NMS1E1 Flashcards
unilateral CN V, VII, and VIII abnormalities are caused by lesions in
cerebellopontine angle lesion
unilateral CN III, IV, V and VI abnormalities are caused by lesions in
cavernous sinus lesions
combined CN IX, X and XI abnormalities are caused by lesions in
jugular foramen syndrome
lower motor neuron lesions of combined bilateral X, XI, and XII
bulbar palsy
upper motor neuron lesions of combined bilateral X, XI, and XII
pseudobulbar palsy
the most common causes of intrinsic brain stem lesion in younger and older patients
younger - multiple sclerosis
CN III nucleus is located where
edinger-westphal nucleus: superior colliculus
CN IV nucleus is located where
inferior colliculus
CN V nucleus is located where
mid pons
CN VI nucleus is located where
dorsal pons
CN VII nucleus is located where
caudal pons
CN X nucleus is located where
dorsal medulla
nucleus ambiguus is located where
dorsal medulla
nucleus salivatorius is located where
border of pons and medulla
edinger-westphal is located where
superior colliculus
CN XII nucleus is located where
medulla beneath 4th ventricle
look at “NMS I - quiz 2”
CN 1-6
involves the optic nerve or tract, the most common cause of MS
retrobulbar neuritis
choked disc
papilledema
commonly a symptom of increased intraccranial pressure due to brain tumors, abscesses, hemorrhage, hypertension and other causes
papilledema
associated with decreased visual acuity and a change in the color of the optic disc to light pink, white or gray
optic atrophy
an example of a lesion affecting the medial longitudinal fasciculus (MLF)
multiple sclerosis
of the 2 super nuclear pathways for eye movement, which one is thought to control mostly sacccadic (rapid, darting) movement
frontal lobe
of the 2 super nuclear pathways for eye movement, which one is thought to control mostly smooth or following movement
occipital lobe
disease of which cranial nerve causes ptosis and corectasia
CN III
disease of which cranial nerve causes difficulty in looking down
CN IV
disease of which cranial nerve causes trouble lateral deviating the eye
CN VI
if there are sympathetic lesions distal to the bifurcation of the common carotid arteries and it occurs along the internal pathway what will be the symptoms
pupilloconstriciton and ptosis
if there are sympathetic lesions distal to the bifurcation of the common carotid arteries and it occurs along the external pathway what will be the symptoms
vasodilation and anhydrosis
sympathetic paralysis due to disruption of sympathetic contractile impulses to the small muscle of Muller causes what condition
enophthalmos
how is central vision tested
snellen or sloan charts
clinical testing for peripheral vision is accomplished via which technique
confrontation
how big should the cup to disc ratio be
the cup should be less than 1/2 the disc
what is indicated when the cup to disc ratio is greater than 1/2
there may be increased interocular pressure (glaucoma would be expected
collectinos of degenerative deposits that often appear in the fundus of elderly people
drusen
motor fibers for the muscles of mastication are controlled by which CN
C.N. V
the primary function of the RIGHT lateral pterygiod
moves the tip of the jaw to the LEFT
the primary function of the LEFT lateral pterygoid
moves the tip of the jaw to the RIGHT
opthalmic division lesions causing corneal inflammation and ulceration is called
neuroparalytic keratitis
sharp painful facial sensation in the clear distribution of the opthalmic, maxillary or mandibular divisions of the trigeminal is most likely due to what pathology
trigeminal neuralgia (tic douloureux)
when observing volume of the muscles of mastication, jaw deviation, opposition of jaw closure and lateral jaw movements along with palpation of the temporalis and masseter while the patient clenches their teeth. which CN is being tested
trigeminal
which CN is responsible for taste sensibility on the anterior 2/3 of the tongue
facial
sympathetic stimulation causes increase secretion of thin and watery saliva
FALSE: parasympathetic stimulation does that. sympathetic stimulation causes scant supply of thick and turbid saliva
peripheral facial paralysis
prosopoplegia
lesion of the facial nerve peripheral to the geniculate ganglion causes what
bell’s palsy
ageusia
complete taste loss
peripheral lesions in cranial nerve VII must be proximal to the stylomastoid foramen to affect taste
TRUE
what findings confirm the diagnosis as bell’s palsy
complete hemifacial (one sdie) paralysis without loss of taste on the ipsilateral anterior 2/3 of the tongue
sole function of the cochlear division of CN VIII
provide hearing
a decrease or loss of hearing
hypoacusis
an increase in intensity of hearing
hyperacusis
vestibular diseases are always accompanied by
vertigo
how is a nystagmus termed right or left
the side towards which the fast movement occurs is the side for which the nystagmus is named
if there is no fast component, the nystagmus is termed
pendular
