Ch12 Brainstem I Flashcards
(131 cards)
1
Q
Motor Columns are
A
GSE
GVE
SVE
2
Q
GSE- is adjacent to
A
midline
3
Q
FSE CN are
A
3,4,6,12
4
Q
Visceral motor nuclei are in two columns:
A
GVE
SVE
5
Q
GVE is related to which nervous system?
A
parasympathetic
6
Q
GVE CN are
A
3,7,9,10
7
Q
SVE innervate muscles of
A
branchiomeric origi
8
Q
SVE CN are
A
5,7,9,10,11
9
Q
Sensory Columns, Visceral sensory columns: are
A
SVA
GVA
SSA
GSA
10
Q
SVA is related to which censes
A
taste and smell
11
Q
SVA CN are
A
1
7
9
10
12
Q
GVA is sensory from
A
viscera
13
Q
GVA CN are
A
9
10
14
Q
SSA CN are
A
2 (sight)
8 (hearing & equilibrium)
15
Q
GSA is sensory for
A
head (trigeminal)
16
Q
GSA CN are
A
5
7
9
10
17
Q
Olfactory Nerve (SVA) Specialized:
A
chemoreceptors
18
Q
CN1 chemoreceptors are located on
A
the superior nasal cavity
19
Q
nasal chemoreceptors send axons through
A
cribiform plate
20
Q
Olfactory Nerve track doesn’t go though ____ while going to the temporal lobe
A
thalamus
21
Q
CN1 lesions are causes
A
ansomia
hyeprosmia
parasmia
22
Q
def: anosmia
A
loss of smell
23
Q
def: hyperosmia
A
increased sensitivity to smell
24
Q
def: parosmia
A
abnormal sensations of smell
25
CN1 lesions are caused by
* cocaine and other inhalants
* tumor of frontal lobe or pituitary gland
* viral infection
* trauma at the cribiform plate
26
Optic Nerve II testing includes
```
Inspection
Funduscopic exam
Visual Acuity
Reflexes
Confrontation testing of visual fields
```
27
Optic Nerve II Physiological problems: includes
cataracts
nyctalopia
uncorrected nearsightedness
28
define cataract
protein in the lens of the eye changes from clear to opaque
29
biggest contributor to cataract is
UV light exposure
30
cataracts is most common in what population?
elderly patients and welders
31
nyctalopia is due to
Vit A deficiency
32
nyctalopia causes
impaired night vision
33
in nyctalopia, cones takes longer to
recover vision when blasted by high beams
34
the inspection of CNII includes
exopthalmos
eye alignment
Pupils - PERRLA
35
Exopthalmos is ____ of eyes
bulging
36
PERRLA refers to
pupils-equal-round-reactive to light-accommodate
37
Funduscopic exam includes
disc
vessels
background
macula
38
How would you expect the pigments in a person with a darker skin:
more pigments
39
Trigeminal nerve V component
SVE
| GSA
40
Trigeminal nerve 3 divisions
Ophthalmic
Maxillary
Mandibular
41
CN V Sensory lesions leads to
paresthesia
anesthesia
diminished absent reflexes
42
lesions in brainstem lead to _____ loss
ipsilateral
43
CN V Motor lesions leads to
muscle weakness
atrophy
diminished or absent jaw jerk reflex
44
Trigeminal Neuralgia aka
Tic Douloureux
45
Trigeminal Neuralgia Pt feels
stabbing electric pain in Trigeminal nerve distributions
46
Trigeminal Neuralgia frequency
rare
| 150 cases/ 1 m
47
Trigeminal Neuralgia is more common in what population?
women 30-50
48
Trigeminal Neuralgia attacks lasts about
1-2 min
49
Trigeminal Neuralgia attacks can happen over ____ per day
100 times
50
what tigers Trigeminal Neuralgia attacks
```
cold exposure
touch
pressure
eating
swallowing
```
51
Trigeminal Neuralgia Pts are prone to
sucide
52
Trigeminal Neuralgia is possibly caused by
1. blood vessel compression
2. M.S.
3. tumor
4. damage from dentistry/surgery
5. subluxation (dentate ligament)
6. idiopathic
53
Herpes Zoster aka
Varicella
Chickenpox
Shingles
54
Herpes Zoster Virus goes dormant and hides in
nerve ganglia
55
under what cirumstances the H zoster may become active again?
stress
56
describe Shingles
eruption of small, extremely painful vesicles along the distribution of the nerve
57
shingles can affect which nerves?
any cutaneous nerve
| unilaterally, does NOT cross mid-line
58
Most common affected CN by shingles is
CN V
59
Facial nerve VII component
SVE
GSA
SVA
60
Facial nerve VII parasympathetic (GVE) - makes
tear
saliva
muscus
61
what problmes that interfere with CN VII
TMJ problems or damage to lacrimal gland
62
CN VII SVA function is
taste of sweet, salty, & sour on the anterior 2/3 of the tongue
63
Facial nerve VII lesions results in
Facial muscle weakness
64
facial Upper motor neuron lesion effect
spares forehead
| forehead gets innervation from both nerves, both cerebral hemispheres
65
Lower motor neuron lesion affect
above and below the ey
66
Bell Palsy is
facial nerve paralysis
67
Bell Palsy rate
4/10000 people
68
Bell Palsy is accompanied with
pain around the ear
drooling
speech impediment
eyelid may not close
69
Bell Palsy onset is
sudden
70
Bell Palsy 80% recover in
2-6 weeks
71
if Bell Palsy recovery is delayed beyond 12 weeks then it becomes
permanent
72
Bell Palsy becomes permanent when
nerves begin to take over other muscle fibers; resembles a grimace that makes the unaffected side appear paralyzed
73
Bell Palsy can lead to increased sensitivity to
sounds on the affected side
74
tensor tempani muscle - innervated by
CN V
75
stapedius - innervated by
CN X
76
Ramsay Hunt Syndrome is described as
Bell’s Palsy + Shingles
77
in Ramsay Hunt Syndrome, H zoster attacks which nerve?
