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Neuroscience BB Exam 1 > Section 10 - Cranial Nerves > Flashcards

Section 10 - Cranial Nerves Flashcards

1
Q

What is inferior alternating hemiplegia (medial medullary syndrome)? (Damage to anterior spinal artery)

A

Damage of hypoglossal nucleus, corticospinal tract, and medial lemniscus

  • Deviation of tongue to side of lesion
  • Contralateral hemiparesis
  • Contralateral proprioception, vibration, fine touch
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2
Q

Damage to the lower motor neuron for CN XII results in :

A

Deviation of tongue to side of lesion

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3
Q

Damage to the upper motor neuron for CN XII (internal capsule) results in:

A

Deviation of tongue to opposite side of lesion

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4
Q

Damage to the internal capsule for facial motor nucleus fibers will result in:

A

Drooping of facial mm. in lower quadrant of contralateral face

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5
Q

Paralysis of SCM and trapezius (CN XI lesion) produces:

A
  • Drooping of ipsilateral shoulder

- Difficulty turning head to contralateral side against resistance

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6
Q

CN XI damage can go unnoticed in cervical cord injury if the ______ is also injured.

A

Corticospinal tract

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7
Q

Damage to CN XI fibers in the internal capsule results in:

A

Ipsilateral deficits (fibers UNCROSSED)

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8
Q

Bilateral damage of CN X leads to:

A

Aphonia, aphagia, inspiratory stridor, dyspnea, potentially deadly (esp. if dorsal motor nuc. damaged)

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9
Q

Ipsilateral damage of CN X leads to:

A
  • Dysphagia (unilateral pharyngeal/laryngeal mm.)
  • Dysarthria (weakness of laryngeal mm. and vocalis m.)
  • No gag reflex
  • No cough reflex
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10
Q

What is often not detectable in CN X injury?

A

Taste loss (epiglottis, roof of tongue)

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11
Q

How does the gag reflex work?

A

Afferent: CN IX (impaired sensation on posterior 1/3 of tongue)
Efferent: CN X (constrictors of pharynx - nucleus ambiguus) (stylopharyngeus is IX)

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12
Q

Injury of CN IX is relatively rare; happens most often at _______.

A

jugular foramen, with X and XI

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13
Q

Damage to CN IX can result in:

A
  • Loss of carotid sinus reflex (BP regulation)
  • Loss of gag reflex
  • Loss of taste to posterior 1/3 of tongue
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14
Q

What is glossopharyngeal neuralgia?

A

Attacks of intense idiopathic pain from sensory distribution; spontaneous or from stimulation (talking or swallowing), can be disabling (pharynx, caudal tongue, tonsil, maybe middle ear)

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15
Q

What is jugular foramen syndrome (Vernet syndrome)?

A

Damage just immediately internal to foramen - hit CN IX, X, XI

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16
Q

What is Collet-Sicard Syndrome?

A

Damage just external to jugular foramen - hit CN IX, X, XI, XII

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17
Q

What is retropharyngeal syndrome (Villaret syndrome)?

A

Damage further outside the jugular foramen - hit CN IX, X, XI, XII, and superior cervical ganglion (Horner’s); ipsilateral

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18
Q

What are the two different types of vertigo?

A

Subjective: Patient thinks they are moving
Objective: Patient think surrounding objects are moving

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19
Q

Lesion of CN VIII results in:

A
  • Hearing loss
  • Tinnitus
  • Vertigo
  • Dizziness
  • Ataxia
  • Nystagmus
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20
Q

What is nystagmus?

A

Rhythmic oscillatory movements of the eyes from interruption of vestibular influence over the brainstem motor neurons controlling the eye movements and environment (also, nausea and vomiting)

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21
Q

What is Meniere’s syndrome?

A

Hearing loss and sound distortion, vertigo, and sensation of dizziness/unsteadiness on walking or standing. Results from increase in endolymphatic pressure.

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22
Q

What is sensorineural hearing loss?

A

Damage to the cochlea, spiral ganglion, or cochlear fibers ipsilaterally - brainstem lesion can affect more localized system

23
Q

What is conductive hearing loss?

A

Failure of conduction through the middle ear, typically ossicles

24
Q

What is the result of infranuclear damage to CN VII fibers?

A

Bell’s palsy. Ipsilateral hemiparalysis, upper and lower face affected. Decrease in nasal and oral secretions, decrease in tears and saliva, no taste in ant. 2/3 of tongue (all ipsilateral).

25
Q

What is supranuclear facial paralysis of CN VII (also called a CENTRAL SEVEN LESION)?

A

Lesion of internal capsule –> contralateral drooping of mouth. There is bilateral innervation for upper face, so that is normal.

26
Q

What are some consequences of CN VII damage?

