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BDS2 OCB > OCB03-2007 > Flashcards

OCB03-2007 Flashcards

1
Q

How do you test C.I?

A

Strong smelling things (eg coffee) at the nose

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2
Q

What could cause bilateral anosmia?

A

Trauma

Parkinson’s disease

COVID-19

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3
Q

What is anosmia?

A

Partial or complete loss of sense of smell

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4
Q

What could cause unilateral anosmia?

A

Frontal lobe lesion

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5
Q

What is functional anosmia?

A

Only able to detect odours occasionally

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6
Q

How do you test the cranial nerves associated with the eyes?

A

Inspection of eyes, eyelids, iris and pupils for any cloudiness

Pupillary reactions

  • light reflex with hand separation
  • focusing on finger

Visual acuity with standardised Snellen chart and Ishihara test

Visual fields (peripheral vision)

Eye movement (following a finger)

Fundoscopy with ophthalmoscope

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7
Q

What is the Ishihara test used for?

A

Test for colour blindness/deficiency

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8
Q

What pupillary reactions are normal?

A

Light with hand separation should result in one pupil constricting

Focusing on a finger should result in equal constriction of both pupils

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9
Q

What is a direct pupillary reaction?

A

Reaction in the eye you are testing

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10
Q

What is a consensual pupillary reaction?

A

Reaction in the eye you are not testing

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11
Q

What structures should you see in a fundoscopy?

A

Optic cup

Optic disc

Fovea

Macula

Arteries and veins

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12
Q

What will you see in a fundoscopy of someone with papilloedema?

A

Swelling of optic disc

Margins of optic disc are not clear (blurred)

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13
Q

What is papilloedema often seen with?

A

Brain tumours

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14
Q

What will you see in a fundoscopy of someone with optic atrophy?

A

Paler and larger optic disc

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15
Q

How do you test eye movement?

A

Ask patient to follow finger with their eyes

Do not move head

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16
Q

Which cranial nerve controls eyelid elevation and what muscle is involved?

A

Oculomotor nerve (C.III)

Levator palpebrae superioris

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17
Q

What will you see in a patient with an oculomotor nerve palsy?

A

Pupil dilation in affected eye

Affected eye will look down and laterally at rest

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18
Q

What will you see in a patient with a trochlear nerve palsy?

A

Affected eye will look up and medially at rest

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19
Q

What will you see in a patient with an abducens nerve palsy?

A

Affected eye will not be able to look to the same side/laterally (abduct)

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20
Q

What is abducens nerve palsy often associated with?

A

Brain tumours

Increased intracranial pressure

21
Q

What are the two rules of double vision?

A

Double vision is maximal in the direction of gaze of the affected muscle

The false image is the outer image that arises in the affected eye

22
Q

What may cause single palsies of the cranial nerves controlling eye movement?

A

Medical = diabetes, atherosclerosis

Surgical = Tumour, aneurysm, trauma

23
Q

What causes a single cranial nerve pathology?

A

Supranuclear lesion (CNS) or peripheral lesion

24
Q

What causes multiple cranial nerve pathology?

A

CNS lesion of systemic diseases

25
Q

Describe external ophthalmoplegia.

A

Paralysis of multiple extraocular muscles

Common with myopathic or mitochondrial conditions

Not due to single nerve lesions

26
Q

How do you test the sensory aspect of C.V?

A

Touch face lightly with cotton for each branch of trigeminal (forehead, cheek, chin)

Unconscious corneal reflex with cotton on the cornea

27
Q

How do you test the motor aspect of C.V?

A

Patient tries to push jaw against clinician’s fingers to assess strength

Palpation to assess bulk

28
Q

Describe Frey’s syndrome.

A

Affects auriculotemporal branch of C.V near parotid

May be due to trauma or parotid surgery

Sweating and redness around nerve when patient smells/tastes certain chemicals

29
Q

What are some common causes of inferior alveolar nerve damage?

