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NMS > CN I-VI > Flashcards

CN I-VI Flashcards

1
Q

what are the three exams for CN I?

A

observation of external nose
observation of internal nose
sense of smell in both nostrils

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2
Q

unilateral or bilateral anosmia is commonly caused by..

A

blocked nasal passage, cold, loss with aging, trauma

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3
Q

bilateral anosmia may also be caused by…

A

blocked nasal passage, cold, loss with aging, trauma

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4
Q

rare causes for unilateral anosmia include…

A

minor head trauma

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5
Q

nutritional cuases for anosmia include

A

zinc deficiency

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6
Q

function of rods

A

See in low light

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7
Q

functions for cones

A

See colors

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8
Q

function of optic chiasm

A

nasal half decusate, temporal half uncrossed

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9
Q

retinal area for centrla visionis…?

A

macula

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10
Q

the remainder of the retina is concerned with___and___.

A

paracentral and peripheral vision

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11
Q

retrobulbar neuritis involves…?

A

optic N or tract, MC cause is MS

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12
Q

optic neuritis involves…?

A

various forms of reninitis

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13
Q

papilledema involves…?

A

increased intracranial pressure

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14
Q

optic atrpohy involves…?

A

decreased visual acuity and change in color/optic disc

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15
Q

secondary optic atrophy involves…?

A

glaucoma

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16
Q

foster kennedy syndrome

A

tumors at base of frontal lobe, ipsilateral blindness and anosmia

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17
Q

tay sachs disease

A

cerebromacular degeneration with severe mental deficiency

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18
Q

holmes-Adie syndrome

A

tonic pupillary reaction and absence of one or more tendon reflexes

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19
Q

extropia

A

outward/lateral movement

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20
Q

esotropia

A

inward/medial movement

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21
Q

hypertropia

A

up

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22
Q

hypotropia

A

down

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23
Q

inability to laterally gaze may be affected by…

A

disease of CN VI, MS

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24
Q

frontal lobe controls

A

saccadic (rapid/darting) eye movement

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25
Q

occipital lobe controls

A

smooth or following eye movement

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26
Q

the fast component of nystagmus respresents

A

saccadic movement from the frontal lobe

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27
Q

the mooth component is what follows in nystagmus is controlled by…

A

occipital lobe

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28
Q

ptosis can be caused by…

A

paralysis/superior tarsal muscle

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29
Q

lesions affecting CN IV make ti difficult for the patient to…

A

roll their eyes

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30
Q

what test is performed to isolater CN VI?

A

6 cardinal fields of gaze

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31
Q

lesions affecting CN VI make it difficult for the patient to…

A

look left and right

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32
Q

lesions affecting CNII will diminish..

A

pupilloconstriction with bilateral assymmetry

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33
Q

lesions affecting CN III will affect the primary motor portion of the eye refle and it will diminish…

A

ability to carry out pupilloconstriction in ipsilateral eye

34
Q

loss of diencephalon or midbrain function results in….

A

unopposed sympathetic (pupillodilator) domonance

35
Q

pupils that are fixed and dilated represent…

A

brain dead patients

36
Q

holmes-adie syndrome has the following clinical findings

A

reaction to light slow, consricted longer, dilate slow

37
Q

argyll robertson pupill has the following clinical findings

A

no direct or indirect reaction to light, only accomodation

38
Q

identify potential causes for argyll robertson syndrome

A

diabetes, neurosyphilis

39
Q

horner’s syndrome is caused by…

A

lesions of neck proximal to carotid artery

40
Q

signs and symptoms of horner’s syndrome

A

ptosis, pupiloconstriction
facial anhydrosis
ipsilateral facial vasodilation

41
Q

summary of CN III, IV, VI examination

A

what do the eyes look like from the outside?
how do the eyes function?
what do the eyes look like on the inside?

42
Q

eyelid ptosis may be caused by lesions involving..

A 
hypothalamus
brainstem
spinal cord
peripheral CN 3
peripheral sympathetics
myoneural pathways
possible muscular and local causes
43
Q

describe the proess to evaluate the patietnt’s ocular alignment

A

look straight forward, lateral (bilateral) check for sceral tissue, elicit ciliospinal refle

44
Q

visual acuity is assessed by utilizing?

A

snellen chart

45
Q

assessment of peripheral vision

A

confrontation

46
Q

what cranial nerves are being evaulated when testing for peripheral vision

A

III, IV

47
Q

what are the degrees that we should see in peripheral vision on each side?