causes convection currents in the semicircular canals
caloric irrigation
if cold water is placed in the right ear, what will happen to the eyes
the right eye will present with nystagmus to the left
how would you differentiate whether there is a vestibular problem from a cervicogenic problem
swivel chair test
a test that compares the hearing of the patient to the doctor’s hearing
schwabach’s test
a test where a loud noise from out of sight causes the patient to blink
malingering test
what is the doctor looking for in the malingering test
the patient to blink as a result of the loud noise (auditopalpebral reflex)
loss of voice
aphonia
faulty articulation
dysarthria
no articulation
anarthria
faulty swallowing
dysphagia
no swallowing
aphagia
increased air entering into nasal cavity
hypernasal
decreased air entering into nasal cavity
hyponasal
motor nerve to tongue
hypoglossal
cardinal finding in CN XII disease
paralysis of the tongue
vibratory sensation in the lower extremity travels up which spinal tract
gracilis
vibratory sensation of the upper extremity travels up which spinal tract
cuneatus
loss of vibratory perception
pallanesthesia
what is the finding if a patient falls with eyes open and closed during the romberg test
cerebellar deficit and/or vestibular mechanism deficit
what is the finding if a patient falls with eyes closed during the romber test
dorsal column pathology
which other tests for proprioceptive sense have the same positive test findings as rombergs
- hopping on one foot
abnormal findings for the finger-to-nose test
dyssynergia and dysmetria
uncoordinated movement
dyssynergia
inaccuracy in measuring distance
dysmetria
which other tests have the same positive findings as finger-to-nose
- finger to finger
normal finding for rapid alternating movement test
diadochokinesia (performing actions properly)
diadochokinesia
performing actions properly
abnormal finding for rapid alternating movement test
dysdiadochokinesia (inability to perform actions properly indicate possible cerebellar dysfunction)
dysdiadochokinesia
inability to perform actions properly indicate possible cerebellar dysfunction
how is the holmes rebound phenomenon test performed
patient contracts the flexors of the forearm against resistance by the doctor. doctor lets go suddenly and normal check reflex should be observed
pinching the achilles tendon
abadie’s sign
pinching the testicles
pitres’ sign
pinching or striking the ulnar nerve
biernacki sign
deep pain can also be tested by placing pressure on the eyeball
TRUE
when pain is diminished or absent while performing the deep pain and pressure sensation test, what is indicated
dorsal column disease; like tabes dorsalis
placing a common objects in the patient’s hand while their eyes are closed and asking them to identify the objects
stereognosis
the patient assesses the relative weight of similarly sized and shaped objects that have different weights
barognosis
touch the patient somewhere on the skin and have them point to the area just touched
topognosis
write a letter or number on the palm of the patient’s hand and ask them to identify it
graphognosis
placing your forearm against the patient’s forearm and asking them to touch their arm
somatognosis
the ability for the patient to know that they are ill
nosognosis
superficial/exteroreceptive/cutaneous sensations
- pain
non-discriminating touch
thigmesthesia (merkle)
well localized touch
topesthesia (meissner)
definition of a nerve root lesion
pressure or irritation of spinal cord or nerve roots prior to exiting the IVF
the common denominators that are used for making the diagnosis of a nerve root compression are by testing these things
- sensation (dermatome testing)
this condition will give a segmental pattern of dysfunctions compared to a multi-dermatomal pattern
nerve root entrapment
this condition will give a multi-dermatomal pattern of dysfunction compared to a segmental pattern
peripheral nerve entrapment
area of skin supplied by a single posterior spinal nerve root
dermatome
what will be the first sensation lost due to nerve root compression
light touch
what will be the second sensation lost due to nerve root compression
pain and temperature
what will be the last sensation lost due to nerve root compression
vibration and position sense
which spinal tracts are being tested for utilizing light touch
lateral and anterior spinothalamic tracts
which spinal tracts are being tested for utilizing pain and temperature
lateral spinothalamic tract
which spinal tracts are being tested for utilizing vibration and position sense
dorsal column
in which order will sensation return when sensations are lost due to compression of a nerve root
reverse order in which it was lost; vibration and position sense, pain and temperature, light touch
paresthesia can be caused by
nerve irritation
hyperesthesia can be caused by
nerve irritation
hypoesthesia can be caused by
nerve compression
anesthesia can be caused by
nerve compression