A

Implants

Root treatment

Wisdom tooth surgery

30
Q

What is loss of sensation of half the face often associated with?

A

Herpes infection

31
Q

How do you test C.VII?

A

Scrunch eyes closed

Wrinkle forehead

Blow out cheeks

Smile

Unconscious corneal reflex with cotton on cornea

32
Q

Why do we do the corneal reflex when the patient is unconscious? What does this test?

A

Very uncomfortable if awake

C.V and C.VII

33
Q

What is Bell’s palsy?

A

Unilateral lower motor neuron lesion of facial nerve

34
Q

Which part of the face is often spared with an upper motor neuron lesion of the facial nerve? Why?

A

Forehead

Both hemispheres contribute to muscles in this area, allowing for compensation

35
Q

What is a common cause of unilateral upper motor neuron lesions of the facial nerve?

A

Cerebrovascular accidents

36
Q

What are the two auditory assessments and which nerve do they test?

A

Rinne’s test

Weber’s test

Cochlear branch of vestibulocochlear nerve (C.VIII)

37
Q

Describe the Rinne’s test.

A

Tests for conductive hearing

512Hz tuning fork vibrated both near the ear and on the mastoid process

Normally, hearing will be better near the ear/via air than on mastoid process

38
Q

Describe Weber’s test.

A

Tests for sensineural hearing loss

256Hz tuning fork vibrated on centre of top of head

Normally, sound will be heard equally in both ears

39
Q

How do you test the vestibular division of C.VIII?

A

Observe gait

Hallpike manouevre for nystagmus

40
Q

What is the Hallpike manouevre?

A

Rapidly moving from sitting to supine position with head turned 45º to one side then returning to sitting after 20-30s

Repeat for the other side

Observe for nystagmus

41
Q

Which cranial nerve tests involve the mouth and tongue?

A

Asking about taste

Listening to voice

Visual inspection of surfaces and uvula

Gag reflex

Tongue movement and appearance

42
Q

What observations may indicated pathology of tongue?

A

Small tongue with:

  • fasciculations = bilateral LMN lesion
  • reduced movement = bilateral UMN lesion

Unilateral tongue deviation with:

  • wasting = LMN lesion
  • normal bulk = UMN lesion
43
Q

How do you test C.XI?

A

Turn head to each side and check SCM size (equal or unequal)

Ask patient to try to turn head against resistance/clinician’s hand

Check trapezius size on each side

Ask patient to shrug against resistance from clinician’s hands

44
Q

What may a bilateral accessory lower motor nerve lesion actually be the result of?

A

Myopathy

45
Q

What cranial nerves will a cerebellopontine angle lesion affect?

A

Trigeminal nerve (C.V)

Facial nerve (C.VII)

Vestibulocochlear nerve (C.VIII)

(Unilateral)

46
Q

What cranial nerves will a cavernous sinus lesion affect?

A

Oculomotor (C.III)

Trochlear nerve (C.IV)

Ophthalmic division of trigeminal nerve (V1)

Abducens nerve (C.VI)

(Unilateral)

47
Q

Describe Horner syndrome.

A

Damage to sympathetic trunk, congenital or acquired

Ptosis/bletharoptosis (drooping of upper eyelid)

Anhidrosis (inability to sweat normally)

Miosis (excessive pupil constriction)

Enophthalmos (posterior displacement of eyeball in orbit, bony changes)

May be caused by CNS stroke or demyelination or PNS trauma, carotid dissection, aortic aneurysm, tumour

48
Q

Describe myotonic dystrophy.

A

Most common muscular dystrophy in adults (1/8000) and subject to anticipation

Possible anaesthetic complications

Facial involvement:

  • forehead muscle wasting
  • bilateral eyelid drooping
  • malocclusion
  • muscle weakness causes general tired appearance
49
Q

Describe myasthenia gravis.

A

Treatable, generalised neuromuscular acquired weakness due to AChR antibodies

Facial involvement:

  • droopy eyelids
  • unusual eye movements

BDS2 OCB (22 decks)

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