A

60 degrees superior
60 degrees nasal
75 degrees inferior
100 degrees temporally

48
Q

6 cardinal fields of gaze assesses

A

etraocular movement

49
Q

accomodation is assessing

A

convergence, puilloconstriction, lens thickening

50
Q

3 components of accomodation

A

convergence
lens thickening
pupilloconstriction

51
Q

causes for nystagmus..

A

conflicting proprioceptive input from CN VIII and cervical and cerebellar sources

52
Q

the side toward which the quick component of nystagmus travels is the side that

A

bears the name

53
Q

coneal light reflex evaluate for..

A

relative position of the 2 points of reflection of light

54
Q

describe how the corneal light reflex test is performed

A

patient’s eyes forward, light source shined into both eyes

55
Q

pupillary light reflex evaluate the patient for

A

constriction of both pupils equally, assuming intract pathways

56
Q

describe how the pupillary light reflex test is performed

A

introduce light into one eye, note pupilloconstriction in both eyes, switch to toher eye and do the same

57
Q

swinging flashlight light relfex evaluates the patient for

A

equal pupilloconstriction

58
Q

describe how the swinging light reflex test is performed

A

shine light in eye, watch other eye, if it doesn’t constrict as much, then there may be a retinal or CN II lesion

59
Q

marcus gunn phenomenon

A

apparent pupillodilation with light

60
Q

identify 4 basic components to the funduscopic exam while trying to identify pathological changes

A

optic disc
vessels
macula
general background

61
Q

the margins between the optic disc in the fundus should be..

A

sharp temporally and less so medially

62
Q

if the physiological cup is greater than half the size of the disc this indicates

A

increased intraocular pressure (glaucoma)

63
Q

papilledema has the following funduscopic characteristics…

A

the disc appears blurred with jagged edges
tortuous, engorded veins
loss of venous pulsations at disc margin
obliteration of physiologic cup and optic disc and edema

64
Q

pseudo-papilledema typically is seen in what percent of the population?

A

up to 5%

65
Q

identify pictures of eyes

A 
normal fundus
optic atrophy
optic neuritis
papilledema
glaucoma
detached retina
diabetic retinopathy
hypertensive retinopathy
drusen bodies
66
Q

CN V functions as a mixed crainial nerve. what are the 3 divisions?

A

opthalmic
maxillary
mandibular

67
Q

true or false: CN V includes the angle of the jaw

A

false

68
Q

describe a sensory exam of CN V

A

introduce sharp and light touch stimulus with the aptient’s eyes open
random sharp pinprick with one control and have the patient point to the area that they feel was touched with the sharp pinprick and cotton wisp (eyes closed)
compare side to side light touch (eyes closed)
compare side to side with pinprick (eyes closed
if findings are an area of hyperesthesia or hypoesthesia then the area of question should be compared to an area that we already know has intact sensory function

69
Q

where else do we perform the sensory exam?

A

upper extremities

70
Q

cervical afferents to the facial nerve nuclei provides a neurological innervation to…

A

the face, but sparing the angle of the jaw

71
Q

the mandibular branch of CN V has what kind of branch?

A

recurrent/meningeal branch

72
Q

the recurrent/meningeal branch innervates what?

A

dura

73
Q

what are the muscles of mastication?

A

temporalis, masseter and medial pterygoid

74
Q

what is the primary function of the right lateral pterygoid is to move the jaw tip..

A

to the left

75
Q

what is the primary function of the left lateral pterygoid is to move the jaw tip…

A

to the right

76
Q

peripheral nerve or brainstem disease affecting CN V is usually responsible for…

A

sensory impairment

77
Q

peripheral nerve or brainstem disease causing and impairment often has atrophy of the…

A

temporalis and masseter

78
Q

corneal ulceration and/or inflammation may be present when a lesion fracture the opthalmic division and this is termed…

A

neuroparalytic keratitis

79
Q

referred pain tot he face may have what kind of causes?

A

TMJ syndrome
oral problems
dental problems

80
Q

another name for trigeminal neuralgia?

A

tic douloureux/fathergill’s neuralgia

81
Q

what is trigeminal neuralgia?

A

pain in a clear distribution pattern involving CN V

82
Q

examination of CN V

A

observe motor function, muscle volume, observation of jaw deviation on forced opening, opposition of jaw on closure and lateral jaw movements
palaption of masseter and temporalis muscle while clenching
LMN lesion affecting CN V may occur anywhere in the nerve cell body from the pontine nucleus to the peripheral CN and will result in paralysis and denervation atrophy of the mastication muscles
corneal reflex is assessing the sensory reflex CN V and motor reflex CN VII (may be diminished in early MS)

NMS (16 decks)

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