A
  • Loss of corneal blink reflex (efferent limb - palpebral part of orbicularis oculi, GSE)
  • Loss of taste to ant. 2/3 of tongue
  • Hyperacusia (stapedius)
  • Flaccid facial paralysis
27
Q

Damage to CN VI can lead to:

A
  • Convergent (medial) strabismus
  • Horizontal diplopia
  • Middle alternating hemiplegia (abducens ipsilateral, body contralateral hemiparalysis)
28
Q

Damage to the MLF leads to internuclear ophthalmoplegia:

A

Inability to adduct eye on attempt to gave in opposite direction (LR works, but MR in other eye doesn’t move with it)

29
Q

Sudden cortical damage involving frontal eye field (PPRF) results in ______

A

involuntary conjugate deviation of eyes to side of lesion

30
Q

What is one-and-a-half syndrome?

A

Lesion of abducens nucleus and ipsilateral MLF –> only contralateral LR moves

31
Q

What is Wallenberg’s syndrome (lateral medullary syndrome)?

A

Lesion of V within medulla (spinal trigeminal tract) results in ipsilateral loss of pain/thermal sense on face AND contralateral loss of same sensations on the body (ALS). Also can see motor deficits related to nucleus ambiguus or vestibular nuclei. Can be from occlusion of PICA.

32
Q

What are the limbs of the corneal reflex?

A

Afferent: V1
Efferent: VII (7)

33
Q

What are the limbs of the sneeze reflex?

A

Afferent: V2
Efferent: V, VII, XII, phrenic n.

34
Q

What is the jaw jerk reflex?

A

Stretch of periodontal ligaments leads to contraction (masseter and temporalis) of jaw (V3) (not always lost with unilateral lesion)

35
Q

With lesion of CN V, jaw deviates…how?

A

To side of lesion when closing.

36
Q

What are the limbs of the lacrimal reflex?

A

Afferent: V1
Efferent: VII

37
Q

What is trigeminal neuralgia (tic douloureux)…humor me.

A

Severe, unexpected pain restricted to one or more divisions of CN V; paroxysms of intense pain from stimulation usually around lip, nose, cheek; occurs V2>V3>V1 (seen in MS; can be compression of superior cerebellar a.)

38
Q

What are status trigeminus?

A

Tic-like, painful contractions of maticatory mm. (sometimes happens with trigeminal neuralgia)

39
Q

CN IV lesions can come from:

A

lesion of root in ambient cistern or cavernous sinus, or superior orbital fissure –> paralysis of superior oblique m.

40
Q

CN IV lesions lead to:

A
  • SO paralysis (can’t go down and out)
  • Vertical diplopia
  • Compensatory head tilting for extorsion
41
Q

Lesion in nucleus of CN IV leads to:

A

Contralateral paralysis (receives input from gaze center, riMLF)

42
Q

Lesion in CN IV nerve:

A

Ipsilateral paralysis

43
Q

Lesion in MLF does what to CN IV?

A

Contralateral paralysis

44
Q

What are some consequences of CN III paralysis?

A
  • Ptosis
  • Ophthalmoplegia
  • Diplopia
  • Dilated (mydriasis)/fixed pupil (sphincter pupillae m.)
  • Paralysis of accommodation (ciliary m.)
  • Slow pupillary light reflex
45
Q

CN III lesion can be caused by:

A
  • Uncal hernation

- Aneurysm of carotid or posterior communicating

46
Q

Innervation for the eye muscles by the oculomotor nerve is all ipsilateral, except for ______

A

superior rectus m.

47
Q

What is superior alternating hemiplegia?

A

Lesion of CN III and corticospinal tract

48
Q

Due to GVE fibers being on the periphery of the nerve, visceromotor signs can appear without extraocular mm., like in trauma (not always the case in disease).

A

Too lazy to make it a question. Reuben wanted the flashcards done today.

49
Q

Diabetes mellitus affects _____ before ______

A

internal GSE fibers; external GVE fibers. Larger vessels inside the nerve are compromised.

50
Q

What are some symptoms of a vestibular schwannoma?

A
  • Tinnitus
  • Unsteady gait
  • Progressive hearing loss
  • Weakness of ipsilateral facial mm.
  • V sensory deficits, tic douloureux
51
Q

Tell me some shit about meningiomas.

A
  • Occur on margins of internal acoustic meatus
  • Produce facial weakness, then hearing loss, trigeminal pain
  • Usually doesn’t erode meatus, unlike vestibular schwannoma
52
Q

What are epidermoid tumors, and what can they cause?

A
  • Clusters of epidermis trapped during development (epidermoid cysts, cholesteatomas)
  • Contain debris, protein, cholesterol and spillage can cause meningitis, damage to V, VII, VIII
53
Q

What is facial diplegia?

A

Bilateral paralysis of facial mm.

- Seen in Mobius syndrome, Lyme disease, Guillan-Barre, Corynebacterium diphtheriae

54
Q

What are hemifacial spasms?

A

Irregular, maybe painful contractions maybe triggered by facial contraction
- can follow Bell’s palsy, compression of facial n. (like by AICA)

Neuroscience BB Exam 1 (10 decks)

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