Cranial Nerve Testing AND Acute Otitis Media Flashcards Preview

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Flashcards in Cranial Nerve Testing AND Acute Otitis Media Deck (46):
1

Most frequent diagnosis in sick children visiting the pediatricians office

-80% of children under 2 have experienced this

Acute Otitis Media (AOM)

2

Acute otitis media is a

Bacterial infection of the middle ear

3

What are some major risk factors for AOM?

Age (6-18 months), day care, lack of breast feeding, tobacco smoke, pacifier use

4

Shorter and more horizontal in children, making it easier to get AOM

Eustachian tube

5

In AOM, we see inflammatory edema of the mucosa of the

Nose, nasopharynx, and Eustachian tube

6

In AOM, the Eustachian tube gets obstructed, which causes a negative middle ear pressure that leads to

Fluid accumulation

7

In AOM, the eardrum is initially stretched

Inward

8

Once the infection progresses and fluid pressure has built up, the tympanic membrane

Bulges outward

9

Fever, irritability, headache, poor feeding, and disturbed sleep are symptoms of

AOM in infants

10

The most common symptom of AOM in older children is

Ear pain (otalgia) and ear tugging

11

AOM is defined by examining the tympanic membrane, where we would see

Bulging of membrane, and posible whitish discoloration

12

How do we test the Opthalmic nerve (CN I)?

By recognition of odors (test one nostril at a time)

13

To test for the Optic nerve (CN II) we would do a

Visual field test and look for visual acuity and pupillary light reflex

14

How can we test cranial nerves III, IV, and VI?

The H test to check eye muscle movements

15

When testing CN III, it is important to distinguish the

Somatic motor function from the autonomic function

16

How can we distinguish the somatic motor and parasympathetic innervation from CN III?

Somatic motor will be inferior and medial rectus and inferior oblique

Parasympathetic will be to tet sphincter pupillae

17

Ptosis is going to be a lesion in either

CN III or a sympathetic lesion (we have to distinguish)

18

How can we test the Trigeminal nerve (CN V)?

Cutaneous sensation (for all 3 divisions) and mastication (for V3)

19

Testing sensation above the eyes tells us about the

Opthalmic division (V1) of V

20

Testing sensation between the eyes and mouth lets us test the

Maxillary division (V2) of the Trigeminal nerve

21

Testing sensation below the mouth tells us about the

Mandibular division (V3) of the trigeminal nerve

22

To test for the mandibular division, we can also check mastication. If there is a lesion, upon protrusion, the mandible will deviate

TOWARDS the side with the lesion (due to paralysis of ipsilateral lateral pterygoid)

23

How can we test the Facial Nerve (VII)

Facial movements, facial symmetry, posterior auricular sensation, and taste

24

If we test the ability to close the eyes tightly we are testing the

Orbicularis oculi which is innervated by VII

25

If we test the ability to close the lips tightly while puffing out the cheeks, we are testing the

Orbicularis oris (innervated by CN VII)

26

How can we test the frontalis branch of VII?

Wrinkle the forehead

27

By having the patient smile, we are testing the

Zygomaticus major and minor (VII)

28

Also, when testing CN VII we want to look for symmetry of

Labionasal folds

29

How can we test the Vestibular cochlear nerve?

Hearing test (i.e. bone conduction vs air conduction) and we can test for vestibular function

30

The Weber and Rinne test will test which cranial nerve

Cochlear division of CN VIII

31

How can we test The Glossopharyngeal nerve (CN IX)

Test the gag reflex and sensation from mucosa of oropharynx

32

We can test the Vagus nerve (CN X) by testing

Palate movement, the voice, and swallowing

33

Contraction of the palatal and pharyngeal muscles (levator palati, pharyngeal constrictors, and palatopharyngeus) will asses the

Vagus nerve (CN X)

34

How can we test the Accessory nerve (CN XI)

Shoulder shrug (traps) and Head turn (sternoclediomastoid)

35

How can we test the function of the Hypoglossal Nerve (CN XII)

Tongue protrusion (genioglosus)

36

With a lesion of the Hypoglossal nerve (XII) the tongue will deviate

TOWARDS the side of the lesion (due to paralysis of the genioglossus)

37

What are the SYMPATHETIC pathologies of the head and neck?

1.) Ptosis
2.) Miosis
3.) Anhydrosis

38

Paralysis of the smooth muscle component of the lavator palpebrae superioris

Ptosis

39

Paralysis of the dilator pupillae muscle

Miosis

40

Loss of sweat gland innervation

Anhydrosis

41

The pupillary light reflex and accomidation reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) CN II
2.) CN III (parasympathetic)

42

The corneal blink reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) V1
2.) VII

43

The jaw jerk reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) V3
2.) V3

44

The gag reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) IX
2.) X

45

The cough reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) X
2.) X and spinal nerves (Thoracic and Lumbar)

46

The tensor tympani reflex will test the

1.) Sensory (Afferent) limb of
2.) Motor (Eferrent) Limb of

1.) VIII
2.) V3

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