Cranial Nerves + Palsies Flashcards

1
Q

Mnemonic for sensory or motor nerves

A
I. Some 
II. Say 
III. Marry 
IV. Money 
V. But 
VI. My 
VII. Brother 
VIII. Says 
IX. Big 
X. Brains 
XI. Matter 
XII. Most 
S = Sensory 
M = Motor
B = Both
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2
Q

CN I

A

Olfactory

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3
Q

CN II

A

Optic

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4
Q

CN III

A

Oculomotor

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5
Q

CN IV

A

Trochlear

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6
Q

CN V

A

Trigeminal

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7
Q

CN VI

A

Abducens

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8
Q

CN VII

A

Facial

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9
Q

CN VIII

A

Vestibulocochlear

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10
Q

CN IX

A

Glossopharyngeal

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11
Q

CN X

A

Vagus

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12
Q

CN XI

A

Accessory

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13
Q

CN XII

A

Hypoglossal

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14
Q

Function of CN I

A

Smell

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15
Q

Function of CN II

A

Sight

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16
Q

Function of CN III

A
Pupil constriction 
Accommodation 
Eyelid opening 
Eye movement: 
- Medial rectus (inward)
- Superior rectus (upward)
- Inferior recuts (downward)
- Inferior oblique (up and out)
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17
Q

Function of CN IV

A

Eye movement:

- Superior Oblique (down + out)

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18
Q

Function of CN V

A

Fascial sensation

Mastication

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19
Q

CN V1

A

Ophthalmic

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20
Q

CN V2

A

Maxillary

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21
Q

CN V3

A

Mandibular

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22
Q

Function of CN VI

A

Eye movement:

- Lateral rectus (outward)

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23
Q

Mnemonic for Eye muscle nerve innervation

A

LR6 SO4 AO3

Lateral rectus = CN VI
Superior oblique = CN IV
All others = CN III

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24
Q

Function of CN VII

A

Facial movement
Taste (Anterior 2/3rd of tongue)
Lacrimation
Salivation

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25
Q

Function of CN VIII

A

Hearing

Balance

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26
Q

Function of CN IX

A

Taste (Posterior 1/3rd of tongue)
Salivation
Swallowing
Mediates input from carotid body + sinus

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27
Q

Function of CN X

A

Phonation
Swallowing
Innervates viscera

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28
Q

Function of CN XI

A

Head and shoulder movement

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29
Q

Function of CN XII

A

Tongue movement

30
Q

Pathway of CN I

A

Cribiform plate

31
Q

Pathway of CN II

A

Optic canal

32
Q

Pathway of CN III

A

Superior orbital fissure (SOF)

33
Q

Pathway of CN IV

A

Superior orbital fissure (SOF)

34
Q

Pathway of CN V1

A

Superior orbital fissure (SOF)

35
Q

Pathway of CN V2

A

Foramen rotundum

- rotates under the eyes

36
Q

Pathway of CN V3

A

Foramen ovale

- mouth is an oval

37
Q

Pathway of CN VI

A

Superior orbital fissure (SOF)

38
Q

Pathway of CN VII

A

Internal auditory meatus

- smile when you hear “auditory music”

39
Q

All nerves to do with the eye apart from CN II have a pathway through the

A

Superior orbital fissure (SOF)

40
Q

Pathway of CN VIII

A

Internal auditory meatus

- need to hear “auditory music”

41
Q

Pathway of CN IX

A

Jugular foramen

- jug of water to swallow

42
Q

Pathway of CN X

A

Jugular foramen

- jug of water to swallow

43
Q

Pathway of CN XI

A

Jugular foramen

- head back to swallow water from jug

44
Q

Pathway of CN XII

A

Hypoglossal canal

- tongue = “glossal”

45
Q

Ptosis
Dilated + fixed pupil
Down + out eye

A

Third nerve (CN III) palsy

  • can be secondary to tectorial herniation
    • pain = posterior communicating artery aneurysm
46
Q

Downward gaze
Vertical diplopia (going downstairs/ reading a book)
May develop a head tilt
Out + out eye

A

Fourth nerve (CN IV) palsy

47
Q
Trigeminal neuralgia 
Loss of corneal reflex (afferent)
Loss of facial sensation 
Paralysis of muscles of mastication 
Deviation of jaw to weak side
A

Fifth nerve (CN V) palsy

48
Q

Defective abduction

Horizontal diplopia

A

Sixth nerve (CN VI) palsy

49
Q
Flaccid paralysis of upper + lower face
Includes forehead
Loss of corneal reflex (efferent)
Loss of taste
Hyperacusis
Dry eyes
A
Facial nerve (CN VII) palsy
"Bell's palsy" = diagnosis of exclusion
  • ages 20-40 most common
  • pregnancy is increased risk factor
50
Q

Hearing loss
Vertigo
Nystagmus

A

Problem with CN VIII

51
Q

Hypersensitive carotid sinus reflex

Loss of gag reflex (afferent)

A

Problem with CN IX

52
Q

Uvula deviates away from site of lesion
- “points away” as further away in mouth
Loss of gag reflex (efferent)

A

Problem with Vagus nerve (CN X)

53
Q

Weakness turning head to contralateral side

A

Problem with CN XI

54
Q

Tongue deviates towards side of lesion

- points “towards”

A

Problem with CN XII

55
Q

Corneal reflex

A

Afferent: CN V1 (Ophthalmic)
Efferent: CN VII (Facial)

56
Q

Jaw jerk reflex

A

Afferent: CN V3 (Mandibular)
Efferent: CN V3 (Mandibular)

57
Q

Gag reflex

A

Afferent: CN IX (Glossopharyngeal)
Efferent: CN X (Vagus)

58
Q

Carotid sinus reflex

A

Afferent: CN IX (Glossopharyngeal)
Efferent: CN X (Vagus)

59
Q

Pupillary light reflex

A

Afferent: CN II (Optic)
Efferent: CN III (Oculomotor)

60
Q

Lacrimation reflex

A

Afferent: CN V1 (Ophthalmic)
Efferent: Facial nerve (CN VII)

61
Q

Accessory nerve (CN XI) supplies

A

Sternocleidomastoid

Trapezius

62
Q

CN III enervates AO eye muscles +

A

Levator palpebrae superioris

63
Q

Third nerve palsy + pain + meningism =

A

Posterior communicating artery aneurysm

64
Q

Management for Bell’s palsy (CN VII palsy)

A
  1. Prednisolone
    Eye-lubricants, artificial tears
    Tape eye shut

Severe: Anti-virals

65
Q

Bell’s palsy
+ Post-auricular pain
+ vesicular rash around ear / hard palate/ anterior tongue

A

Ramsay-Hunt Syndrome

66
Q

Cause of Ramsay-Hunt Syndrome

A

Varicella zoster virus (VZV)

67
Q

Bells palsy is caused by a

A

LMN lesion

68
Q

Facial palsy
+ Forehead sparing
+ Eye is able to close

A

UMN lesion

69
Q

Innervation of chorda tympani (branch of facial nerve)

A

Supplies submandibular + sublingual gland (secretion)

Supplies anterior 2/3 tongue (sensory)

70
Q

Management of Third Nerve palsy

A

Craniotomy