CN VII
78
Ramsay Hunt Syndrome pain (posterior ear) precedes paralysis by
24-72 hours
79
Ramsay Hunt Syndrome may involve which CN in addition to facial
CN V
80
Ramsay Hunt Syndrome is more likely to have ____ effects
residual
81
Vestibulocochlear aka
Cochleovestibular
Acoustic
Statoacoustic
CN VIII
82
Cochlear Nerve; Sensorineural deafness means
cochlea or the nerve is damaged
83
Sensorineural deafness characteristic
inner ear infection
Meniere disease
noise-induced deafness
toxicity
84
Cochlear Nerve; Conductive deafness means
mechanical deficit in getting sound to the cochlea
85
Conductive deafness characteristic
obstruction
eardrum damage
osteosclerosis
external or middle ear infection
86
Cochlear lesion signs
Tinnitus
| Auditory scotomas
87
Tinnitus includes
ringing, buzzing, roaring in the ear
88
Auditory scotomas means
loss of hearing at certain frequencies
89
Schwannoma aka
coustic neuroma
| cerebellopontine angle tumor
90
Schwannoma causes hearing loss with
tinnitus
91
Schwannoma damage is due to tumor growing on
the acoustic nerve
92
Schwannoma symptoms may include
facial pain and sensory loss from CNV involvement
| may involve facial nerve
93
if Schwannoma reached CN 9 and 10 it can lead to
hydrocephalus
94
Vestibular Nerve lesions can cause
Dizziness
Impulsion
Vertigo
95
feeling of unsteadiness is called
Dizziness
96
abnormal feeling of motion is called
Vertigo
97
feeling of being pushed is called
Impulsion
98
Dizziness, Impulsion, Vertigo can cause
motion sickness
99
Peripheral Vestibular; timing
2-5 sec lag between motion & nystagmus; then it goes away in 30 sec
100
Peripheral Vestibular; Vertigo is
extreme
101
Peripheral Vestibular; caused by
Schwannoma
Vestibular Neuritis (viral)
Meniere Disease
BPPV
102
Peripheral Central; timing
constant nystagmus
103
Peripheral Central; Vertigo is
none
104
Peripheral Central; caused by
```
Ischemia (stroke)
Infection (in CNS)
inflammation (M.S.)
Toxin
METS
```
105
Endolymphatic Hydrops Meniere Syndrome aka
Endolymphatic Hydrops
106
Meniere is ____ ear disorder
inner
107
Meniere is caused by
too much fluid production increases pressure
| overstimulates inner ear
108
Meniere leads to
overproduction of endolymph
| progressive cumulative deafness, possibly with vertigo
109
overproduction of endolymph leads to
parasympathetic problems
110
Glossopharyngeal IX exits skull at
Jugular Foramen
111
Glossopharyngeal IX exits skull with
X & XI
112
Glossopharyngeal IX Lesions leads to
glossopharyngeal neuralgia
tachycardia
loss of gag reflex & dysphagia
loss of bitter taste on posterior 1/3 of tongue
113
tachycardia with no loss of oculocaridac reflex indicates a problem with
CN IX
114
tachycardia with a loss of oculocaridac reflex indicates a problem with
CN X
115
Vernet Syndrome aka
Jugular foramen syndrome
116
Vernet Syndrome location
Jugular foramen
117
Vagus nerve X unilateral Lesion ablative signs
hoarseness,
dyspnea
dysphagia
uvular deviation AWAY from the affected side
118
Vagus nerve X binilateral Lesion ablative signs
Death
119
Vagus nerve X irritative signs
increased parasympathetic tone
| echelasia
120
echelasia means
food backed up in esophagus
or
stomach dilation
121
Spinal Accessory nerve XI is
SVE
122
Spinal Accessory nerve XI arise from
the anterior horns of C1- C5
123
Spinal Accessory nerve XI innervates
SCM & trapezius ipsilaterally
124
CN XI internal medullary branch goes back into skull & out from
jugular foramen
125
CN XI Lower motor neuron lesion signs
ipsilateral weakness of shoulder shrug and contralateral head rotation
126
CN XI Upper motor neuron lesion signs
deficit turning head to contralateral side
| increased tone, but weakness
127
SCM is innervated (contra or ipsi-lateral)
ipsilateral
128
Hypoglossal nerve XII is
GSE
129
Hypoglossal is motore to
muscle of the tongue
130
Hypoglossal test
inspection for deviation
| muscle test
131
Lesion Signs:
- Atrophy on the lesion side of tongue
- Deviation of tongue toward the lesion
- Fasciculation – twitching on the side of lesion
