Cranial nerve testing

Question 1

Anosmia

Answer 1

Complete loss of smell

Question 2

When is anosmia concerning?

Answer 2

New onset, unilateral (suggests intracranial mass)

Question 3

What are causes of bilateral anosmia?

Answer 3

Chronic rhinitis

Fracture of cribriform plate

Question 4

Dysosmia/parosmia

Answer 4

Difficulty identifying odours

Question 5

Phantosmia

Answer 5

Hallucination of an odour when none is present

Implies problem in the olfactory cortex

Question 6

What is optic nerve responsible for?

Answer 6

Vision and sensory portion of pupil constriction

Question 7

What are the 3 tests used to assess function of the optic nerve?

Answer 7

Assess visual acuity
Test peripheral vision
Check pupillary light reflex

Question 8

Where does light refraction occur?

Answer 8

Via cornea and lens

Question 9

There are no rods or cones at the optic nerve entry point. What is this point called?

Answer 9

Physiologic blind spot

Question 10

At birth, what is the distance at which babies can have visual fixation?

Answer 10

8-10 inches

Question 11

What is visual acuity at birth?

Answer 11

20/400

Question 12

What is visual acuity at 6-12 mo?

Answer 12

20/50

Question 13

At what age are babies able to track objects smoothly and symmetrically?

Answer 13

3-4 months

Question 14

When is the lens able to change shape and focus on distant or near objects?

Answer 14

6 months

Question 15

T/F: optic nerves and tracts are myelinating at the same time as the visual cortex is increasing in density

Answer 15

True!

Question 16

T/F binocular use of visual pathways is activity driven and should be learned early in life

Answer 16

True!

Question 17

T/F myelination ends in the central visual pathways at 6-12 months

Answer 17

False- happens until 4 years old

Question 18

/F development of the visual cortex continues until you are 20

Answer 18

False- continues through first decade (10 years old)

Question 19

When should we start visual screening for kiddos?

Answer 19

3 years old

Question 20

T/F we use a Snellen chart to test visual acuity in kids

Answer 20

False- Allen eye chart

Question 21

What is a good visual acuity for kids 3-5 years old?

Answer 21

20/40 or better

Question 22

What is good visual acuity for kids 5+ years old?

Answer 22

20/32 or better

Question 23

Amblyopia

Answer 23

Lazy eye
Unilateral
Leading cause of monocular vision loss
Ocular structures are normal

Question 24

If a kid has anisometropia, what are they at an increased risk of getting?

Answer 24

Amblyopia

The dominant eye will take over and the less dominant eye will become lazy

Question 25

What is anisometropia?

Answer 25

Unequal refractive power between the two eyes

Question 26

Treatment for preventing amblyopia in a kid thwt has anisometropia?

Answer 26

Corrective lenses

Question 27

What is tropia?

Answer 27

Eye deviation and poses a risk for amblyopia, especially if it constantly occurs

Question 28

Where is the image created in myopia?

Answer 28

In front of the retina

Question 29

Is the refractive power too great or too little in the lens with myopia?

Answer 29

To great

Question 30

Is the refractive power too little or too great with hyperopia?

Answer 30

Too little

Question 31

Where does the image come into focus in hyperopia?

Answer 31

Behind the retina

Question 32

In axial myopia, what is the shape of the eyeball?

Answer 32

Longer than average, increasing risk foe degenerative changes

Question 33

Axial hyperopia shape of eyeball?

Answer 33

Shorter than average

Question 34

Define astigmatism

Answer 34

Abnormally shaped cornea causing unequal refraction in different meridians of the eye

Question 35

What occurs with age? A) myopia B) presbyopia C) hyperopia

Answer 35

B) presbyopia

Question 36

Which aspect of the visual field is greatest?

Answer 36

Temporal

Question 37

What constitutes legal blindness?

Answer 37

Total diameter of vision loss is less than or equal to 20 degrees in the BETTER eye

Question 38

Which side of the brain are right visual field images processed?

Answer 38

Left side of the brain

Question 39

What is a scotoma?

Answer 39

An area of depressed vision surrounded by normal vision

Question 40

What is a scintillating scotoma and what is it a prodrome for?

Answer 40

Partial alteration in the visual fields that is a common prodrome to classic migraines (Migraines with Aura)

Question 41

What would cause hemianopsia bilaterally?

Answer 41

Pituitary tumour damaging the optic chiasm

Question 42

What would cause left homonymous hemianopsia?

Answer 42

Right optic tract defect | Or complete Right optic radiation defect

Question 43

What would cause homonymous right superior quadrantic defect?

Answer 43

Partial left optic radiation lesion

Question 44

What would cause COMPLETE right eye blindness?

Answer 44

Lesion of the optic nerve

Question 45

Does crainial nerve 3 generate an afferent impulse or an efferent response?

Answer 45

Efferent response bilaterally!

Question 46

T/F | A patient should have both a direct and consensual response as part of the normal pupillary light reflex

Answer 46

True

Question 47

What kind of scents do we use to test OLFACTORY nerve?

Answer 47

Familiar, mild scents - not noxious smells