlear fluid > move hair = transduce vibrations into electrical pulse > CN VIII

21
Q

CN VIII tests?

A

Hearing: tests ear canal, drum bones
- whisper in pts ear
-tunning forks (if heard better through skull then ear = problem)

Balance & eqm: tests vestibular apparatus
-observe pt standing with eyes closed (if falls or goes to one side = issue)

22
Q

CN IX function & entry/exit points?

A

CN IX: glossopharyngeal, BOTH

SENSORY:
1. sensation from pharynx, external ear & chemo/barorecptors in carotid body (autonomic)
2. Tast posterior 1/3 of tongue (somatic)

MOTOR:
1. Swallowing (somatic)
2. Parotid gland (salivary gland) innervation (autonomic)

EXIT/ENTRY: jugular foramen

23
Q

CN IX Test?

A

Gag reflux
- tongue elevates (CN X) when stimulus detected (CN IX)

24
Q

CN X Function & entry/exit?

A

CN X: Vagus, BOTH

SENSORY:
1. Sensation from visceral organ, pharynx, external ear (somatic)
2. sensory input from aortic baro/chemoreceptors (autonomic)

MOTOR:
1. Pharyngeal m. (swallowing) + laryngeal m (vocal cords) (somatic)
2. Parasympathetic NS input into visceral organs (heart, lungs, liver, GI) (autonomic)

ENTRY/ EXIT: Jugular Foramen

25
Q

CN X Test?

A

Vagus n
-does pt have hoarse voice?
- tell pt to say ahhh (elevation of palate)

26
Q

CN XI function, entry & exit points?

A

CN XI: Accessory N, MOTOR

FNC: Innervation of SCM & Trapeziums (somatic)
ENTRY: foramen magnum
EXIT: Jugular Foramen

27
Q

CN XI test?

A

turn head against resistance & shrug shoulders

28
Q

Which CN is not a true CN?

A

CN IX: Accessory

-cell body located in cervical spinal cord

29
Q

CN XII function & entry/exit point?

A

CN XII: Hypoglossal, MOTOR

FNC: Innervate tongue (speech, swallowing)
ENTRY/EXIT: hypoglossal canal

30
Q

CN XII test?

A

-ask pt to stick out tongue & move to the side

31
Q

Dorsal column-medial lemniscal system pathway?

A

touch, vibration & proprioception

Dorsal horn, dorsal column, cross over in medulla

sensory > 1st neuron > dorsal horn > dorsal column > synapse in medulla w/ 2nd neuron >crosses over > synapse with 3rd in thalamus > post central gyrus

32
Q

Spinothalamic tract pathway?

A

pain & temp

dorsal horn, crosses over in dorsal horn, lateral, anterior column

Sensory > neuron > dorsal horn > synapse w/ 2nd neuron & crosses over >lateral, anterior column > synapse w/ 3rd in thalamus > post central gyrus

33
Q

To test dermatomes of dorsal column-medial lemniscal pathway & spinothalamic tract?

A

dorsal column-medial lemniscal pathway:
- dull/soft (touch)
-for vibration: use running fork on bony prominence

Spinothalamic tract:
-sharp

Neurophysiology (2 decks)

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