The Brainstem and Cranial Nerves Flashcards
Where are the pyramids?
They are the two ridges either side of the midline running down the medulla.
What is the main function of the nerve axons travelling through the pyramids?
They carry the main motor pathways.
What are the major signs and symptoms of damage to the facial nerve after it has exited the skull?
Flaccid paralysis of muscles of facial expression.
Loss of parasympathetic innervation to lacrimal gland so dry eye.
loss of stapedius muscle so even quiet sounds seem very loud.
What effect is facial nerve damage likely to have on speech?
Loss of muscles of facial expression mainly impairs lip mobility therefore problems with bilabials, labiodentals etc.
What are the major signs and symptoms of damage to the vestibular nuclei?
Vestibular nuclei damage > dizziness, vertigo, often nystagmus
What are the major signs and symptoms of damage to the cochlear nuclei?
Cochlear nuclei > sensorineural deafness
How do you test function of the glossopharyngeal nerve?
Test the gag reflex.
What happens to the soft palate if the tenth cranial nerve is damaged?
Can’t raise soft palate evenly = palatal insufficiency
If the soft palate cannot be raised - what speech problems will this cause?
Escape of air into nasal cavity therefore hypernasality. Problems with velics.
How would you test for damage to the tenth cranial nerve?
CNX supplies muscles of palate (test by asking patient to raise palate = say “Aaaaa”, pharynx (not so easy to test), larynx – easiest to test by asking client to cough but they will probably show varying degrees of dysphonia as well.
How would you test for damage to the twelfth cranial nerve?
ask client to stick out tongue. If damaged tongue will deviate to injured side.
What speech problems are likely to arise from damage to the tenth cranial nerve?
dysphagia because pharyngeal constrictors paralysed.
dysphonia because larynx paralysed with danger of silent aspiration, unaware of foreign bodies (e.g. food) in larynx.
What is dysphagia?
difficulty with/inability to swallow
Would dysphagia occur if the ninth cranial nerve was damaged?
IX is sensory supply to mucosa of pharynx therefore can’t sense when food enters pharynx therefore can’t initiate reflex phases of swallowing e.g. pharyngeal and oesophageal phases
