CN VII-XII

Question 1

what muscles does CN VII innervate?

Answer 1

all muscles of facial expression as well as taste sensitivity to the anterior 2/3 of the tongue (sweet, sour, salty)

Question 2

the corticobulbar tract controls…

Answer 2

volitional movements of he forehead musculature equally from each cerebral hemisphere

Question 3

what is usually spared in unilateral lesions involving corticobulbar pathways?

Answer 3

forehead movement

Question 4

the lower face requires ____movement, therefore it receives a greater percentage of ____observation and _____lesions may have long term effects

Answer 4

unilateral
contralateral
contralateral

Question 5

CN VII innervates what muscle?

Answer 5

stapedius

Question 6

what is the function of the the stapedius?

Answer 6

dampen movement of tympanic membrane

Question 7

stimulation of the parasympathetic fibers cause increased secretion of ____saliva

Answer 7

thin and watery

Question 8

stimulation of sympathetic fibers cause increased secretion of _____saliva

Answer 8

thick and turbid

Question 9

bell’s palsy

Answer 9

a condition that causes facial paralysis and is considered a LMN lesion (all ipsilateral facial muscles distal to the lesion are affected)

Question 10

stroke

Answer 10

a type of facial paralysis, gradient of facial weakness due to bilateral innervations
Forehead is spared

Question 11

examination of CN VII

Answer 11

instruct patient to look up and check fro symmetry in head wrinkles (note drooling, dysarthria, dysphagia)

Question 12

the receptors are located in what part of the ear?

Answer 12

semicircular canals, utricle and saccule of middle ear

Question 13

describe the pathway sound gets to the ear

Answer 13

impulses are carried to the vestibular ganglia and pass through the vestibular nerve
vestibular nerve through internal auditory meatus to brainstem and terminate on 4 of vestibular nuclei OR
pass through the inferior cerebellar peduncle as part of the vestibulocerebellum

Question 14

what conflicting information will result in nystagmus?

Answer 14

CN II, IV or VI and CN VIII

Question 15

the receptors of the cochlear division are located where?

Answer 15

organ of corti in the cochlea

Question 16

hypoacusis with or without tinnitius is probably from…

Answer 16

conduction loss, receptor disease or lesion affecting CN VIII

Question 17

hypoacusis

Answer 17

partial loss of hearing

Question 18

hyperacusis

Answer 18

increased sensitivity to certain frequency and vlume ranges of sound

Question 19

hyperacusis can be due to…

Answer 19

CN VII disorder or centrally located problem

Question 20

there are 2 major varieties of hearing loss

Answer 20

conductive and sensorineural

Question 21

common etiologies for conductive hearing loss

Answer 21

auditory canal obstruction
direct/indirect trauma to tympanic membrane
trauama/aging of ossicles
accumulation/fluid in middle ear

Question 22

sensorineural hearing loss is typically treated to…

Answer 22

disease of organ of corti or auditory nerve

Question 23

what do you assess for when testing the vestibular division of CN VIII?

Answer 23

signs of vertigo

unsteadiness with or without falling, nystagmus, pallor, sweating, vomiting and hypotension

Question 24

the side toward which the fast component of nystagmus occurs…

Answer 24

on the side which the nystagmus is named

Question 25

carloric irrigation

Answer 25

utilizes warm (103-110F) or cold (drops/ice) water

Question 26

COWS

Answer 26

cold opposite | warm same

Question 27

explain the mechanism of a positive swivel chair test

Answer 27

holding head keeps vestibulocochlear proprioceptors inactivated, therefore only activating cervical proprioceptors

Question 28

what are the four cochlear divisions tests?

Answer 28

observation of external and internal ear | weber and rinne test

Question 29

what are the two tests of the vestibular division?

Answer 29

swivel chair tests, caloric irrigation

Question 30

what do you do with the earlobe during an adult otoscopic exam?

Answer 30

pull ear up and back

Question 31

what do you do with the earlobe during a child otoscopic exam?

Answer 31

pull ear down and out

Question 32

weber's test lateralizes to the right, what are the findings?

Answer 32

right air conduction deafness or left sensorineural deafness

Question 33

weber's test lateralizes to the right and rinne's on the right was 10:10 (bone conduction:air conduction) and on the left was 10:20, what are the findings?

Answer 33

right air conduction deafness

Question 34

weber lateralizes to the right and rinne's on the right was 10:20 (bone conduction:air conduction) and on the left was 10:10, what are the findings?

Answer 34

sensorineural deafness on the left

Question 35

weber's test lateralizes to the right and rinne's on the right was 10:20 (bone conduction:air conduction) and on the left was 2:4 (bone conduction:air conduction), what are the findings?

Answer 35

sensorineural deafness on left

Question 36

review picutres of otoscopic pictures

Answer 36

``` normal red reflex foreign body in ear acute otitis media suppurative otitis media tympanostomy tube perforated tympanic membrane ```

Question 37

CN IX and X innervate what muscle?

Answer 37

stylopharyngeus

Question 38

stylopharyngeus

Answer 38

elevates the pharynx and larynx as well as aids in raising the soft palate

Question 39

CN X action

Answer 39

helps with active swallowing and articulation as a unilateral paralysis of CN X will be followed by tranient paresis of the soft palate, pharynx and larynx on the affected side along with absent gag reflexes and absens ocular cardiac reflex

Question 40

what happens with bilateral CN X paralysis

Answer 40

it is not compatible with life

Question 41

dysarthria

Answer 41

faulty articulation

Question 42

dysphagia

Answer 42

difficulty swallowing

Question 43

hypernasal

Answer 43

increased air entering the nasal pathway

Question 44

hyponasal

Answer 44

decreased air entering nasal pathway

Question 45

What are the tests for CN IX and X?

Answer 45

have the patient say AHH and watch for bilateral elevation of soft palate say ku-lah-me gag reflex

Question 46

gag reflex

Answer 46

touch the base of the tongue, the initiation of the gag reflex is sensory portion of cranial nerve IX and the motor function of CN X

Question 47

tests for CN XI

Answer 47

muscle strength of trap and SCM

Question 48

SCM actions

Answer 48

tilt head to the same side turn chin to opposite side flex head when contracted bilaterally

Question 49

trapezius actions

Answer 49

tilt head to same side turn chin to opposite side elevate shoulder when contracted bilaterally

Question 50

fibers of CN XII originate in what nucleus? where does it emerge?

Answer 50

hypoglossal nuclei | emerge from the bottom of the brainstem

Question 51

what are the tests for CN XII

Answer 51

have patient stick out the tongue | have patient do tongue in cheeck test

Question 52

a lesion involving the R CN XII will cause the tongue to what?

Answer 52

deviate to the left

Question 53

what do you look out for when the patient sticks out the tongue?

Answer 53

fasciculations