Disorders of the Cranial Nerves Flashcards

1
Q

Name and function of CN I

A

Olfactory nerve

Olfaction

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2
Q

Name and function of CN II

A

Optic nerve

Vision

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3
Q

Name and function of CN III

A

Oculomotor nerve

Control of eye muscle activity, pupillary constriction

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4
Q

Name and function of CN IV

A

Trochlear nerve

Control of eye muscle activity

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5
Q

Name and function of CN V

A

Trigeminal nerve
Ordinary sensation
Control of muscles of mastication

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6
Q

Name and function of CN VI

A

Abducens nerve

Control of eye muscle activity

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7
Q

Name and function of CN VII

A
Facial nerve 
Taste 
Control of muscles of facial expression 
Lacrimation 
Salivation
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8
Q

Name and function of CN VIII

A

Vestibulocochlear nerve
Hearing and balance
Ordinary sensation from ear

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9
Q

Name and function of CN IX

A

Glossopharyngeal nerve
Taste
Ordinary sensation from ear
Salivation

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10
Q

Name and function of CN X

A

Vagus nerve
Taste
Control of muscles of larynx and pharynx
Parasympathetic innervation beyond the diaphragm

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11
Q

Name and function of CN XI

A

Accessory nerve

Control of sternocleidomastoid and trapezius muscle

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12
Q

Name and function of CN XII

A

Hypoglossal nerve

Control of tongue muscles

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13
Q

Testing sense of smell would assess the function of what cranial nerve?

A

Olfactory

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14
Q

How to assess optic nerve function

A
Visual acuity 
Visual fields
Pupillary reactions
Fundoscopy 
Colour vision
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15
Q

How to assess oculomotor, trochlear and abducens nerves function

A

Assess for ptosis
Pupils of equal size
Pupillary reaction
Eye movements - vertical and horizontal

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16
Q

How to assess trigeminal nerve function

A

Assess sensation in ophthalmic, maxillary and mandibular divisions
Power of muscles of mastication
Corneal reflex
Jaw jerk

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17
Q

How to assess facial nerve function

A

Assess muscles of facial expression (raise eyebrows, bear teeth etc.)
Corneal reflex
Taste

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18
Q

How to assess vestibulocochlear nerve function

A

Rinne’s and Weber’s tests to assess hearing

Dix-Hallpike manouvre and Unterberger’s test to assess vestibular function

19
Q

How to assess glossopharyngeal and vagus nerve function

A

Movement of palate
Gag reflex
Quality of speech
Quality of cough

20
Q

How to assess accessory nerve function

A

Head turning and shoulder shrug (sternocleidomastoid and trapezius function)

21
Q

How to assess hypoglossal nerve function

A

Appearance, movement and power of tongue

22
Q

Fibres tested by pupillary light reaction

A

CN II afferent fibres

CN III efferent fibres

23
Q

Fibres tested by corneal reflex

A

CN V afferent fibres

CN VII efferent fibres

24
Q

Fibres tested by jaw jerk

A

CN V afferent and efferent fibres

25
Q

Fibres tested by gag reflex

A

CN IX afferent

CN X efferent

26
Q

Causes of dilated pupils

A
Youth 
Dim lighting 
Anxiety/excitement 
Mydriatic eye drops 
Amphetamine use 
Third nerve palsy 
Brain death
27
Q

Causes of small pupils

A
Old age 
Bright light 
Miotic eye drops 
Opiate overdose 
Horner's syndrome
28
Q

Examples of eye movement disorders

A
Isolated third nerve palsy 
Isolated fourth nerve palsy 
Isolated sixth nerve palsy 
Combination of isolated third, fourth and sixth nerve palsies 
Supranuclear gaze palsy 
Nystagmus
29
Q

Microvascular causes of isolated third nerve palsy

A

Diabetes
Hypertension
(painless, pupil spared)

30
Q

Compressive causes of isolated third nerve palsy

A

Posterior communicating artery aneurysm
Raised ICP
(painful, pupil affected)

31
Q

Causes of isolated sixth nerve palsy

A

Idiopathic
Diabetes
Meningitis
Raised ICP

32
Q

Causes of nystagmus

A
Congenital 
Serious visual impairment 
Peripheral vestibular problem 
Central vestibular/brainstem disease 
Cerebellar disease 
Toxins
33
Q

Clinical features of trigeminal neuralgia

A

Paroxysmal attacks of lancinating (piercing/stabbing) pain

34
Q

Cause of trigeminal neuralgia

A

Vascular loop - compression of fifth nerve in the posterior fossa

35
Q

Treatment of trigeminal neuralgia

A

Carbamazepine

Surgery if medication resistant

36
Q

Presentation of Bell’s palsy

A

Idiopathic facial nerve palsy
Unilateral facial weakness
May be preceded by pain behind the ear
Eye closure affected

37
Q

Treatment of Bell’s palsy

A

steroids

38
Q

Presentation of vestibular neuronitis

A

Sudden onset, disabling vertigo, vomiting

39
Q

What is dysarthria

A

Disordered articulation and slurring of speech

40
Q

What is dysphagia

A

Difficulty swallowing

41
Q

Cause of bulbar palsy

A
Bilateral lower motor neurone lesions affecting CN IX-XII
e.g. 
Motor neurone disease 
Polio 
Malignancy 
Vascular lesions of medulla 
Syphilis
42
Q

Clinical features of bulbar palsy

A

Wasted, fasciculated tongue
Dysarthria
Dysphonia
Dysphagia

43
Q

Causes of pseudobulbar palsy

A

Bilateral upper motor neurone lesions e.g. vascular lesions in both internal capsules

44
Q

Clinical features of pseudobulbar palsy

A
Spastic, immobile tongue 
Dysarthria 
Dysphonia 
Dysphagia 
Brisk jaw reflex 
Brisk gag reflex