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BMB Test 2 > B7-024 Facial Weakness > Flashcards

B7-024 Facial Weakness Flashcards

1
Q

for the lower face, the wiring UMN control is analogous to […]

A

corticospinal tract

(crosses)

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2
Q

for the upper face, the wiring UMN control is […]

A

bilateral

(makes it difficult to move one eyebrow)

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3
Q

if the […] is spared, it is an UMN (central) lesion

A

forehead

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4
Q

if both the upper face and lower face are involved, it is a […] lesion

A

peripheral (LMN or facial nerve)

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5
Q

hallmark of brainstem lesion

A

alternating hemiplegia

(affects ipsilateral cranial nerve and contralateral long tract)

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6
Q

pattern:
entire face
contralateral leg (UMN)

[where is the lesion?]

A

brain stem
alternating hemiplegia

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7
Q

entire face affected
no alternating hemiplegia

A

extra axial 7th

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8
Q

functions of the facial nerve at the facial motor nucleus [3]

A

face muscles
stapedius (dampens sound)
digastric

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9
Q

functions of the facial nerve at the gustatory nucleus

A

taste to anterior 2/3s of tongue

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10
Q

functions of the facial nerve at the main sensory nucleus

A

ear region sensation

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11
Q

functions of the facial nerve at the superior salivatory nucleus [3]

A

lacrimal glands
submandibular glands
sublingual glands

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12
Q

dry eyes
hyperacusis
decreased taste
facial weakness

[indicate lesion affecting]

A

facial nerve

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13
Q

idiopathic
peripheral CN VII palsy

A

Bell’s palsy

(thought to be caused by inflammation, but unknown etiology)

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14
Q

Bell’s palsy caused by inflammation from reactivation of VZV

vesicles in the ear

A

Ramsay Hunt syndrome

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15
Q

Bell’s palsy secondary to Lyme disease

A

peripheral 7th from neuroborrelosis

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16
Q

should KC patients with Bell’s palsy be tested for Lyme?

A

no, often false positive. It’s not an endemic area

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17
Q

reactivation of HSV1 within the […] can cause Bell’s palsy

A

geniculate ganglion

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18
Q

secondary defect from Bell’s palsy due
to afferent reinnervation

A

synkinesis

(can cause gustatory tears and facial spasm as well)

19
Q

grading scale for recovery from Bell’s palsy

A

House and Brackmann grading scale

(1 is normal, 6 is total paralysis)

20
Q

[…] of patients will Bell’s palsy will have normal recovery

A

70%

(usually takes about 3-8 weeks)

21
Q

poor prognostic factors for Bell’s palsy

A

older age
non-ear region pain
complete palsy
gradual onset (longer than 3 days)
vertigo
diabetes
hypertension

22
Q

prevention of exposure keratitis [2]

A

eye lubrication
eye patching

23
Q

treatment for Bell’s palsy [2]

A

steroids (high evidence)
acyclovir (low evidence, unless VZV)

24
Q

the facial motor nuclei supplying the lower motor neurons going to the lower face receive input from the […] cerebral hemisphere

A

contralateral

25
Q

the facial nerve originates in the

A

pons

26
Q

the facial nerve enters the temporal bone through the

A

internal auditory canal

27
Q

the facial nerve exits the temporal bone through the

A

stylomastoid foramen

28
Q

cause of Bell’s palsy

A

inflammation of the facial nerve within the temporal bone causes ischemia, demyelination, and axon loss

29
Q

acute facial weakness along with ipsilateral limb weakness may indicate

A

stroke

(treat with thrombolytic)

30
Q

pain […] the ear is a poor prognostic indicator for functional outcome

A

outside the region of the ear (non-ear pain)

(not ear pain itself)

31
Q

most common peripheral facial palsy

A

Bell palsy

32
Q

Bell palsy usually develops after […] reactivation

A

HSV

33
Q

most patients with Bell palsy gradually recover, but […] can occur

A

aberrant regeneration

34
Q

other causes of facial palsy [5]

A

Lyme disease
VZV (ramsay Hunt)
sarcoidosis
tumors (in parotid)
diabetes mellitus

35
Q

[UMN or LMN lesion of Facial]

lesion is in the motor cortex

A

UMN

36
Q

[UMN or LMN lesion of Facial]

affects the contralateral side

A

UMN

37
Q

[UMN or LMN lesion of Facial]

only affects lower muscles of facial expression

A

UMN

38
Q

[UMN or LMN lesion of Facial]

forehead is spared

A

UMN

(due to bilateral innervation)

39
Q

[UMN or LMN lesion of Facial]

lesion at the facial nucleus

A

LMN

40
Q

[UMN or LMN lesion of Facial]

lesion is in the connection from the motor cortex to the facial nucleus

A

UMN

41
Q

[UMN or LMN lesion of Facial]

lesion anywhere along CN VII

A

LMN

42
Q

[UMN or LMN lesion of Facial]

ipsilateral side is affected

A

LMN

43
Q

[UMN or LMN lesion of Facial]

affects the upper and lower muscles of facial expression

A

LMN

44
Q

[UMN or LMN lesion of Facial]

can be associated with incomplete eye closure, hyperacusis, loss of taste to anterior tongue

A

LMN

BMB Test 2 (17 decks)

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