CN I-VI Flashcards
(82 cards)
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
2
Q
unilateral or bilateral anosmia is commonly caused by..
A
blocked nasal passage, cold, loss with aging, trauma
3
Q
bilateral anosmia may also be caused by…
A
blocked nasal passage, cold, loss with aging, trauma
4
Q
rare causes for unilateral anosmia include…
A
minor head trauma
5
Q
nutritional cuases for anosmia include
A
zinc deficiency
6
Q
function of rods
A
See in low light
7
Q
functions for cones
A
See colors
8
Q
function of optic chiasm
A
nasal half decusate, temporal half uncrossed
9
Q
retinal area for centrla visionis…?
A
macula
10
Q
the remainder of the retina is concerned with___and___.
A
paracentral and peripheral vision
11
Q
retrobulbar neuritis involves…?
A
optic N or tract, MC cause is MS
12
Q
optic neuritis involves…?
A
various forms of reninitis
13
Q
papilledema involves…?
A
increased intracranial pressure
14
Q
optic atrpohy involves…?
A
decreased visual acuity and change in color/optic disc
15
Q
secondary optic atrophy involves…?
A
glaucoma
16
Q
foster kennedy syndrome
A
tumors at base of frontal lobe, ipsilateral blindness and anosmia
17
Q
tay sachs disease
A
cerebromacular degeneration with severe mental deficiency
18
Q
holmes-Adie syndrome
A
tonic pupillary reaction and absence of one or more tendon reflexes
19
Q
extropia
A
outward/lateral movement
20
Q
esotropia
A
inward/medial movement
21
Q
hypertropia
A
up
22
Q
hypotropia
A
down
23
Q
inability to laterally gaze may be affected by…
A
disease of CN VI, MS
24
Q
frontal lobe controls
A
saccadic (rapid/darting) eye movement
25
occipital lobe controls
smooth or following eye movement
26
the fast component of nystagmus respresents
saccadic movement from the frontal lobe
27
the mooth component is what follows in nystagmus is controlled by...
occipital lobe
28
ptosis can be caused by...
paralysis/superior tarsal muscle
29
lesions affecting CN IV make ti difficult for the patient to...
roll their eyes
30
what test is performed to isolater CN VI?
6 cardinal fields of gaze
31
lesions affecting CN VI make it difficult for the patient to...
look left and right
32
lesions affecting CNII will diminish..
pupilloconstriction with bilateral assymmetry
33
lesions affecting CN III will affect the primary motor portion of the eye refle and it will diminish...
ability to carry out pupilloconstriction in ipsilateral eye
34
loss of diencephalon or midbrain function results in....
unopposed sympathetic (pupillodilator) domonance
35
pupils that are fixed and dilated represent...
brain dead patients
36
holmes-adie syndrome has the following clinical findings
reaction to light slow, consricted longer, dilate slow
37
argyll robertson pupill has the following clinical findings
no direct or indirect reaction to light, only accomodation
38
identify potential causes for argyll robertson syndrome
diabetes, neurosyphilis
39
horner's syndrome is caused by...
lesions of neck proximal to carotid artery
40
signs and symptoms of horner's syndrome
ptosis, pupiloconstriction
facial anhydrosis
ipsilateral facial vasodilation
41
summary of CN III, IV, VI examination
what do the eyes look like from the outside?
how do the eyes function?
what do the eyes look like on the inside?
42
eyelid ptosis may be caused by lesions involving..
```
hypothalamus
brainstem
spinal cord
peripheral CN 3
peripheral sympathetics
myoneural pathways
possible muscular and local causes
```
43
describe the proess to evaluate the patietnt's ocular alignment
look straight forward, lateral (bilateral) check for sceral tissue, elicit ciliospinal refle
44
visual acuity is assessed by utilizing?
snellen chart
45
assessment of peripheral vision
confrontation
46
what cranial nerves are being evaulated when testing for peripheral vision
III, IV
47
what are the degrees that we should see in peripheral vision on each side?
60 degrees superior
60 degrees nasal
75 degrees inferior
100 degrees temporally
48
6 cardinal fields of gaze assesses
etraocular movement
49
accomodation is assessing
convergence, puilloconstriction, lens thickening
50
3 components of accomodation
convergence
lens thickening
pupilloconstriction
51
causes for nystagmus..
conflicting proprioceptive input from CN VIII and cervical and cerebellar sources
52
the side toward which the quick component of nystagmus travels is the side that
bears the name
53
coneal light reflex evaluate for..
relative position of the 2 points of reflection of light
54
describe how the corneal light reflex test is performed
patient's eyes forward, light source shined into both eyes
55
pupillary light reflex evaluate the patient for
constriction of both pupils equally, assuming intract pathways
56
describe how the pupillary light reflex test is performed
introduce light into one eye, note pupilloconstriction in both eyes, switch to toher eye and do the same
57
swinging flashlight light relfex evaluates the patient for
equal pupilloconstriction
58
describe how the swinging light reflex test is performed
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
marcus gunn phenomenon
apparent pupillodilation with light
60
identify 4 basic components to the funduscopic exam while trying to identify pathological changes
optic disc
vessels
macula
general background
61
the margins between the optic disc in the fundus should be..
sharp temporally and less so medially
62
if the physiological cup is greater than half the size of the disc this indicates
increased intraocular pressure (glaucoma)
63
papilledema has the following funduscopic characteristics...
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
pseudo-papilledema typically is seen in what percent of the population?
up to 5%
65
identify pictures of eyes
```
normal fundus
optic atrophy
optic neuritis
papilledema
glaucoma
detached retina
diabetic retinopathy
hypertensive retinopathy
drusen bodies
```
66
CN V functions as a mixed crainial nerve. what are the 3 divisions?
opthalmic
maxillary
mandibular
67
true or false: CN V includes the angle of the jaw
false
68
describe a sensory exam of CN V
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
where else do we perform the sensory exam?
upper extremities
70
cervical afferents to the facial nerve nuclei provides a neurological innervation to...
the face, but sparing the angle of the jaw
71
the mandibular branch of CN V has what kind of branch?
recurrent/meningeal branch
72
the recurrent/meningeal branch innervates what?
dura
73
what are the muscles of mastication?
temporalis, masseter and medial pterygoid
74
what is the primary function of the right lateral pterygoid is to move the jaw tip..
to the left
75
what is the primary function of the left lateral pterygoid is to move the jaw tip...
to the right
76
peripheral nerve or brainstem disease affecting CN V is usually responsible for...
sensory impairment
77
peripheral nerve or brainstem disease causing and impairment often has atrophy of the...
temporalis and masseter
78
corneal ulceration and/or inflammation may be present when a lesion fracture the opthalmic division and this is termed...
neuroparalytic keratitis
79
referred pain tot he face may have what kind of causes?
TMJ syndrome
oral problems
dental problems
80
another name for trigeminal neuralgia?
tic douloureux/fathergill's neuralgia
81
what is trigeminal neuralgia?
pain in a clear distribution pattern involving CN V
82
examination of CN V
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)
