NMS 6

Question 1

CN I

Answer 1

sensory: smell is tested in one nostril at a time with eyes closed
anosmia: loss sense of smell
parosmia: distorted sense of smell

Question 2

CN II

Answer 2

sensory: vision is tested with Snellen Chart for visual acuity, visual fields (peripheral vision)
direct light reflex: CN 2 and 3
consenual light reflex: CN 2 and 3
accomodation: eyes converge, pupils constrict, lens convexity

Question 3

CN III

Answer 3

motor: levator palpebrae, inferior oblique, superior, medial and inferior rectus
parasympathetic: ciliary muscles and constrictor pupillae
direct light reflex
indirect light reflex
accomodation
strabismus (deviation of both eyes)
ptosis (eyelids droop due to weakness or paralysis of levator palpebrae

Question 4

CN IV

Answer 4

superior oblique muscle (down and in)

Question 5

CN V

Answer 5

sensory: touch forehead, cheekbone, and chin with cotton wisp, corneal relfex, jaw jerk, oculocardiac reflex, general sensation of anterior 2/3 of tongue
motor: muscles of mastication (temporalis, internal pterygoid, masseter, external pterygoid)

Question 6

tic douloureaux

Answer 6

trigeminal neuralgia
extreme, sporadic, suddne burning or shock-like face pain that lasts anywhere from a few seconds to as long as 2 minutes per episode
lightening like, excruciating pain is repetitie, occuring several times per day
pain typically felt onone side of jaw or cheek

Question 7

CN VI

Answer 7

motor: lateral rectus muscle

Question 8

CN VII

Answer 8

sensory: taste anterior 2/3 of tongue (sweet, salty, sour)
motor: muscles of facial expression

Question 9

bell’s palsy

Answer 9

unilateral facial paralysis caused by trauma, virus or immune mediated response and is not permanent
intial pain behind the ipsilateral ear, twitching, weakness or paralysis, drooping eyelid, drooping corner of mouth, drooling, dry eye, impairment of taste
entire motor loss of half of face, forehead will not wrinkle, LMNL, CN7

Question 10

CN VIII

Answer 10

sensory: vestibular-balance, mittelemeyer, barany caloric test, rhomberg’s.
cochlear- weber, rinne, whisper, auditory acutity/watch

Question 11

meniere’s disease (endolymphatic hydrops)

Answer 11

cause is unknown, but probably results from abnormality in the fluids of the inner ear
episodic rotational vertigo, hearing loss, tinnitus

Question 12

CN IX

Answer 12

sensory: gag, uvula, carotid reflex, taste to posterior 1/3 of tongue (bitter)
motor: stylopharyngeus muscle elevates pharynx and larynx, dilates pharynx to permit swallowing

Question 13

CN X

Answer 13

sensory: epiglottis and laryngeal muscles of swallowing (palate, pharynx, contracting muscle)
motor: gag, carotid reflex, uvular reflex

Question 14

torticollis (wry neck)

Answer 14

spasm of SCM muscle

Question 15

uvualr reflex

Answer 15

palate and uvula deviate to the oppostive side of lesion when patient says ahh

Question 16

CN XI

Answer 16

motor: trapezius and SCM: shoulder shrug with head rotation against resistance

Question 17

CN XII

Answer 17

motor: tongue muscles- stick out tongue, deviation to side of lesion; look for atrophy and fasciculations

Question 18

if there is a left optic nerve lesion, what would you see when you do light reflex?

Answer 18

when you shine it in the left eye, the light reflex is absent
when you shine it in the right eye, the light reflex is present

Question 19

if there is a left oculomotor lesion, what would you see when you do light reflex?

Answer 19

when you shine it in the left eye, the light reflex is absent in the left eye, present in right eye
when you shine it in the right eye, the light reflex is present

Question 20

if there is a right oculomotor lesion, what would you see when you do the light reflex?

Answer 20

when you shine it in the left eye, the light reflex is present in the left eye, absent in the right eye
when you shine it in the right eye, the light reflex is present